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BackgroundTuberculosis (TB) despite being preventive and treatable still imposes a huge burden of morbidity and mortality in developing and developed countries. We aimed to investigate the spatial and geographical distribution of TB in Hamadan province during 1992-2013.Materials and MethodsThis cross-sectional study was performed in Hamadan province, West of Iran using the surveillance database. We examined the trend for incidence rates of all TB forms including Smear Positive Pulmonary TB (SPPT), Smear Negative Pulmonary TB (SNPT) and Extra pulmonary TB (EPT) per 100,000 populations. Poisson regression model was used to estimate the standardized rates for incidence rate of all types of TB per each county.ResultsIn this study 3,602 TB patients including 1,359 SPPT, 987 SNPT, and 1,256 EPT were included during 1992-2013. Trend of all types of TB decreased from 1992 to 2013. The Average Annual Percent change (AAPC) for all types of TB was significantly (P<0.05) decreased, AAPC= -6.4 (95% CIs: -10.7, -1.9). Among SPPT, SNPT, and EPT incidence rates, the maximum change was related to SNPT (-11.6; 95% CIs: -24.2, 3), while it was -1.4 (-8.7, 6.4) for SPPT and -5.8 (-11.4, 0.1) for EPT.ConclusionOur results showed that the incidence of TB in Hamadan province during a 22-year period has decreased 6.4% on average, somehow higher than the national average. Furthermore, our study showed that the risk of extra-pulmonary occurrence in western parts of the province is higher than others parts.Keywords: Tuberculosis, Spatio-temporal analysis, Incidence, Hamadan}
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زمینه و هدفاندام فوقانی انتهایی از مستعدترین نقاط بدن در بروز اختلالات اسکلتی-عضلانی هستند؛ از این رو انتخاب بهترین تکنیک برای ارزیابی ریسک ارگونومیکی آنها بسیار مهم است. هدف مطالعه حاضر مقایسه دو تکنیک شاخص استرین (SI) و حد مجاز مواجهه برای سطح حرکات دست (ACGIH-HAL) و بررسی ارتباط آنها با شدت علائم سندرم تونل کارپ در قصابان است.روش کارجمعیت مطالعه این پژوهش همه قصابان شهر همدان هستند. پس از مشاهده فعالیت های کاری آنها، ارزیابی ها با استفاده از هر دو تکنیک انجام شد. اندازه گیری شدت علائم سندرم تونل کارپ نیز با استفاده از پرسشنامه بوستون صورت گرفت و ضریب کاپا برای تعیین میزان توافق دو تکنیک استفاده شد. همچنین ارتباط میان سطوح ریسک پیش بینی شده به کمک دو تکنیک و شدت علائم سندرم تونل کارپ با تعدیل اثر متغیرهای فردی اثرگذار از قبیل سن، شاخص توده بدن و شاخص مچ دست، با استفاده از تحلیل رگرسیون مشخص شد.یافته هادر این پژوهش، 152 قصاب ارزیابی شدند. تکنیک های SI و ACGIH-HAL به ترتیب 76 و 102 مورد را با ریسک کم (69 مورد مشابهت)، 40 و 27 مورد را با ریسک متوسط (8 مورد مشابهت) و 36 و 23 مورد را با ریسک بالا (18 مورد مشابهت) بررسی کردند. ضریب کاپای دو تکنیک 36/0 به دست آمد (0/001>P). با تعدیل اثر فاکتورهای فردی، هر دو تکنیک ارتباط معنا داری با شدت علائم سندرم تونل کارپ داشتند، اما ارتباط تکنیک SI بالاتر بود.نتیجه گیریتکنیک SI در مقایسه با تکنیک ACGIH-HAL برآورد بالاتری از ریسک دارد و به نظر می رسد قدرت پیش بینی کنندگی تکنیک SI بیشتر از تکنیک ACGIH-HAL باشد.کلید واژگان: ارزیابی ریسک, اندام فوقانی انتهایی, سندرم تونل کارپ}Background and ObjectivesUpper extremities are very vulnerable to work-related musculoskeletal disorders and selecting the best technique for assessing their exposure to ergonomic risk factors is of pivotal importance. This study aimed to compare two techniques of SI and ACGIH-HAL and assess their relationship with carpal tunnel syndrome (CTS) among butchers.MethodsThe study population was all butchers in Hamadan, Iran. After observing the activities, the assessments were conducted using both techniques. The severity of CTS syndromes was assessed using Boston questionnaire. The agreement between the techniques was investigated using Kappa coefficient. The association between the risk levels obtained from the techniques with the severity of CTS syndromes were assessed by regression analysis and fixing the effect of personal factors such as age, body mass index, and wrist ratio index.Resultsa total number of 152 butchers were evaluated. SI and ACGIH-HAL techniques respectively recognized 76 and 102 cases as low risk (agreement in 69 cases), 40 and 27 cases as moderate risk (agreement in 8 cases), and 36 and 23 cases as high risk (agreement in 18 cases). The Kappa coefficient between two techniques was 0.36 (P<0.001). By fixing the effects of age, body mass index, and wrist ratio index, both techniques had significant association with the severity of CTS syndromes. However, the association between SI and severity of CTS syndrome was higher than that of ACGIH-HAL.ConclusionSI had a higher estimate of risk than ACGIH-HAL. It seems that the predictive ability of SI for the severity of CTS syndrome is better than that of ACGIH-HAL.Keywords: Risk assessment, Upper extremities, Carpal Tunnel Syndrome}
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BackgroundHomeless people are at a higher risk of blood-born infectious diseases. The aim of this study was to estimate the prevalence of HIV, HBV, HCV and related risk factors among male homeless people.
Study design: A cross-sectional study.MethodsThis study was conducted in Khorramabad City, western Iran from January to June 2015. A pre-designed validated questionnaire was used to collect the data on behavioral and other potential risk factors. Blood samples were taken in order to diagnose HIV, hepatitis B and C infections. The prevalence of HIV, hepatitis B, C and related risk factors was reported with a 95% confidence interval (CI).ResultsThe participants were 307 male homeless people with a mean (±SD) age of 35.86 (±9.62) yr. The prevalence of HIV, HBs Ag, and HCV Ab positive cases was 6.51% (95% CI: 4.23, 9.90), 0.98% (95% CI: 0.31, 3.00), and 31.27% (26.31, 36.71), respectively. The prevalence of co-infections of HIV and HCV Ab was 5.76% (95% CI: 1.34, 8.51). The most common recently used drugs were heroin, methamphetamine, and opium with a prevalence of 44.30%, 41.04%, and 24.76%, correspondingly.ConclusionsAccording to this study, prevalence of HIV and hepatitis C among homeless people was considerable. Abusing heroin, methamphetamine, and industrial drugs was also significant. Considering the association between drug abuse, HIV, and hepatitis C infections, planning for effective control and preventive interventions is important in homeless people.Keywords: Homeless People, HIV, Hepatitis B, Hepatitis C, Prevalence, Iran} -
BackgroundHIV and AIDS have many different epidemiological, social and political aspects. The aim of this study was to determine the research priorities according to the necessary aspects of HIV and AIDS in Iran.MethodsThe national and international databases were searched to obtain the published articles regarding HIV and AIDS in Iran. All Epidemiologic studies were included in this review for assess research priorities.ResultsOf 3059 retrieved references, 362 studies were included. The most studies were conducted in Tehran, Kermanshah, Fars and Kerman provinces. The cross-sectional studies with 71.55% have higher proportion. Studies related to adherence to treatment (0.55%), drug resistance (0.83%) and experience, perception and behavior of HIV/AIDS patients (0.83%) had the lowest proportion of conducted studies. Proportion of studies regarding prevention of HIV was 2.76%. The authors of studies on female sex workers (FSWs) (63.64%) and prisoners (58.82%) suggested further studies on these groups.ConclusionAccording to our results, the high-risk groups such as female sex workers, injecting drug users and prisoners are in priority for research. Moreover, topics related to the prevention of HIV and AIDS, adherence to treatment and antiretroviral drug resistance are other research priorities in Iran.Keywords: HIV, AIDS, Research priority, Iran}
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Quality of Life in Elderly Iranian Population Using the QOL-brief Questionnaire: A Systematic ReviewBackgroundDue to the increase in the elderly population in different societies, their primary needs, physical and mental health, and quality of life, is important. This study aimed to estimate the overall mean score of the QOL based on the Qol-Brief questionnaire in the elderly population of Iran.MethodsThe international and national databases, including; Medline, Scopus, Science Direct, MagIran, and SID were searched up to Feb 2015. All studies, addressed the quality of life among the healthy Iranian elderly population using WHO-QOL-BRIEF questionnaire, were included. The random effect model was used for data analysis and the results were reported with a 95% confidence.ResultsOut of 2150 studies, seven studies involved 1366 elderly participants were included in the meta-analysis. The pooled mean score of total QOL was 60.1±4.6. The pooled mean score of quality of life for physical health was 55.13 [51.03, 59.22], for environmental was 51.80 [45.50, 58.10], for psychological was 56.68 [53.29, 60.08] and for the social relationship was 57.82 [55.79, 59.86]. The men had a better status and in two health domains, including; physical and psychological health.ConclusionThe results of this study stress the necessity of attention to the quality of life in the domains of physical health (especially in women), and environmental health in the elderly population.Keywords: Quality of life, Systematic review, Elderly}
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IntroductionBurden of HIV and AIDS is considerably different among regions and countries of the world. The aim of this study was to assess of inequality in the prevalence of HIV, according to human development index among countries of the world.MethodsIn this study the desired outcome was prevalence of HIV, which estimated in 100 countries in 2012. The annual report of UNAIDS was used for prevalence of HIV in countries. Also, we used data for the human development index of the countries from UNDP. We defined inequality of human development index in the prevalence of HIV by using the concentration index.ResultsConcentration index for prevalence of HIV among 25-49 years adults was -0.217574 (95% CI: -0.07422, -0.361125). This index indicated the inequality in the prevalence of HIV base on the human development index and concentrating more HIV subjects in poor countries. Also concentration indexes in the prevalence of HIV among young males and females were 0.229920 and -0.200014 respectively.ConclusionResults of this study emphasized on inequality in the prevalence of HIV and concentration HIV in countries with lower human development index, so the international organization must perform fundamental actions to help these countries, such as prevention, care and treatment programs.Keywords: Inequality, HIV, Prevalence, Human development index, Concentration index}
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