International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110926363363MD, Professor of Pediatrics, Faculty of Medicine, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.2011092620110929<p>In spite of worldwide anti-tobacco policies, and increase in public awareness on harmful effects of tobacco, still smoking is one of the global public health problems.&nbsp; In addition to its negative impacts on public health and economy, smoking is considered as a disease, registered in the tenth revision of the International Classification of Diseases (ICD-10; F17), and deserves our attention and special care due to its harmful consequences. Different actions have been implemented for quitting smoking or putting health warnings on tobacco packaging. The recent report of the World Health Organization (WHO) reported the latter action as the greatest progress of the <em>WH</em>O <em>Framework</em> Convention on <em>Tobacco</em> Control (WHO FCTC).¹</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/363http://ijpm.mui.ac.ir/index.php/ijpm/article/download/363/349

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110509144144ENPhD, Center for Medical Technology Assess- ment, Department of Medical and Health Sciences, Linköping University, Sweden.PhD, Associate Professor, Center for Medical Technology Assess- ment, Department of Medical and Health Sciences, Linköping University, Sweden.PhD, Professor, Center for Medical Technology Assess-ment, Department of Medical and Health Sciences, Linköping University, Sweden.201103172011050520110503<p><strong>Objectives:</strong> The topic of this work is health research evaluation including basic and clinical medical research, as well as healthcare research. The main objects are to explore possible approaches for valuing research in economic terms and to prepare an analytical model for evaluation of health research using the Swedish context. The study also aims to identify potential effects and their significance, and to provide a basis for discussions about the effects of research investments.</p><p class="abstract"><strong>Methods:</strong> The study has reviewed ten articles indicating positive effects, in the form of improved health and economic growth. The study also developed a model applied to Swedish health research.</p><p class="abstract"><strong>Results:</strong> The review indicates that positive effects, in the form of improved health and economic growth, have a value that greatly exceeds the costs of the research investments. The tentative model applied to Swedish health research also indicates predominantly positive returns, but in a lower range than the review would imply. Methodological problems, however, entail major uncertainty in the cited results.</p><p class="abstract"><strong>Conclusions:</strong> Accurate determination of the economic value of research would require significantly better basic data and better knowledge of relationships between research, implementation of new knowledge, and health effects. Information in support of decisions about future allocation of research resources is preferably produced by a combination of general analyses and strategically selected case studies.</p><p class="abstract"><strong>Keywords:</strong> Medical research, Policy-making, Social impact, Innovation.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/144http://ijpm.mui.ac.ir/index.php/ijpm/article/download/144/350

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110706158158ENMSc, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran and Shiraz University of Medical Sciences, Shiraz, Iran.MD, PhD, Department of Epidemiology and Biostatistics, School of Public Health, and Knowledge Utilization Research Center (KURC), Tehran University of Medical Sciences, Tehran, Iran.PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.DVM, MSc, PhD, Professor, Center for Community Based Participatory Research (CBPR), and Department of Epidemiol- ogy and Biostatistics, School of Public Health, and Knowledge Utilization Re- search Center (KURC), Tehran niversity of Medical Sciences, Tehran, Iran.2011040820110629<p><strong>Objectives:</strong> Identifying the underlying factors contributing to smoking among teenagers is important in establishing smoking control programs. The present study was designed to identify and compare factors revealed in a preceding qualitative study conducted on 13-15 year-old boys living in two different socio-economic districts in the Northern and Southern parts of Tehran.</p><p class="abstract"><strong>Methods:</strong> Two completely similar case-control studies, each with 200 subjects, were conducted using a snowball sampling. The case and control subjects were matched based on the intimacy relations, i.e. six smokers were recruited in each of the Northern and Southern districts; they were then asked to introduce one of their smoker friends as a case and a non-smoker one as a control.</p><p class="abstract"><strong>Results:</strong> Multi-variable conditional logistic regression revealed that having a smoker father is the single effective factor in the two districts. As for boys living in the Northern (wealthier) part of the city, social capital (OR: 0.59, 95% CI: 0.43-0.81) played a protective role against smoking, whereas quitting home after a quarrel (OR: 15.07, 95% CI: 1.54-147.25), monthly allowance (OR: 2.22, 95% CI: 1.29-3.82) and hyperactivity (OR: 1.69, 95% CI: 2.64-240.45) were associated with a higher risk of becoming a smoker.</p><p class="abstract"><strong>Conclusions:</strong> The studied variables can be classified as personal, familial, and school-level factors. Familial intervention is effective for all the factors which revealed to be influential on the risk of becoming a smoker. It could be concluded that interventions on the family level should be used to prevent the cigarette use in Tehran.</p><p class="abstract"><strong>Keywords:</strong> Smoking, Teenagers, Male, Snowball sampling.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/158http://ijpm.mui.ac.ir/index.php/ijpm/article/download/158/351

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110706157157ENMSc, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, and Shiraz University of Medical Sciences, Shiraz, Iran.MD, PhD, Department of Epidemiology and Biostatistics, School of Public Health, and Knowledge Utilization Research Center (KURC), Tehran University of Medical Sciences, Tehran, Iran.PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.DVM, MSc, PhD, Professor, Center for Community Based Participatory Research (CBPR), and Department of Epidemiology and Biostatistics, School of Public Health, and Knowledge Utilization Research Center (KURC), Tehran University of Medical Sciences, Tehran, Iran.2011040620110629<p><strong>Objectives:</strong> One of the main strategies to prevent smoking is delaying onset of smoking in adolescents. Thus, identifying the age of smoking and smoking pattern in adolescents gives important knowledge for planning the intervention programs on smoking.</p><p class="abstract"><strong>Methods:</strong> Students aged 13-15 years old living in the Northern and the Southern Tehran were selected through two separate snowball samplings. In each area six smokers were considered as the seeds and were asked to introduce a smoker friend. The sampling continued until one hundred study subjects were recruited in each area.</p><p class="abstract"><strong>Results:</strong> Although in the area with wealthier socioeconomic status the age at which smoking started was one year more, the number of days of smoking, number of consumed cigarettes, not willingness to quit smoking, ease of access to cigarettes, mother and siblings smoking were more frequent. In contrast, seeing anti-smoking advertisements, father smoking, teachers smoking and education about the adverse effects of smoking were lower than the area with poorer socioeconomic status.</p><p class="abstract"><strong>Conclusions:</strong> The community level interventions such as not selling cigarettes to juniors, quit smoking help and support, and education of families must be revised. The role of families, through the supervision and control over their children, and parents&rsquo; avoidance of smoking should be emphasized.</p><p class="abstract"><strong>Keywords:</strong> Cigarette smoking, Socioeconomic status, Urban disparity, Iran.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/157http://ijpm.mui.ac.ir/index.php/ijpm/article/download/157/352

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110421132132ENNutrition Program, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia and Dietetic Program, Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia.Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.201102232011041720110407Objectives: Metabolic&nbsp; syndrome&nbsp; can&nbsp; be&nbsp; diagnosed&nbsp; according&nbsp; to several&nbsp; different&nbsp; criteria&nbsp; such&nbsp; as&nbsp; the&nbsp; latest&nbsp; International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment&nbsp; Program&nbsp; III&nbsp; (NCEP ATPIII),&nbsp; and World Health Organization (WHO). The objectives of this study were to determine the&nbsp; prevalence&nbsp; of metabolic&nbsp; syndrome&nbsp; and&nbsp; the&nbsp; concordance&nbsp; between&nbsp; the above mentioned definition, and hypertriglyceridemicwaist criteria. <br />Methods: This cross sectional study was done in Bachok, Malaysia and involved 298 respondents aged between 18 to 70 years. Multistage&nbsp; random&nbsp; sampling method was&nbsp; used&nbsp; to&nbsp; identify&nbsp; study&nbsp; locations while&nbsp; convenient&nbsp; random&nbsp; sampling method was&nbsp; applied&nbsp; to select individuals. Hypertriglyceridemic waist was defined from an internationally acceptable cut-off criterion. Kappa statistic&nbsp; (&kappa; test) was&nbsp; used&nbsp; to&nbsp; determine&nbsp; the&nbsp; concordance&nbsp; between&nbsp; various&nbsp; definitions and hypertriglyceridemic-waist. <br />Results: The prevalence of metabolic syndrome based on different definitions was&nbsp; 32.2%&nbsp; (IDF),&nbsp; 28.5%&nbsp; (NCEP ATP&nbsp; III)&nbsp; and&nbsp; 12.4% (modified WHO).&nbsp; The&nbsp; prevalence&nbsp; of&nbsp; hypertriglyceridemic-waist was 19.7% and based on&nbsp; the&nbsp; IDF criteria a&nbsp; total of 97.5% participants&nbsp; with&nbsp; hypertriglyceridemic-waist&nbsp; had&nbsp; metabolic&nbsp; syndrome. <br />The&nbsp; IDF&nbsp; criteria&nbsp; showed&nbsp; the&nbsp; highest&nbsp; concordance&nbsp; with&nbsp; NCEP ATPIII criteria (&kappa; = 0.63), followed by hypertriglyceridemic-waist criteria (&kappa; = 0.62) and WHO criteria (&kappa; = 0.26). <br />Conclusions: The prevalence of metabolic&nbsp; syndrome was highest using&nbsp; the&nbsp; IDF&nbsp; criteria&nbsp; compared&nbsp; to&nbsp; NCEP&nbsp; ATPIII,&nbsp; modified WHO and hypertriglyceridemic-waist. There was a good concordance&nbsp; of&nbsp; IDF&nbsp; criteria&nbsp; with&nbsp; NCEP&nbsp; ATP&nbsp; III&nbsp; and&nbsp; hypertriglyceridemic-waist criteria. <br />Keywords:&nbsp; Hypertriglyceridemic-waist,&nbsp; Metabolic&nbsp; syndrome, <br />Malaysia.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/132http://ijpm.mui.ac.ir/index.php/ijpm/article/download/132/353

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110312102102ENMD, MPH, Associate Professor, Infec-tious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran and The University of Queensland Center for Clinical Re-search, Brisbane, Queensland, Australia.MD, Azad Islamic University, Tehran, Iran.2011010620110121<p><strong>Objectives:</strong> Total white blood cells (WBCs) decrease slightly in the elderly. In response to an acute infection, the number of WBCs increases and in sepsis, the increase is very dramatic. There are some reports about the effects of increased number of WBCs as a predisposing factor of bacteremia. An association between neutrophilia and leukopenia and increased mortality rate in the elderly has also been observed. We compared peripheral WBC counts in young and elderly patients with sepsis.</p><p class="abstract"><strong>Methods:</strong> A case-control study was carried out on 130 admitted patients who were divided into two groups based on age, &ge; 65 years (case group) and &lt; 65 years (control group). All patients were hospitalized with the diagnosis of sepsis in two teaching hospitals in Tehran, Iran, 2001-2006.</p><p class="abstract"><strong>Results:</strong> Mean WBC counts at admission time were 17061.5 &plusmn; 14240.2 /ml in the case group and 13567.7 &plusmn; 9888.0 /ml in the control group. There were statistically significant associations between age and history of infection and history of hospitalization during the last month in the case group and also between age and source of infection (P &lt; 0.05).</p><p class="abstract"><strong>Conclusions:</strong> The history of infection and the history of hospitalization during the last month with sepsis are important risk factors in elders.</p><p class="abstract"><strong>Keywords:</strong> Sepsis, Leukocytosis, Elderly.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/102http://ijpm.mui.ac.ir/index.php/ijpm/article/download/102/354

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110628191191ENMD, MPH, Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Assistant Professor, Nutrition, Food Sciences and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Endocrine Research Center, Re-search Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.2011061820110619<p><strong>Objectives:</strong> The aim of this study was to assess leisure time physical activity and its determinants among adults in Tehran.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study comprised adults (n = 7285), aged 20 years and older. The subjects were participants of the Tehran Lipid and Glucose Study between 2002 and 2004. Information on the number of days spent on different activities during a week and the time devoted to each activity on a typical day was recorded. In addition, each activity, weighted by its relative intensity, was referred to as a metabolic equivalent.</p><p class="abstract"><strong>Results:</strong> The prevalence of inactivity was 69.8% (95% CI: 68.7-70.8) in the whole population and 30.2% (95% CI: 27.2-33.1%) of men and 30.3% (95% CI: 27.7-32.8%) of women were considered as active. Leisure time physical activity less than 30 min/week was scored in 1590 (50.6%) men and 1803 (43.5%) women. The most frequent leisure time physical activity performed by men (96.1%) and women (95.2%) was walking. A negative association was observed in men between leisure time physical activity and increased work hours, older age, more cigarette smoking and higher body mass index (69.8% were overweight and 75.3% were obese; P &lt; 0.05). Leisure time physical activity was more likely to be associated with high educational levels in men. In addition, there was a statistically significant relationship between physical inactivity and occupation in both men and women.</p><p class="abstract"><strong>Conclusions:</strong> The prevalence of physical inactivity among adults in Tehran was high. Leisure time physical inactivity was more likely to be associated with older age, more cigarette smoking, more working hours, and higher body mass index. Public health efforts are needed to improve people's participation in physical activities in Iran.</p><p class="abstract"><strong>Keywords:</strong> Physical inactivity, Adults, Tehran, Leisure time.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/191http://ijpm.mui.ac.ir/index.php/ijpm/article/download/191/355

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110417147147ENPharm D, Isfahan Pharmaceutical Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Pharm D, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Department of Clinical Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.Pharmacy Student, School of Pharma-cy, Isfahan University of Medical Sciences, Isfahan, Iran.2011032620110929<p>Objectives: Emergency contraception&nbsp; (EC)&nbsp; is a special contraception method&nbsp; that prevents pregnancy after an unsafe sexual contact. Pharmacists, as&nbsp; the most available member of medical&nbsp; team have a unique role in patient education for appropriate use of contraceptive methods. <br />In this study, we assessed the pharmacists' knowledge about emergency contraception. <br />Methods: A&nbsp; researcher made&nbsp; questionnaire was&nbsp; developed&nbsp; and&nbsp; used according&nbsp; to national guide&nbsp; line and electronic databanks. A group of experts&nbsp; and&nbsp; pharmacists&nbsp; validated&nbsp; the&nbsp; questionnaire.&nbsp; Reliability&nbsp; was measured by Half&ndash;Split Test. The questionnaires were&nbsp; filled by pharmacists. <br />Results:&nbsp; Average&nbsp; knowledge&nbsp; score&nbsp; were&nbsp; 8.12&nbsp; &plusmn;&nbsp; 0.28&nbsp; for&nbsp; women&nbsp; and&nbsp; 7.83 &plusmn; 0.31 for men (from a maximum of 15) which showed no significant&nbsp; difference&nbsp; between men&nbsp; and women&nbsp; (P =&nbsp; 0.492).&nbsp; There was&nbsp; no significant difference between pharmacists who had precipitated in continuing education programs and that of those who had not (P = 0.286). <br />Scores of pharmacists who graduated 13 years ago or more did not significantly differ from others (P = 0.287). <br />Conclusions: Because of low scores of pharmacist&rsquo;s knowledge about EC&nbsp; and&nbsp; the&nbsp; importance&nbsp; of&nbsp; unintended&nbsp; pregnancy&nbsp; prevention,&nbsp; its&nbsp; improvement&nbsp; is an urgent need. Regular and&nbsp; frequent continuing education programs could be one of the recommended interventions. <br />Keywords: Knowledge, Pharmacist, Isfahan, Emergency contraception.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/147http://ijpm.mui.ac.ir/index.php/ijpm/article/download/147/356

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110628149149ENDepartment of Family Medicine & Public Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman. Gulf Health Research, Muscat, Oman.University of Toronto, Toronto, Canada.Dibetes Center, King Saud University, Al Riyadh, KSA.201104012011052220110522<p><strong>Objectives:</strong> This study aimed to assess the impact of diabetes mellitus and hypertension as well as other demographic and clinical characteristics on perceived health status in primary health centers in Oman.</p><p class="abstract"><strong>Methods:</strong> In a cross-sectional retrospective study, 450 patients <br />(aged &ge; 18 years) seen at six primary health centers in Wilayat A' Seeb in the Muscat region, Oman, were selected. Perceived health status of the physical (PSCC) and mental (MSCC) components of quality-of-life were assessed using the 12-item short form health survey (SF-12). The analyses were performed using univariate statistical techniques.</p><p class="abstract"><strong>Results:</strong> The mean age of the participants was 54 &plusmn; 12 years and they were mostly female (62%). The presence of both diabetes mellitus and hypertension was associated with lower physical scores compared to those with diabetes alone (p = 0.001) but only marginally lower than those with hypertension alone (p = 0.066). No significant differences were found across the disease groups in mental scores (P = 0.578). Age was negatively correlated (p &lt; 0.001) but male gender (P &lt; 0.001), married (p &lt; 0.001), literate (p &lt; 0.001) and higher income (p = 0.002) were all associated with higher physical scores. Moreover, longer disease duration was associated with lower physical scores (p &lt; 0.001). With regards to the mental status, male (p = 0.005), marriage (P = 0.017) and higher income (p &lt; 0.001) were associated with higher mental scores. Polypharmacy was associated with lower physical (p &lt; 0.001) and mental (p = 0.005) scores.</p><p class="abstract"><strong>Conclusions:</strong> The presence of both diseases was associated with lower physical scores of perceived health status. Health status was also affected by various demographic and clinical characteristics. However, the results should be interpreted in light of the study&rsquo;s limitations.</p><p class="abstract"><strong>Keywords:</strong> Perceived health status, Hypertension, Diabetes mellitus, Primary health centers, Oman.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/149http://ijpm.mui.ac.ir/index.php/ijpm/article/download/149/357

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110628227227ENAssociate Professor, Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Child Health Promotion Research Center,IUMS Isfahan, Iran.Associate Professor, Department of Ophthalmology, Farabi Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Department of Pediatrics, Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Associate Professor, Department of Genetics, Isfahan University of Medical Sciences, Isfahan, Iran.Assistant Professor, Department of Pediatric Nephrology, Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.2011062020110620<p><strong>Objectives:</strong> The aim of this study was to determine steroid dependent and independent ocular abnormalities in children with nephrotic syndrome (NS). Due to the relapsing nature of NS prolonged usage of corticosteroid puts the patients at the risk of ocular side effects of prednisolone. Since published data evaluating both steroid dependent and independent ophthalmic findings in children with NS is scarce, we evaluated ophthalmic findings in this group of patients according to the response to steroid.</p><p class="abstract"><strong>Methods:</strong> The study population consisted of 35 patients with steroid-sensitive NS (SSNS) and 40 patients with steroid-resistant NS (SRNS). The patients who aged 2-18 years underwent ophthalmologic examination for steroid dependent and independent ocular abnormalities.</p><p class="abstract"><strong>Results:</strong> The median age of patients was 7.2 years (ranged 1.2-19 years). Forty-seven subjects were men and 28 were women. Patients with SRNS had significantly higher systolic and diastolic blood pressure than patients with SSNS (p &lt; 0.05). Forty-five out of 75 patients (60%) had either steroid dependent or independent ophthalmic symptoms. Twenty percent of the patients had steroid dependent and 29% had steroid independent ocular abnormalities. Posterior subcapsular cataract and myopic astigmatism were the most common steroid dependent and independent ophthalmologic symptoms, respectively</p><p class="abstract"><strong>Conclusions:</strong> Steroid independent eye involvements are not uncommon in NS children and should be considered especially in SRNS.</p><p class="abstract"><strong>Keywords:</strong> Nephrotic syndrome, Children, Steroid, Ocular problems.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/227http://ijpm.mui.ac.ir/index.php/ijpm/article/download/227/358

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110509161161ENPhysiology Research Center, Depart-ment of physiology, Isfahan University of Medical Sciences, Isfahan, Iran.Physiology Research Center, Depart-ment of physiology, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Health and Sport Medicine, School of Physical Education, University of Tehran, Iran.Physiology Research Center, Depart-ment of physiology, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran.201104112011050720110507<p><strong>Objectives:</strong> Cardiac tertiary prevention programs intend to support the recovery course following coronary artery bypass grafting (CABG). We investigated the effects of attendance at cardiac rehabilitation (CR) programs following CABG on patients&rsquo; mortality, morbidity and health related quality of life.</p><p class="abstract"><strong>Methods:</strong> Eighty patients who underwent CABG were selected in a way that half of them had attended a cardiac rehabilitation program and the other half had not. Health related quality of life (HRQoL) was measured using the Short Form 36 (SF-36) questionnaire at a mean of 23.4 months postoperatively. Severity of cardiac symptoms on the basis of the New York Health Association (NYHA), the occurrence of any neurological symptoms, hospitalization and restoration of patients to their previous level of performance in social activities were assessed after CABG surgery.</p><p class="abstract"><strong>Results:</strong> There were no deaths. There were no differences in postoperative NYHA scores, neurological symptoms, and hospitalization. Three of the eight health domains measured by SF-36, namely general health (P = 0.010), physical function (P = 0.002), and mental health <br />(P &lt; 0.001), showed significantly better values for attendants than non-attendants. Rehabilitation participants returned to their previous level of performance in social activities more than their control counterparts.</p><p class="abstract"><strong>Conclusions:</strong> Higher general health scores (SF-36) were associated with attendance at CR programs. The findings of this study provide rationale to consider a broader scope of physiological and psychosocial parameters to predict outcomes of CABG surgery.</p><p class="abstract"><strong>Keywords:</strong> Coronary artery bypass grafting, Cardiac rehabilitation, Health related quality of life.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/161http://ijpm.mui.ac.ir/index.php/ijpm/article/download/161/359

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110628182182ENMD, Professor, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Anesthesiologist, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Assistant Professor and Fellowship in Critical Care Medicine, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.MD, Associate Professor, Fellowship in Cardiac Anesthesia, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.201105052011052320110523<p><strong>Objectives:</strong> Throat pain is a common postoperative complaint. In this study, we aimed to determine its incidence of throat pain after rhinoplasty by general anesthesia (GA) or conscious sedation (CS).</p><p class="abstract"><strong>Methods:</strong> We evaluated throat pain in postanesthesia care unit, 4, 12 and 24 hours after surgery using a numerical rating scale (NRS) in a clinical trial. A total number of 252 consecutive females aging over 18 years undergoing GA or CS for elective rhinoplasty entered the study after implementing inclusion and exclusion criteria. A logistic regression model was used to predict having throat pain.</p><p class="abstract"><strong>Results:</strong> The incidence of throat pain after CS and GA in postanesthesia care unit, 4, 12 and 24 hours after rhinoplasty were 34.9% vs. 34.9% (P = 0.99), 27.0% vs. 33.3% (P = 0.27), 14.3% vs. 22.2% (P = 0.10), 10.3% vs. 15.9% (P = 0.19), respectively. The odds ratio for throat pain was statistically significant for nausea/vomiting in postanesthesia care unit (OR = 11.1, 95% CI: 5.7-21.8; P &lt; 0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Method of anesthesia had no independent role in predicting throat pain. Although larynx of subjects undergoing general anesthesia is manipulated by tracheal intubation, sedation has its specific risks for promoting throat pain after surgery. Therefore, neither CS nor GA is superior in terms of throat pain.</p><p class="abstract"><strong>Keywords:</strong> Conscious sedation, General anesthesia, Sore throat, Incidence.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/182http://ijpm.mui.ac.ir/index.php/ijpm/article/download/182/360

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110421114114ENMD, Department of Pediatric Hematol- ogy, School of Medicine, and Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Assistant Professor, Department of Biology, University of Isfahan, Isfahan, Iran.MD, Isfahan University Health Center, University of Isfahan, Isfahan, Iran.BSc, Department of Biology, University of Isfahan, Isfahan, Iran.MD, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Isfahan University of Medical Sciences, Isfahan, Iran.201101282011040820110319<p><strong>Objectives:</strong> Obesity and increased blood pressure are identified as risk factors for cardiac and pulmonary disorders. On the other hand, iron deficiency (another preventable disease) is common in adolescence and considered as associated with health impairment. The present study evaluates body mass index (BMI) and its association with blood pressure and hematological indices in freshman students entering the University of Isfahan in 2009.</p><p class="abstract"><strong>Methods:</strong> All the 1675 students who entered the University of Isfahan in September 2009 were examined. Height, weight, BMI, blood pressure, hemoglobin (Hb) and red blood cell (RBC) indices of these students were measured. The prevalence of high blood pressure, its association with BMI and the relation between BMI and anemia, iron deficiency and educational achievement were assessed.</p><p class="abstract"><strong>Results:</strong> All participants, including 514 males and 1161 females, went under clinical observations. The average age was 20.7 &plusmn; 3.8. year Among the students, 18.2% of males and 20% of females were underweight. High systolic blood pressure was more common in the students with BMI &gt; 25 kg/m² (p &lt; 0.001). Anemia was seen in 8.7% of females. In males, however, a relation between anemia frequency and BMI &lt; 18.5 kg/m² was more distinct (p = 0.002). There was no association between anemia and students&rsquo; average test scores.</p><p class="abstract"><strong>Conclusions:</strong> High incidence of abnormal BMI in the study population, and its association with systolic blood pressure indicate the importance of nutritional guidelines and counseling programs for freshman students. On the other hand, high incidence of anemia in this population ascertains the necessity of anemia screening programs before academic studies.</p><p class="abstract"><strong>Keywords:</strong> Body mass index, Systolic blood pressure, Iron deficiency anemia.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/114http://ijpm.mui.ac.ir/index.php/ijpm/article/download/114/361

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110509142142ENMD, Department of Infectious and Tropical Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Department of Infectious and Tropical Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Department of Rheumatology, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Department of Infectious and Tropical Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.201103152011050320110414<p class="abstract">Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause. In this study, we report a case of SLE that was presented with persistent vomiting and liver involvement. To our knowledge, this is the first description of a patient with hepatic necrosis as the initial presentation of SLE in a previously healthy woman without any significant past medical history. In the literature, we found few cases of SLE with liver necrosis. In addition, all the cases found had a past medical history of a missed abortion or other complications of the disease. Therefore, if a young woman presents hepatic necrosis with a background of a previously missed abortion, it is better to perform anti-nuclear antibody (ANA) and anticardiolipin antibody tests as a preventive method for early diagnosis and early treatment.</p><p class="abstract"><strong>Keywords:</strong> Hepatitis, Systemic lupus erythematosus, Hepatic necrosis.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/142http://ijpm.mui.ac.ir/index.php/ijpm/article/download/142/362

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110813181181ENMBChB, BMedSci (Hons), S1 Plastic Surgery, Salisbury District Hospital, Salisbury, England, United Kingdom.MBBS, MRCS, PhD, ST3 Plastic Surgery.BSc (Hons) MBBS, MD, FRCS (Plast), Consultant Plastic Surgeon.FRCS (Plast), Consultant Plastic Surgeon.201105042011081120110808<p><strong>Objectives:</strong> We report a rare case of burns following the use of automated air-fresheners.</p><p class="abstract"><strong>Methods:</strong> We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described.</p><p class="abstract"><strong>Results:</strong> A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms resulting in a seven-day hospital admission. The burns were treated conservatively.</p><p class="abstract"><strong>Conclusions:</strong> To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale.</p><p class="abstract"><strong>Keywords:</strong> Air-freshener, Burns, Aerosol, Public health.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/181http://ijpm.mui.ac.ir/index.php/ijpm/article/download/181/363

International Journal of Preventive Medicine (Int J Prev Med)2008-78022420110927366366MD, Professor of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences,Isfahan,Iran.2011092720110929<p class="matn">The need for highly effective tick-borne encephalitis (TBE) vaccines has increased globally due to a variety of factors including climate, social, economic and demographic changes, which are thought to have promoted the expansion of the endemic region of TBE viruses. The first TBE vaccine, FSME-IMMUN(&reg;) Inject, was introduced in the 1970s and has been continually improved since then to enhance both its safety and immunogenicity. The current formulation was established in 2001 and is marketed as FSME-IMMUN(&reg;). This review summarizes findings of the <strong>clinical</strong> development programme since 2001 regarding determination of the optimal dose, conventional and rapid vaccination schedules, vaccination in adults, the elderly and special patient populations, safety, immunogenicity, and immunopersistence in adults and children, comparison of FSME-IMMUN(&reg;) with another commercially available TBE vaccine as well as post-marketing vaccination outcome. This successful research programme demonstrated the strong immunogenicity and continued safety of the FSME-IMMUN(&reg;) vaccine, which is further confirmed by the performance reported under field conditions.</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/366http://ijpm.mui.ac.ir/index.php/ijpm/article/download/366/364