Iranian Journal of Public Health
Volume:53 Issue: 11, Nov 2024

Preeclampsia (PE) caused 30%-40% of maternal and newborn deaths worldwide. Despite unclear exact cause, strategies exist to mitigate less severe PE effects. This review explores PE etiology, pathophysiology, risk factors, impact, and prevention.

Searching Scopus, PubMed, ProQuest, Google Scholar, and Science Direct for “preeclampsia and pregnancy” and “prevention” yielded 2012–2022 articles.

Preeclampsia features abnormal placental changes, altered immunity response, trophoblast apoptosis, and reduced uterine perfusion. Risk factors include hypertension history, nulliparity, age over 40, BMI over 35 kg/m², family history, amniotic pregnancy, and long pregnancy interval. This condition risks cardiovascular and neonatal morbidity, straining health resources. Prevention involves aspirin, vitamin D, exercise, folic acid, diet, early screening, and antenatal care.

Findings emphasize enhancing health literacy and preeclampsia education in prenatal care to mitigate PE risk among women. Further research, novel therapies, and assessing prevention strategies with accessible educational materials and multidisciplinary approaches are warranted to enhance pregnant women's health literacy and decrease PE risk.

This systematic review and meta-analysis aimed to explore the effectiveness of acupuncture for patients with diabetic nephropathy (DN).

Nine online databases were searched: China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform, Chinese BioMedical Literature Database, China Clinical Trial Centre, Embase, PubMed, the Cochrane Library, and Web of Science. The search period was from the establishment of the database to 1 September 2023. The quality of the literature was evaluated using the Cochrane Risk of Bias Assessment Tool, and the data were analyzed using STATA/MP17 and Review Manager 5.3 software.

A total of 221 articles were identified, and 13 studies were included. The total sample size was 899, including 452 and 447 cases in the experimental and control groups, respectively. The meta-analysis showed that acupuncture combined with modern medical treatment was effective in improving urinary albumin excretion rate, 24 h urinary microalbumin, serum creatinine, blood urea nitrogen, fasting plasma glucose, 2 h postprandial plasma glucose, total cholesterol, high-density lipoprotein cholesterol, hypersensitive C-reactive protein, and interleukin-6 in patients with DN. Adverse events were reported in only one trial; therefore, this review cannot yet conclude on the safety of acupuncture intervention in DN.

The clinical efficacy of acupuncture combined with modern medicine in DN is superior to that of modern medicine alone. To better evaluate the efficacy and safety of acupuncture intervention for DN, more rigorously designed large-sample, multicentre, randomized controlled trials are needed to provide evidence support in the future.

Work-Related Musculoskeletal Disorders (WRMSDs) are prevalent and costly diseases in military occupations. WRMSDs are prevalent and costly diseases in military occupations. We investigated the exposure to ergonomic risk factors and the prevalence of musculoskeletal disorders (MSDs) among military personnel in the workplace.

We aimed to investigate MSDs by conducting electronic searches on Persian databases such as SID, MagIran, and IranMedex, and English databases like PubMed, Web of Sciences, and Scopus. The search was not restricted by time and was conducted until Dec 20, 2021. Two researchers independently extracted the data, and the quality of the research was evaluated using the STROBE checklist. The results of different studies were merged and incorporated into the analysis using Comprehensive Meta-Analysis (CMA) v3 software.

Eleven qualitative studies found that 92% of the respondents were men (83% to 96%). The mean age was 34.17 ± 0.16 yr, with a confidence interval (of 95% CI:33.85-34.48). The mean BMI was 25±0.39 with a confidence interval of 95% CI:24.28-25.84. The mean work record was 12.89±0.81 yr with a confidence interval of 95% CI:11.30-11.48. The highest outbreak of MSDs is in the knee at 38.1% (95%CI:32.1-44.4), 37.6% of the neck (95% CI:24.8-52.5), and 32.5% of the shoulder. (95%CI:22.5-44.3) was observed.

The wide role of various dimensions of work tasks and repetitive tasks (such as lifting, moving or changing positions, standing for long periods, as well as improper postures) in causing WRMSDs. Additionally, the risk factor in the workplace has financial implications for the military organization. The reduction of physical and psychological demands, as well as the improvement of ergonomic standards in the workplace, should be addressed to decrease MSDs in military centers.

Osteoporosis is the most common systemic skeletal disease worldwide. We aimed to review the latest studies related to osteocalcin and osteoporosis to clarify this relationship more precisely.

A systematic literature search was performed to review studies on the effects of osteocalcin on osteoporosis, on studied published between January 2013 and January 2023. We systematically reviewed Web of Science, PubMed, ProQuest, Scopus, and Google Scholar.

The search yielded 4903 records, including 1063 from PubMed, 2307 from Scopus, 1084 from Web of Science, 408 from ProQuest, and 41 from Google Scholar, and twelve articles were included for data extraction and quality assessment. A significant increase in the serum level of osteocalcin was observed in postmenopausal women with osteoporosis (P<0.05), and there was a negative correlation between bone mineral density and the serum level of osteocalcin.

Osteocalcin could be a promising marker for the diagnosis and screening of patients with osteoporosis.

Hepatitis virus infections are among the serious emerging health issues. They are the primary causes of cirrhosis and hepatocellular carcinoma. Growing evidence shows a link between certain genomic variations and inflammation including viral infection such as HBV and HCV. Therefore, this study aimed to comprehensively review studies that analyze the effect of host genomic variations on the risk of contracting viral hepatitis in Iranian population.

The study was conducted according to the PRISMA Statement. All Persian and English case-control articles published until the beginning of June 2023 were included in the study. Two authors reviewed the articles independently. The third author reviewed the final results. Pathway analysis and protein interactions were also performed using GO and STRING databases.

Seventy relevant studies were retrieved. Fifty-three studies examined the association of SNPs with the risk of HBV infection. In terms of genetic variations, 25 genes and 44 SNPs were identified. Tumor necrosis factor alpha, Interleukin 28B, and Interleukin 10 were the most prevalent considered genes. The most common polymorphisms were in the interleukin family. Moreover, the top five identified molecular functions were cytokine activity, cytokine receptor binding, molecular function regulator, protein binding, and signaling receptor binding.

The polymorphisms of genes involved in the production of immune factors, cytokines, interleukins, and their receptors are associated with the risk of HBV and HCV infections in the Iranian population. Moreover, the extracellular and intracellular signaling pathways and the regulating molecules of these processes can be considered as important factors in liability for these viral infections.

Tuberculosis (TB) and infection of Hepatitis C virus (HCV) have appeared as major public health problems. The present systematic review and meta-analysis aimed at determining the relationship between TB and the risk of HCV infection.

Google Scholar, Embase, Medline, Pubmed, web of sciences (ISI), and Scopus were searched until March 2022. The pooled ORs of HCV in patients with TB were calculated utilizing the random-effect model with a 95% confidence interval (CI). test was utilized for evaluating the heterogeneity. To check publication bias Egger and Beggs' tests were used.

From among 1500 articles from 2006 to 2020, 13 studies were examined and analyzed based on the inclusion/exclusion criteria. The overall risk of HCV infection in patients with TB was (OR: 1.34, 95% CI: 1.10-1.63, P=0.001). According to the type of the countries subgroup analysis, the risk of HCV infection in patients with TB in developing countries was (OR: 1.95, 95% CI: 1.00-3.80), which was higher than the risk in developed countries (OR: 1.47, 95% CI: 1.42-1.52). In addition, the risk of hepatitis C infection in men compared to women (OR: 1.84, 95% CI: 1.75-1.94, P=0.001) and in age groups over 65 yr compared to other age groups (OR: 1.46, 95% CI: 0.98-2.16) was significantly higher.

The results of this study emphasized the importance of screening HCV in patients with TB. Being aware of the presence or absence of HCV in these patients can contribute to their effective treatment.

Reducing the under-five child mortality is vital to a nation’s development; global progress has been made in the past two decades. Nevertheless, substantial efforts in the Sub-Saharan Africa region are required to address critical risk factors to attain the Sustainable Development Goals (SDGs) by 2030. We aimed to identify the impact of socio-economic, demographic, and geographic factors on under-five child mortality in Kenya.

This study utilized data from the 2022 Kenyan Demographic and Health Survey (KDHS). We extracted mortality data for children under the age of five and demographic, socio-economic, and household/geographic factors.

Overall, 19,530 children under the age of five yr were included, with 9,950 (50.95%) males and 9,580 (49.05%) females. Amongst children, 18,836 (96.45%) were alive and 694 (3.55%) were dead. Study findings revealed a significant association between the mother’s age and the child's death. Mothers aged between 15 and 19 yr of age indicate higher odds of child death. The odds of death of children not breastfed is 1.69 times that of other children. Mothers who had no child above five years old previously had higher odds of child mortality than those with at least three children above five years old.

Under-five child mortality is significantly associated with breastfeeding, the mother’s age, and mothers who had a child previously in Kenya. The identified significant determinants align well with the SDG 2030 targets of improving socio-economic status, healthcare systems and reducing inequality. Therefore, the study suggests that preventing underaged women’s pregnancy, proper maternal nutrition among pregnant women, and breastfeeding should be practiced as they are more likely to reduce under-five child mortality.

The most important and remarkable aspect of occupational neoplasms is that they are preventable. We aimed to examine the trends and projections of mortality rates attributed to occupational neoplasms (MAON) and occupational tracheal, bronchus, and lung cancer (MAOLCa) in the world, G7 countries, and Turkey from 1990 to 2040.

The study was ecological one. Data for the study were obtained from the Global Burden of Disease (GBD) Foresight Visualization. For the study, time points were set every five years. For each time point, the age-standardized MAON, MAOLCa, and their 95% confidence intervals (CIs) were recorded. Rates were analyzed by joinpoint regression analysis.

Globally, MAON was projected to decrease from 3.81% in 1990 to 2.83% in 2040. According to the joinpoint regression analysis, the joint year for the world was 2020. In Germany, the US, the UK, Italy, Canada and Turkey, the trend for MAON showed a decrease, similar to the global trend. However, MAON was stable in France and increased in Japan. Globally, MAOLCa was expected to decline gradually from 19.44% to 16.82% from 1990 to 2040. In the US, France and Turkey, the trend for MAOLca decreased, similar to the global trend. However, it was stable in the UK, Italy, and Canada and increased in Germany and Japan.

MAON tended to decrease worldwide and in the six countries, except France and Japan. MAOLCa tends to decrease worldwide, in the US, France, and Turkey, increase in Germany and Japan, and remain stable in the UK, Italy, and Canada.

WeChat public platform has become an important source for the public to obtain health information. We aimed to explore the key factors affecting users’ willingness to adopt health information and their action mechanisms.

From April 2023 to May 2023, the users of WeChat public platforms were surveyed via online questionnaires, and the factors influencing users’ willingness to adopt health information and their action mechanisms were analyzed using quantitative statistics and structural equation model (SEM).

The influencing factors of users’ willingness to adopt health information in WeChat public platforms could be divided into the following three dimensions: health belief, information, and platform. Perceived benefits, perceived threats, information quality, source credibility, and platform atmosphere all have significantly positive effects on information adoption willingness. Among them, information quality also positively affects users’ perceived benefits; perceived barriers negatively affect the willingness to adopt information.

Through the analysis of the influencing factors of users’ willingness to adopt health information in WeChat public platforms, it could provide reference for enhancing the public health information service capability of WeChat public platforms and elevating the health self-management level of the public.

Understanding the general health and well-being of the aged population requires an understanding of several factors, among which the interplay between physical activity and sleep quality are the most efficient determinants. There is still much to learn about the precise ways that different components of sleep quality affect different kinds of physical activity in older persons, accordingly, the study aims to provide a comprehensive understanding of the interaction between these variables.

An online questionnaire-based investigation was conducted between August and September 2023. This cross-sectional study analyzed data from 1,437 participants aged 50 to 89 years. The questionnaire evaluated levels of physical activity, sleep satisfaction, and demographic data. We used cluster analysis, regression analysis, and factor analysis to investigate the connections between these variables.

Factor analysis revealed a single factor that accounted for 51.95% of the variance in all variables linked to sleep, and this factor represented overall quality of sleep. Regression analysis revealed that gender significantly predicted sleep quality, with females reporting lower sleep satisfaction. While strenuous exercise did not significantly affect sleep quality, moderate exercise was a positive predictor of sleep quality that neared statistical significance. Furthermore, cluster analysis revealed that those who engaged in more physical activity had higher-quality sleep.

These results highlight the significance of encouraging physical activity to improve older adults' sleep quality. Specific programs that promote moderate exercise may enhance this population's general health and sleep quality. Future research should focus on longitudinal studies to create causality and modify intervention strategies aimed at promoting healthy aging.

We aimed to determine whether the prepregnancy cerclage for women with cervical incompetence with absent ecto‑cervix affects the time from surgery to conception and subsequent pregnancy outcome.

This retrospective study was carried out on patients with at least one previous history of second-trimester abortion and extremely short cervix found by gynecological examination. A total of 40 cases of McDonald's cerclage before pregnancy were performed. The time from surgery to conception and pregnancy outcome were followed up for 4 years. The main outcomes were the time from surgery to conception, and the gestational week of delivery, miscarriage rate, preterm delivery rate.

Between September 2018 and December 2022, 37 women became pregnant following prepregnancy cerclage. In total, 36 babies were born to 37 mothers. The recurrence rate of second-trimester miscarriage was 8.11% (3/37) and the preterm birth rate was 29.73% (11/37). Mean time from surgery to conception was 38w (range 2w-160w).Mean gestational age at delivery was 36 weeks +4 (256 days).The live birth rate was 100%. There were no maternal complications, no intestinal and bladder injuries.

Cervical incompetence patients with absent ecto‑cervix may benefit from prepregnancy cerclage without affecting the interpregnancy interval.

We aimed to identify the factors influencing safety accident management activities for hospitalized children in children’s hospitals.

In August 2022, data were collected from 170 nurses across seven children’s hospitals in Gwangju Metropolitan City, Korea. The collected data were analyzed using independent t-tests, analysis of variance, Pearson’s correlation analysis, and multiple regression analysis.

Safety accident management activities for hospitalized children differ significantly based on nurses’ experience in children’s hospitals (P=0.048). Safety accident management activities were positively correlated with patient safety culture (r=0.47, P<0.001), critical thinking (r=0.35, P<0.001), and nursing work environment (r=0.51, P<0.001). Furthermore, the most influential determinant of safety accident management activities for hospitalized children was the nursing work environment (β=0.42, P<0.001), followed by nurses’ experience in children’s hospitals (β=0.20, P=0.004), and patient safety culture (β=0.17, P=0.041). These variables had an explanatory power of 34.0 % (adjusted R2=0.34, P<0.001).

A positive nursing work environment and strong patient safety culture are essential for increasing safety accident management activities among children’s hospital nurses. Additionally, children’s hospitals should provide support to the nursing staff and implement policies that encourage long-term retention of experienced nurses.

Obesity is an epidemic non-communicable disease in South Africa (SA). Few data exist on rural schoolchildren. This study presented the association between paediatric obesity, anthropometric parameters and physiological traits in schoolchildren in the Alice Location of Raymond Mhlaba Municipality, South Africa.

The sum of 305 schoolchildren including girls 146; boys 159 between 5 – 7 years old were enrolled. Body mass index (BMI) specific for gender and age was used to describe overweight and obesity. Systolic/Diastolic blood pressure (SBP and DBP) was ≥ 90th percentile for gender and age. An aneroid sphygmomanometer was used to measure blood pressure (BP).

15.75% of girls were overweight compared to 10.69% of boys while 16.35% of boys were obese compared to 10.27% of girls. Pre-hypertension was detected in both girls (2.0%) and boys (0.3%). SBP and DBP were significantly (P<0.05) associated with body mass, stature, BMI, hip and waist circumference (HC & WC), the sum of skinfolds, fat-mass (FM), fat-free mass (FFM), and fat-free mass index (FFMI).

Overweight, obesity and pre-hypertension are predominant amongst rural SA schoolchildren living in Alice location. Routine check-up and control of excessive weight gain in schoolchildren is crucial for early prevention of potential cardiovascular diseases in the future.

Dry mouth, masticatory discomfort, and swallowing in older individuals are important factors affecting overall health. To improve their quality of life, efforts are required to improve their oral function. Therefore, this study implemented a training program evaluating oral function to confirm improvements in swallowing.

The study was conducted for approximately 4 months, from Jul to Oct 2023. Participants aged 65 yr or older were selected from welfare facilities in the metropolitan region, with 24 participants in both the intervention and control groups.

As a result of a study conducted on oral function training program, the intervention group exhibited significant improvements in the simulated swallowing flow rate (P <0.05), bite force (P <0.001), and tongue pressure (P <0.001).

The oral function training program effectively improved simulated swallowing flow rate, bite force, and tongue pressure. Consequently, there is an opportunity to implement oral function training programs at accessible welfare centers for older individuals in the community.

M6A RNA methylation and the tumor microenvironment (TME) have been reported to play important roles in the progression and prognosis of clear cell renal cell carcinoma (ccRCC). However, whether m6A RNA methylation regulators affect the TME in ccRCC remains unknown. Thus, we aimed to evaluate comprehensively the effect of m6A RNA methylation regulators on the TME in ccRCC.

Transcriptome data of ccRCC were obtained from TCGA database. Consensus clustering analysis was conducted based on the expression of m6A RNA methylation regulators. Survival differences were evaluated by Kaplan–Meier analysis between the clusters. The DESeq2 package was used to analyze the differentially expressed genes (DEGs) between the clusters. GO and KEGG pathway analyses were performed by the ClusterProfiler R package. The CIBERSORT algorithm was used to evaluate immune infiltration.

The expression of 15 m6A regulators significantly differed between ccRCC and normal kidney tissues. Based on the expression of these 15 m6A regulators, two clusters were identified by consensus clustering, in which cluster 1 had better overall survival (OS). Overall, 4,429 DEGs were identified between the two clusters and were enriched in immune-related biological processes. Cluster 1 had lower immune and ESTIMATE scores, higher expression of HLA and lower expression of immune checkpoint molecules. Moreover, immune infiltration and expressions of Th1/IFNγ gene signature were also significantly different between the two clusters.

Our study revealed m6A regulators were important participants in the development of ccRCC, with a close relationship with the TME.

We investigated the changes of Heart Rate Variability (HRV) parameters, which reflect the state of the regulatory mechanisms of cardiovascular system, among medical students during routine academic period and examination session.

The study was conducted in Jan-Feb 2024, at the IHSM in Bishkek, Kyrgyz Republic, among the healthy 70 students (mean age 19.71 ± 1.54 years) from India and Pakistan. For each student, two ECG recordings were performed: one 3 weeks before the exam and one 10-15 minutes after exam.

The results of study demonstrated that after the exam, students presented significantly higher HR, AMo, SI, VLF, LF and lower SDNN, TP, HF compared before the exam (P<0.05). Distribution of students showed that on a routine academic period 53% of students belonged to sympathotonic, 14% to vagotonic and 33% to normotonic. During the examination period the number of sympathotonic increased to 74%, but the number of vagotonic and normotonic decreased to 4% and 22% respectively.

Each type revealed an individual reaction to exam stress: in the group of vagotonic there was a slight activation of the SNS; in sympathotonic students there was a tension of regulatory mechanisms, leading to depletion of adaptive mechanisms; in the group of normotonic there was a shift in the vegetative balance towards the sympathetic link of ANS.

Variations in the distribution and prevalence of pathogens in ticks can have significant consequences for human health. Information on these variables in Transcaucasia is scarce, so the aim of our study was to conduct a large-scale study to detect selected tick-borne infectious agents in Armenia.

Overall, 209 adult ticks were collected from different hosts including 4 samples from human clothes. We tested ticks using high-throughput microfluidic single-cell real-time PCR to detect 42 genospecies of pathogens. We used GIS to determine biotic and abiotic factors governing the prevalence of pathogens and applied statistical analyses to test the association between prevalence of pathogens depending on hosts, locality and environment.

From 209 samples, 134 were positive to targeted pathogens. Anaplasma phagocytophilum Foggie, 1949 was the most prevalent case (44%). The highest overall prevalence was observed in ticks from sheep (74%), followed by cows (67%) and calves (60%). The highest multiple infection rates were also detected in sheep (40%) and calves (40%) followed by cows (28%). One statistically significant association was found among co-infections (P<0.05). The prevalence of pathogens varied according to locality. The abundance of Anaplasma spp. is significantly correlated with “slope” and “vegetation” factors. Similar patterns were detected for other pathogens.

This was the first large-scale survey of multiple tick-borne pathogens in Armenia and Transcaucasia. The results of this study shed light on spatial variations in pathogen infection rate among adult ticks found on hosts and underline a number of environmental determinants of pathogen distribution among ticks.

Healthcare program monitoring can play a key role in evaluating their implementation and identifying their strengths and weaknesses.

This study was performed with the exploratory sequential mixed methods design in 2023 at Tehran, Iran. The information was categorized into indicators, refining, analysis, interpretation, reporting, and proposed challenges and recommendations.

Medical Sciences Department of Public Health (TUMSDoPH) evaluation of its public health programs revealed a comprehensive approach covering a wide spectrum from disease management to health promotion, emphasizing electronic health records, targeted disease interventions, and strategies for non-communicable diseases, alongside efforts to enhance community health.

There is a need for initiating “the monitoring committee” under the supervision of the deputy chancellor for public health to monitor key performance indicators and policies to discover the problems of each part of the health system and provide recommendations.

Cutaneous leishmaniasis (CL) is one of the most common parasitic diseases in many regions of Iran. It has a major role in deprived societies. We aimed to identify Leishmania species based on molecular as ITS1-rDNA-PCR internal transcribed spacer 1 (ITS1) region, microscopy, and culture techniques in diagnosing cutaneous leishmaniasis.

From April 2018 to May 2020, we conducted a cross-sectional study involving 32 patients with suspected CL lesions in Sistan and Baluchistan Province, located in southeast Iran. Samples were subjected to microscopic examination, culture, and PCR amplification targeting the internal transcribed spacer 1 (ITS1) region. DNA sequencing was performed on PCR-positive samples for species identification and phylogenetic analysis.

PCR demonstrated superior sensitivity (93.75%, 30/32) compared to culture (56.25%, 18/32) and microscopic examination (53.1%, 17/32). Molecular analysis revealed that L. major was the predominant causative agent of CL in the study area, with L. tropica occurring less frequently. Sequencing and phylogenetic analysis of the ITS1 region showed high intraspecies similarity among L. tropica isolates, while L. major isolates exhibited greater genetic diversity.

This study shows the co-existence of L. major and L. tropica in Mirjaveh, southeast Iran, with L. major as the primary cause. While L. tropica isolates displayed high genetic similarity, L. major samples were more diverse, indicating different epidemiological patterns. These findings highlight the importance of molecular methods for accurately identifying Leishmania species and understanding CL epidemiology in the region.

The world is changing rapidly, mainly due to the impact of megatrends that have an impact on the entire human life, particularly in medical sciences. Medical research methodologies such as cohort studies provide very critical information, but it is not clear what would be its destination in the future. In this short article, we have tried to offer a somewhat different perspective on the future of cohort studies by analyzing the texts and their conclusions from the author's viewpoint. According to our assessment, cohorts will play a key role in medical research, but their methodology will significantly change in terms of designing, implementing, analysing, and applying the findings. The new generation of cohort study extracts most of their information from electronic health records, and it is not just restricted to a particular geographic area. With the changes in the levels of occupational exposure, risk factors, and the introduction of Omics, likely, occupational and birth cohorts as well as human diseases will likely undergo fundamental changes in the future. Big data will provide researchers with new opportunities, but information extraction and analysis require a team of specialists from several scientific fields. Furthermore, participants are likely to play a more active role in setting priorities and implementing research findings.