Journal of Advances in Medical and Biomedical Research
Volume:26 Issue: 118, Sep-Oct 2018

There is a requisite need to document the health literacy status and its determinants for making recommendations for public health promotions. The aim of this study was to determine the prevalence of limited health literacy and its associated factors in Iranian studies. Search queries were made in PubMed, SCOPUS, SID, Irandoc, IranMedex, and Magiran from 2000 to 1 April 2016. The quality of the selected studies was assessed using the Critical Appraisal Skills Program checklists. Thirty one original papers were incorporated into the systematic review. We conducted meta-analysis using a random effects model. All analysis was performed using comprehensive meta-analysis [CMA] v.2 statistical software. The thirty one papers reviewed include data on 28,138 subjects, and report a prevalence of low health literacy between 4.8% and 79.9%. Pooled analysis of these data show that the weighted prevalence of low health literacy was 37.01% (95% confidence interval [CI]: 36.97%, 37.04%) and of marginal health, literacy was 30.76% (95% CI: 30.72%, 30.79%). Low educational levels, old age, poor employment situation, and low economic status were the most important determinants of limited health literacy. In the multivariate meta-regression model, the years of the studies were significantly associated with health literacy prevalence rates. Only a third of the population had adequate health literacy and health literacy was poor among vulnerable groups such as the unemployed, older and less educated people. So, considering appropriate strategies for each of these groups could have a significant role in improving community health literacy.

Ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) is a class II membrane glycoprotein that binds to insulin α receptor and can interfere in insulin signaling pathway. Transcription factor-7-like 2 (TCF7L2) is a transcription factor which plays a critical role in pancreatic β cell activity. ENPP1 and TCF7L2 gene polymorphisms may have functional role in susceptibility to type2 diabetes (T2D). The aim of this study was to investigate the association of reported K121Q and C/T rs7903146 variants of ENPP1 and TCF7L2 genes with the risk of T2D in our population 240 T2D and 240 healthy subjects were recruited. Genotyping was carried out by PCR-RFLP method. T test was used for association study. ENPP1 121Q (CC) genotype was significantly higher in T2D comparing to controls (OR;1.61, 95% CI;1.02-2.55, P=0.02) and a significant association between the frequency of C allele and T2D was observed (OR;1.339, 95%CI;1.04-1.72, P=0.012). TT genotype of TCF7L2 C>T rs7903146 was significantly higher in T2D patients (OR;0.67, 95% CI;0.49-0.98, P=0.02), but the T allele could not significantly affect the risk for T2D in our population. The high frequency of Q allele of the ENPP1 K121Q and TT genotype of the TCF7L2 might be considered as a predisposing factor for T2D.

Sleep behaviors have a significant impact on a child's quality of life; thus, sleep disorders are a major concern for parents. These disorders show the highest prevalence amongst pre-school children which can lead to mood disorders and the disruption of cognitive and emotional abilities. These side effects can subsequently cause failure in school, family problems and psychiatric disorders. Primarily, a list of kindergartens located in Zanjan city were selected with the help of the State Welfare Organization of Iran. The cluster sampling method was used and 345 samples were randomly entered to the study. Parents were asked to respond to the researcher’s questions based on BEARS questionnaire. Finally, the data were analyzed using SPSS software. 304 out of 345 children participating in the study (88%) had sleep disorders. Fear of sleeping alone was the most reported sleep disorders (59.4%). Our study showed that the use of mass media reduced sleep-related problems (P=0.027). There was a significant relationship between maternal education and sleep disorders, and the lowest prevalence of sleep disorders was observed amongst children whose mothers held a bachelor's degree (P=0.008). The high prevalence of sleep disorders in this study suggests that such psychological problems require special attention on the part of pediatricians, pediatric psychiatrists and general health professionals with an orientation towards teamwork.

2-arachidonoylglycerol (2-AG) and anandamide (AEA) are two major endocannabinoids. Using inhibitors of the enzymatic pathways involved in the elimination of 2-AG and AEA as well as synthetic 2-AG, we examined the effectiveness of these endocannabinoids on epileptiform activity induced in Wistar rats by pentylenetetrazol (PTZ). Adult male Wistar rats were used in this study. Epileptiform activity was induced in dult male Wistar rats by PTZ injection (20 mg/kg, i.p.). To inhibit 2-AG degradation WWL70 and JJKK048 (JJKK048: 1 mg/kg, WWL70: 5 mg/kg, i.p.) were used. To inhibit AEA elimination, URB597 and LY2183240 (URB597: 1 mg/kg, LY2183240: 2.5 mg/kg, i.p.) were used. Synthetic 2-AG was also examined (1 mg/kg, i.p.) before the PTZ injection. All drugs were dissolved in DMSO as vehicle and injected (i.p.) 15 minutes before the PTZ injection. Latency to onset and duration of the epileptiform activity were considered for statistical analysis. Injection of (JJKK048+WWL70) before the PTZ significantly increased latency to onset of the epileptiform activity (p<0.01), while reduced duration of the epileptiform activity in comparison to the vehicle (p<0.05). In addition, 2-AG administration significantly increased latency to onset of the epileptiform activity (p<0.05) and reduced duration of the epileptiform activity in comparison to the vehicle (p<0.01). However, these indexes did not show significant changes when URB597+LY2183240 were injected before the PTZ (p>0.05). It seems increased level of 2-AG but not AEA,effectively decreases PTZ induced epileptiform activity of the hippocampus.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic obstructive and irreversible disease which has a high mortality and morbidity rate. Systemic inflammation and the thrombotic process can influence the prognosis of these patients. The objectives of this study were to evaluate prognostic effects of CBC indices (WBC, PMN, MPV, RDW), forced expiratory volume-one second (FEV1) and mean Pulmonary Artery Pressure (mPAP) in the prognosis of COPD patients with acute exacerbation of the disease. This cross-sectional study was performed on exacerbated COPD patients who were admitted to the emergency department, Afzalipour Hospital, Kerman, Iran during 2016-2017. For all the patients, CBC was assessed as they arrived then Pulmonary Function Test and echocardiography were conducted.  In order to create the final model, we employed multivariate regression analysis. A total of 1078 patients were enrolled during one year, of which 58.3% were male. In multivariate analysis, White blood cells (WBC), Polymorphonuclear leukocytes (PMN), Mean platelet volume (MPV), Red Cell Distribution Width (RDW), FEV1 and mPAP were the six variables which are independently associated with hospital mortality and ICU admission. Sensitivity, specificity and area under the curve for these six variables model were 78.5, 92 and 86% respectively. Since the inflammatory and thrombotic events are influential in the prognosis of COPD patients, it may be possible to predict patients outcome with CBC related indices (WBC, PMN, MPV and RDW), although other important risk factors such as pulmonary hypertension and FEV1 decrease should be considered as well.

Benzimidazoles such as albendazole are being used in some conditions to treat the hydatid disease, the common parasitic infections of humans and livestock that caused by Echinococcus granulosus. However, treatment with these drugs is not always with complete success. In this study we evaluate the in vitro efficacy of flubendazole (FLBZ) plus praziquantel (PZQ) against E. granulosus protoscoleces and microcysts. Viable and aseptically cultured protoscoleces were treated for 17 days with 5 µg/ml FLBZ, 1 µg/ml PZQ and a combination of both drugs. The viability of protoscoleces was assessed daily by microscopic observation and eosin test. Experiment was repeated three times and drug efficacies were presented as the mean value of protoscoleces viability rate. Developed microcysts from continues cultivation of protoscoleces were subjected to this treatment as same as protoscoleces, for 21 days. Structural changes of microcysts were visualized by inverted and transmission electron microscopy. The most protoscolicidal efficacy was significantly detected in the culture treated with the combination of FLBZ and PZQ, so that all protoscoleces were killed in the nine days post-treatment. Meanwhile, 21.7±9.5% and 30.8±5.3% of protoscoleces that incubated with the FLBZ or PZQ alone were still viable, respectively. Degenerative changes occurred in microcysts on four days of co-treatment with the drugs, while these occurred on six and eight days with FLBZ or PZQ alone, respectively. This study indicates the favorable combined effect of the FLBZ and PZQ against E. granulosus protoscoleces and microcysts in vitro.

Children with Autism spectrum Disorder (ASD) are limited in participation in everyday activities due to the nature of their disorder. Participation means involvement in life situations. The aim of this study was to evaluate psychometric properties of “the Children Participation Assessment Scale-Parent Version” (CPAS-P) in activities outside of school in Iranian children with ASD. The sample consisted of 55 parents of 6-12 years old children with ASD who selected with convenience sampling. For assessing the convergent validity of CPAS-P and Vinland Adaptive Behavior Scale (VABS), the spearman's correlation coefficient test was used. The internal consistency and test-retest reliability were determined by using the Cronbach's alpha and the intraclass correlation coefficient (ICC), respectively. The mean age of children was 7.62 years. Cronbach's alpha was obtained 0.91 to 0.94, which indicates the proper internal consistency and ICC was 0.90 to 0.95, which indicates the acceptable test-retest reliability. Finally, significant correlations were reported between CPAS-P and VABS tests in related subscales. Increasing independence in doing daily activities of children with ASD is a concern for rehabilitation professions such as occupational therapists. Valid and reliable instruments are necessary for documenting treatment that should culturally adapted among Iranian children. According to the result of this study, CPAS-P has good psychometric properties for clinical practice and research.

Regional differences exist in the prevalence of birth defects. This study was undertaken to determine the prevalence and related factors with birth defects in Zanjan, Iran. This descriptive analytic study was performed in Zanjan province during 2015–2016. Data included 41265 child births, which were extracted from the Iranian Mother and Newborn (IMAN) web system report of the Zanjan province hospitals (country electronic childbirth register system). Data was analyzed using descriptive, uni-variate, and multi-variate logistic regression tests. The prevalence of birth defects in Zanjan was 0.7%. Gestational age (odds ratio [OR]: 0.917, 95% CI: 0.869–0.967, P =0.002) and birth weight (OR=0.999, 95% CI: 0.999 – 1.000, P< 0.001) reduced the chance of birth defects, while consanguineous marriage of parents (OR: 1.745, CI 95%: 1.298–2.347, P< 0.001), and mother’s doctoral degree increased its prevalence (OR: 3.928, 95% CI: 1.058–14.584, P =0.041). It seems that premarital counseling, screening tests before and during pregnancy, and education, especially for being pregnant in appropriate age and conditions, could be the suitable approaches for reducing the birth defects