Publications by authors named "Firouz Amani"

18 Publications

  • Page 1 of 1

Pentacam Indices in Photorefractive Keratectomy Surgery.

J Med Life 2020 Oct-Dec;13(4):523-529

Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.

Refractive eye surgeries are one of the most non-emergent ophthalmic surgeries due to the effect on the reduction of refractive errors, increasing visual acuity, enhancing the quality of vision, and indirectly increasing the quality of life of patients. The aim of this study was to determine Pentacam indices in the patients who underwent photorefractive keratectomy (PRK) during 2014-2018, as well as to show their correlation with the type of refractive error. This descriptive cross-sectional study was performed on 2215 eyes of 1125 patients undergoing PRK surgery. The patients' checklist, including demographic information, refractive index, keratometry, pachymetry, corneal surface zone indices, and progressive corneal thickness indices, was provided. All data were analyzed using the IBM SPSS software, version 25. The findings showed that there was a significant association between posterior corneal astigmatism (PCA) and anterior corneal astigmatism (ACA) (p=0.00). The mean Kmax front was recorded as 44.844 ± 1.58 D, which was significantly correlated with the type of refractive errors (p=0.00). According to the findings, there was a significant relationship between anterior chamber indices and refractive error types and their severity (p=0.00). There was also a significant correlation between the surface zone and keratoconus indices (i.e., index of surface variance - ISV, index of vertical asymmetry - IVA, index of height asymmetry - IHA, and minimum radius of curvature - Rmin) with refractive errors (p=0.00). The findings showed that some of the Pentacam indices could be related to the types of refractive errors in patients undergoing PRK surgery. Therefore, their evaluation is of great importance in this regard.
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January 2021

The Incidence of Minor β-thalassemia Among Individuals Participated in Premarital Screening Program in Ardabil Province: North-west of Iran.

Mater Sociomed 2019 Dec;31(4):294-297

Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

Introduction: The most effective way to prevent thalassemia is to screen for the disease at the population level and then to evaluate the molecularity of individuals. Considering the importance of minor β-thalassemia and its high prevalence in societies.

Aim: to investigate the incidence of minor β-thalassemia among Individuals participated in Premarital Screening Program in Ardabil province: North-west of Iran.

Methods: This descriptive cross-sectional study was conducted on 39620 individuals participated in the national screening program for Minor β-Thalassemia. Of them 1925 cases had mean corpuscular volume (MCV) < 80 in one person or couple which referred to HbA2 concentration check.

Results: Of all 1925 cases, 95 cases (4.93%) had HbA2>3.5 and defined as Minor β-Thalassemia. The total incidence of minor β-thalassemia among all participated people was 2.4%. Of thalassemia cases 48.4% were women and 51.6% were men. Of all β-thalassemia cases, 49.5% live in Ardabil city and rest of them live in other cities.

Conclusion: Results showed that the prevalence of minor β-thalassemia in Ardabil province was lower than country average rate and a study should be done in future for exact estimation of the disease.
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December 2019

Effect of Music Therapy with Periorbital Massage on Chemotherapy-Induced Nausea and Vomiting In Gastrointestinal Cancer: A Randomized Controlled Trail.

J Caring Sci 2019 Sep 1;8(3):165-171. Epub 2019 Sep 1.

Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Music and massage therapy are among the approaches of complementary medicine. Patients with cancer have been hugely encouraged in recent years to use complementary medicine to relieve chemotherapy-induced nausea and vomiting. The present study was conducted to determine the effect of music and periorbital massage therapy on chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancers. The present single-blind clinical trial study was conducted on 60 patients with gastrointestinal cancer undergoing chemotherapy who were randomly assigned to control and music plus massage therapy groups. Two interventions were concurrently carried out on patients in music plus massage therapy group while receiving chemotherapy medication, but the control group received no intervention. Rhodes questionnaire was used to assess nausea and vomiting before and 24 hours after chemotherapy. Data were analyzed using descriptive and analytical statistical tests (Chi-square and t-tests). Music plus periorbital massage therapy significantly reduced nausea and vomiting in patients undergoing chemotherapy compared to the control group. According to the results, using music plus periorbital massage improves nausea and vomiting in patients undergoing chemotherapy, and can be considered as a complementary medicine method in conjunction with other medicinal therapies to relieve symptoms of patients with cancer.
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September 2019

Epidemiologic Trend of Smear-Positive, Smear-Negative, Extra Pulmonary and Relapse of Tuberculosis in Iran (2001-2015); A Repeated Cross-Sectional Study.

J Res Health Sci 2017 05 20;17(2):e00380. Epub 2017 May 20.

Department of Biostatistics and Epidemiology, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Trend analysis is an important tool to monitor epidemiological changes of disease over time to guide resource allocation. This study aimed to study incidence trends and change-points of smear positive, smear negative, extra-pulmonary and relapse of tuberculosis (TB) in Iran from 2001 to 2015.

Study Design: Repeated cross-sectional study METHODS: Nonlinear segmented regression was used to describe TB incidence trends; annual percent change (APC), average annual percent changes (AAPC) and change points for each disease separately.

Results: Of 154930 TB cases, 49.8% were smear positive, 19.7% smear negative, 27.32% extra-pulmonary and 3.18% relapse. For all TB types, the peak of incidence was in 2001. Two change point were estimated for all TB types (P<0.05). The APC of all TB types were -6.51 (95% CI: -7.4, -5.4) for first and 2.4 (95% CI: 0. 7, 4.1) for second segment. Although the trends were significantly decreasing from 2001 to 2015 for smear positive (AAPC=2.06%), smear negative (AAPC=3.57%), extra pulmonary (AAPC=3.2%) and relapse (AAPC=3.3%), the AAPCs of trends were not significant from 2006 to 2015. Except for Extra pulmonary TB (APC=4-.9%, 95%CI:-10, 1.2), the APCs of the last segments were significant.

Conclusions: Even though the TB incidence rates were decreasing, the amount of reductions seem inadequate, to reach the goals of TB control in Iran. Especially, the increase in the extra-pulmonary TB rates is a point of concern that highlights more attention is required for these cases. It is essential to improve economic supports toward TB control, illegal immigrants, data registry systems and physician's sensitivity in TB detection.
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May 2017

Study Frequency of Hypertension and Obesity and their Relationship with Lifestyle Factors (Nutritional Habits, Physical Activity, Cigarette Consumption) in Ardabil City Physicians, 2012-13.

Indian J Community Med 2016 Oct-Dec;41(4):268-272

School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Background And Objective: Few studies have been done on lifestyle of Iranian physicians. As physicians have important role in health promotion, the main goal of the study was to assess the lifestyle of this influential group.

Materials And Methods: A cross-sectional descriptive study was conducted on lifestyle of all registered physicians of Ardabil hospitals, Iran, 2012-13. In this research, 225 physicians were selected, by using simple random sampling. Demographic and lifestyle data were obtained by self-report using standard questionnaires, physical activity by official Iranian short-version of the international physical activity questionnaire, and dietary intake by food frequency questionnaire. Weight and height was performed according to standard protocols by using standardized and zero calibrated instruments. Data were analyzed by inferential statistics using Statistical Package for the Social Sciences. 16 software.

Results: Findings showed that 8% of participants were hypertensive, 21.3% smoker, 40%-47% inactive, 51.1% overweight, and 18.2% obese. There was a significant relationship between blood pressure and self-reported lifestyle habits ( < 0.05). And 70.7% of males and 74.1% of females had regular 10-min walking each day and moderate activity of males was significantly higher than females ( < 0.05). Food frequency weekly consumption of overweight and obese physicians were significantly higher than normal weight physicians ( < 0.05).

Conclusion: Few doctors follow a healthy lifestyle; this may have a negative effect on society attitude about health.
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November 2016

Factors Affecting Preferences of Iranian Women for Breast Cancer Screening Based on Marketing Mix Components.

Asian Pac J Cancer Prev 2016 ;17(8):3939-43

Community Medicine Group, Faculty of Medicine, Ardabil University of Medical Sciences, Ardebil, Iran E-mail :

Background: According to recent statistics, the breast cancer rate is growing fast in developing countries. In North West Iran, the incidence of breast cancer after esophageal and gastric cancers has the highest rate. Previous studies have also indicated that women in this region show reluctance to do breast cancer screening. There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience.

Materials And Methods: In the present qualitative study, thirty-two women with breast cancer were interviewed about their experiences of breast cancer screening. A semi-structured interview guide was designed to elicit information specific to the 4 P's in social marketing.

Results: Three main categories emerged from the analysis: price, service and promotion. Subcategories related to these main categories included factors effective in increasing and decreasing cost of screening, current and desirable features of screening services, and weakness of promotion.

Conclusions: Screening programs should be designed to be of low cost, to meet patients' needs and should be provided in suitable places. Furthermore, it is essential that the cultural beliefs of society be improved through education. It seems necessary to design an executive protocol for breast cancer screening at different levels of primary health care to increase the women's willingness to undergo screening.
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February 2017

Amblyopia Prevention Screening Program in Northwest Iran (Ardabil).

Int J Prev Med 2016 1;7:45. Epub 2016 Mar 1.

Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Background: The aim of this study was to evaluate the results of amblyopia screening in Ardabil Province in three examination levels by kindergarten teacher, optometrist, and ophthalmologist.

Methods: In a cross-sectional study, the results of the national amblyopic prevention program in 2-6 years old children in Ardabil Province were investigated in 2012. The results pertained to the examinations of children participating in this research were collected in the national approved forms. The data were entered into the computer and were analyzed using statistical methods in SPSS 18.

Results: Around 38,844 children (51.7%) out of 75173 with 2-6 years old qualified children participated in the screening program in Ardabil Province. In the first stage of screening, 1068 children (33.1%) are visually impaired in one eye and 2160 children (66.9%) are visually impaired in two eyes. In the second stage, the results related to the examinations by optometrists indicated that the prevalence of refractive errors, strabismus, and others were 70%, 27.8%, and 2.2%, respectively. Refractive errors problem was most prevalent in Ardabil city (72.6%).The prevalence of refractive errors, strabismus, and other reasons in amblyopic children was 51.3%, 23.9%, and 24.8%; respectively.

Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.
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April 2016

Epidemiology of Childhood Cancer in Northwest Iran.

Asian Pac J Cancer Prev 2015 ;16(13):5459-62

Assistant prof in Pediatrics, Ardabil University of medical Science, Iran E-mail :

This case series study was performed for all 83 children below 14 years old suffering from cancer during 2010-2013 who were registered in Ardabil pediatric cancer registry (APCR). The required data were collected by questionnaire and analyzed with SPSS.19 statistical methods software. Some 51 (61.4%) of cases were male. The mean age of patients was 5.8 years. Of the total, 60 (72.3%) of cases were from urban areas. Results showed that leukemia with 54.2%, CNS with 12% and neuroblastoma with 8.4% were the most prevalent childhood malignancies in Ardabil province. Based on the under 14 year old population estimated from Ardabil province, the cumulative incidence rate was 95.4 patients per one million. The incidence rate was relatively high so that childhood cancers should be considered as an important issue in health policy making in Ardabil province of Iran.
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May 2016

Association between hepcidin, haemoglobin level and iron status in stage 4 chronic kidney disease patients with anaemia.

J Pak Med Assoc 2015 Apr;65(4):354-7

Department of Dialysis, Ardabil University of Medical Sciences, Ardabil, Iran.

Objective: To explore the probable association of serum hepcidin and haemoglobin levels with iron and inflammation statuses in patients of chronic kidney disease stage 4 with anaemia.

Methods: The cross-sectional study was conducted at Tabriz University of Medical Sciences, Iran, from March 2011 to October 2012, and comprised patients of chronic kidney disease stage 4 with anaemia. Serum biochemical factors as well as hepcidin, ferritin, interleukin 6, high sensitivity C-reactive protein and iron levels were measured using standard methods. Statistical correlations were established using regression analysis and Pearson's correlation coefficient.

Results: There were 40 patients among whom 15(37.5%) were males and 25(62.5%) were females with an overall mean age of 55.68±14.4 years. There was a significant inverse relationship between hepcidin and haemoglobin levels (p<0.05). There were significant correlations between hepcidin with iron status, nutritional and inflammatory markers such as ferritin, Total iron binding capacity, albumin and interleukin 6 (p<0.05 each).

Conclusions: Hepcidin had negative correlation with haemoglobin level in stage 4 chronic kidney disease patients with adequate iron stores, which could be effective in the development of anaemia in such patients.
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April 2015

Lupus-like membranous nephropathy: Is it lupus or not?

Clin Exp Nephrol 2015 Jun 4;19(3):395-402. Epub 2014 Jul 4.

Department of Pathology, Rush Medical College, Chicago, IL, USA.

Background: Membranous glomerulonephritis is typically classified as idiopathic or secondary to systemic lupus erythematosus (SLE), hepatitis B, drugs, toxins, other infections, or malignancy. Not infrequently in some patients without a definite diagnosis of SLE, pathologic features of secondary membranous nephropathy are seen e.g., mesangial and/or subendothelial deposits, tubuloreticular inclusions, and full house immunofluorescence. In these patients, there is uncertainty about the etiology, response to therapy, and prognosis of membranous GN.

Methods: We retrospectively reviewed the charts of 98 patients with membranous GN at San Francisco General Hospital and John Stroger Hospital of Cook County over a 10-year period. Data were collected and analyzed using SPSS.18.

Results: Thirty-nine (40 %) had idiopathic membranous GN (Group 1), thirty-six (37 %) had lupus membranous GN (Group 2) and twenty-three (23 %) had some pathological features of secondary membranous GN, but no definite etiology of membranous GN (Group 3). At baseline (at time of renal biopsy) and after mean follow-up of 3.5 years, the average serum creatinine (in mg/dL) in Group 1 was (1.6 ± 1.0 versus 1.6 ± 1.7), Group 2 was (1.8 ± 2.5 versus 1.2 ± 0.9) and Group 3 was (1.1 ± 0.4 versus 1.27 ± 0.83), respectively. For the same time points, the average urine protein to creatinine ratio (g/g) in Group 1 was (9.8 ± 7.1 versus 5.7 ± 6.7), Group 2 was (4.2 ± 3.9 versus 1.7 ± 2.2), and Group 3 was (7.4 ± 5.7 versus 3.1 ± 3.8). In addition, during the follow-up period, eleven of 39 (28 %) in Group 1, two of 36 (6 %) in Group 2, and three of 23 (13 %) in Group 3 progressed to end-stage renal disease and were started on dialysis.

Conclusions: It appears that patients with lupus membranous GN have better renal prognosis than patients with idiopathic membranous GN. The renal prognosis for patients with pathological features of lupus membranous but no diagnosis of systemic lupus (lupus-like membranous GN) falls in between. Further studies are needed to determine if Group 3 patients can (a) definitively be classified as true idiopathic membranous GN or lupus membranous GN or (b) they have a separate disease from either M-type phospholipase A2 receptor membranous nephropathy or systemic lupus-induced membranous nephropathy.
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June 2015

Does lipoic acid consumption affect the cytokine profile in multiple sclerosis patients: a double-blind, placebo-controlled, randomized clinical trial.

Neuroimmunomodulation 2014 6;21(6):291-6. Epub 2014 May 6.

Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: A limited amount of data exists regarding the effect of lipoic acid (LA), an oral antioxidant supplement, on cytokine profiles among multiple sclerosis (MS) patients.

Objective: We aimed to assess the effect of daily consumption of LA on the cytokine profiles in MS patients.

Methods: In this double-blind, placebo-controlled, randomized clinical trial, 52 relapsing-remitting MS patients with an age range of 18-50 years were recruited into 2 groups: LA consumption (1,200 mg/day) or placebo. Patients followed their prescribed supplements for 12 weeks. Fasting blood samples for cytokine profile measurement were collected at baseline and after the intervention. Anthropometric parameters were measured based on the standard guidelines.

Results: INF-γ, ICAM-1, TGF-β and IL-4 were significantly reduced in the LA group compared to the placebo group [(INF-γ: 0.82 ± 0.2 vs. 0.2 ± 0.2 pg/ml, p < 0.0001), (ICAM-1: 20.2 ± 9.4 vs. 8 ± 10 ng/ml, p = 0.0001), (TGF-β: 103.1 ± 20.2 vs. 54.9 ± 26 ng/ml, p < 0.0001) and (IL-4: 0.1 ± 0.1 vs. 1.02 ± 1.7 ng/ml, p = 0.0112)]. No significant changes in TNF-α, IL-6, EDSS and MMP-9 were found between the LA and placebo groups (p = 0.6, p = 0.8, p = 0.09 and p = 0.8, respectively).

Conclusion: The results suggested that consumption of 1,200 mg LA per day beneficially affects several inflammatory cytokines including INF-γ, ICAM-1 TGF-β and IL-4. Further investigations are needed to verify the beneficial role of LA on other cytokine profiles among MS patients.
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March 2015

Global epidemic trend of tuberculosis during 1990-2010: using segmented regression model.

J Res Health Sci 2014 ;14(2):115-21

Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran.

Background: Tuberculosis (TB) is a pandemic disease. It is the second leading cause of death from infectious diseases after human immunodeficiency virus (HIV) in the world.The main objective of this paper was to determine and compare the epidemiology of TB incidence rate and its trend changes during 1990-2010 in six WHO regions regarding age, gender and income levels.

Methods: The Average Annual Percent Change (AAPC) and Annual Percent Change (APC) of TB incidence, mortality, treatment-successes, case detection rates, as well as change points of trend was estimated using segmented regression model. The number of change points was selected by the permutation procedure based on likelihood ratio test.

Results: Two change points for global TB incidence rate trend with AAPC5years equaling -1.4 % was estimated, the maximum AAPC5years of six regions was attributed to the American region (-3.5%). AACP of TB treatment-successes rate for Eastern Mediterranean (+2.2), the Americas (+1.6), south East Asia (+.8) and Global (+1.1) were significant (P<0.05). Moreover AACP5years of TB case detection rate for South East Asia (+7.5), Eastern Mediterranean (+4.9), Africa (+2.8) and the Americas (+1.7) were significant (P<0.05). Globally, all of income categories had descending trend of TB incidence and mortality rate, except the upper-middle income level that had ascending incidence trend (AAPC=+0.7%).

Conclusions: Globally, TB incidence and mortality rates have downturn trend and TB treatment successes and detection rates have upward trend, but their changes rate are insufficient to reach the goal of TB stop strategy. The economic levels have effect on trend, with no clear pattern, so it seems necessary that evaluation TB control programs based on characteristics of countries for reach TB control goals.
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November 2015

Healing initial of appendectomy infection wounds with aggressive washing method.

Iran Red Crescent Med J 2013 Sep 5;15(9):786-8. Epub 2013 Sep 5.

Ardabil University of Medical Sciences, Ardabil, IR Iran.

Background: Appendicitis is one of the most common causes of mortality, despite medical advances it continues to be a major problem.

Objectives: The main goal of this study was healing initial of appendectomy infection wounds with aggressive washing method.

Patients And Methods: This study is a semiexperimental investigation which was performed on 300 patients with perforated appendicitis and infected ulcers who were selected randomly during 2001-2005. Patients were investigated with aggressive washing and primary repair, and necessary data was collected and analyzed.

Results: From all patients, 284 were improved, and 16 cases were complicated, from them 10 patients in the first week, 4 patients in the second week, and 2 patients in the third week had ulcer infection.

Conclusions: The results showed that aggressive washing method is an effective technique in patients with perforated appendicitis and wound infection.
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September 2013

Epidemiology of esophageal cancer in ardabil province during 2003-2011.

Asian Pac J Cancer Prev 2013 ;14(7):4177-80

Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran. s.sadeghiyeh

Background: The aim of this research was to perform an epidemiologic survey of esophageal cancer in Ardabil province.

Materials And Methods: In this cross-sectional descriptive study, 661 patients diagnosed with EC were studied from March 2002 to May 2011 e. The necessary data were collected with a checklist from the documents in Ardabil Cancer Registry (ACR) and analyzed by statistical methods with SPSS.18 software.

Results: Of the total new cases of EC registered in ARC during study period, 430 (65.1%) of patients were male with the male to female standard ratio was 1.18, with a statistically significant gender bias. The most common morphology of EC was squamous cell carcinoma (SCC, 68.8%) followed by adenocarcinoma (28.5%). It was observed that in most of patients, EC lesions were in the middle third of esophagus. In addition, most patients were rural and about 40% had smoking habits. The age-standardized incidence rate of cancers was 48.4 per 100,000 among females and males. The annual incidence rates in males and females was 7.1 and 6.7 per 100,000; respectively.

Conclusions: Results showed that the prevalence and annual incidence rate of cancer in Ardabil province is lower than other areas of the country with a male predominance and a relatively high proprortion of adenocarcinomas.
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March 2014

The effect of acupressure on sanyinjiao and hugo points on labor pain in nulliparous women: a randomized clinical trial.

J Caring Sci 2013 Jun 1;2(2):123-9. Epub 2013 Jun 1.

Acupuncturist and President, Iranian Scientific Acupuncture Association, Tehran, Iran.

Introduction: Most women have experienced child birth and its pain, which is inevitable. If this pain is not controlled it leads to prolonged labor and injury to the mother and fetus. This study was conducted to identify the effect of acupressure on sanyinjiao and hugo points on delivery pain in nulliparous women.

Methods: This was a randomized controlled clinical trial on 84 nulliparous women in hospitals of Ardebil, Iran. The participants were divided by randomized blocks of 4 and 6 into two groups. The intervention was in the form of applying pressure at sanyinjiao and hugo points based on different dilatations. The intensity of the pain before and after the intervention was recorded by visual scale of pain assessment. To determine the effect of pressure on the intensity of labor pain, analytical descriptive test was conducted in SPSS (version 13).

Results: There was a significant decrease in mean intensity of pain after each intervention in the experimental group with different dilatations (4, 6, 8, and 10 cm). Moreover, the Student's independent t-test results indicated that the mean intensity of pain in the experimental group after the intervention in all four dilatations was significantly lower than the control group. Repeated measures ANOVA test indicated that in both experimental and control groups in four time periods, there was a statistically significant difference.

Conclusion: Acupressure on sanyinjiao and hugo points decreases the labor pain. Therefore, this method can be used effectively in the labor process.
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June 2013

Analysis of the relationships between esophageal cancer cases and climatic factors using a Geographic Information System (GIS): a case study of Ardabil province in Iran.

Asian Pac J Cancer Prev 2013 ;14(3):2071-7

Community Medicine, Ardabil University of Medical Science, Ardabil, Iran.

Esophageal cancer is a mjaor health problems in many parts of the world. A geographical information system (GIS) allows investigation of the geographical distribution of diseases. The purpose of the present study was to explore the relationship between esophageal cancer and effective climatic factors using GIS. The dispersion distribution and the relationship between environmental factors effective on cancer were measured using Arc GIS. The highest degree of spread was in Germi town and the least was in Ardabil city. There was a significant relationship between effective environmental factors and esophageal cancer in Ardabil province. The results indicated that environmental factors probably are influential in determining the incidence of esophageal cancer. Also, these results can be considered as a window to future comprehensive research on esophageal cancer and related risk factors.
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January 2014

Community based needs assessment in an urban area: a participatory action research project.

BMC Public Health 2012 Mar 7;12:161. Epub 2012 Mar 7.

Department of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Background: Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment.

Methods: The method of participatory action research (PAR) was used. The study was carried out in an area of high socio-economic deprivation in Ardabil, a city in the northwest of Iran, which is currently served by a branch of the Social Development Center (SDC). The steering committee of the project was formed by some university faculty members, health officials and delegates form Farhikhteh non-governmental organization and representatives from twelve blocks or districts of the community. Then, the representatives were trained and then conducted focus groups in their block. The focus group findings informed the development of the questionnaire. About six hundred households were surveyed and study questionnaires were completed either during face-to-face interviews by the research team (in case of illiteracy) or via self-completion. The primary question for the residents was: 'what is the most important health problem in your community? Each health problem identified by the community was weighted based on the frequency it was selected on the survey, and steering committee perception of the problem's seriousness, urgency, solvability, and financial load.

Results: The main problems of the area appeared to be the asphalt problem, lack of easy access to medical centers, addiction among relatives and unemployment of youth. High participation rates of community members in the steering committee and survey suggest that the PAR approach was greatly appreciated by the community and that problems identified through this research truly reflect community opinion.

Conclusions: Participatory action research is an effective method for community assessments. However, researchers must rigorously embrace principles of mutual cooperation, respect for public ideas, and a robust belief in community empowerment in order to pave the way for responsible and active citizen participation in the various stages of research.
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March 2012

Five year survival of women with breast cancer in Ardabil, north-west of Iran.

Asian Pac J Cancer Prev 2011 ;12(7):1799-801

Community Medicine Department, Ardabil University of Medical Science, Ardabil, Iran.

Breast cancer is the most common cancer in women, and the major cause of cancer deaths in women 20-59 years old. The present retrospective study was undertaken to examine survival in all newly diagnosed breast cancer in Iran. One hundred and sixty-one breast cancer registered patients in 2003 were included in the study and followed up for 5-years from cancer diagnosis. Data were analyzed using life tables and Kaplan Meier for estimating relative survival rates and Cox's proportional hazard model to investigate the interaction between variables. The mean age of the patients at diagnosis was 45.5 (SD=12.3), ranging from 19 to 86 years. Of all patients 90 (56%) were alive and 71 (44%) were dead after five years. Using life table analysis, the overall relative 5-year survival rate was found to be 51% (SE=0.05). Using Cox regression model analysis variables such as age, surgery, location and drug therapy significantly influenced survival. According to the results, the overall 5-year survival rate in Ardebil province was lower than other places of Iran and most countries in the world and needs to be improved. Also, results showed that breast cancer screening programs, awareness regarding early detection of breast cancer and education of health care providers are necessary.
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July 2012