Publications by authors named "Shahnaz Rimaz"

17 Publications

  • Page 1 of 1

Short-term effects of air pollutants on hospitalization rate in patients with cardiovascular disease: a case-crossover study.

Environ Sci Pollut Res Int 2021 Jan 23. Epub 2021 Jan 23.

Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Science, Tehran, Iran.

Considering the increasing rate of hospitalization due to the symptoms intensification, and the increasing trend of air pollution, this study aimed to determine the relationship between the amount of air pollutants and the incidence of cardiovascular disease leading to hospitalization. This case-crossover study was carried out on the data of admitted patients with cardiovascular disease such as hypertension, ischemic heart disease, and cerebrovascular disease in Urmia during 2011-2016. Weather data about air pollutants (NO2, PM10, SO2, and CO) were obtained from the meteorological department of Urmia. The data were coded for each patient and matched with the meteorological data for statistical modeling. The data were analyzed through STATA version 14. Conditional logistic regression was used to estimate the effects of air pollutants on cardiovascular disease adjusted to air temperature, relative humidity, and air pollutants. The final analysis was performed on 43,424 patients with cardiovascular disease using code I10-I99 including ischemic heart disease, hypertension, and cerebrovascular disease adjusted to air temperature and relative humidity. Of all pollutants, CO with each increase 10 μg/m had a meaningful relationship with the incidence of cardiovascular hospitalization. By selecting the window of exposure, 1, 2, and 6 days before admission, lag 6 (6 days) was the best estimation for exposure time in the patients with cardiovascular patients (OR 1.0056, CI 1.0041-1.007), and in the patients with ischemic heart disease (OR 1.000055, CI 1.000036-1.000075) and in the patients with hypertension (OR 1.000076, CI 1.00002-1.000132). Regarding cerebrovascular disease, no statistically significant association was observed. The results showed that only CO was associated with an increased risk of admission in patients with cardiovascular disease, ischemic heart disease, and hypertension, and there was no clear evidence for pollution effects on cerebrovascular diseases.
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http://dx.doi.org/10.1007/s11356-021-12390-2DOI Listing
January 2021

Prevalence of cigarette smoking and its related factors among Iranian male workers.

Med J Islam Repub Iran 2020 5;34:150. Epub 2020 Nov 5.

Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Smoking is considered as the second leading risk factor of early death and disability throughout the world. Smoking is the second leading risk factor of early death and disability in the world. The workplace is an important setting for the implementation of cigarette smoking prevention and control interventions. This study aimed to determine the prevalence of cigarette smoking and related factors by focusing on ADHD and risk-taking behaviors among a sample of Iranian workers. This cross-sectional study was conducted on 2434 male workers of Kaveh Industrial City in Saveh. Random cluster sampling was used in the selection of workers. All workers completed five sets of anonymous and validated questionnaires. ADHD was measured by Conner's Adult ADHD Rating Scales. Data analysis was done using chi-square, independent t-test and logistic regression model in STATA 10. Also, P-value <0.05 was considered statistically significant. The mean age of the workers was 32.80±7.05 years. The prevalence of cigarette smoking in the lifetime, last year, last month, and daily or almost daily in the last month were 26.2%, 20.6% , 18.5%, and 13.1% respectively. After adjustment, age (OR=1.08), sensation seeking (OR=1.57), hookah smoking (OR=4.21), alcohol use (OR=2.51), sexual risk behaviors (OR=2.25), religiosity (OR=0.95) and self-esteem (OR=2.02) were associated with cigarette smoking. Our results showed that 13.1 % of workers were regular smokers (daily or almost daily). Specific programs in workplaces, including interventions to enhance self-steam and reduce anxiety, can be effective in lowering cigarette smoking prevalence. Also, comprehensive interventions to reduce or prevent different risk-taking behaviors can be considered as elements of preventive action plans.
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http://dx.doi.org/10.34171/mjiri.34.150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787013PMC
November 2020

Estimation of cardiovascular and respiratory diseases attributed to PM10 using AirQ model in Urmia during 2011-2017.

Med J Islam Repub Iran 2020 10;34:60. Epub 2020 Jun 10.

Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran.

Quantification of the attributed effects of air pollution determines the impact of air pollutants on the community and shows the critical condition of air quality. This study aimed to quantify and estimate the cardiovascular and respiratory diseases attributed to PM10 in Urmia during 2011-2016. In this descriptive-analytic study, at first, hourly data of pollutant PM10 concentrations were received from air pollutants station located in the Department of Environmental Protection. The data were evaluated using AirQ2.2.3 software after primary and secondary processes and filtering. The results showed that the mean annual concentration of PM10 during 2011-2016 was 88.66, 92.45, 81.22, 78.38, 113.78, and 92.67 μg /m3, respectively. The number of hospitalized cases due to respiratory diseases attributed to PM10 in this period was 486, 525, 459, 453, 684, and 552, respectively, and the number of cases due to cardiovascular diseases was 188, 203, 177, 175, 263, and 213, respectively. Considering the attributed health effects of PM10, the necessary measures should be taken to identify the causative agents and to understand the mechanisms of these processes and correct them.
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http://dx.doi.org/10.34171/mjiri.34.60DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500423PMC
June 2020

Quality Of Life And Stigma Among People Living With HIV/AIDS In Iran.

HIV AIDS (Auckl) 2019 12;11:287-298. Epub 2019 Nov 12.

Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Background: Stigma against HIV profoundly affects the quality of life (QOL) of people living with HIV/AIDS (PLWHA). We aimed to assess the factors associated with QOL in PLWHA in Iran, specifically HIV-related stigma, sociodemographic and clinical characteristics.

Methods: Two hundred PLWHA participated in this cross-sectional study. Data were collected using sociodemographic, stigma, and WHO-QOL-BREF questionnaires. Correlations, ANOVAs, and Student's -distribution tests were performed as bivariate analyses. We employed stepwise multiple linear regression analysis to explore the main factors associated with QOL domains.

Results: Six domains of QOL were negatively correlated with three domains of stigma (p<0.001 for all). Stepwise multiple linear regression revealed that, after adjusting for confounders, lack of healthcare insurance, having no basic knowledge of HIV/AIDs prior to diagnosis, low monthly income of participants and family, and stigma (blaming and distancing, discrimination, and fear) were associated with low mean score of different domains of QOL.

Conclusion: Our findings indicated that increasing HIV/AIDS-related stigma decreases QOL in PLWHA in Iran. Attention toward decreasing stigma, improving healthcare plan, and cultivating economic condition should be given high priority to ensure improvement in total QOL and corresponding domains in PLWHA's life.
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http://dx.doi.org/10.2147/HIV.S221512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858798PMC
November 2019

Risk taking behaviors in relation to Attention Deficit and Hyperactivity Disorder in Iranian male workers: a latent class analysis.

Neuropsychiatr Dis Treat 2019 28;15:2513-2520. Epub 2019 Aug 28.

Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Background: Risk taking behaviors are a serious risk to the health and safety of workers. The aims of this study were to identify the subgroups of workers on the basis of risk taking behaviors and assess the independent role of ADHD on the membership of participants in each latent class.

Methods: This cross sectional study was performed on 2434 workers. The sample was selected through random cluster sampling from Kaveh Industrial City. All workers completed five sets of checklists and questionnaires. Data analysis was performed using chi-square, Fisher's exact test, and latent class analysis.

Results: Four latent classes were identified; namely, 1) very low risk (65.6%), 2) low risk (27.8%), moderate risk (4.1%) and, high risk (2.5%). After adjusting for other studied covariates, having ADHD significantly increased the odds of membership in moderate risk class (OR=3.42, 95% CI: 2.21 -5.29) and high risk class (OR=3.10, 95% CI: 1.80 -5.34) compared to very low risk class. Also, having anxiety increased the odds of membership in latent class 2 (OR=1.28, 95% CI: 1.02-1.62), 3(OR=2.15, 95% CI: 1.51-3.10) and 4 (OR=2.06, 95% CI: 1.32-3.22) in comparison to class 1. Among all participants, 187 (7.7%) had ADHD and among studied variables, ADHD has the strongest role in the membership of subjects in different classes.

Conclusion: Results from the present study indicate that 6.6% of the workers fell under moderate or high risk class. Focusing on the treatment of ADHD with considering other comorbid factors such as anxiety may be helpful in designing and executing effective programs to reduce risk taking behaviors among workers.
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http://dx.doi.org/10.2147/NDT.S221858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717848PMC
August 2019

Challenges in the design, conduct, analysis, and reporting in randomized clinical trial studies: A systematic review.

Med J Islam Repub Iran 2019 30;33:37. Epub 2019 Apr 30.

Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.

Randomized clinical trials have been considered as the gold standard for evaluating the effectiveness and safety of medical interventions; however, there are major barriers to their design, conduct, analysis, and reporting. They are multidisciplinary and involve different steps and face a variety of challenges that may vary from one country to another. The aim of this study was to provide a comprehensive presentation of the challenges of clinical trial studies in different steps including design, conducting, analysis, and reporting. In this study, all original articles conducted during 1991-2017 that reviewed the barriers to clinical trial studies at one of the steps of design, conducing, analysis, and reporting of the results in Medline (through PubMed), Embase, Web of Sciences, Scopus, and Google Scholar were considered. The searched keywords were as follow: challenges, barriers, and randomized clinical trial. The following barriers in different steps of randomized clinical trials were identified: general barriers include insufficient knowledge and understanding of clinical research and research methodology, barriers to ethical and regulatory systems, and lack of funding. The investigator-initiated trials may face similar problems to those of sponsor-initiated trials, such as handling regulatory systems, administrative and financial issues, multiple languages, and different patient compensation approaches. The challenge related to design was poor planning. Other challenges were lack of manpower and financial resources, inappropriate statistical methods for analysis (analysis challenges), and challenges related to reporting which include selective reporting. Based on the results of this systematic review, the most important challenges were barriers related to handling ethical and regulatory systems, patient recruitment, and lack of budget and skilled staff for conducting clinical trials. Training to improve the quality of randomized clinical trial studies in different steps and levels was the most important recommendation in these studies.
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http://dx.doi.org/10.34171/mjiri.33.37DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708114PMC
April 2019

The effect of Cornus mas fruit extract consumption on lipid profile, glycemic indices, and leptin in postmenopausal women- A randomized clinical trial.

Phytother Res 2019 Nov 16;33(11):2979-2988. Epub 2019 Aug 16.

Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.

Menopause, which occurs following a declined ovarian activity and reduced estrogen levels, can lead to long-term changes in lipid and glycemic profiles and increases the risk of cardiovascular disease and osteoporosis. Cornelian cherry (Cornus mas) is rich in phytochemicals and antioxidants, which appears to be useful in reducing the postmenopausal complications. This interventional, double-blinded, randomized clinical trial carried out on 84 menopaused women aged 45-60 years old. They were randomly divided into two groups. The treatment group received three capsules of 300 mg of Cornus mas extract (CME), and control group received three capsules of 300 mg of starch powder per day for 8 weeks. Then, BMI, waist circumference, glycemic indices, lipid profile, serum apoproteinase, apoprotein B100, fibrinogen, and leptin were measured. The dietary intakes were evaluated using 24-hr dietary recall questionnaire. The consumption of CME in comparison with the control group resulted in a significant reduction in weight, body mass index, waist circumference, LDL to HDL ratio, total cholesterol to HDL ratio, and fibrinogen. There was also a significant increase in HDL and ApoA1 levels in the treatment group. Furthermore, there was a significant decrease in BMI, waist circumference, fasting insulin, and insulin resistance index after 8 weeks of using CME. Summing up the results, it can be concluded that CME can have possible effects on decreasing BMI, waist circumference, and improving some aspects of lipid profile and glycemic indices in postmenopausal women.
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http://dx.doi.org/10.1002/ptr.6476DOI Listing
November 2019

Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study.

J Prev Med Public Health 2018 Mar;51(2):64-70

Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Objectives: In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran.

Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis.

Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge.

Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.
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http://dx.doi.org/10.3961/jpmph.17.174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897233PMC
March 2018

Comparing of Cox model and parametric models in analysis of effective factors on event time of neuropathy in patients with type 2 diabetes.

J Res Med Sci 2017 31;22:115. Epub 2017 Oct 31.

Endocrine Research Center, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Cox proportional hazard model is the most common method for analyzing the effects of several variables on survival time. However, under certain circumstances, parametric models give more precise estimates to analyze survival data than Cox. The purpose of this study was to investigate the comparative performance of Cox and parametric models in a survival analysis of factors affecting the event time of neuropathy in patients with type 2 diabetes.

Materials And Methods: This study included 371 patients with type 2 diabetes without neuropathy who were registered at Fereydunshahr diabetes clinic. Subjects were followed up for the development of neuropathy between 2006 to March 2016. To investigate the factors influencing the event time of neuropathy, significant variables in univariate model ( < 0.20) were entered into the multivariate Cox and parametric models ( < 0.05). In addition, Akaike information criterion (AIC) and area under ROC curves were used to evaluate the relative goodness of fitted model and the efficiency of each procedure, respectively. Statistical computing was performed using R software version 3.2.3 (UNIX platforms, Windows and MacOS).

Results: Using Kaplan-Meier, survival time of neuropathy was computed 76.6 ± 5 months after initial diagnosis of diabetes. After multivariate analysis of Cox and parametric models, ethnicity, high-density lipoprotein and family history of diabetes were identified as predictors of event time of neuropathy ( < 0.05).

Conclusion: According to AIC, "log-normal" model with the lowest Akaike's was the best-fitted model among Cox and parametric models. According to the results of comparison of survival receiver operating characteristics curves, log-normal model was considered as the most efficient and fitted model.
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http://dx.doi.org/10.4103/jrms.JRMS_6_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680655PMC
October 2017

Sexual Risk Behaviors and Condom Use Barriers in Iranian Men with Substance Use Disorders.

Addict Health 2017 Jan;9(1):40-47

Associate Professor, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.

Background: We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs).

Methods: Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis.

Findings: The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participants' education and marital status (P < 0.001). Only the partner barrier subscale had a significant negative relationship (P = 0.003) with RSB.

Conclusion: Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628767PMC
January 2017

Economic Effects of 1978 Tabas Earthquake (Iran).

Arch Iran Med 2016 Jun;19(6):409-13

2)Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran, 6)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Natural disasters are one of the most important adverse health events. The earthquake that happened in the city of Tabas in 1978 was ranked third in terms of number of deaths caused by natural disasters over the past 100 years in Iran. This study was aimed to evaluate the economic and human capital consequences of earthquake in Tabas district.

Methods: We used a two percent random sample of Iran Census Dataset from 2006 to run a difference-in-difference study. The difference-in-difference methodology was used to evaluate (1) the mean changes in variables including years of schooling and wealth; (2) the odds changes in primary school completion and literacy of people born (5 or 10 years) post-event versus (5 or 10 years) pre-event in Tabas compared with the same values for those born in the same period of time in the control districts.

Results: Differential increase in years of schooling for being born 10 years after the earthquake versus in 10 years before earthquake in Tabas was one-third of a school year less than in the control districts. There were 89.5% and 65.4% decrease in odds that an individual is literate, and 0.26 and 0.104 average decrease in the SES index for those born in Tabas in periods of 5 and 10 years, respectively, compared with control districts.

Conclusion: Tabas earthquake had negative long-term effects on human capital and wealth. This study can help official authorities to promote educational and economic plans and to implement comprehensive reforms in earthquake-stricken areas.
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http://dx.doi.org/0161906/AIM.007DOI Listing
June 2016

Investigation of relationship between social capital and quality of life in female headed families.

Med J Islam Repub Iran 2015 3;29:270. Epub 2015 Oct 3.

Assistant Professor of Sexual Health Promotion, Iranian Centre of Addiction Studies (INCAS), Institution of Risk Behaviour Reduction, Tehran University of Medical Sciences, Tehran, Iran.

Background: Although most studies on female-headed families focus on women's access to social support, the associations between social capital and quality of life in these families are unclear in many societies (such as Iran). This study aimed to determine the associations between social capital and quality of life in Iranian female headed families.

Methods: This cross-sectional study was performed on 152 female-headed households supported by Tehran Municipality, district 9 from April 2011 to July 2012. Convenience sampling was employed. Data were collected using demographic questionnaire, the Iranian version of World Health Organization Quality of Life, and the Word Bank Social Capital. Descriptive and multiple regression methods were used to analyze the data.

Results: The mean±SD age of participants was 50.8±13.8 years. Findings revealed that in quality of life, the domains of environment health and social relation received the lowest (9.87 ± 2.41) and the highest (12.61 ±3.43) scores respectively; and with respect to social capital, membership in groups and social trust had the least (19.61 ± 17.11) and the most (51.04 ± 17.37) scores, respectively. The multiple regression model revealed a significant positive association between total score of the quality of life and the total score for the social capital (p< 0.001).

Conclusion: Findings suggest that quality of life of female-headed families and social capital domains are strongly related. This means that by improving the social capital, women's life can also be improved.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715401PMC
January 2016

Intimate partner violence and risky sexual behaviors among Iranian women with substance use disorders.

Med J Islam Repub Iran 2015 7;29:174. Epub 2015 Feb 7.

Research Assistant, Iranian National Center of Addiction Studies (INCAS), Institution of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran.

Background: Intimate partner violence (IPV) and risky sexual behaviors are serious and overlapping public health problems that disproportionately affect drug-involved women. Despite the fact that drug-using women experience extensive IPV, to date, no studies have investigated the association of IPV and risky sexual behaviors among drug-using women in Iran.

Methods: Drug-using women (N =120) were recruited from a rehabilitation center in Tehran from March to October, 2009. The Revised Conflict Tactics Scale (CTS2), a standardized questionnaire, was used to collect data regarding violence. We used t-test and logistic regression models to explore the relationship between IPV domains and specific sexual risk behavior outcomes using SPSS 21.

Results: The means (sd) for CTS2 domains were as follows: negotiation 4.29 (1.55), psychological violence 2.55 (1.51), sexual violence 0.37 (1.00), physical abuse 1.17 (1.49), injury 2.18 (1.97), and the mean total score was 1.69 (0.96). We found significantly higher injury scores, but lower sexual abuse scores among women with sexually-transmitted infection (STI) compared to women without STI (p-values 0.030 and <0.0001, respectively). In addition, we found that psychological abuse was positively associated with STI (p-value 0.03) and increased condom use (p = 0.010), possibly mediated through an increased likelihood of having multiple partners.

Conclusion: The findings revealed that in Iran drug-involved women experience high rates of IPV and that IPV is associated with increased risky sexual behavior.

Implication: Preventive interventions for violence that are integrated within drug treatment programs, as well as harm reduction programs are highly recommended.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431434PMC
June 2015

A study on factors that drive variation in the levels of social capital among people living with HIV/AIDS in Iran.

Glob J Health Sci 2015 Mar 30;7(3):351-7. Epub 2015 Mar 30.

Associate Professor of Epidemiology, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Social capital is increasingly used in relation to health issues, particularly in sexually transmitted diseases/infections and health behaviors. Experiences indicated that social capital can contribute in changing HIV related risk behaviors and a decline of HIV infection through social groups and networking and make more effective use of HIV/AIDS prevention, care, and treatment services. We aimed to assess social capital in these persons through a quantitative study.

Method: This cross-sectional study was performed with a convenience sample of 300 people living HIV/AIDS referred to a counseling center of behavioral diseases, in Imam Khomeini Hospital, in Tehran, the capital of Iran, during September 2011 to May 2012. Data collection tools were a demographic questionnaire and World Bank Social Capital Questionnaire (SC-IQ). The analysis of data was performed by the SPSS statistic software version 18. To identify factors influencing social capital in participations, Pearson correlation coefficient, ANOVA, t-test, and a multiple regression were applied. The significant level was considered 0.05 in this study.

Results: 165 (55%) were male and the rest female. The mean age of participants was 34.3 ± 7.5. The mean score of total social capital was 2.34 ± 0.5 in all participants. The domain of individual trust had the highest mean score (2.53 ± 0.66). The lowest mean score was related to the domain of social trust and associative relations (2.23 ± 0.62). Variables such as ethnicity, age, and middle economic status had a significant impact on the domain of individual trust so that the mean score of this component of social capital was lower among women (0.396) than men. Factors affecting total social capital were ethnicity and middle economic status.

Conclusion: Finding emphasized on the role of economic status, ethnicity and gender in persons living with HIV/AIDS. Thus recommended that policy makers and program managers consider social groups and networks, especially in women in the design and delivery of intervention strategies to reduce HIV transmission.
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http://dx.doi.org/10.5539/gjhs.v7n3p351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802139PMC
March 2015

Investigation of relationship between social capital and quality of life in multiple sclerosis patients.

Glob J Health Sci 2014 Aug 15;6(6):261-72. Epub 2014 Aug 15.

PHD student in Epidemiology, Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman/IRAN..

Background: A large portion of existing medical research on Multiple Sclerosis patients focuses more on predicting medical variables (such as diagnosis, treatment) and individual variables such as the onset of disease, gender, etc., rather than broader socio-contextual factors. So that, here has yet been no study investigating factors such as social capital in Multiple Sclerosis patients.

Aim: The purpose of this study is determining the relation between social capital and quality of life in Multiple Sclerosis patients who referred to Iran Multiple Sclerosis Society in 2012.

Method: This cross-sectional study was conducted on 172 patients visiting Iran Multiple Sclerosis Society (Tehran) during 10 months via convenience samplings and face to face interviews. Tools for collecting data included World Bank's social capital integrated questionnaire (SC-IQ) and Multiple Sclerosis Quality of Life (MSQOL) -54.

Results: The average age of patients was 34/8 ± 9/6. The analysis of the six dimensions of social capital questionnaire showed that the highest average score belonged to membership in groups and networks (63/3 ± 15/3) and the lowest one was about trust and solidarity (44/3 ± 13/7).The results of the regression model showed that there is a statistical significant and positive relation between social capital and quality of life (P > 0.0001).

Conclusion: Since the present study has been conducted for the first time in this vulnerable subpopulation of patients, its results can provide invaluable information regarding the quality of life and at the same time present hypotheses about the contributing factors.
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http://dx.doi.org/10.5539/gjhs.v6n6p261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825513PMC
August 2014

Validity and Reliability of the Iranian Version of the HIV/AIDS Stigma Instrument-PLWHA (HASI-P).

Health Promot Perspect 2013 31;3(2):194-205. Epub 2013 Dec 31.

Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran.

Background: HIV/AIDS disease has remained highly stigmatized all over the world even though the increasing accessibility of its treatment. This study was designed to adapt the HIV/AIDS Stigma Instrument (HASI) to the Iranian People Living with HIV/AIDS (PLWHA).

Methods: Translation -back translation of the scale into Persian was done. Then, the validity and reliability of the instrument were evaluated. The validity of the translated scale was assessed in three ways: evaluating its linguistic validity, assessing its content validity by a panel of nine experts, and exploring its construct validity by factor analysis. The internal con-sistency of the translated scale was evaluated by Cronbach's Alpha.

Results: HASI showed a good Content Validity Index (CVI value >0.75) and Content Validity Ratio (CVR >0.78). The internal consistency of the instrument regarding the total score was α=0.89. The three stigma sub-scales that were dis-tancing and blaming (8 items, α=0.87), fear (3 items, α=0.82), and discrimination (5 items, α=0.83).

Conclusion: This article reports the development and validation of a new measure of stigma, i.e. HIV/AIDS Stigma Instrument in PLWHA (HASI-P), and pro-vides evidence to support its content validity and internal consistency.
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http://dx.doi.org/10.5681/hpp.2013.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963664PMC
April 2014

Immunity status in children with Bacille Calmette-Guerin adenitis. A prospective study in Tehran, Iran.

Saudi Med J 2006 Nov;27(11):1719-24

Department of Pediatrics, Iran University of Medical Sciences, Research Center of Pediatric Infectious Diseases, Hazrat Rasool Hospital, Niayesh Ave, Satarkhan Street, Tehran 14455, Republic of Iran.

Objective: To determine the immunity status of children with Bacille Calmette-Guerin (BCG) lymphadenitis (patient group) and unaffected children (control group) in Iran.

Methods: We performed this longitudinal case-control study on 75 children between 2 months to 14 years old in Rasool Akram and Markaz Tebbi Hospital, Tehran, Iran during the period of 2 years (2000-2002).

Results: Ninety percent of patients had normal immunoglobulin, 10% had low level, 96.1% had normal nitro blue tetrazolium test and 3.9% had lower activity. There was a significant difference in the total lymphocyte CD3, CD8, CD19, CD16/CD56 and natural killers (NK) cell but no significant difference in the CD4/CD8 ratio and CD4 between case (n=75) and control (n=100) groups. Thirty-eight cases with mild lymphopenia, isolated CD4, CD3, CD19, NK cells (CD16/CD56) deficiency in 3 (22%); idiopathic disseminated BCG infection (unknown immunodeficiency type) in 3 (22%) patients were observed. Thirty-eight cases were diagnosed as mild immune deficient without any previous recurrent infections (mild lymphopenia; Isolated CD4; CD3 or CD19 deficiency. Natural killers (CD16/CD56) deficiency in 3 (22%); idiopathic disseminated BCG infection (unknown immunodeficiency type) in 3 (22%) patients. The natural killers (CD16/CD56) deficient cases responded well to 3 antimycobacterial drugs without immunomodulator. Natural killers cell deficiency not yet reported as a risk factor for progression and complication of BCG infection. All cases of idiopathic disseminated BCG infection (unknown immunodeficiency type) with nonlethal and indulgent BCG infections responded well to needle aspiration and antimycobacterial drugs with immunomodulator (gamma interferon).

Conclusion: In cases with multiple and recurrent BCG lymphadenitis without any previous recurrent infection complete immunological studies should be carried out. Most cases with mild immune deficiency usually response well to needle aspiration alone or combine with antimycobacterial drugs. The combination of IFN-gamma and chemotherapy in cases of idiopathic disseminated infections caused by BCG and without previous recurrent other infection except mycobacterium species, can limit the disease.
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November 2006