International Journal of Preventive Medicine
Volume:4 Issue: 4, Apr 2013

About 100,000 Iranian have been exposed to chemical weapons during Iraq‑Iran conflict (1980‑88). After being spent of more than two decades, still about 30,000 of them are under follow‑up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long‑acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

The internet is a phenomena that changes human, specially the younger generation’s, life in the 21st century. Online communication is a common way of interacting among adolescents who experience feelings of social anxiety. The aim of this study was to investigate the relationship between social anxiety and online communication in adolescents. Three hundred and thirty students aged 13‑16 years were selected from eight middle and high schools in Isfahan by multistage cluster sampling. Each of them completed a survey on the amount of time they spent communicating online, the topics they discussed, the partners they engaged with and their purpose for communicating over the internet. They also completed the social anxiety scale of adolescents.Data were analyzed using Pearson correlation and multiple regression. Results of the Pearson analysis showed that online communication has a significant positive relationship with apprehension and fear of negative evaluation (AFNE), and a significant negative relationship with tension and inhibition in social contact (TISC) (P < 0.01). The results of regression analysis showed that the best predictor of online communication is AFNE, TISC. It is suggested that students from middle school get assessed in terms of the level of social anxiety. Then, the quality and quantity of their online communication should be moderated through group training and consulting and referral to medical centers, if needed. The results of this study may lead to optimal use of online communications and reduce the personal, social and psychological problems of adolescents.

Influenza disease is one of the oldest medical problems that can cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students’ knowledge, attitudes, and practices (KAP) is critical to save patientslife.The aim of this study was to determine the score of KAP toward the Pandemic H1N1 and their predictor factors among the medical and dental residents and fellowships of Shiraz University of Medical Sciences, Iran. In 2009, 125 participants were recruited in a convenient sampling cross‑sectional survey. Self‑reported questionnaire were used and results were analyzed applying appropriate statistical tests. The mean score of participants’ knowledge, attitude and practice were 22.6, 21.1 and 26.5 respectively. Participants practice had significant linear positive correlation with knowledge and attitude. Also, their age was significantly and directly correlated to knowledge and practice. The educational major, age, and sex were significant predictors of responder’s knowledge score and age was the only significant predictor of both attitude and practice scores. High knowledge is not sufficient lonely for improve attitude and practices.It seems that traditional educational models are not efficient and governments should emphasize to advanced and motivational education methods including health belief model and motivational interview at postgraduate levels. Perhaps younger students, dentists and males have less motivation to change their attitude and behavior, so we can focuses our interventions in these groups.

Based on literature, in vitro cholesterol removal of lactic acid bacteria has been accounted for their in vivo cholesterol reduction. But recently, it has been proposed that such in vitro characteristic may not be directly relevant to their in vivo activity. The objective of this study was to find how much in vitro cholesterol reducing potential of Lactobacillus plantarumA7 (LA7), a native strain isolated from an infant fecal flora, reflects its in vivo efficiency. LA7 previously showed serum cholesterol reducing capability in mice subjected to fatty diet. Here, we investigate whether the given strain is capable of in vitro cholesterol assimilation or consumption. LA7 was cultured in whole milk and de‑Man–Rogosa– Sharpe (MRS) added with water‑soluble cholesterol. Colorimetric method was adopted for cholesterol determination in both cultured media during incubation period. No cholesterol assimilation was detected by growth and incubation of the active culture in either of the medium. Thus, in vivo cholesterol function of LA7 was not caused by cholesterol consumption. A comprehensive review of literature on the related studies also showed that there are other documented studies’ evidenced the uncertainty of the direct relation between in vitro and in vivo studies. cholesterol removal from the cultured media may not be considered as an appropriate integral index for selection of Lactobacillus strains with cholesterol‑lowering activity.

Identification of disease risk factors can help in the prevention of diseases. In assessing the predictive value of continuous variables, a routine procedure is to categorize the factors. This yield to inability to detect non‑linear relationship, if exist. Multivariate fractional polynomial (MFP) modeling is a flexible method to reveal non‑linear associations. We aim to demonstrate the impact of choice of risk function on the significance of variables. We selected 6508 HIV‑infected persons registered in the Australia National HIV Registry between 1980 and 2003 to assess the predictors associated with the risk of death after HIV infection prior to AIDS. First, CD4 count as a categorical factor with three other categorical variables (age, sex, and HIV exposure category) was entered into the Cox regression model. Second, CD4 counts as a continuous variable along with other categorical variables were entered into the fractional polynomial (FP) model. Both the Cox and FP models showed age ≥ 40 years and hemophiliac patients were significantly associated with increased risk of death. In the categorized model, the CD4 variable did not reach the significance level. However, this variable was highly significant in the MFP model. The FP model showed slightly better performance in terms of discrimination ability and goodness of fit. The FP model is a flexible method in detecting the predictive effect of continuous variables. This method enhances the ability to assess the predictive ability of variables and improves model performance.

Vaccination against fatal viral and bacterial diseases is still the best protective way to lower morbidity and mortality rate in end‑stage renal disease (ESRD) patients. It has been reported that there is high incidence of low protective levels of IgG after vaccination in ESRD adult patients. The aim of this study was to evaluate the protective status of vaccination against diphtheria and tetanus in ESRD children after completing routine vaccination. This cross‑sectional study was carried on 83 participants less than 18 years including 27 patients on hemodialysis or peritoneal dialysis and 56 normal populations from February 2008 until December 2008 at St. Alzahra hospital, Isfahan, Iran. To determine anti‑tetanus and anti‑diphtheria antibodies level, Tetanus IgG ELISA kit (IBL International, Germany, RE56901) and Diphtheria IgG ELISA kit (IBL International, Germany, RE56191) were used. The participants must not received immunoglobulin, blood products or immunosuppressive medication in the current 6 months. The mean age of case and control group were 12.5 ± 2.7 years and 11.7 ± 3.3 years, respectively, P > 0.05. According to IgG levels, 93% of hemodialysis patients and approximately 87% of peritoneal dialysischildren needed booster doses of diphtheria vaccination. The results for IgG titer against tetanus revealed that in 91% of hemodialysis patients and 83% of peritoneal dialysis children booster doses of tetanus were recommended. Booster doses of vaccines may be required in ESRD children. Measuring serum IgG levels against vaccines to define protective levels are recommended.

Behavioral risk factors are responsible for a substantial portion of chronic disease. Educating patients is a professional responsibility of medical practitioners. However, it has been observed that physicians did not practice what they preach. We aimed to study whether medical colleges inculcate health‑promoting lifestyle among medical students during their stay in medical colleges. Two cross‑sectional study conducted in two conveniently selected medical colleges in southern India. Fourth year MBBS students were included in the study. A pre‑tested self‑administered multiple choice type questionnaire was used to collect data. Information was sought on the behavioral factors, namely smoking, alcohol use, junk food consumption, and physical activity, before joining the medical college and at the time of the study. Out of 176 respondents, 94 (53%) were males and 82 (47%) were females. The number of smokers had increased from 24 (13.6%) to 46 (26.1%) and the number of alcohol consumers from 34 (19.3%) to 77 (43.8%) since they joined medical college. The number of students doing any physical activity declined from 76 (43.2%) to 43 (24.4%) and their food habits became unhealthier during the same period. The study reported an increase in health‑risking behavior and a decline in health‑promoting behavior among medical students during their stay in medical college.

Different stressors induce learning and memory impairment and physical activity influence learning and memory enhancement. In this research, we investigated the effect of synchronized running activity with stress on acquisition and retention time of passive avoidance test. Male Wistar rats were randomly divided into five groups as follows: Control (Co), Sham (Sh), Exercise (Ex), Stress (St), synchronized exercise with stress (St and Ex) groups. Chronic restraint stress was applied by 6 h/day for 21 days and treadmill running 1 h/day for 21 days. For evaluation of learning and memory, initial and step‑through latency were determined at the end of study by using passive avoidance learning test. Our results showed that: (1) Exercise under no stress provides beneficial effects on memory acquisition and retention time compared to Control group; especially retention time had significantly (P < 0.05) increased in exercised group. (2) Chronic stress with and without synchronized exercise significantly (P < 0.01, P < 0.05, respectively) impaired acquisition and retention time. (3) Body weight differences were significantly (P < 0.01, P < 0.001 and P < 0.001) lower than Control group in exercise, stress and synchronized exercise with stress groups, respectively. (4) Adverse effects of restraint stress (psychical stress) were probably greater than physical activity effects on learning, memory and weight loss. The data confirmed that synchronized exercise with stress had not significantly protective role in improvement of passive avoidance acquisition and retention time; hence it did not significantly improve learning and memory deficit in stressed rats; whereas exercise alone could improve memory deficit in rats.

Compressive neuropathy of median nerve is relatively common but development of an hourglass like constriction is a rare phenomenon. The purpose of this study is to show morphologic changes of median nerve in advances carpal tunnel syndrome. Eighty patients with thenar atrophy, anesthesia and paresthesia of first, second and third finger and severe changes of EMG‑NCV were chosen for surgery. All the cases were operated by classic approach. At ten cases, nerve was constricted in point and in six patients’ area constriction was seen. Internal and external neurolysis was performed in all the cases. In two of them because of the wide and severe constriction, resection and end‑to‑end repair was performed. All the patients have been examined periodically. Mean follow‑up was 12 month (8‑40). According to grading, pain degree (from 8‑9 pre operation to 3‑4 post operation) and two point discrimination (from the mean of 14 mm (13‑20 mm) to 8 mm (6‑10 mm)) decreased. Grip power was increased from the mean of 10 kg to 21 kg. In 15 cases return of sensation, and in 13 cases improvement of opposition power was seen. We recommend epineurolysis for mild to moderate constriction and also end‑to‑end repair may be needed if extensive and severe constriction was found. It means that if we manage mild to moderate constriction sooner, it can prevent the need for further surgical procedure because of sever constriction.

Motivational interviewing (M.I.) is an option for modifying an individual’s behavior. It is used as an educational method in recent years. The aim of our study was to indicate whether or not education, using lecture alone and lecture with M.I., would affect the performance of nursing personnel regarding their hand hygiene. If so, which of these two methods were most effective for this purpose? This was an interventional study conducted in Bahrami Pediatric Hospital in Tehran. The study population consisted of all nursing personnel in the hospital. Considering the responsibilities of different nurses and their educational status, we divided them into three classes. The participants of each class were randomly assigned to either the control or experiment groups training lecture alone or lecture with M.I., respectively. We used Independent‑t, Paired‑t, Mann‑Whitney U and Wilcoxon signed ranks tests for analysis. Education using lecture alone improved the hand hygiene performance of nursing personnel only in the first and third classes (P = 0.002 and P = 0.001, respectively). Similarly, lecture combined with M.I. improved the hand hygiene performance of personnel in the first and third classes (P < 0.001 and P = 0.004, respectively). The latter method was more effective compared to lecture alone in the first and third classes (P < 0.001 and P = 0.013, respectively). Education based on lecturing improves hand hygiene performance among nursing personnel. It will be more effective if combined with M.I.

Increasing prevalence of obesity is a major health concern. Lifestyle behaviors and diet play an important role in developing childhood obesity. The aim of this study was to determine the association between major dietary patterns and overweight/obesity in a group of Iranian school‑aged children. This cross‑sectional study was conducted in Isfahan, Iran with 637 elementary school‑aged children. A semi‑quantitative food‑frequency questionnaire was used to assess usual dietary intakes. Data on socio‑demographic, physical activity and other lifestyle habits were collected using standard questionnaires. Obesity was determined based on national cut‑offs. Factor analysis was used for identifying major dietary patterns. Three major dietary patterns were extracted; “Healthy,” “Western,” and “Sweet‑Dairy.” After adjusting for confounders, girls in the second quartile of healthy pattern, were more likely to be overweight (odds ratio [OR] =2.23, Confidence intervals [CI] =1.003, 4.96) compared to those in the highest quartile. Likelihood of being overweight was lower for girls in the second quartile of western dietary pattern versus the fourth quartile (OR = 0.46, CI = 0.21, 1.01). Accordingly, lower adherence to sweet and dairy pattern was associated with lower body mass index (BMI) among girls (OR = 0.42, CI = 0.21, 0.85). There was no significant relationship between western and sweet‑dairy pattern with BMI among boys, however, significant association was observed between lowest and highest quartiles of healthy pattern (OR = 0.36, CI = 0.15, 0.84). We found significant associations between the three dietary patterns and obesity among girls. Only healthy pattern was related to weight status of schoolboys. Longitudinal studies will be needed to confirm these associations.

The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult re sidents of Shiraz, Iran. In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking <1 year; 13.4% smoked 1-2 years and 73.9% smoked>2 years. Almost half of those surveyed (48.9%) smoked <10 cigarettes per day (cpd); 28.4% smoked 10-15 cpd; 14.8% smoked 16-19 cpd, and 8%>20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Prevalence of hookah smoking in women approximated that of men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

Considering the importance and prevalence of obesity and the desire to lose weight, especially among women, this study intended to investigate the relationship between Body Mass Index, body satisfaction, and weight control behavior among women employees in Isfahan. An analytical cross‑sectional study was conducted among 408 women who were selected by stratified random sampling method among employees at Isfahan University and Isfahan University of Medical Sciences during 2012. The data collection tool was a multidimensional questionnaire which comprised two sections: Demographic Tool and Body Satisfaction Tool (7 items), Weight Control Behavior Scale (18 items). Age, marital status, educational level, and multiparity were significantly correlated with body size satisfaction. Seventy‑five participants were dissatisfied with their weight and 60.5% reported a desire to lose weight; 92.15% of women studied had participated in a healthy dieting behavior and 10.8% of them had participated in an unhealthy one during the past six months. There was an inverse correlation between body satisfaction and Body Mass Index (BMI) (r = −0.64, P = 0.001). Ninety percent of participants had at least one of the dieting behaviors. There was an inverse significant relationship between body satisfaction and dieting behaviors (r = −0.19, P = 0.001). Due to the importance of the prevention of obesity and the necessity of having a normal BMI in order to prevent subsequent complications, precise self‑evaluation of body size can be used to focus on designing and conducting public health programs, especially for women.

This study aimed to assess the salt intake of Iranian children, and to assess the correlation of urinary electrolytes excretion with blood pressure. This cross-sectional study was conducted in 2011-2012 among 3-10- year-old children, selected by multi-stage cluster sampling from urban and rural areas of Isfahan, Iran.The sodium (Na), potassium (K) and creatinine (Cr) were measured in a random sample of the children’s first morning fasting urine. Three- day averages of dietary intakes were analyzed by the Nutritionist-4 software. The mean (SD) of urinary Na was 177.17 (28.68) mEq/day without significant difference according to gender and living area. The mean (SD) dietary intakes of Na and K were 2017.76 (117.94) and 1119.06 (76.03) mg/day, respectively. Children of urban and rural areas consumed similar sources of salty foods (bread, cheese and snacks) and had low intake of vegetables. No significant association was documented between urinary electrolytes excretions and blood pressure. This study, which to the best of our knowledge is the first of its kind in the Middle East and North Africa region, revealed that Iranian young children consume a large amount of sodium and small amount of potassium. The non-significant associations of electrolyte excretions with blood pressure may be because of the very young age group of participants. Given the development of preference to salt taste from early childhood, and the tracking of risk factors of chronic diseases from this age, reducing salt intake of young children should be emphasized.

HIV/AIDS continues to be a major global health problem. The aim of this study was to evaluate common opinions and beliefs about HIV/AIDS among Iranian teenager girls. This Qualitative study (face‑to‑face interviews with tape recording) was conducted among fifty female teenager school students inUrmia‑Iran. The thematic analysis indicated the main information sources for HIV/AIDS among teenage girls to be their mother and teachers. The participants had little concern about the dissemination of HIV/AIDS in Iran. Using a common syringe is mentioned as the main risk factor for HIV transmission. There were some misconceptions about the at‑risk group among teenage girls. Considering the misconceptions among the teenage girls, their beliefs should be reformed and reorganized in order to reduce the risk of exposure to HIV. The best practice is training life skills in the school level.