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Epidemiology and Health System Journal - Volume:4 Issue: 1, Winter 2017

Epidemiology and Health System Journal
Volume:4 Issue: 1, Winter 2017

  • تاریخ انتشار: 1395/12/08
  • تعداد عناوین: 12
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  • Hugo Leonardo Pereira Matsuchita, Amanda De Faveri Pitz, Francine Nesello Melanda *, Regina Mitsuka Bregano, Francisco Jose Abreu De Oliveira, Fabiana Maria Ruiz Lopes Mori, Maria Claudia Noronha Dutra De Menezes, Idessania Nazareth Costa, Wander Rogerio Pavanelli, Monica Lucia Gomes Pages 1-9
    Background And Aims
    We investigated the children of Parana State, Brazil the prevalence of intestinal parasitosis and the associated factors involved in the transmission of intestinal parasites, and we genotyped the Giardia duodenalis isolates obtained.
    Methods
    Fecal samples were analyzed by established microscopic methods.
    G. duodenalis positive samples were subjected to genotypic characterization by PCR amplification of sequences of the glutamate dehydrogenase gene (gdh) and by enzymatic digestion with the restriction enzyme NlaIV for classification of genotypes.
    Results
    Of the 877 samples tested, 41% were positive for some intestinal parasitosis, the most common being the presence of protozoa (87.8%). Lack of basic sanitation and poor health education were associated for the intestinal parasite cases found, and the only associated factor for giardiasis was low family income. The G. duodenalis assemblages of gdh amplified samples were 68.6% B and 31.4% AII.
    Conclusion
    These data demonstrate the importance of epidemiological studies for the development of effective strategies with the aim of decreasing the incidence of intestinal parasites in children. Moreover, these results contribute to our knowledge of G. duodenalis assemblages circulating in the world and also offer support for future work on the molecular and clinical aspects of giardiasis.
    Keywords: Giardiasis, Intestinal parasitosis, Epidemiology
  • Amit Gupta *, Sushama Chaphalkar Pages 10-17
    Background And Aims
    The frequency of chronic hepatitis B virus infection varies totally in different part of the world but it could be categorized as high, intermediate and low endimicity. In this regard, development of safe and effective vaccines against infectious diseases especially hepatitis B virus that are still required for emerging new pathogens, re-emerging old pathogens and in order to improve the inadequate protection conferred by existing vaccines. In this study, immunological studies were conducted pertaining to investigate the aqueous leaves extract of Calotropis gigantea and Ficus religiosa for determining its adjuvant effect against hepatitis B vaccine containing surface antigen (HBsAg).
    Methods
    In this study, our group evaluated the secondary metabolites that are present in the aqueous extract using high performance thin layer chromatography (HPTLC) and estimated its antibody (IgG) titre against HBsAg using variable doses (2.5-10 mg) of aqueous leaves extract of these medicinal plants and also determined splenocyte proliferation assay (ex vivo studies) on day 4 where mice (n=5) were immunized subcutaneously on day 0 with HBsAg (20 µg/ml, 100 µl).
    Results
    The results showed that aqueous leaves extract showed anti-HBsAg titre and also enhanced splenocyte proliferation assay at higher doses (10 mg, 50 µl) as compared to control.
    Conclusion
    Overall, the results showed that aqueous leaves extract of Calotropis gigantea and Ficus religiosa showed adjuvant activity against HBsAg.
    Keywords: Calotropis gigantean_Ficus religiosa_Hepatitis B vaccine_Adjuvant
  • Kazem Hosseinzadeh *, Raheleh Sadegh Pages 18-23
    Background And Aims
    In Iran, according to the available data on health statistics, injuries are the as the common cause of death in different age groups after chronic heart diseases. The aim of this study was to present detailed information on eight common injuries.
    Methods
    This study is an analysis on existing data (secondary study on recorded data) in Health Informatics System (HIS) available in Qazvin Health Management Office (QHMO), Iran. Permission to use these data was provided by researchers and the Health Research Ethics Board at the Qazvin University of Medical Sciences and also approved this analysis. Eight categories of injuries were derived from HIS and analyzed in SPSS software.
    Results
    The total registered injuries in the whole population of Qazvin province was 22,821 (30% in females) from March 2014 to March 2015. From this, 1688 (7.3%) occurred in children under five years old. The rate of falling, violence, traffic and burns related injuries were in the top. About 69% of total injuries were in urban, and near 13 in villages.
    Conclusion
    Children are the main victims of adults’ car crashes. Most of the children’s injuries take place at homes and roads. Some educational programs in order to increase children’s safety are in progress. There is not a good system to evaluate these interventions’ outcomes, and as such doing more study in this field is needed.
    Keywords: Injury, Children, Falling, Violence, Traffic injuries
  • Rouhullah Dehghani, Leila Mesgari *, Mohsen Fathi Moghadam, Fereshteh Rezaian, Fereshteh Nasudian, Elham Sudayfian, Mojtaba Babai, Elahe Chimehi Pages 24-30
    Background And Aims
    Beauty salons are considered as the places which the environmental health and renovation are adhered too. they can improve the society’s health and influence controlling the diseases. Not considering this issue causes the spread of skin and hair diseases and infections and louse. This study was aimed to determine the health status of beauty salons of Kashan in 2014.
    Methods
    This descriptive-analytical study was done in 2014 in Kashan. Out of 320 beauty salons in Kashan, 220 were selected at random. Collecting the data was through observation, interview, filling the questionnaires and check lists in the beauty salons. Data collection was done on the basis of the environmental health evaluation form for beauty salons. The check list related to each beauty salon was completed and the data were analyzed by SPSS software.
    Results
    The results of this study showed that 45.5% of the salon employees had participated in the special course of public health and 54.5% had personal health card. Fifty one point four percent of them were acceptable in terms of personal hygiene and 52.7% shared the tools and equipment. Half of the beauty salons had been sanitized and 52.3% of them had soaps and towels.
    Conclusion
    The results showed that the beauty salons in Kashan had acceptable building status. Some personal hygiene factors such as personal health card, public health certificate and observing personal hygiene needs more training. Also, more supervision and inspection must be carried out by the environmental health experts.
    Keywords: Beauty Salon, Hygiene Status, Kashan, Environmental Health
  • Amir Mehrdadi, Shahnaz Sadeghian, Ashraf Direkvand Moghadam*, Aatollah Hashemian Pages 31-36
    Background And Aims
    Students experience some degrees of mental disorders during their life. Therefore, the present study was conducted to determine the prevalence and risk factors of mental disorders among the secondary school students in Ilam, Iran.
    Methods
    This is a cross sectional study, carried out among the secondary school students in Ilam, Iran. We assessed 841 students including 446 males and 395 females from all grades of secondary school. A multistage cluster sampling method was used. Data were collected using two instruments including both demographic information questionnaire and DSM-IV. SPSS software was used to analyze the data of this project.
    Results
    Totally, 841 secondary students were studied. Overall 34.96% of all the participants of the study had mental disorders. The Mean ± SD of participant's age and gender has not significant differences between groups (P>0.05). The results show that anxiety disorders are the most common disorder among the study population. Although no one in the study population had an adaptation disorders.
    Conclusion
    About a third of students in Ilam province experience the mental disorders. So, we suggest that the school counselors consider pay attention to this important issue in their consulting planning.
    Keywords: Anxiety disorders, DSM, IV, Mental disorders
  • Leila Rostamizadeh *, Sayed Rafi Bahavarnia, Roya Gholami Pages 37-43
    Background And Aims
    Congenital anomalies are as the major causes of stillbirths, neonatal death, disability and childhood health problems all over the world. The aim of this study was to determine the incidence and pattern of congenital anomalies in newborn during the first 24 hours of life in Shahid-Madani hospital, Azarshahr, Tabriz, during two periods 2002-2003 and 2012-2013 years.
    Methods
    This is a records-based descriptive study with 4515 newborns who were delivered at Shahid-Madani hospital.
    Results
    The incidence of congenital anomalies in newborns during 2002-2003 and 2012-2013 years was 1.31% and 1.06 respectively. We found that the incidence rate of congenital anomalies has declined during one decade, and also the pattern of these has varied. In 2002-2003, the most common anomaly was musculoskeletal system anomaly whereas in 2012-2013, the genitourinary system was the most frequent anomaly.
    Conclusion
    Our findings showed incidence and pattern of congenital anomalies have changed during one decade. Research into the etiology, prevention and prenatal care planning must focus on in prevalent congenital anomalies in this city.
    Keywords: Congenital, Abnormalities, Epidemiology, Newborn, Iran
  • Mohammad Sasanipour, Saeedeh Shahbazin* Pages 44-52
    Background And Aims
    Recent studies on mortality in Iran, in recent years clearly emphasize that unintentional injuries are the main cause of reducing Iranian life expectancy in Iran. This article aimed to assess the role of major causes of death for mortality patterns in the country by sex in 2010.
    Methods
    Experimental results of this study are based on death registration system of Ministry of Health (MOH). Using multiple decrement and single decrement life tables, years of life which could be savedare calculated if unintentional accidents were to be eliminated from causes of death. Then the composition of age groups is decomposed.
    Results
    The results showed that unintentional injuries are cause of reduction of 2.3 years of Iranian men’s life and 0.8 years for women. More detailed results show that mortality from unintentional accidents in active age groups (15-64 years old), have a great role in reducing the life expectancy of the people. The men’s share is more than 70%, but for women the share of age groups of 15-65 years old is less than men, in return, it is more for women under 15 years old is more.
    Conclusion
    Since high rate of deaths due to unintentional accidents are preventable, control and intervention, especially among young people, and society development needs to improve the health of the main age groups, mean young, so investments to increase productivity and improve the health of young people is necessary.
    Keywords: Life expectancy at birth, Unintentional accidents, Multiple decrement life tables, Decomposition
  • Leili Yekefallah, Tahereh Ashktorab, Azam Ghorbani, Marzieh Pazokian *, Jalil Azimian, Rasool Samimi Pages 53-60
    Background And Aims
    Anxiety is a common reaction when people encounter new problems where they do not know what expect. The nurses are responsible for assessing the patient and helping them with the procedure of endoscopy. This study investigates differences in anxiety level of patients who receive nursing process of Orlando's theory prior to endoscopy examination compared to a control group.
    Methods
    A Quasi -experimental research design was used in this study. Samples were 60 adult patients who were randomly assigned to two groups (30 patients each). Patients in the study group receive nursing process of Orlando's theory by the researcher plus the routine hospital intervention, while the control group only received the routine hospital intervention. The Spielberger State-Trait Anxiety Inventory (STAI scale) is administering to both groups before and after endoscopy examination. STAI, a self-reporting psychometric test, is used to assess state anxiety levels. STAI has demonstrated reliability and validity in previous studies.
    Results
    Statistically significant difference was evident between the 2 groups regarding the mean of anxiety level of patients after the intervention. Before the intervention, the mean of anxiety level in the control and study groups were 47±9 and 58 ±11 and after the intervention were: 41±7, 35±7, respectively.
    Conclusion
    Intervention groups have the lower mean of anxiety level after the intervention. Female patients in this study experienced low level anxiety compared to male patients after Orlando nursing process. The data suggest that endoscopy unit personnel and the referring physician should consider the patient’s perception of the procedure. Detailed information on the procedure and training in relaxation techniques should be given. Positive re-appraisal and information on sensations to be anticipated, rather than procedural details, will be more successful in alleviating stress and anxiety.
    Keywords: Orlando's theory, Anxiety levels, Endoscopy examination
  • Azam Sabahi, Leila Ahmadian *, Fatemeh Salehi, Sayed Mahmoud Mirzaee Pages 61-68
    Background And Aims
    Among all cancers, colon cancer is common and deadly, yet preventable. The estimated worldwide incidence of colon cancer is more than one million new cases per year. This study was done to identify the epidemiological features and risk factors of colon cancer in different regions of Birjand.
    Methods
    This retrospective, descriptive analytical study of patients with colon cancer was conducted in Birjand educational hospitals. This study examined the patients whose colon cancers had been confirmed by a pathologist (2006-11). Statistics related to these patients were collected from pathology centers affiliated to Birjand University of Medical Sciences. Data were analyzed using descriptive (frequency and relative frequency) and analytical (chi square test) statistics. SPSS software was used to analyze the collected data.
    Results
    Results of the present research showed that a total of 38 people with colon cancer were hospitalized in Birjand educational hospitals between 2006 and 2011. In the present study, there was a significant difference between the patients’ job and the type of morphology (P=0.018) and the therapeutic procedures (P=0.001); Adenocarcinoma was mainly reported among housewives (n=10, 76.9%). Concerning therapeutic procedures, housewives underwent colectomy surgery more than other groups (n=8, 61.5%).
    Conclusion
    Controlling colon cancer which is one of the most common cancers in the world is a great epidemiologic success. The findings of this study presented a complete and exact image of epidemiology of this cancer in the region and provided the authorities with precious information; therefore, they can make decisions about identifying colon cancer risk factors in the region.
    Keywords: Colon cancer, Cancer epidemiology, Prevalence
  • Ali Janati, Edris Hasanpoor*, Farzaneh Aslani, Elaneh Haghgoshayie, Ebrahim Hassanzadeh Pages 69-77
    Background And Aims
    Quality of visit services is a decisive aspect of patient-physician communication that its inadequacy can negatively influence the diagnosis efficiency. The aim of this study was to survey visit quality at provincial level during plan of health sector evolution in Tabriz.
    Methods
    A sample of 540 patients who referred to the outpatient clinics (Sheikh Al Raeis of Tabriz Province) in North West of Iran was randomly selected. Data were collected by a researcher-made checklist and summarized using descriptive statistical methods.
    Results
    The average visit time was found to be 8.52 minutes, which is significantly lower than the minimum average of 15 minutes approved by the Iranian Ministry of Health and Medical Education (MOHME). The average of waiting time was found to be 101.57 minutes for patients. The results showed that the structural quality was found to be 51.36%, process quality was found to be 62.69% and outcome quality was found to be 50.82%.
    Conclusion
    Visit length was shorter than other developed and developing countries. If the consultation process in health care delivery to patients is incorrect or incomplete, the following process will be without quality and security. This study showed that visit time is short and waiting time is very long.
    Keywords: Visit quality, Health sector evolution, Physician- patient relationship, Outpatients
  • Masoumeh Pourhadi, Fereshteh Ahmadinejad, Reza Maghsoudi, Mohammad Saeid Jami * Pages 78-83
    Background And Aims
    Charcot Marie Tooth disease (CMT) is the most prevalent hereditary neuropathy and its frequency is 1 in 2500. CMT is a heterogeneous disease and has different clinical symptoms. The prevalence of CMT and involved genes differ in different countries. CMT patients experience considerable sleep problems and a higher risk of decreased quality of life. In this work it was aimed to provide a review on the genetic and epidemiologic aspects of this disease.
    Methods
    In the current review article, we performed a literature search on the epidemiology of Charcot–Marie–Tooth disease” and provided a brief review on epidemiology, genetic, and complications of CMT. Databases Web of Science and PubMed were searched using the Endnote software for the publications on CMT during 2000 to 2016.
    Results
    Charcot Marie Tooth disease has different prevalence around the world and is the most common neuropathy. Epidemiological studies have estimated the prevalence of CMT in Japan 1/9200, in Iceland 1/8300, in Spain 1/3500 and in Italy 1/5700.The patients have different phenotype and the age of onset. There is a variety of inherited patterns of disease and many genes have been identified responsible whose mutations are main cause of the disease.
    Conclusion
    Due to the impact of this kind of disabilities on the national health, further studies seem to be necessary to gain better knowledge of the disease particularly in the regions with higher prevalence. Moreover molecular biology services offered by genetic laboratories can reduce the incidence of disorder.
    Keywords: Charcot Marie Tooth, Neuropathy, Electrophysiology, Epidemiology
  • Morteza Arab Zozani *, Mitra Mahdavi, Mazdeh, Sayed Alireza Hosseini, Reza Majdzadeh, Ali Akbari Sari Pages 84-90
    Background And Aims
    Immunosuppressive regimens are a key component for successful kidney transplantation. This systematic review aimed to assess the efficacy and safety of combination therapy of everolimus with tacrolimus in kidney transplantation recipients.
    Methods
    Results were limited to English-language articles. Trials where recipients received another regimen were excluded. The Cochrane Central Register of Controlled Trials and MEDLINE were searched via the optimally sensitive strategies for the identification of randomized trials, combined with the following MeSH headings and text words: Everolimus, Certican, Zortress, tacrolimus, prograf, and kidney transplantation.
    Results
    Five relevant studies of everolimus in combination with tacrolimus were identified and results of them were interpreted. Two trials investigated Fix dose of everolimus in combination with low (1.5-3 mg) versus standard dose of tacrolimus (4-7 mg). One trial investigated variable doses of everolimus (1.5 mg/day or 3 mg/day) in combination with fix dose of tacrolimusand two trials compared fix dose of everolimus versus reduction or elimination of tacrolimus. Sample size of RCTs ranged from 20 to 398 and the follow up time ranged from six to 24 months. The quality score on the Jadad score was 3 in all five trials indicating moderate quality.
    Conclusion
    Immune suppressive regimens including everolimus in combination with tacrolimus therapy show better safety and efficacy compared with single-mode but these differences were not significant in overall studies. In general, compared with a regimen without combination of everolimus with tacrolimus, the newer immunosuppressive regimen consistently reduced the incidence of short-term biopsy-proven acute rejection. However, evidence about impact on side-effects, long term graft loss, compliance and overall health-related quality of life is limited.
    Keywords: Everolimus, Tacrolimus, Kidney transplantation