International Journal of Preventive Medicine
Volume:5 Issue: 5, May 2014

It has been estimated that nearly half of the world’s population is at the risk of contracting malaria with sub Saharan Africa being the most risky area. The existing frontline malaria control interventions are not only expensive but also become ineffective owing to the emergence of insecticide and drug resistance. It calls for an innovative approach in terms of potential and reliable vaccine as an additional tool. Over centuries, the public health experts have been actively engaged to formulate a safe, affordable and potential malaria vaccine and accordingly a notable achievement has also been attained. However, many challenges are required to be flagged immediately and effectively to devise an ideal prophylactic malaria vaccine. Therefore, the global community has to remain waiting quite a few more years to build a wannabe malaria‑free world in the near future.

Some studies have shown the possible role of protein‑energy malnutrition (PEM) in persistence of endemic goiter in iodine replenished areas. The present study was conducted to assess the association between PEM and goiter in schoolchildren of Isfahan, Iran. In a cross‑sectional study using multistage cluster random‑sampling, 2331 schoolchildren with age ranged from 6‑13 years old with a female to male ratio of 1.60 were enrolled. Thyroid size was examined by two endocrinologists for goiter detection. Children were considered goitrous if they had palpable or visible goiters according to World Health Organization (WHO)/United Nations children’s Fund/International Council for the Control of Iodine Deficiency criteria. Weight and standing height were measured using the standard tools and anthropometric indices were calculated using the WHO AnthroPlus software developed by the World Health Organization. Height‑for‑age Z‑scores (HAZ), weight‑for‑age Z‑scores (WAZ) and body mass index (BMI) for age were calculated for each child. Children with a HAZ, WAZ or BMI‑for‑age of Z‑score < –2.0 were classified as stunted, underweight or thin, respectively. Blood samples were drowned to measure serum thyroid hormones. Overall, 32.9% of subjects were classified as goitrous. Weight, height, BMI, WAZ and BMI‑for‑age Z‑score were significantly lower in children with goiter than in children who did not have goiter (P < 0.05). The prevalence of goiter in thin children was higher than that in non‑thin ones (48.4 vs. 31.6%, odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.52‑2.69, P < 0.001). Although 33.4% of non‑stunted children were goitrous, 31% of stunted ones had goiter (P = 0.5). According to the logistic regression model taking sex and age as covariates, the only significant parameter affecting palpable goiter detection was thinness (OR = 2.13, 95% CI: 1.22‑3.69, P < 0.001). In the present study, we found a high prevalence of goiter in children who were malnourished. It seems that PEM may play a role in the still high prevalence of goiter in this region.

Solid waste management has emerged as an important human and environmental health issue. Municipal solid waste workers (MSWWs) are potentially exposed to a variety of occupational biohazards and safety risks. The aim of this study was to describe health practices and safety measures adopted by workers in the main municipal company in Alexandria (Egypt) as well as the pattern of the encountered work related ill health. A cross‑sectional study was conducted between January and April 2013. We interviewed and evaluated 346 workers serving in about 15 different solid waste management activities regarding personal hygiene, the practice of security and health care measures and the impact of solid waste management. Poor personal hygiene and self‑care, inadequate protective and safety measures for potentially hazardous exposure were described. Impact of solid waste management on health of MSWWs entailed high prevalence of gastrointestinal, respiratory, skin and musculoskeletal morbidities. Occurrence of accidents and needle stick injuries amounted to 46.5% and 32.7% respectively. The risk of work related health disorders was notably higher among workers directly exposed to solid waste when compared by a group of low exposure potential particularly for diarrhea (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2‑3.8), vomiting (OR = 2.7, 95% CI = 1.1‑6.6), abdominal colic (OR = 1.9, 95% CI = 1.1‑3.2), dysentery (OR = 3.6, 95% CI = 1.3‑10), dyspepsia (OR = 1.8, 95% CI = 1.1‑3), low back/sciatic pain (OR = 3.5, 95% CI = 1.8‑7), tinnitus (OR = 6.2, 95% CI = 0.3‑122) and needle stick injury (OR = 3.4, 95% CI = 2.1‑5.5). Workers exposed to solid waste exhibit significant increase in risk of ill health. Physician role and health education could be the key to assure the MSWWs health safety.

The people residing in coastal areas of Visakhapatnam are mostly engaged in fishery, which is always been a physically demanding job, and numerous factors have direct or indirect impact on the health of fishermen; but, the data about their physical fitness or health status is quite scanty. Thus, the present study was conducted to assess their cardiorespiratory fitness pattern, as well as morphometric characters, which may be influenced by their occupation. In this retrospective cohort study, 25 young fishermen (mean age of 22.8 ± 1.92 years) were randomly selected from Araku valley of Visakhapatnam District, Andhra Pradesh and compared with 25 subjects who were randomly selected from college students (mean age of 21.9 ± 2.25 years) of Kolkata, West Bengal. Some physical and physiological fitness variables including height, weight, body mass index, body surface area, physical fitness index, anaerobic power, and energy expenditure were measured along with their morphometric characters. Analysis of data indicated a significant difference in blood pressure, physical fitness index, energy expenditure, body fat percent and anaerobic power among fishermen compared to controls. However, there were no changes in morphometric characters between the two groups. Findings of this small‑scale population‑based study indicated that health and physical fitness of young fishermen is under the influence of both occupational workload and nutritional status, as found by body composition and morphometric characters.

It has been reported that epilepsy is a disorder of the central nervous system that causes memory impairment. This study examines the role of the aqueous extract of Boswellia on the learning disability of the pentylenetetrazol (PTZ)‑induced kindled rats. In this experimental study, 64 male rats were used. Kindling seizures were induced by three injections of 25 mg/kg of PTZ every 15 min. Control animals received normal saline instead. To evaluate the therapeutic effect of Boswellia extract on the PTZ‑induced cognitive deficits, the aqueous extract (0, 0.1, 0.5 or 1 g/kg, i.p.) were administrated to all animals for three consecutive days. At 24 h later, passive avoidance learning of animals was examined using shuttle box apparatus, respectively. The time required for the animal stepping through the dark chamber was determined as step‑through latency (STL). Data were subjected to the t‑test and analysis of variance and followed by Tukey’s test for multiple comparisons. The STL of the kindled rats was significantly reduced compared with control ones (22/375 ± 4/19 for kindled and 295 ± 15/71 for control groups, respectively). Aqueous extract of Boswellia improved passive‑avoidance learning ability in both control and PTZ‑kindled animals (P < 0.05). The results can be stated that the Boswellia extract is offset by harmful effects of seizures on cognitive function and consumption of Boswellia extract increases the learning ability in epileptic animals.

The objective of this study is to assess the safety and preventative effects of aminophylline on the incidence of chronic lung disease (CLD) in very premature infants. This was a long follow‑up randomized clinical trial. The prophylactic effect of aminophylline on the incidence of CLD was investigated in very premature infants. The study group received aminophylline for the 1st 10 days of life and control infants received no aminophylline during the 1st 10 days of life. Fifty‑two infants participated (26 aminophylline, 26 controls). Premature infants on aminophylline had clearly shorter oxygen dependency time than those in the control group. Median time of oxygen dependency was 3 (0‑9.5) days and 14 (3‑40.5) days in group A and C, respectively (P: 0.001). Incidence of CLD was significantly different between the two groups. Only two infants (8.7%) on aminophylline developed CLD, when compared to 11 infants (44.0%), who did not receive aminophylline (P: 0.006). No side‑effects were reported in the neonates (P: 1). This study supports the preventative effects of aminophylline on the incidence of CLD in very premature infants. In other words, the more premature the infants, the greater will be the preventative effect of aminophylline on the incidence of CLD.

Drug abuse is now‑a‑days one of the gravest social harms. Recent years have experienced a drastic rise in drug abuse among school and university students. Thus, the need for special attention to the issue is deemed important. The present study was conducted with the aim of assessing the impact of life skills training on promotion of drug abuse preventive behaviors. This field trial experimental study was conducted on 60 students of Gonabad Medical University selected through quota random sampling and assigned randomly into two Intervention and control groups. Data were collected through a questionnaire, including two sections of demographic information and drug abuse preventive behaviors. The questionnaire was first assessed as to its validity and reliability and then administered both before and after educational intervention and also as a follow‑up 4 years after intervention – Data were then analyzed using t‑tests and Chi‑square. Comparison of post‑test mean scores of drug abuse preventive behaviors of both groups showed a significant difference (P < 0.01) which remained stable 4 years after intervention. There was a significant relationship between father’s educational level and drug abuse preventive behaviors (P < 0.01). Life skills’ training is effective in the promotion of drug abuse preventive behaviors of university students.

In recent years, adipose tissue, due to the stem cells contained within, has found a new special place in laboratory and clinical applications. These adipose‑derived stem cells (ADSCs) have the same characteristics of bone marrow mesenchymal stem cells (BMSCs). Although bone marrow (BM) is not easily accessible and its procurements may be painful, most patients possess excess fat which can be obtained by less invasive methods; this makes adipose tissue ubiquitous, available and an ideal large‑scale source for research on clinical applications. BMSCs and ADSCs were harvested from three healthy human and were characterized using flow‑cytometry. After they were treated for neurosphere formation using basic fibroblast growth factor, epidermal growth factor, B27; terminal differentiation was performed. In this study, we used immunocytochemistry, real time‑polymerase chain reaction and western blotting techniques for detection and comparison of Nestin, microtubule‑associated protein‑2 (MAP‑2) and glial fibrillary acidic protein (GFAP) markers in human ADSCs and BMSCs. Under appropriate conditions ADSCs can differentiate into neuron‑like cells and express neural markers the same as BMSCs, also the expression of GFAP marker in differentiated cells derived from ADSCs was significantly lower than the cells derived from BMSCs (P < 0.05). While the expression of MAP‑2 marker in both groups was the same. However, due to its advantages and according to our results based on the expression levels of GFAP and MAP‑2, adipose tissue rather than BM could represent a more appropriate stem cell source for investigating the application of these cells in understanding the pathophysiology and in treatment of neurodegenerative disorders.

Hypertension is one of the most important determinants of death due to vascular damage and is fast emerging as a high burden disease in India. However, its documentation is poor in the country. This study aims to estimate the rate and the causal pattern of mortality in a cohort of people with high blood pressure as compared to normotensives. The study setting is Varkkala, a rural village in southern Kerala, India, and the study design was that of a prospective cohort. A total of 77,881 participants of age 20 years and above were considered for analysis. The rate and risk of all cause mortality (death due to any cause) among hypertensives were quantified and compared against the normotensives. The causes of death were also analyzedin both the groups. Cox proportional hazard models were created to estimate the hazard ratios of death among hypertensives adjusted for sociodemographic factors, behaviors, and comorbidities. The incidence proportion of deaths in the study was 4.28% during the follow‑up period of 6 years. The relative risk of mortality was 3.13 (CI: 2.91-3.37) in the high BP group. The age‑adjusted hazard ratio of all cause mortality for the high BP group was 2.96 (2.56-3.42). Coronary artery disease was the major cause of death among the subjects with high BP. The study revealed high prevalence of hypertension in the study population. A person with hypertension is at three times higher risk of death due to any cause compared to a normotensive individual even after adjustment for age.

This study aimed to investigate and compare the bacterial safety of handmade and commercial ready‑to‑use enteral feeding formulas used in an Iranian teaching hospital. In this experimental study, a total number of 70 samples (21 handmade formulas sampled at two sampling times, i.e. the time of preparation and 18 h after preparation, and 28 commercial ready‑to‑use formulas) were studied. Total count of viable microorganisms, coliform count and Staphylococcus aureus count for all samples were conducted. Out of 42 handmade samples, 16 samples (76%) had total viable counts greater than 103 CFU/g in the first sampling time and 17 samples (81%) had total viable counts greater than 103 CFU/g in the second sampling time. Also, 11 (52%) had coliform contamination in the first sampling time which reached 76% (16 samples) in the second sampling time. Regarding contamination with S. aureus, 5 samples (24%) were contaminated in the first‑ and 13 samples (62%) were contaminated in the second‑sampling time. Out of 28 commercial formulas, 27 samples (96%) had total viable counts greater than 103 CFU/g. Also, 24 samples (86%) were contaminated with S. aureus and 27 samples (96%) were contaminated with coliforms. In order to compare these two formulas, the results of Mann‑Whitney test showed that contamination of ready‑to‑use formulas in all three microbiological samples was significantly more than that for handmade samples. The results of the present study indicate that the microbial safety of enteral feeding solutions in this hospital is much lower than standard values, demonstrating that the development of protocols for clean techniques in the preparation, handling and storage of both commercial and handmade enteral feeds is necessary.

In order to provide better advice for prevention of obesity and eating disorders among children, there is a need to have more knowledge of their dietary patterns. This study examined meal and snacking patterns of primary school children in Tehran. A total of 761 male and female primary school children from all educational areas in Tehran were recruited in a cross‑sectional survey. The data was collected by interviewing the students and their mothers or caregivers. Information on food consumption patterns was collected by one 24‑h‑recall and one snack‑oriented food frequency questionnaire which covered a period of 1 month. Means, standard deviations, frequencies, percentages, energy and nutrient analyzes and nutrient densities were reported. All of the students snacked at least once on the day of the survey. Snacks provided 38% of total energy intake by the students. Fruits and sweet snacks were consumed by almost all of the students during a week. Energy and most nutrient intakes from meals were greater than those consumed from snacks. Snacks had a higher density of fiber, carbohydrate, calcium, iron, vitamin C, riboflavin and thiamin and had a lower density of protein, fat and niacin, compared with main meals. Salty snacks such as extruded cheese curls (Cheetos) and chips were not consumed so often. Results provide detailed information about dietary patterns, which in turn enable development of targeted messages and/or interventions to improve nutritional status of school children.

Tocotrienols (T3) were neglected in the past; today, get attentions due to their antioxidant and none‑antioxidant activity. The objective of this study was to evaluate the effects of the daily intake of 200 mg T3 added in canola oil over 8 weeks on microalbuminuria, inflammation, and nitrosative stress in type 2 diabetic patients. This study was a double‑blinded, placebo‑controlled, randomized trial. A total of 50 patients with T2DM and FBS >126 mg/dl treated by non‑insulin hypoglycemic drugs were randomly assigned to receive either 15 ml T3‑enriched canola oil (200 mg/day T3) or pure canola oil for 8 weeks. Urine microalbumin, volume and creatinine levels, serum hs‑CRP, and nitric oxide (NO) levels were measured before and after intervention. From 50 patients participated in this study, 44 completed the study. There were no significant differences in baseline characteristics, dietary intake, and physical activity between groups. Urine microalbumin and serum hs‑CRP were declined significantly in T3‑treated group. At the end of the study, patients who treated with T3 had lower urine microalbumin (11 (9, 25) vs. 22 (15, 39.75) nmol/dl, P = 0.003) and hs‑CRP changes (−10.91 ± 15.5 vs. −9.88 ± 27.5 Pg/ml, P = 0.048) than control group. A non‑significant decrease was also observed in serum NO level in T3‑treated group with no changes in urine volume and creatinine levels. These findings indicate that T3 leads to ameliorate proteinuria and can protect the kidney against inflammation (hs‑CRP) and nitrosative stress (NO).

Maternal mortality ratio (MMR) is one of the main indicators of the millennium development goals and its accurate estimation is very important for the countries concerned. The objective of this study is to evaluate the applicability of capture‑recapture (CRC) as an analytical method to estimate MMR in countries. We used the CRC method to estimate MMR in Iran for 2004 and 2005, using two data sources: The maternal mortality surveillance system and the National Death Registry (NDR). Because the data registry contains errors, we defined three levels of matching criteria to enable matching of cases between the two systems. Increasing the matching level makes the matching criteria less conservative. Because NDR data were missing or incomplete for some provinces, we calculated estimates for two conditions: With and without missing/incomplete data. According to the CRC method, MMR in 2004 and 2005 were 33 and 25 in the best‑case scenarios respectively and 86 and 59 in the worst‑case scenarios respectively. These estimates are closer to the ones reported by United Nations Agencies published in 2010, 38 and Hogan’s study, 30 in 100,000 live births in 2005. The MMR estimation by CRC method is slightly different from the international studies. CRC can be considered as a cost‑effective method, in comparison with cross‑sectional studies or improvement of vital registration systems, which are both costly and difficult. However, to achieve accurate estimates of MMR with CRC method and decrease the uncertainty we need to have valid databases and the absence of such capacities will limit the applicability of this method in developing countries with poor quality health databases.

There is an international emphasis on providing timely and high quality data to monitor progress of countries toward Millennium Development Goals. Iran’s Multiple Indicator Demographic and Health Survey (IrMIDHS) aimed to provide valid information on population and health outcomes to monitor progress in achieving national priorities and health programs and to assist policy makers to design effective strategies for improving health outcomes and equity in access to care. A cross‑sectional multi‑stage stratified cluster‑random survey is conducted through face‑to‑face household interviews. The sampling frame is developed using Iran’s 2006 population and housing census. Provincial samples ranging are from a minimum of 400 households per province to 6400 households in Tehran province. Cluster size is 10 households. The target sample includes 3096 clusters: 2187 clusters in urban and 909 clusters in rural areas. IrMIDHS instruments include three questionnaires: Household questionnaire, women aged 15‑54 questionnaire, children under five questionnaire, supervision and quality assessment checklists and data collection sheets and standard weight and height measurement tools for under‑five children. A cascading decentralized training method is used for training data collection and supervision teams. Quality assurance procedures are defined for the five steps of conducting the survey including: Sampling, training data collection and training teams, survey implementation, data entry and analysis. A multi‑layer supervision and monitoring procedure is established. All the questionnaires are double entered. IrMIDHS will provide valuable data for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policy makers. The collaborative nature of the study may facilitate better usage of its results.

Pregnancy tumor is a benign, hyperplastic lesion of the gingiva, considered to be reactive or traumatic rather than neoplastic in nature. The term pyogenic granuloma is a misnomer as it is not filled with pus or granulomatous tissue histologically. It is multi factorial in nature, which shows an exaggerated response to stimuli such as low grade or chronic irritation, trauma or hormonal variations. Higher levels of sex hormones during pregnancy produce effects on sub gingival microflora, the immune system, the vasculature and specific cells of periodontium which in turn in the presence of local irritants exaggerate the lesion. Since the lesion is clinically indistinguishable from other type of hyperplastic conditions, histological findings are required for proper diagnosis. We present a case report of recurrent pyogenic tumor which showed the evidence of pre‑existing localized periodontitis with extensive horizontal bone destruction. The lesion was excised by electrocautery combined with conventional flap procedure after parturition period. During 3 and 6 months follow‑up period post‑operative healing showed satisfactory results without recurrence.

A 48‑year‑old morbidly obese woman with a left medial meniscal tear and moderately severe degenerative joint disease (DJD) reported for 14‑month follow‑up visit from arthroscopic surgery. She reported a resolution of pain, swelling and an improved range of motion (ROM). The patient was first evaluated 14 months ago, and at that time was considered a strong candidate for total knee replacement due to her limited (ROM), knee pain, swelling and functional impairment. At a 3 month visit prior to her initial evaluation the patient voluntarily enrolled in a nutritional and exercise program overseen by a licensed personal trainer and kinesiologist. At her final evaluation 14 months later, it was noted that in addition to her improved knee symptoms, the patient lost 15% of her initial bodyweight and exhibited significant gains in quadriceps strength. Her clinical exam and imaging suggested an arrest of progression of her joint disease. It was decided mutually by the patient and physician that she was no longer a candidate for total knee replacement surgery. Although the association between her weight loss and her knee DJD can only be hypothesized, this case report may highlight the need to discuss weight loss as an alternative treatment modality for end stage DJD.

Anthropometric indices are widely used to assess the health and nutritional status of children The aim of the present study was determination of malnutrition and compare estimates of under nutrition among young children under 2 years of age from Birjand city of Iran using WHO growth standard and the National Center for Health Statistics (NCHS) references. The cross‑sectional descriptive study conducted on 822 children under 2 years of age mean z scores for weight‑for‑age and height‑for‑age and prevalence underweight, stunting and wasting were calculated using the new WHO growth standards and compared with NCHS references. Compared with NCHS reference, the mean height for age were lower and mean weight for age scores were almost similar using the WHO standards. Prevalence underweight, stunting, and wasting using WHO standards were 5.2-8.2% and 1.9%, respectively, compared to 6.5-37.3% and 1% based on the NCHS references. Using WHO standards resulted differences in mean z score for height for age and changes in prevalence of stunting compared with NCHS references in Birjand city children.

Prelacteal feeding is an underestimated problem in a developing country like India, where infant mortality rate is quite high. The present study tried to find out the factors determining prelacteal feeding in rural areas of north India. A crosssectional study was conducted among recently delivered women of rural Uttar Pradesh, India. Multistage random sampling was used for selecting villages. From them, 352 recently delivered women were selected as the subjects, following systematic random sampling. Chi‑square test and logistic regression were used to find out the predictors for prelacteal feeding. Overall, 40.1% of mothers gave prelacteal feeding to their newborn. Factors significantly associated with such practice, after simple logistic regression, were age, caste, socioeconomic status, and place of delivery. At multivariate level, age (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.13‑2.74), caste and place of delivery (OR = 2.23, 95% CI = 1.21‑4.10) were found to determine prelacteal feeding significantly, indicating that young age, high caste, and home deliveries could affect the practice positively. The problem of prelacteal feeding is still prevalent in rural India. Age, caste, and place of delivery were associated with the problem. For ensuring neonatal health, the problem should be addressed with due gravity, with emphasis on exclusive breast feeding.

To assess the caries risk among 12‑years old children using the Cariogram and to evaluate it by comparing with the actual change in DMFT and DMFS over a period of two year. A two year prospective study was conducted among 12 years age group school going children in Davangere city. At the baseline relevant and required information regarding the oral hygiene, diet, fluoride usage were obtained using a specially prepared pro forma and the saliva samples were collected from study subjects and the required microbiological analysis was done, as per the instructions of Cariogram version 1997. Caries experience was assessed using DMFT and DMFS index. Re‑examination was done after two years and caries increment was calculated. The data so obtained was fed into the Cariogram software based on which they were divided in five groups which were; 0‑20% (high risk), 21‑40%, 41‑60%, 61‑80% and 81‑100% “Chance of avoiding caries”. The caries risk profile generated by the software was compared with caries increment over two years and subjected to statistical analysis. Eighty nine point twenty nine percent of the children in the very low risk group as predicted by Cariogram at baseline did not develop new caries lesions by the end of two years follow‑up. Higher risk children at baseline developed higher number of new carious lesions. Cariogram can be a reliable tool in caries prediction. It can aid in identifying different risk groups in a community and developing preventive strategies for reducing caries risk in children.