فهرست مطالب yahya salimi

 Sleep is a vital physiological process that plays a crucial role in various aspects of human health and well-being. Regarding the important role of diet on the sleep quality, the present study aimed to assess the association of dietary inflammatory index (DII) with the sleep outcomes and also to provide the potential mechanisms of action.

 PubMed, Web of Science and Scopus databases and Google Scholar search engine were systematically searched for relevant studies related to DII and sleep outcomes using appropriate search terms until February 2024.

 From the initial systematic search of databases, 197 studies were retrieved. However, only 14 of them met the criteria for evaluation. Out of these, eleven studies indicated a significant correlation between higher DII scores and poor overall sleep quality and/or short/long sleep duration or its subscales. On the contrary, four studies did not find any proof of this association.

 This systematic review indicated that following an anti-inflammatory diet could potentially lead to an improvement in the sleep outcomes. Well-designed clinical trials in the future will be necessary to provide a better understanding and quantification of this association.

Monitoring alcohol consumption in population is very important for planning public health and evaluation of the efficiency of intervention strategies. The aim of this study was to use wastewater-based epidemiology (WBE) to estimate alcohol consumption in a Kermanshah City and calculate risk assessment using the margin of exposure (MOE) approach.

Raw composite wastewater samples (5 hours) were collected form the entrance of Kermanshah wastewater plant over a 30 days’ period. Ethyl sulfate metabolite was used to measure the alcohol content of the samples, which is excreted in the urine after consuming alcohol by humans and enters into the wastewater collection network. After centrifugation and filtration, the samples were directly injected into the liquid chromatography with tandem mass spectrometry LC-MS/MS for analysis. After calculation of alcohol consumption rate with back-calculation method, the results were used for risk assessment by MOE.

In general, the average amount of alcohol consumption during sampling in the society was 0.332 ml per person of equal age and over 15 years of age (adult) per day, which was equal to 0.121 liters of pure alcohol per person per year. We found no significant difference in the amount of alcohol consumption between the weekend and working days of the week, and also between  sampling days in Ramadan and ordinary  days. In 90% of the samples taken, the risk associated with alcohol consumption was higher than MOE=100 and only in 3 samples the MOE value was in the "risk" category.

The results of this study showed that wastewater-based epidemiology can provide appropriate timely and transisional  information on alcohol use and its associated exposure risks in the community. Also, the amount of alcohol consumption in the population in our study was much lower than those in the European and American countries.

All people living in a society are not equally at risk of COVID-19 infection and hospitalization. The current study is aimed to determine the factors related to COVID-19 infection and hospitalization among participants of Ravansar Non-Communicable Disease (RaNCD) cohort study. 

The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively. 

In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.     

Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.

The available evidence has made the long-term accompaniment of COVID-19 and its other variants with human life predictable. Different studies have proposed different and, in some cases, contradictory findings as factors determining the duration of hospitalization of patients with COVID-19. The present study aimed to identify the factors related to the duration of ICU length in patients with COVID-19.

The present study retrospectively analyzed the data related to patients aged 1 to 97 years with COVID-19 registered in Isfahan's COVID-19 registration system. The data of those patients with COVID-19 who were alive at the time of discharge (n=453) were analyzed in the present study. Information related to laboratory findings, clinical data, and co-morbidities were collected. T-test, correlation, and analysis of variance tests were used in crude analysis. The linear regression model was used to determine the factors related to the ICU length and their importance.

The mean (SD) of intensive care unit days was 0.64 (2.39). Higher than normal values of INR, hemoglobin, and creatinine increased the average length of stay in ICU by 2.45 (p=0.001), 3.82 (p <0.001), and 0.72 (p <0.001) days, respectively. Among underlying co-morbidities, the presence of other respiratory diseases significantly increased the average length of stay in the ICU by 1.5 days (p=0.024). Standardized regression coefficients also showed that higher-than-normal hemoglobin and increased WBC values were the most important variables predicting ICU hospitalization length.

The higher-than-normal values of hemoglobin and increased WBC values are the most important predictors of the length of hospitalization in the ICU. The findings of the present study can be helpful in the decision-making of specialists to reduce the duration of hospitalization in the ICU and to help diagnose more critical cases.

Women's quality of life is essential both for women’s and their family’s health. The aim of this study was to examine the quality of life status and interaction of subjective socioeconomic status and violence, on quality of life of married women in west of Iran.

This was a cross-sectional study that recruited 1533 married women using multi-stages sampling method. Multiple linear regression was employed for estimating adjusted association and 95% confidence intervals.

The mean (SD) age of the participants was 33.67(11). The majority of participants (92%) experienced some degree of domestic violence. Less than half of women (46.70%) perceived medium socioeconomic status. Mean (SD) score of quality of life was 3.57 (0.94). There was a significant statistical interaction between socioeconomic status and domestic violence on quality of life.

These findings suggest that considering the interaction of subjective socioeconomic status with domestic violence in prevention program, especially in poor categories of family, appears to be one of the important ways in improving married-females’ quality of life.

Smoking is the leading cause of preventable death. Female smokers bear a greater risk of experiencing an ST-segment elevation myocardial elevation (STEMI) than male smokers.

This study aimed to investigate gender and smoking-related survival differences one-year post-STEMI.

This registry-based cohort study included all STEMI patients of Imam Ali Hospital, Kermanshah, Iran. All eligible adult patients with STEMI were enrolled. Baseline data and one-year post-STEMI data were collected. Cox proportional models were used to estimate crude and full-adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs). All analyses were performed using Stata.

During 2080.9 person-years, 22 patients were lost to follow-up (success rate = 99%). There were 2,279 STEMI patients (22.99% women) during the study period. Men were younger than women (58.50 ± 12.22 vs. 65.26 ± 11.56 years, P ˂ 0.001). In men, smoking was a protective factor against in-hospital mortality in the unadjusted model (HR = 0.49, 95% CI: 0.31 – 0.78, P = 0.002), but was not a protective factor after adjusting for age, hypertension, dyslipidemia, diabetes, creatine kinase-MB, body-mass index, LDL-cholesterol, HDL-cholesterol, glomerular filtration rate, anterior wall MI/LBBB, left ventricular ejection fraction and reperfusion therapy (HR = 0.66, 95% CI: 0.34 – 1.25, P = 0.198).

Although male smokers with STEMI had a lower in-hospital mortality rate, this difference did not persist in the adjusted model. Thus, the smokers’ paradox phenomenon was not proven. The better outcomes of men with STEMI compared to women are probably related to their younger age and fewer risk factors at the time of presentation.

The aim of this study was to evaluate the effect of health sector evolution plan (HSEP) on the prevalence of cesarean section and vaginal delivery in public hospitals in Kermanshah province.

In the present study, cesarean section (C-section) and vaginal delivery data were collected and evaluated in 17 public hospitals from 2009 to 2019. The main variables of this study included the prevalence of C-section and the prevalence of vaginal delivery for 121 months, both were obtained by dividing the number of deliveries by C-section and vaginal delivery by the total number. Interrupted time series analysis was used to examine the effect of HSEP on the prevalence of cesarean and vaginal delivery rates.

The prevalence of C-section before and after the HSEP was 42.5% and 43.2%, respectively. Months before the intervention, the rate of C-section was increasing by 0.13%, which was statistically significant. In the first month after the intervention, the prevalence of     C-section decreased by 3.6% that was statistically significant. The share of C-section in the months after the implementation of the HSEP showed a monthly increase of 0.12% compared to before the intervention, which was statistically significant.

The results of the study showed that the HSEP has led to a significant reduction in C-section in short term, but in the months after the implementation of the plan, the prevalence of C-section has increased again.

Serological studies are based on the detection of antibodies. However, the produced antibodies decrease over time; therefore, such methods cannot provide a valid estimate of prevalence and incidence. The present study aimed to determine the serum prevalence and cumulative incidence in the Ravansar cohort population (Youth and RaNCD Cohort) in October 2020.

A random sample of 716 people aged > 18 years old were selected from the participants in the Ravansar cohort study in October 2020. Euroimmun anti-SARS COV-2 IgG ELISA kits (Lübeck, Germany) were used to measure antibody levels. Seroprevalence was estimated with considering of cut-off = 1, and cumulative incidence (modified and modified based on test specificity) was determined using modeling.

In the present study, the serum prevalence of COVID-19 viral infection in the Ravansar cohort population from 22 October 2020 to 18 November 2020 was estimated to be %35.16 (95%CI: %31.64, %38.79). Modified Cumulative incidence and modified based on test characteristics from 20 February to 18 November 2020 were estimated to be %68.85 and %67.71, respectively. 

Although very high cumulative incidence may be a sign of approaching herd immunity, adherence to health protocols is still recommended due to the potential role of asymptomatic cases in transmitting the disease to other members of the community; and the presence of new variants of the virus and reduced antibody levels should be considered.

Iran, after China, emerged as one of the first COVID-19 epidemic countries. Despite all efforts to interrupt new transmission chains, the virus continued to quickly spread across the country. WHO has highlighted a crucial role for social factors and intersectoral collaboration to tackle COVID-19. This study aimed to identify challenges related to the upstream determinants and downstream risk factors of COVID-19 infection in Iran as perceived by health professionals at different levels of service administration. We conducted a qualitative study in October 2020. A directed qualitative content analysis was done to explore the views of health professionals and administrators toward determinants of COVID-19 infection in Iran. Using a deductive approach, we tested the implications of the WHO Commission on the Social Determinants of Health (CSDH) framework regarding COVID-19. The determinants of COVID-19 infection in Iran are referred to as: 1) upstream social determinants, including political considerations in dealing with COVID-19, conflicting authority structures between and within organizations and sectors, poor intersectoral collaboration, unstable macroeconomic environment, pandemic crisis management, poor governance in the health system, cultural and societal values, trust and social capital, and individuals’ socioeconomic status; and 2) downstream risk factors, including poor health literacy, poor compliance with COVID-19 prevention guidelines, secrecy related to the infection, individual’s health status, lifestyle, and virus characteristics. It is essential to motivate people to practice preventive COVID-19 infection behaviors. To change the behavior at the population level, a complex fusion of policy and practice, and dealing with the complexity of structural determinants and downstream risk factors are needed.

Irritable bowel syndrome (IBS) might be associated with psychiatric disorders such as obsessive-compulsive disorder (OCD). This meta-analysis was conducted to compare the rate of OCD among patients with IBS and otherwise healthy controls.

This study was conducted using a meta-analysis approach. International databases including PubMed, Web of Science, and Scopus, as well as the Google Scholar search engine were searched from 1985 to August 2020 to find the related studies. The standardized mean difference (SMD) of OCD between case and control groups was calculated and pooled by using a random-effects model. In addition, meta-regression and sub-group analysis were performed to identify variables that possibly explain the heterogeneity.

A total of 5167 patients including 1451 IBS patients for case and 3716 for control group entered 15 related studies were included in the analysis. Based on the results of the random effects analysis, the rate of obsessive-compulsive disorder in IBS patients in case group was higher than the control group (Pooled standardized mean difference, 0.76, I2 = 87.8%; 95% CI, 0.54-0.98; P <0.001). Egger’s (P = 0.083) and Begg’s (P = 0.09) tests did not show significant publication bias. Subgroup analysis also revealed that the type of studies and IBS diagnostic criteria were identified as factors affecting heterogeneity.

The present meta-analysis demonstrated that the obsessive-compulsive disorder score in IBS patients was higher than the control group, regardless of subgroup analysis or meta-regression. Due to the significant relationship between these two disorders, psychiatrists and gastroenterologists can provide strategies and techniques for individual or group treatment of obsessive-compulsive disorder in patients with IBS based on the cognitive-behavioral therapy.

Our study aimed to compare the 1-year therapeutic outcome between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease (CAD).  This retrospective cohort study was conducted on 150 patients with multivessel CAD who underwent CABG or PCI in Imam Ali Cardiovascular Center, Kermanshah, Iran, between March 2017 and March 2019. Data were collected using a checklist developed based on the study objectives. Differences between subgroups were assessed by using the independent t test and the χ2 test (or the Fisher exact test). A multivariate binary logistic regression model was used to determine factors associated with referral to CABG or PCI.  The mean age was 63.48 (SD=9.73) years in the PCI group and 60.54 (SD=10.85) years in the CABG group (P=0.741). The CABG group was more likely to have left main disease (16.6% vs 0%; P<0.001). The PCI group was more likely to take an antiplatelet (viz, clopidogrel) and nitrates, whereas the CABG group was more likely to take antihypertensives (angiotensin receptor blockers) and anticoagulants (viz, rivaroxaban and warfarin) (P<0.05). The CABG had significantly higher rates of major bleeding (P=0.003) and arrhythmia (P=0.045) than the PCI group. There was a significant difference in the mortality between the 2 treatment groups (9.3% of the CABG group vs 1.3% of the PCI group; P=0.029). Left main disease was associated with an increased odds of referral to CABG (OR=0.02; P=0.015).  PCI was associated with a lower adverse clinical outcome than CABG in patients with multivessel CAD. (Iranian Heart Journal 2022; 23(1): 25-33)

An adequate perception of the degree to which one is at risk of having or contracting HIV is necessary for behavioural change and the adoption of safe behaviours. There are limited data regarding HIV risk perceptions among female sex workers in Iran. This study aimed to determine the HIV risk perception status and its association with sexual behaviours among female sex workers in Tehran.

A cross sectional study was conducted among 170 female sex workers in Tehran. Participants were recruited using a combination of snowball, purposeful, and convenience sampling methods. Multiple logistic regression was used to identify adjusted associations between background factors, sexual behaviours, and HIV risk perception. The analysis was conducted by the “logistf” package in the R statistical system. P-value less than .05 was considered as statistically significant.

Among the participants, 122 (77%) reported high HIV risk perception. Most female sex workers with high HIV risk perception reported that they did not consistently use condoms (n=120, 98%. Female sex workers with a higher frequency of sex work (AOR=1.18, 95% CI: 1.08, 1.31), inconsistent condom use (AOR=0.15, 95% CI: 0.02, 0.66),  a history of HIV testing (AOR=5.1, 95% CI: 1.2, 26.0), and low HIV knowledge (AOR=0.97, 95% CI=0.95, 0.996) were more likely to report high HIV risk perception.

Most female sex workers with risky sexual behaviours had a high HIV risk perception. Effective educational programs are suggested to enable female sex workers to correctly assess their own HIV risk and change risk behaviors based on self-assessment of actual risk.

There is great need across the globe for self-report scales of depression that are brief to administer, comprehensive in content, and psychometrically valid. As most of the widely used and well-validated scales originate in English, it is essential to carefully translate them, following the psychometric validation of the adapted scales. The current study aimed at investigating the translation and validation of the Persian version of one of the most widely utilized self-report depression scales in the world, the patient health questionnaire (PHQ). The current study evaluated the validity and reliability of the PHQ in a population-based sample of 600 adult survivors of an earthquake in Iran in 2015. Researchers used the forward-backward method to translate the PHQ-9 into the Persian language. Data were analyzed using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Consistent with the results of validation studies on the original English-language versions of the scales, the current study found strong evidence of internal consistency (Cronbach’s alpha = 0.86). CFA suggested that the 1-factor structure fit reasonably well. Convergent validity was confirmed by the significant and positive correlation between the scores of national stressful events survey for posttraumatic stress disorder-short scale (NSESSS-PTSD) and the PHQ-9 (r = 0.29, P < 0.001). Approximately one-third of the sample reported some depression symptoms, with less than 10% indicating moderately severe to severe symptoms. Although replication studies are needed, the current study results suggested that the Persian version of the PHQ-9 was a valid and reliable tool to efficiently, comprehensively, and accurately assess depression symptoms in the Iranian subjects.

Equity in healthcare utilization is a major health policy goal in all healthcare systems. This study aimed to examine socioeconomic inequalities in public healthcare utilization in Kermanshah City, western Iran.
Study design: A cross-sectional study.
Using convenience sampling method, 2040 adult aged 18-65 yr were enrolled from Kermanshah City in 2017. A self-administrated questionnaire was used to collect data on socio-demographic characteristics, socioeconomic status, behavioral factors, and utilization of public healthcare services (inpatient and outpatient care) over the period between from May to Aug 2017. The concentration index (C) was used to measure and decompose socioeconomic inequalities in the utilization inpatient and outpatient care in public sector. The indirect standardization method was used to estimate the horizontal inequity (HI) indices in inpatient and outpatient care use.
The utilization outpatient (C=-0.121, 95% CI: -0.171, -0.071) and inpatient care in public sector (C=-0.165, 95% CI: -0.229, -0.101) were concentrated among the poor in Kermanshah, Iran. Socioeconomic status, health-related quality of life, marital status and having a chronic health condition were the main determinants of socioeconomic-related inequalities in the utilization of inpatient and outpatient care in public sector among adults. The distributions of outpatient (HI=-0.045, CI: -0.093 to 0.003) and inpatient care (HI= -0.044 95% CI: -0.102, 0.014) in Kermanshah were pro-poor. These results were not statistically significant (P The utilization of public healthcare services in Iran are pro-poor. The pro-poor distribution of inpatient and outpatient care in public facilities calls for initiatives to increase the allocation of resources to public facilities in Iran that may greatly benefit the health outcomes of the poor.

Ghrelin is an orexigenic gut hormone that induces food intake and produces a positive energy balance. Exercise can influence ghrelin levels. The effects of exercises on serum ghrelin level are conflicting.
To evaluate the effect of military training on fasting serum acylated ghrelin (active form of ghrelin).
A pretest-posttest design study was performed on 41 healthy lean males who were sedentary before their recruitment. Their fasting serum acylated ghrelin and glucose, weight, waist circumference and hunger were determined at baseline and after completing 4 weeks of military training.
Serum acylated ghrelin and glucose significantly increased (both P Four weeks military training increases fasting acylated ghrelin level independent of changes in weight or waist circumference. We suggest that ghrelin increases to counterbalance the exercise-induced negative energy balance.

Photorefractive keratectomy (PRK) is a safe and effective surgical keratorefractive technique which is done with the application of mitomycin-C (MMC) in cases of high myopia to prevent the formation of corneal haze This study was conducted to evaluate 3-year visual acuity and quality outcomes of PRK-MMC in high myopia. This before-after study was conducted on 20 individuals (40 eyes) with myopia more than 6.0 diopter (D). Visual acuity and quality indices were evaluated before and three years after the procedure and their stability was examined between the 1st and 3rd years. At 3 years after surgery, mean uncorrected visual acuity was 0.03±0.06 in the logarithm of minimum angle of resolution (logMAR) unit which showed a significant improvement when compared to baseline (P

In the presence of non-adherence, intention-to-treat analysis preserves randomization, but does not lead to a valid comparison of outcome between the assigned groups. Using a reanalysis of Diabetes Prevention Program, this study aimed to estimate the causal effect of treatment with intensive lifestyle intervention or metformin vs. placebo on blood pressure and lipid profile using G-estimation after accounting for non-adherence.
The Diabetes Prevention Program randomized 3,052 pre-diabetic individuals to metformin (N = 1015), placebo (N = 1014), or an intensive lifestyle intervention (N = 1023). G-estimation was used to estimate the causal effect of intensive lifestyle intervention or metformin vs. placebo on blood pressure and lipid profile in 2,973 patients who had adherence data. For comparison, we also performed the standard intention-to-treat analysis.
The G-estimation results showed that intensive lifestyle substantially improves systolic and diastolic blood pressure and lipid profile. The G-estimates of the effects of metformin vs. placebo as well as intensive lifestyle intervention vs. metformin on blood pressure and lipid profile were also stronger than the intention-to-treat effect estimates.
G-estimation suggests that intensive lifestyle modification improves known risk factors for cardiovascular disease, including systolic blood pressure, diastolic blood pressure, triglyceride, and HDL levels more than what standard ITT analysis suggests. Adherence to the assigned treatment should be measured in all randomized trials, and G-estimation should be the standard analysis of randomized trials with substantial non-adherence.

Positive mental health is one of the important health concepts, which generally evaluates people’s emotional, psychological, and social well-being. The current study aimed at investigating positive mental health status in East Azerbaijan earthquake survivors.
In this study, a sample of 600 rural adult survivors of East Azerbaijan earthquake were selected by multistage sampling method. Data were collected using positive mental health questionnaire and demographic checklists through face-to-face interview. To analyze data, different statistical tests, including t test were used.
Findings of the current study showed no significant difference between the mean scores of positive mental health and its social subscales in the studied villages. However, the mean scores of emotional well-being subscale in slightly damaged villages and mean scores of psychological well-being subscale in severely damaged villages were higher and significant (P Attention to long-term mental and social outcomes is the missing link of health studies in incidents and disasters, which must be considered to recover and enhance mental and social health of survivors of natural disasters at the earliest time after the incidents.

Systemic Lupus Erythematosus (SLE) is a heterogeneous complex relapsing-remitting autoimmune disease. The role of genetics is obvious in predisposition of the disease. Several Single Nucleotide Polymorphisms (SNPs) in ETS1 and WDFY4 showed association with SLE in genome-wide association studies. The aim of this study was to examine the association of the SNPs in ETS1 and WDFY4 genes with SLE in an Iranian population.
This study was performed on 280 patients that were not related to one another, and 281 healthy control subjects matched based on age, sex, and ethnicity, all of which were of Iranian origin. Rs10893872 and rs1128334 in the ETS1 gene, and rs877819 and rs707397 in the WDFY4 gene were genotyped using MGB TaqMan Allelic Discrimination Real-Time PCR.
Our results showed no association in all mentioned SNPs with the susceptibility and clinical features of SLE in the Iranian population.
The results were not consistent with genome-wide association studies performed on Asian and Caucasian populations.

Emotional intelligence (EI) has recently been considered as one of the necessary elements for success and achievement in medical fields. The present study was conducted in Iran to compare the EI in medical and non-medical students adjusted for the other relevant factors.
This cross-sectional study was conducted from October 2011 to January 2012 on 872 students of medicine, paramedical and non-medical groups in Tehran University and Tehran University of Medical Sciences, Tehran, Iran selected by multi-stage weighted cluster sampling. The Farsi version of revised Schutte Emotional Intelligence (FEIS) was used to estimate emotional intelligence.
The mean of total EI was equal to 124.9 (SD=8.4) out of 205 and the means for its dimensions were as follows: regulation of emotions 39.3 (SD=5.1), utilization of emotions 26.7 (SD=3.6) and appraisal of emotions 33.5 (SD=5.3). While the paramedical and non-medical student's total EI score was significantly higher than the medical students', in the utilization of emotions dimension, the medical students scored significantly higher than the other two groups.
The lower levels of the medical student's total EI score in comparison with paramedical and non-medical students in this study demands the relevant authorities to pay even more attention to the selection and training of medical students.

Nowadays, by development of societies, health related quality of life has become a very important issue. Traditionally for health assessment, some indexes such as; morbidity, mortality, and life expectancy, have been taken into consideration but these factors are not able to assess life satisfaction. The present study was aimed to investigate the relationship between rural women’s health-related quality of life (HRQOL) and domestic violence. Patients and This cross-sectional study was carried out in the rural districts of Kermanshah, Iran, 2012. Using multistage cluster sampling, 394 women were selected. They completed WHOQOL-BREF and Conflict Tactics Scale (CTS) questionnaires. Data analyzed by SPSS 16, using Pearson correlation and regression tests. The mean scores of total QOL were 55.8 ± 12.9. There was significant inverse correlation between domestic violence dimensions and all health-related quality of life domains (P < 0.01). Domestic violence can affect rural women’s health-related quality of life negatively. Regarding the hidden nature of domestic violence and its presence in all communities, taking into consideration policies to reduce violence through legal education and raising women awareness can positively affect women’s quality of life.

Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status. This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran.Patients and This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables. Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI. 068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure. The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status.

Background and Intrauterine device (IUD) is one of the modern methods of contraception; one of the problems in using this method is its early removal. This study aimed to determine one-year survival rate and discontinuation causes of IUD use in Kermanshah, Iran. In this cohort study, data were collected from patients with IUD using a questionnaire containing demographic and IUD related variables. Patients were followed for one year or until the time that IUD removed. Then, the data were analyzed using Cox regression model. Kaplan-Meier method was used to determine the duration of IUD use. The mean age of the 274 studied women was 28.2 ± 6.2 years. 15% of them had removed their IUD and the most common reason for withdrawal was related to bleeding and spontaneous removal. The highest IUD removal rate was occurred in the first 6 months and the mean duration of IUD use in people who had IUD removal was 4.2 ± 3.8 months. A significant correlation was found between previously used of IUD and IUD removal. So that, those who did not have a history of IUD use have a greater rate ratio (P = 0.04). In this study, the 6-month survival rate of IUD was 88.7% and one-year survival was 85%. The results show that bleeding and spontaneous removal is the main reasons for discontinuation of this method; therefore, it is necessary to devise strategies to reduce removal rate and increase the time maintenance of IUD.

Disability is more based on social, rather than medical aspects. Lack of attention and social support may impact on participation of people with physical disability in various aspects and their return to normal life in the society.. This study was conducted to determine perceived social support and related factors among physically disabled in the city of Tehran..Patients and This cross-sectional study by using simple random sampling was conducted on 136 people with physically disabled who were covered by Welfare Organization of Tehran. The Norbeck social support questionnaire was used. Multiple linear regression analysis with the backward method was used to identify the adjusted association between perceived social support as dependent variable and demographic variables as independent variables.. The present sample comprised of 68 (50%) male and 68 (50%) female with the mean age of 33 (SD = 8.9) years. Based on the results, mean of functional support was 135. 57 (SD = 98.77) and mean of structural support was 77.37 (SD = 52.37). Regression analysis model, demonstrates that variables of age and marital status remained in the model as significant predictors of functional support (P = 0.003, P = 0.004, respectively) and structural support (P = 0.002, P = 0.006, respectively).. Based on the results, participants in the study didn’t have favorable status with respect to perceived social support (in all dimensions) from their social network members. While, social support as one of the social determinants of health, plays an important role in improving psychological conditions in people’s lives; therefore, being aware of social support and designing effective interventions to improve it for the disabled is very important..

Migraine is a very painful headache and most people affected with it have multiple attacks of headache for many years. The complications of migraine are associated with missing out on school and weakening of students’ academic performance. The current study was conducted to determine the prevalence of migraine and the frequency of some of its triggers in high school students. A cross-sectional study was performed in the spring of 2010 on 857 high school students in Boukan. Cluster sampling was used and the International Headache Society’s questionnaire and a neurologist’s opinion were used to detect migraine. STATA was used for statistical analysis. The prevalence of migraine was 4. 78% (12% with aura، and 78% without aura)، and the median duration of attacks was 6 hours. Among the migraine triggers were sleep disorders، being the most frequent (63%)، and the least frequent were intakes of canned foods and pepper (2. 44%). The 4. 78% prevalence of migraine، its severity (83% have moderate to severe attacks)، and its impact on reducing students’ productivity can highlight the significance of migraine in this age group. Management of migraine triggers، sleep disorders، avoiding extreme heat and emotional stress are recommended to reduce migraine attacks and subsequently to reduce the number of hours missed out in school.