Publications by authors named "Shahrzad Nematollahi"

29 Publications

  • Page 1 of 1

Effect of maternal mental health during pregnancy on infant growth at six months of age in Suburban communities in South of Iran.

Med J Islam Repub Iran 2020 18;34:157. Epub 2020 Nov 18.

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

Due to the controversial effects of mental health disorders during pregnancy on infant health, the present study aimed to evaluate the effect of gestational depression, stress, and anxiety on the growth of offspring at six months of age in disadvantaged communities in South of Iran. The sample comprised of 470 pregnant women (response rate=98%) who are participated in the Bandar Abbas Pregnancy Cohort study. Maternal mental health was measured by the DASS-21 questionnaire during pregnancy. Data on infant growth was collected based on infant`s growth chart at six months of age. The relative risk of suboptimal infant growth was calculated by Modified Poisson regression models at 5% significant level. The prevalence of depression, anxiety, and stress was 19.0%, 26.1% and 6.5%, respectively. At six months of age, the mean (SD) of infant`s weight (gram), height (cm) and head circumference (cm) were 7287.30 (1019.85), 63.23 (5.62) and 41.39 (2.70), respectively. Compared to normal mothers, the risk of suboptimal weight at six months of age significantly increased by 71% in mothers who were classified as having depression (Adjusted RR: 1.71, 95% CI: 1.07, 2.09). The presence of anxiety significantly increased the risk of suboptimal height at six months of age by 43% (ARR: 1.43, 95% CI: 1.07, 1.92). There were no statistically significant effects of either depression anxiety or stress on the suboptimal head circumference at six months of age. Our results showed that mental health disorders of pregnant women might adversely influence the weight and height growth of offspring within the first six months of age. Screening protocols to early diagnose of mental health disorders during pregnancy, and to strict follow up of diagnosed cases postpartum are proposed.
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http://dx.doi.org/10.47176/mjiri.34.157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813148PMC
November 2020

Five-Year Survival Rate of Bladder Cancer in Iran during 2001-2007.

Iran J Pathol 2021 10;16(1):69-74. Epub 2020 Oct 10.

Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background & Objective: Bladder cancer is the fourth most common cancer in men and the most common cancer in women, comprising 8% of all males and 3% of female tumors. The present study aimed to estimate the five-year survival rates of bladder cancer in Iran.

Methods: Information on 3,337 registered cases of bladder cancer was obtained from the Office of National Cancer Registry in the Ministry of Health and Medical Education (MOH & ME). A telephone survey was conducted to gather additional information, such as survival status, demographic, and clinical profile. Kaplan-Meier estimates of five-year survival rates were calculated according to the age of diagnosis, gender, pathological type, and provincial pole.

Results And Conclusion: Overall five-year survival rate was 77%. According to the pathologic type, five-year survival rates were 81%, 66%, 81%, 42%, 77%, and 82% in low-grade urothelial carcinoma, high-grade urothelial carcinoma, adenocarcinoma, undifferentiated carcinomas, Squamous Cell Carcinomas (SCCs), and other tumors, respectively. Additionally, those tumors were 93%, 88%, 81%, 64%, and 44% among patients whose average ages at diagnosis were < 50, 50-59, 60-59, 70-79, and > 80 years old, respectively. Our study revealed that age and histological type were the major prognostic factors for survival in patients with bladder cancer. Therefore, given the histologic features of the tumor and patients with advanced age, a continuous screening would be highly warranted.
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http://dx.doi.org/10.30699/ijp.2020.118375.2287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691705PMC
October 2020

Re: Neglected Major Causes of Death Much Deadlier Than COVID-19.

J Res Health Sci 2020 06 21;20(2):e00482. Epub 2020 Jun 21.

Men`s Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.34172/jrhs.2020.17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585753PMC
June 2020

The effect of quitting water pipe during pregnancy on anthropometric measurements at birth: a population-based prospective cohort study in the south of Iran.

BMC Pregnancy Childbirth 2020 Apr 22;20(1):241. Epub 2020 Apr 22.

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

Background: Evidence regarding health effects of tobacco cessation during pregnancy is mainly restricted to cigarette while water pipe is the preferred method of tobacco smoking among women in the Middle-East. The present study aimed to assess the effects of cessation of water pipe during pregnancy on birth anthropometric measures in the south of Iran.

Methods: Data on 1120 singleton pregnancies (response rate = 93.4%) from a population-based prospective cohort study in suburban communities in Bandar Abbas city was used. Based on water pipe smoking status, the study subjects were categorized into: 1) those who never smoke water pipe (never smoker); 2) those who stopped water pipe during pregnancy and resumed it postpartum (quitters); 3) those who continued smoking water pipe during their pregnancy (always smokers). The Generalized Linear Models (GLMs) were utilized for the analyses.

Results: Compared to never smokers, quitting water pipe in pregnancy decreased mean birthweight of infants by 99.30 g (β:-99.30, 95%CI:-204.35,-5.75) and an additional decrease of 37.83 g occurred in infants of always smokers (β:-137.13;95%CI:- 262.21,-12.05). Means of birth length did not significantly differ among the three water pipe groups. Means of head circumference, however, significantly increased by 0.79 cm in infants of always smokers (β:079,95%CI:0.13,1.45).

Conclusion: Quitting water pipe during pregnancy had positive effects on infant growth, especially birth weight. Awareness campaigns about health benefits of quitting water pipe during routine prenatal checkups and integration of active follow-up visits into prenatal care protocols for smoking mothers are provided.
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http://dx.doi.org/10.1186/s12884-020-02948-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179000PMC
April 2020

The relationship between maternal mental health during pregnancy and type of delivery in the suburbs of Bandar Abbas during 2017-2018.

Med J Islam Repub Iran 2019 9;33:108. Epub 2019 Oct 9.

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

The effect of maternal mental health during pregnancy on Cesarean section through implications of pre- and postnatal birth have narrowly been investigated. The aim of the present study was to investigate the effect of maternal mental health during pregnancy on the type of delivery in the suburbs of Bandar Abbas. This study used data of 200 mothers registered in a prospective cohort study on pregnant women in the suburbs of Bandar Abbas, South of Iran, during 2016-18. The presence of depression, anxiety, or stress in expecting mothers were measured by DASS-21 questionnaire and the outcome defined as having Cesarean section (Cesarean section) was measured at postpartum. The relative risk (95% CI) was calculated using Cox regression models. All analyses were performed using STATA statistical package, with a significance level of 5%. Information of 196 mothers were collected (98% response rate); the mean age of the participants was 27.28 (±5.62) years. The prevalence of depression, anxiety, and stress was 13.8% (27), 40.4% (40), and 7.6% (15), respectively. Nearly 40% of mothers went through Cesarean section. Compared to mothers with good mental health, the risk of Cesarean section was 96% higher in depressed mothers (RR=2, 95% CI: 1.43-2.74) (p=0.001), 81% higher in anxious mothers (RR=1.81, 95% CI: 1.29-2.53) (p=0.003), and 75% higher in stressed mothers (RR=1.75, 95% CI: 0.86-3.56) (p=0.121). The findings of this study showed that poor mental health, especially anxiety and depression, during pregnancy could increase the risk of Cesarean section. Accordingly, screening protocols for mental health status and prenatal counseling sessions are suggested for pregnant mothers to increase their informed decision on types of delivery.
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http://dx.doi.org/10.34171/mjiri.33.108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946930PMC
October 2019

Knowledge, attitude, and practice among mothers about newborn care in Sindh, Pakistan.

BMC Pregnancy Childbirth 2019 Sep 6;19(1):329. Epub 2019 Sep 6.

Men`s Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Each year nearly 7.7 million children under five years die around the world; out of which approximately 3.1 million of the newborns die during the neonatal period and almost all these (99%) deaths occur in the developing countries. According to the World Health Organization's estimation neonatal deaths account for 45% of the under-five deaths. More than one-third of these deaths occur in the first 24 h of birth, whereas three-quarter of the neonatal deaths takes place in the first seven days of birth. The purpose of this study is to assess the knowledge, attitude, and practices (KAP) among mothers about newborns' care and its related factors in district Badin Sindh province of Pakistan.

Methods: A community-based cross-sectional study was conducted from July 2017 to August 2017 to assess the Knowledge, Attitude, and Practices (KAP) in mothers regarding newborn care. A structured questionnaire was administered, after pretest, for data gathering through face to face interview. All survey participants were identified using multi-stage cluster sampling. A scoring system was used to calculate the level of KAP among participants. Independent sample t-test, ANOVA, and GLM were applied to identify the statistical difference between the means of various groups.

Result: A total of 518 survey participants were interviewed. Among the study sample, more than half of the newborns were bathed within six hours of delivery. Around 50% started breastfeeding after 1 h of birth. A substantial proportion (45%) of mothers gave pre-lacteal feeding and 44.8% of them did not feed colostrum to their newborns. Among those who administered pre-lacteal to their newborn babies included animal/formula milk (15.4%), honey (24.5%) and fresh butter/ghee (5.2. %). Mothers with no education had less significant KAP score about newborn care as compared to those who had higher education (p < 0.05).

Conclusion: This study revealed that high-risk factors such as immediate bathing, application of traditional substances on the cord, delayed initiation of breastfeeding, discarding colostrum and giving pre-lacteal feed to newborns were highly prevalent. This requires urgent attention of Maternal, Newborn and Child Health (MNCH) programs and health care delivery system to prevent harmful care practices and adopt healthy practices especially in the rural settings.
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http://dx.doi.org/10.1186/s12884-019-2479-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729052PMC
September 2019

Spatio-Temporal Analysis of Tuberculosis in Hamadan Province, West of Iran, from 1992 to 2013.

Tanaffos 2019 Jan;18(1):18-24

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

Background: Tuberculosis (TB) despite being preventive and treatable still imposes a huge burden of morbidity and mortality in developing and developed countries. We aimed to investigate the spatial and geographical distribution of TB in Hamadan province during 1992-2013.

Materials And Methods: This cross-sectional study was performed in Hamadan province, West of Iran using the surveillance database. We examined the trend for incidence rates of all TB forms including Smear Positive Pulmonary TB (SPPT), Smear Negative Pulmonary TB (SNPT) and Extra pulmonary TB (EPT) per 100,000 populations. Poisson regression model was used to estimate the standardized rates for incidence rate of all types of TB per each county.

Results: In this study 3,602 TB patients including 1,359 SPPT, 987 SNPT, and 1,256 EPT were included during 1992-2013. Trend of all types of TB decreased from 1992 to 2013. The Average Annual Percent change (AAPC) for all types of TB was significantly (P<0.05) decreased, AAPC= -6.4 (95% CIs: -10.7, -1.9). Among SPPT, SNPT, and EPT incidence rates, the maximum change was related to SNPT (-11.6; 95% CIs: -24.2, 3), while it was -1.4 (-8.7, 6.4) for SPPT and -5.8 (-11.4, 0.1) for EPT.

Conclusion: Our results showed that the incidence of TB in Hamadan province during a 22-year period has decreased 6.4% on average, somehow higher than the national average. Furthermore, our study showed that the risk of extra-pulmonary occurrence in western parts of the province is higher than others parts.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690326PMC
January 2019

The role of socio-economic inequality in the prevalence of hypertension in adults.

J Cardiovasc Thorac Res 2019 30;11(2):116-120. Epub 2019 Jun 30.

Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

The large portion of burden of diseases, especially in the developing countries is attributed to hypertension. Identification of the potential risk factors of hypertension is essential for disease management. In this study we investigated the role of socio-economic inequality in the prevalence of hypertension in Ilam Province. Totally, 690 individuals aged over 15 were enrolled in this cross-sectional study, through systematic random sampling from March 1 to October 30, 2017. Socio-economic status (SES) score was calculated by 7 variables including; age, sex, job, marital status, educational level, and economic status, residency, then, it was divided to five levels. Concentration index was used to estimate the inequality in hypertension. To estimate the percentage contribution in final step elasticity divided to concentration index for each contributor and contributions to inequality is estimated. The concentration index for hypertension was -0.154 95% CI (-0.02, -0.23), therefore hypertension was more prevalent in lower socioeconomic groups. The important socioeconomic contributors in inequality were job (=0.008), educational level (=0.005), and SES (=0.003). According to concentration index decomposition, the main sources of inequality in hypertension were job (15%), educational level (18%), and SES (21%), respectively. Hypertension is more prevalent in lower SES groups and the job, education, and SES are important contributory factors of inequality. One substantial key point to achieve an effectiveness approach to deal with chronic diseases might be building partnership with disadvantaged populations.
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http://dx.doi.org/10.15171/jcvtr.2019.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669432PMC
June 2019

Community health assessment: Knowledge, attitude and practice of women regarding water-pipe smoking in Bandar Abbas.

MethodsX 2019 28;6:442-446. Epub 2019 Feb 28.

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

Based on the results of seventh round of community health assessment (CHA) in suburban areas of Bandar Abbas, "water-pipe smoking in women" was one of the major concerns of community members. Therefore, the present study designed to assess the knowledge, attitude and practice of women towards water-pipe smoking and related factors. High consumption of water-pipe among women was ranked as a prioritized health problem. To diagnose the problem, for creating action plan, the present cross - sectional study was conducted on 205 women aged over 18 randomly selected from Green-Tree region in suburb of Bandar Abbas city. All statistical analyses were performed using SPSS 24 software with 5% as the significant level. 205 women with a mean age of 36.9 (standard deviation:12.86) years, and a water-pipe prevalence of 15.1% were analyzed. The significant predictors of knowledge were educational level (β = 0.182, p-value = 0.037), and being water-pipe smoker (β = -0.251, p-value < 0.001); while for attitude they were educational level (β = 0.221, p-value = 0.002), family size(β = 0.152, p-value = 0.023), and subjective social status(β = 0.149; p-value = 0.035); and for practice they was smoking waterpipe in parents (β = -0.276, p-value < 0.001).The development action plans based on "CHA" could improve public health and enhance the performance of the community through improved education, policies and health interventions.
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http://dx.doi.org/10.1016/j.mex.2019.02.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416371PMC
February 2019

Determine the prevalence of gestational diabetes in Ardakan and its related factors.

MethodsX 2019 27;6:409-416. Epub 2019 Feb 27.

Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Gestational Diabetes (GD) is amongst the most common metabolic disorders. Due to the important complications of GD on maternal and fetal health and in order to identify the prevalence of GD in various climate and cultures, the present studies aimed to determine the prevalence of GD in Ardakan and its related factors in 2014-2015. This cross-sectional study was conducted in 3808 pregnant women referring to rural and urban health centers in Ardakan city in 2013-14. Demographic, clinical, and obstetrics history of the subjects was gathered. GD was defined based on Glucose Tolerance Test (GTT). Descriptive and Logistic regression models were applied. The prevalence of GD was estimated to be 7.5% (286) which was higher in 35-39 age group, urban residents, obese mothers, and pregnancies ended with macrosome babies. The odds of GD was higher in obese mothers by 1.62 times (95%CI: 1.18-2.24), in mothers above ages of 40 by 10.53 (95%CI: 3.8-29.3), in mothers with a history of GD by 3.86 (95%CI:1.65-8.93), and in pregnancies ended with a macro some baby by 2.2 (95%CI: 0.97-5.1). The prevalence of GD in Ardakan was similar to other studies in the area. It seems that improvement of GD screening in older mothers and those with a history of GD could be a priority of surveillance system in Yazd Province.
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http://dx.doi.org/10.1016/j.mex.2019.02.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406171PMC
February 2019

Survival Rate and Predictors of Mortality among Hemodialysis Patients in West of Iran, 1996-2015.

Int J Prev Med 2018 24;9:113. Epub 2018 Dec 24.

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

Background: Hemodialysis (HD) is one of the treatments provided to end-stage renal disease (ESRD) patients. A few studies have investigated the survival rate of HD patients in Iran. Hence, we decided to investigate the survival rate and it is predictors among Iranian ESRD patients.

Methods: This is a retrospective cohort study conducted in 165 HD patients in Tuyserkan city (Hamadan province) during 20 years from 1996 to 2015. The checklist used to gather information was comprised of patients' demographic and clinical information. The analysis was performed using Kaplan-Meier curves, log-rank test, and cox regression model.

Results: The most prevalent cause of ESRD was reported to be high blood pressure (32.7%). The probability of survival rate at the end of 1, 5, and 10 year was 0.65, 0.16, and 0.05, respectively. Results of multivariate cox regression showed that old age, catheter vascular access, and high hemoglobin level have a negative significant effect on survival of HD patients ( < 0.05).

Conclusions: Overall, the survival of HD patients seems to be low in Tuyserkan as compared to other studies. Age, ESRD cause, vascular access, marital status, and hemoglobin level among other factors are proved to have a significant effect on survival probability.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_399_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326016PMC
December 2018

Knowledge, Attitude, Practice of Dengue Fever and Its Related Factors among International Students at Tehran University of Medical Sciences.

Iran J Public Health 2018 Nov;47(11):1777-1779

Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294857PMC
November 2018

A Population-based Prospective Study to Identify Contributors to Mother and Child Health in Suburban Communities: The Cohort Profile.

Iran J Public Health 2018 Mar;47(3):441-448

Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Following community health assessment Project (CHAP) in suburbs of Bandar Abbas city, health problems in women and children such as pregnancy complications and infant/child impaired growth are highly prevalent. Therefore, the present population-based prospective cohort study investigated the effects of a wide range of modifiable exposures during pregnancy and postpartum on mother and child health.

Methods: The sample comprised of 1000 pregnant women in their first gestational trimester, who live in the three most socially and economically vulnerable neighborhoods of Bandar Abbas, are under recruitment during Feb 2016-18. Four structured questionnaires are being carried out from pregnancy to 30 d, 6 months, and 12 months postpartum. Biologic and ultrasound results are also gathered through hospital and health center records. The study is currently close to the end of the recruitment phase.

Conclusion: The results of the interim and final analyses are being translated into applicable preventive action plans aiming to reduce and control modifiable risk factors for ill-health in mothers and children in suburb communities in South of Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971183PMC
March 2018

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran.

Epidemiol Health 2018 13;40:e2018008. Epub 2018 Mar 13.

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

Objectives: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.

Methods: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016-2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).

Results: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).

Conclusions: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
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http://dx.doi.org/10.4178/epih.e2018008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968205PMC
April 2018

RETRACTED ARTICLE: Effective environmental factors on geographical distribution of traffic accidents on pedestrians, downtown of Tehran City.

Int J Inj Contr Saf Promot 2019 12 20;26(4). Epub 2018 Feb 20.

Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The following article has been retracted from publication in the Taylor & Francis journalAli Moradi, 'Effective environmental factors on geographical distribution of traffic accidents on pedestrians, downtown of Tehran City', , https://doi.org/10.1080/17457300.2018.1431933. Version of Record published online 20 February 2018.This article has already been published in the .
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http://dx.doi.org/10.1080/17457300.2018.1431933DOI Listing
December 2019

Comments on prognostic role of copeptin after traumatic brain injury: A systematic review and meta-analysis of observational studies.

Am J Emerg Med 2018 07 13;36(7):1307. Epub 2017 Nov 13.

Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2017.11.026DOI Listing
July 2018

Effective environmental factors on geographical distribution of traffic accidents on pedestrians, downtown Tehran city.

Int J Crit Illn Inj Sci 2017 Apr-Jun;7(2):101-106

Crashes Office, Tehran's Traffic Police, Tehran, Iran.

Introduction: In most countries, occurrence of traffic causalities is high in pedestrians. The aim of this study is to geographically analyze the traffic casualties in pedestrians in downtown Tehran city.

Methods: The study population consisted of traffic injury accidents in pedestrians occurred during 2015 in Tehran city. Data were extracted from offices of traffic police and municipality. For analysis of environmental factors and site of accidents, ordinary least square regression models and geographically weighted regression were used. Fitness and performance of models were checked using the Akaike information criteria, Bayesian information criteria, deviance, and adjusted .

Results: Totally, 514 accidents were included in this study. Of them, site of accidents was arterial streets in 370 (71.9%) cases, collector streets in 133 cases (25.2%), and highways in 11 cases (2.1%). Geographical units of traffic accidents in pedestrians had statistically significant relationship with a number of bus stations, number of crossroads, and recreational areas.

Conclusion: Distribution of injury traffic accidents in pedestrians is different in downtown Tehran city. Neighborhoods close to markets are considered as most dangerous neighborhoods for injury traffic accidents. Different environmental factors are involved in determining the distribution of these accidents. The health of pedestrians in Tehran city can be improved by proper traffic management, control of environmental factors, and educational programs.
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http://dx.doi.org/10.4103/2229-5151.207750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479071PMC
June 2017

Epidemiological characteristics of human brucellosis in Hamadan Province during 2009-2015: results from the National Notifiable Diseases Surveillance System.

Int J Infect Dis 2017 Aug 7;61:56-61. Epub 2017 Jun 7.

Department of Health Education, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

Background: Human brucellosis and recurrent brucellosis is an ever-increasing public health concern, especially in endemic areas like Iran. Nevertheless, little is known regarding the epidemiology and determinants of recurrent brucellosis. Therefore, the objective of this study was to investigate epidemiological patterns and potential determinants of recurrent brucellosis in Hamadan Province during the years 2009-2015.

Methods: Data on reported cases of new and recurrent brucellosis from 2009 to 2015 were obtained from the provincial Notifiable Diseases Surveillance System at Hamadan University of Medical Sciences. Incidence rates per 100000 were estimated at the county level. Binary logistic regression was used to estimate the effects of background characteristics and recurrent brucellosis. The power of discrimination of the model for recurrent brucellosis was assessed using the area under the curve (AUC).

Results: Among 7318 brucellosis cases, the total frequency (%) of recurrent cases was 472 (6.45%). The rate of recurrent brucellosis was higher in females, people aged 50 years and over, people with a history of consuming unpasteurized dairy products with no history of contact with animals, and in the winter season. Multivariable logistic regression analysis showed that female sex (adjusted odds ratio (AOR) 1.36, 95% confidence interval (CI) 1.13-1.65), age ≥55 years (AOR 4.15, 95% CI 2.32-7.42), consumption of unpasteurized dairy products (AOR 1.16, 95% CI 0.96-1.40), and winter season (AOR 1.32, 95% CI 1.03-1.71) are potential risk factors for recurrent brucellosis. The final model that involved all the determinants showed moderate discrimination (AUC 0.61).

Conclusions: Female sex, older age, and winter months were found to be significant determinants of recurrent human brucellosis. Enhanced surveillance systems with an emphasis on these population characteristics will allow effective preventive and protective measures to be implemented and might alleviate the recurrence of brucellosis in the country.
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http://dx.doi.org/10.1016/j.ijid.2017.06.002DOI Listing
August 2017

The Mediating Role of Mental Health in the Relations between Dietary Behaviors and General Health: A Cross-sectional Study.

Adv Biomed Res 2017 1;6:21. Epub 2017 Mar 1.

Department of Epidemiology and Biostatistics, Public Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The aim of this study is to find a pathway to explaining the relations between dietary behaviors with mental health and psychological functioning.

Materials And Methods: This cross-sectional study contains 4763 participants from the employees of Isfahan University of Medical Sciences. In this study, four questionnaires were administered which were provided as follows: demographic characteristics, 21-item dietary behaviors questionnaire, Hospital Anxiety and Depression Scale questionnaire, and 12-item General Health Questionnaire (GHQ-12). We started the analysis with the structural equation modeling (SEM) model with 4 unobserved latent and 16 observed variables.

Results: The results show that the regression coefficient (standard error) of diet behavior on mental health and mental health on GHQ were - 1 (0.37) and 0.02 (0.01) with their values as 0.007 and 0.01, respectively. For this model, the estimated root mean square error of approximation is 0.062 with 90% confidence interval of (0.060-0.065). In addition, the comparative fit indices (CFIs) were as 0.866 for incremental fit index and 0.866 for CFI. All these indices represent fairly good fit of the model to the data.

Conclusion: We can conclude that "lower scores on diet behavior - higher scores on mental health problems" and "higher mean scores in depression and/or anxiety - higher scores in GHQ domains." The SEM results showed that dietary behaviors have significance related to depression and/or anxiety and general health status.
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http://dx.doi.org/10.4103/2277-9175.201333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353764PMC
March 2017

The Mediating Role of Mental Health in the Relations between Dietary Behaviors and General Health: A Cross-sectional Study.

Adv Biomed Res 2017 1;6:21. Epub 2017 Mar 1.

Department of Epidemiology and Biostatistics, Public Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The aim of this study is to find a pathway to explaining the relations between dietary behaviors with mental health and psychological functioning.

Materials And Methods: This cross-sectional study contains 4763 participants from the employees of Isfahan University of Medical Sciences. In this study, four questionnaires were administered which were provided as follows: demographic characteristics, 21-item dietary behaviors questionnaire, Hospital Anxiety and Depression Scale questionnaire, and 12-item General Health Questionnaire (GHQ-12). We started the analysis with the structural equation modeling (SEM) model with 4 unobserved latent and 16 observed variables.

Results: The results show that the regression coefficient (standard error) of diet behavior on mental health and mental health on GHQ were - 1 (0.37) and 0.02 (0.01) with their values as 0.007 and 0.01, respectively. For this model, the estimated root mean square error of approximation is 0.062 with 90% confidence interval of (0.060-0.065). In addition, the comparative fit indices (CFIs) were as 0.866 for incremental fit index and 0.866 for CFI. All these indices represent fairly good fit of the model to the data.

Conclusion: We can conclude that "lower scores on diet behavior - higher scores on mental health problems" and "higher mean scores in depression and/or anxiety - higher scores in GHQ domains." The SEM results showed that dietary behaviors have significance related to depression and/or anxiety and general health status.
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http://dx.doi.org/10.4103/2277-9175.201333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353764PMC
March 2017

Comment on: Effectiveness of ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroids: a multicenter study in China.

Int J Hyperthermia 2017 09 22;33(6):703. Epub 2017 Feb 22.

d Social Determinants of Health Research Center , Kurdistan University of Medical Sciences , Sanandaj , Iran.

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http://dx.doi.org/10.1080/02656736.2017.1292000DOI Listing
September 2017

Global Prostate Cancer Incidence and Mortality Rates According to the Human Development Index.

Asian Pac J Cancer Prev 2016 ;17(8):3793-6

Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran E-mail :

Background: Prostate cancer (PC) is one of the leading causes of death, especially in developed countries. The human development index (HDI) and its dimensions seem correlated with incidence and mortality rates of PC. This study aimed to assess the association of the specific components of HDI (life expectancy at birth, education, gross national income per 1000 capita, health, and living standards) with burden indicators of PC worldwide.

Materials And Methods: Information of the incidence and mortality rates of PC was obtained from the GLOBOCAN cancer project in year 2012 and data about the HDI 2013 were obtained from the World Bank database. The correlation between incidence, mortality rates, and the HDI parameters were assessed using STATA software.

Results: A significant inequality of PC incidence rates was observed according to concentration indexes=0.25 with 95% CI (0.22, 0.34) and a negative mortality concentration index of -0.04 with 95% CI (-0.09, 0.01) was observed.

Conclusions: A positive significant correlation was detected between the incidence rates of PC and the HDI and its dimensions including life expectancy at birth, education, income, urbanization level and obesity. However, there was a negative significant correlation between the standardized mortality rates and the life expectancy, income and HDI.
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January 2017

The role of stem cell therapy in multiple sclerosis: An overview of the current status of the clinical studies.

Adv Biomed Res 2016 16;5:46. Epub 2016 Mar 16.

Isfahan Neurosciences Research Center, Al Zahra Hospital, Tehran University of Medical Sciences, Tehran, Iran.

The complexity of multiple sclerosis (MS) and the incompetence of a large number of promised treatments for MS urge us to plan new and more effective therapeutic approaches that aim to suppress ongoing autoimmune responses and induction of local endogenous regeneration. Emerging data propose that hematopoietic, mesenchymal, and neural stem cells have the potential to restore self-tolerance, provide in situ immunomodulation and neuroprotection, as well as promote regeneration. Thus, in this article, we will first provide an overview of the cell sources for proposed mechanisms that contribute to the beneficial effects of stem cell transplantation, the ideal route and/or timing of stem cell-based therapies for each main stem cell group, and finally, an overview of the current status of stem cell research in clinical trial stages in MS by comparable and healthy therapeutic effects of different stem cell therapies for MS patients.
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http://dx.doi.org/10.4103/2277-9175.178791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817403PMC
April 2016

Epidemiology of Multidrug Resistant Uropathogenic Escherichia coli in Iran: a Systematic Review and Meta-Analysis.

Jpn J Infect Dis 2017 Jan 18;70(1):19-25. Epub 2016 Mar 18.

Department of Microbiology, Pasteur Institute of Tehran.

Urinary tract infection (UTI) is one of the most common infections in humans. It is primarily caused by uropathogenic Escherichia coli (UPEC), which has a high multidrug resistance (MDR). In consideration of the prevalence of MDR-UPEC strains, the aims of the present study were to systematically review the published data about the prevalence rate of MDR-UPEC from different parts of Iran and to establish the overall relative frequency (RF) of these strains in Iran. We searched several databases including PubMed, ISI Web of Science, Scopus, Google Scholar, IranMedex, and Iranian Scientific Information Database by using the following keywords: "Escherichia coli", "multidrug resistant", "MDR", "urinary tract infections", "UTI", "uropathogenic". and "Iran". Articles or abstracts that reported the prevalence of MDR-UPEC were included in this review. We found 15 articles suitable for inclusion in this study. A pooled estimation of 10,247 UPEC strains showed that 49.4% (95% confidence interval = 48.0-50.7%) of the stranis were MDR positive. The RF of MDR-UPEC in different studies varied from 10.5% to 79.2% in the Kashan and Hamedan provinces, respectively. According to the results of the present study, the RF of MDR-UPEC in Iran is high. Thus, measures should be taken to keep the emergence and transmission of these strains to a minimum.
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http://dx.doi.org/10.7883/yoken.JJID.2015.652DOI Listing
January 2017

Effect of taking dietary supplement on hematological and biochemical parameters in male bodybuilders an equation model.

Iran J Nurs Midwifery Res 2015 Nov-Dec;20(6):681-8

Isfahan Center of Health Research, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.

Background: The improved physical action following administration of supplements to bodybuilders was supported by changes in laboratory parameters. Despite the fact that these supplements are sometimes associated both advantage and side effects, this study were conducted for the purpose of evaluating the possible effects of some commonly used supplements in bodybuilders on the hematological and biochemical parameters.

Materials And Methods: In this study, we included 40 male bodybuilders as cases and 40 controls in the age group of 20-40 years. They used different kinds of supplements for 1 year. In general, all the supplements used were classified into two groups: hormonal and non-hormonal. Laboratory tests were requested for evaluation of hematological and biochemical parameters.

Results: In an equation model, we found that weight (P = 0.024), duration of bodybuilding (P < 0.001), and duration of hormone supplement consumption (P < 0.001) were loaded significantly on the latent variables, demographic and dietary supplement, respectively. The relationship between dietary supplement and biochemical and hematological parameters was significant (P = 0.01) and some of these parameters including creatinine (P = 0.023), blood aspartate aminotransferase (AST) (P < 0.001), alanine aminotransferase (ALT) (P < 0.001), and red blood cell distribution (RDW) (P = 0.046) had a significant role than others. In a multivariate regression model, we found that WBC (P < 0.001), platelets (P < 0.001), blood urea nitrogen (BUN; P < 0.001), creatinine (P < 0.001), AST (P = 0.005), and ALT (P = 0.001) were higher in athletes than in controls.

Conclusions: It is strongly advised that there should be some concerns about possible supplement-induced changes in the laboratory exams for bodybuilders. The available supplements are unchecked and not approved by the US Food and Drug Administration (FDA). More studies should be designed for a better and precise administration of each supplement in athletes.
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http://dx.doi.org/10.4103/1735-9066.170004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700687PMC
January 2016

Association of Helicobacter pylori antibodies and severity of migraine attack.

Iran J Neurol 2015 Jul;14(3):125-9

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

Background: Recent studies have shown a positive correlation between Helicobacter pylori infection and migraine headache. The aim of this study was to evaluate the role of H. pylori infection in migraine headache with (MA) and without aura (MO).

Methods: This is a case-control study containing information on 84 patients (including MA, MO) and 49 healthy individuals. The enzyme-linked immunosorbent assay (ELISA) test was used to measure immunoglobulin G (IgG,) immunoglobulin M (IgM) titer in two groups. Headache severity was evaluated according to Headache Impact Test (HIT6) questionnaire.

Results: Mean ± SD of IgM antibody in Migrainous patients 26.3 (23.1) showed significantly difference with control group 17.5 (11.2) (P = 0.004). In addition, the mean ± SD HIT6 in Migrainous patients differed significantly between MA and MO groups 65.5 (4.7), 54.9 (5.3) respectively, P < 0.001). The only significant correlation was found for IgG antibody and HIT6 in MA patients (r = 0.407, P = 0.011) and MO group (r = 0.499, P = 0.002). The risk of migraine occurrence in patients did not significantly associate with the level of IgG and IgM antibodies.

Conclusion: The results give a hope that definite treatment and eradication of this bacterium could be a cure or to reduce the severity and course of migraine headaches.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662684PMC
July 2015

Effect of Brown Rice Consumption on Inflammatory Marker and Cardiovascular Risk Factors among Overweight and Obese Non-menopausal Female Adults.

Int J Prev Med 2014 Apr;5(4):478-88

Food Security Research Center and Department of Nutrition, School of Food Science and Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Brown rice (BR) is unpolished rice with various beneficial compounds such as vitamins, magnesium and other minerals, dietary fiber, essential fatty acids, γ-oryzanol and γ-aminobutyric acid. In the present study, we compared the effects of white rice (WR) and BR on inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and cardiovascular risk factors among non-menopausal overweight or obese female.

Methods: In a randomized cross-over clinical trial, 40 overweight or obese (body mass index (BMI) >25) women were randomly allocated to group 1 (n = 20): Treatment with BR diet and group 2 (n = 20): Treatment with WR diet for 6 weeks (first intervention period). Two participants in group 2 dropped out during this period. After a 2-week washout period, individuals were switched to the alternate diet for an additional 6 weeks (second intervention period) and three subjects in group 2 did not follow this period and eliminated, finally this study was completed with 35 subjects (group 1 = 20 and group 2 = 15). Each one was instructed to consume 150 g cooked WR or BR daily in each intervention period. Cardiovascular risk factors including BMI, waist and hip circumference, blood pressure, serum lipid profiles, fasting blood glucose (FBG) and hs-CRP as an inflammatory marker, were measured 4 times (in study week 0, 6, 8, 14).

Results: BR diet in comparison with WR diet could significantly reduce weight, waist and hip circumference, BMI, Diastole blood pressure and hs-CRP. No significant differences between the two diets were found regarding lipid profiles and FBG.

Conclusions: The present results suggest that BR replacement in the diet may be useful to decrease inflammatory marker level and several cardiovascular risk factors among non-menopausal overweight or obese female.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018597PMC
April 2014