International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310558558ENMedical Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, IranMedical Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, IranIntegrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, IranMedical Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, IranMedical Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, IranIntegrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Due to its high prevalence and absence of curative therapy, IBS has the potential to create tremendous burden on the health care system. Herein, we systematically reviewed the published literature to investigate the epidemiology of IBS in Iran.</p> <p><strong>Methods: </strong>Studies that were reviewed in this article were primarily identified through four online bibliographic databases including PubMed, Google Scholar, IranMedex, and Scientific Information Database. Manual search of reference lists was carried out to identify any additional studies such as relevant abstracts and also recent review articles which may have been missed. Potentially related studies were retrieved and the selection criteria were applied. Eligible articles were reviewed.</p> <p><strong>Results: </strong>From 4176 studies identified, 18 eligible studies were included. It was reported that in Iran, the prevalence of IBS was in the range of 1.1% to 25% and was more common in women. In addition, the difference in frequency of different age groups was minimal. There was a minimal difference in IBS prevalence within different age groups.</p> <p><strong>Conclusions: </strong>In Iran, the incidence of IBS was in the wide range. Since there are not enough population-based studies, researchers should focus on developing well-designed population-based studies to determine the epidemiology of IBS in Iran. Moreover, cohort studies should be conducted in order to investigate the natural history of IBS. Investigating the etiology of IBS and attempt to organize health promotion programs are highly suggested.</p> <strong>Keywords: </strong>computer,windows 8, Irritable bowel syndrome, functional gastrointestinal disorders, epidemiology, systematic review, Iranhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/558http://ijpm.mui.ac.ir/index.php/ijpm/article/download/558/423

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310559559EN20120310<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is one of the most prevalent disorders affecting gastrointestinal tract with a wide range of frequency around the world. In this study, we aimed to review all of the published studies about GERD&rsquo;s prevalence in Iran systematically.</p> <p><strong>Methods: </strong>We searched bibliographic databases including PubMed and Google Scholar and local databases (Scientific Information Database and Iran Medex) to achieve all relevant articles to our subject and included them based on predefined inclusion criteria.</p> <p><strong>Result: </strong>Twenty-two articles were included in the study to estimate the prevalence of GERD in Iran. Based on these articles, the prevalence of GERD in Iran was within the range of 1.9 to 52%.</p> <p><strong>Conclusions: </strong>Due to the differences between studies, such as characteristics of the sampled population and the diagnostic criteria, the reported prevalence of GERD was remarkably different in the reviewed studies. Nonetheless, because of the high prevalence of GERD in Iran, conducting large-scale epidemiological studies should be considered to determine factors associated with the prevalence of GERD to prevent and control it.</p> <strong>Keywords: </strong>Gastroesophageal Reflux Disease, Heartburn, Acid Regurgitation, Iran, Systematic Reviewhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/559http://ijpm.mui.ac.ir/index.php/ijpm/article/download/559/424

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310560560EN20120310<p><strong>Background: </strong>Dyspepsia is an upper gastrointestinal tract syndrome presenting epigastric pain and discomfort, fullness sensation, early satiety, nausea, vomiting, and belching. The prevalence of dyspepsia has been reported to be high all over the world. In this study, we reviewed studies reporting the prevalence of dyspepsia in Iran and discussed the probable risk factors of dyspepsia to shed light on future research on this topic.</p> <p><strong>Methods: </strong>The four electronic databases of PubMed, Google Scholar, IranMedex, and Scientific Information Database were searched. The keywords for the electronic search were &ldquo;dyspepsia&rdquo; and &ldquo;Iran&rdquo;. A manual search of the reference lists of the selected articles was also carried out. Two reviewers reviewed and identified articles independently and selected relevant studies based on our inclusion and exclusion criteria.</p> <p><strong>Results: </strong>Nine articles reporting the prevalence of dyspepsia in Iran were included. The reported prevalence ranged from 2.2% to 29.9%. The majority of studies have reported the prevalence of dyspepsia to be higher in women.</p> <p><strong>Conclusion: </strong>Dyspepsia seems to be highly prevalent in Iran. Considering the wide range of data reported in different studies, conducting further population-based studies is necessary to investigate the epidemiology and risk factors of dyspepsia among Iranians.</p> <strong>Keywords: </strong>Dyspepsia, epigastric pain, dyspepsia prevalence, Iranhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/560http://ijpm.mui.ac.ir/index.php/ijpm/article/download/560/425

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310561561EN20120310<p><strong>Objectives: </strong>Bloating is a common and bothersome gastrointestinal symptom. Despite its high prevalence, associated costs, and effects on the quality of life, very few studies have reported the epidemiology of bloating in Iran. Through this systematic review, findings and limitations of the current research will be discussed.</p> <p><strong>Methods: </strong>In March 2012, we searched PubMed, Google Scholar, Scientific Information Database, IranMedex, and Magiran to find articles for inclusion in the study. Two of the authors screened the articles on the basis of titles and abstracts. The full manuscripts of these publications were then evaluated according to the predefined criteria.</p> <p><strong>Results: </strong>Fifteen articles were included in the study, and data regarding the prevalence of bloating were extracted. The studies depict a prevalence of 1.5% to 8.8% for bloating in the Iranian population. Two studies reported the prevalence of functional bloating to be 1.5% and 10% according to the Rome III and Rome II criteria, respectively. Female to male ratio remains &ge;1 for most of the studies criteria.</p> <p><strong>Conclusions: </strong>In Iran, data on the prevalence of bloating are limited, and have mostly been gathered from a highly selective population. The results of the present study advocate the necessity to perform further studies on the general population, which may help health policy makers in the allocation of the appropriate resources.</p> <strong>Keywords:</strong> Bloating, abdominal distension, epidemiology, Iran, systematic reviewhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/561http://ijpm.mui.ac.ir/index.php/ijpm/article/download/561/426

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310562562EN20120310<p><strong>Background: </strong>Constipation is physically and mentally troublesome for many patients and has adverse effects on their quality of life. The aim of the present study was to systematically review previous studies on the epidemiology of constipation in Iran.</p> <p><strong>Methods: </strong>Bibliographic databases including PubMed, Google Scholar, and Iranian databases including Scientific Information Database, Iran Medex, and Magiran were searched to select studies that reported the prevalence of constipation in Iran.</p> <p><strong>Results: </strong>Overall, 10 articles met the inclusion criteria of the current study. The prevalence of constipation in Iran ranged from 1.4-37%, and the prevalence of functional constipation was reported to be 2.4- 11.2%. Gender, age, socioeconomic status and educational level seem to have major effects on this condition.</p> <p><strong>Conclusion: </strong>The prevalence of constipation is high in Iran. There are very few data available regarding the natural history, quality of life and risk factors of constipation in our country. Conducting populationbased studies is necessary to explore different epidemiological aspects of constipation in Iran.</p> <strong>Keywords: </strong>Constipation, epidemiology, Iran, systematic review.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/562http://ijpm.mui.ac.ir/index.php/ijpm/article/download/562/427

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310563563EN20120310<p><strong>Objectives: </strong>Tooth loss appears to have an important role in the loss of mastication and esthetics. The aim of this systematic review was to investigate the prevalence of tooth loss and edentulism in the Iranian population.</p> <p><strong>Methods: </strong>Studies reviewed in this article were primarily identified via search of the online bibliographic databases including PubMed and Iranian Biomedical Journals, by using &ldquo;tooth loss&rdquo;, &ldquo;edentulism&rdquo;, &ldquo;epidemiology&rdquo;, and &ldquo;Iran&rdquo; as keywords. Studies potentially related to this topic were retrieved and the selection criteria applied. From the chosen studies the eligible articles were reviewed.</p> <p><strong>Results: </strong>Of the studies identified after conducting the search, 10 eligible studies were extracted. The prevalence of tooth loss ranges between 0.3% in 3 to 5-year-old children to 70.7% in adults over 65. There is a lack of well-designed epidemiological studies on edentulism and tooth loss in Iran. The prevalence of tooth loss is high and it increases by aging.</p> <p><strong>Conclusions: </strong>It seems that the prevalence of tooth loss is high among adults in Iran. It is highly suggested that population-based studies should be established to investigate the epidemiology and risk factors of tooth loss in Iran. The results of such studies will be useful in the adoption of appropriate preventive strategies.</p> <strong>Keywords: </strong>Tooth loss, Edentulism, Prevalence, Iranhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/563http://ijpm.mui.ac.ir/index.php/ijpm/article/download/563/428

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310554554ENResident of community medicine, Community Medical Department, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Community Medical Department, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p>Hepatitis C virus (HCV) infection is a serious public health concern throughout the world. Despite its public health prominence, however, how surveillance systems for hepatitis C should be designed is still a challenging issue especially in developing countries such as Iran. Establishing a surveillance system needs an ongoing process of case investigation, data collection, analysis of data and also dissemination of data to public health professionals and health care providers.</p> <p>This review article tries to provide the best recommendations for planning and implantation a surveillance system for HCV infection.</p> <p><strong>Keywords:</strong> Epidemiology, Hepatitis C infection, Iran, surveillance system</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/554http://ijpm.mui.ac.ir/index.php/ijpm/article/download/554/450

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310535535ENMD, Associate Professor, Child Health Promotion Research Center and Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMedical Student, Child Health Promotion Research Center and School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Background</strong>: Celiac disease is one of the malabsorption syndromes leads to growth and development retardation in children. There is no test lonely can definitely diagnose celiac; however, the collection of clinical findings, serologic tests, intestinal biopsy, and response to treatment may diagnose it. Although diagnostic value is variable in different studies, they are used a non-invasive and appropriate screening methods today. This study aimed to evaluate diagnostic value of celiac serologic tests in children less than 15-year-old.</p> <p><strong>Methods</strong>: During two years, this study conducted on children referred to Al-Zahra hospital (Isfahan, Iran). All the children who had duodenal biopsy tests were evaluated in terms of serologic tests and clinical symptoms due to suspected celiac. The results were analyzed through descriptive statistics, chi-square and Fisher&rsquo;s exact tests using SPSS software.</p> <p><strong>Results</strong>: 15.8 percent of children were under 2 years, 37.3 percent between age range of 2 to 12 years and 10.5 percent were above 12 years. 8.1 percent of children with negative anti-endomysial antibody (EMA) suffered from celiac; while 20.0 percent of children with positive EMA suffered from celiac. 15.4 percent of children with negative anti-gliadin antibody (AGA) had celiac; while 11.6 percent of those with positive AGA suffered from it. 11.1 percent of those with negative tissue transglutaminase antibody (tTG) and 37.5 percent with positive tTG suffered from celiac.</p> <p><strong>Conclusion</strong>: According to our study results, there is no correlation between gastrointestinal symptoms such as vomiting diarrhea, anorexia, bulimia, and failure to thrive (FFT) with celiac. TTG was the best screening test method to diagnose celiac disease and other tests such as AGA and EMA do not have high diagnostic value.</p> <p><strong>Keywords</strong>: Celiac, Malabsorption, Anti-gliadin antibody, Anti-endomysial antibody, Tissue transglutaminase antibody</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/535http://ijpm.mui.ac.ir/index.php/ijpm/article/download/535/434

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310536536EN20120310<p><strong>Background:</strong> Mental disorders such as depression, anxiety and dementia are common in elderly. However, physical activity is suggested to be effective in preventing such aging-related disorders. The aim of this study was to investigate the role of physical activity on mental health in later life.<strong> </strong></p><p><strong>Methods</strong><strong>: </strong>Four hundred elderly people were randomly divided into the intervention and control groups. The intervention consisted of exercise twice a week for two months. Mental health status before, just after, and three months after the study was assessed with the 28-item General Health Questionnaire (GHQ-28(.</p><p><strong>Results</strong><strong>:</strong> The mean of the GHQ-28 total scale decreased in the case group and this change remained significant after three months (before: 8 &plusmn; 5.5, after three months: 5.6 &plusmn; 4.6, p &lt; .001).<strong> </strong>GHQ subscales including somatization, anxiety, social dysfunction, and depression decreased significantly in the case group just after and three months after the intervention.</p><p><strong>Conclusion:</strong> Physical activity significantly prevents mental disorder in older adults. Although it has effects on anxiety, social dysfunction, and depression, the greatest influence is on improving the somatization symptoms.</p><strong>Keywords:</strong> Aging, GHQ-28, mental health, physical activityhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/536http://ijpm.mui.ac.ir/index.php/ijpm/article/download/536/417

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310537537ENMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastroenterology, Integrative Functional Gastroenterology Research center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Background:</strong> Intravenous drug users (IVDUs) who share needles/syringes and practice sexual behaviors, are the most important group in the transmission of blood-borne infection diseases such as hepatitis C virus (HCV). Therefore identification of prevalent high-risky behaviors among IVDUs to detect the most route of transmission among them is essential to develop harm reduction programs among IVDUs and decrease HCV transmission from them to community.<strong> </strong></p> <p><strong>Methods: </strong>The cross-sectional study was carried out on 1510 intravenous drug users from November 2008 to February 2009 in Isfahan province, Iran. After obtaining consent form from participants, information was collected by interviewer-administered validated questionnaire. The data was analyzed with descriptive statistical methods by SPSS software, version 15.<strong> </strong></p> <p><strong>Results: </strong>1510 IVDUs participated in the study with the mean age 32.16 &plusmn; 8.26. 66.4% of participants had a history of illegal sexual activity. Among male IVDUs who had illegal sexual contact, 40.6% reported having homosexual contact and 36.2% of them have used condom in their contact. Also 57.7% had sexual contact with female sex workers. 83.5% of IVDUs reported having multiple sexual partners, and 30.9% had IVDUs sexual partners. The mean number of injection and duration of injection among IVDUs were 75.12 &plusmn; 95.51 times per month and 12.34 &plusmn; 7.53 years respectively. 36.9% of subjects have reported sharing needles/syringes.</p> <p><strong>Conclusion: </strong>According to the high prevalence of unprotected sexual contacts and unsafe injection among IVDUs, effectiveness interventions and harm reduction programs are necessary to prevent spread of blood-borne infection diseases particularly HCV. With reduction of risky behaviors and consequently decrease of spread of HCV, these programs benefit both drug users and society.</p> <p>&nbsp;<strong>Keywords: </strong>Hepatitis C<strong> </strong>virus, high-risky behaviors, intravenous drug users</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/537http://ijpm.mui.ac.ir/index.php/ijpm/article/download/537/412

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310538538EN20120310-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/538http://ijpm.mui.ac.ir/index.php/ijpm/article/download/538/422

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310539539ENAssistant Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastroenterology, Integrative Functional Gastroenterology Research center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Background: </strong>Patients with<strong> </strong>hereditary bleeding disorders are at risk of viral infection such as hepatitis C due to frequent transfusion of blood and blood products. This study aimed to determine the prevalence of hepatitis C and associated risk factors in hemophilic patients in Isfahan, the second big province in Iran.</p><p><strong>Methods: </strong>In a descriptive study, patients with hemophilia in Isfahan province were enrolled. A questionnaire, including demographic and risk factors of hepatitis C was completed through a structured interview with closed questions by a trained interviewer for each patient and HCV-Ab test results were extracted from patient records. <strong></strong></p><p><strong>Finding: </strong>In this study, 232 of 350 patients with hemophilia A and B (66%) were positive for hepatitis C. Based on Multivariate Logistic Regression model, no independent risk factor was found. <strong></strong></p><p><strong>Conclusion: </strong>Prevalence of hepatitis C in patients with haemophilia A and B in Isfahan is high. Since no independent risk factor for hepatitis C disease was found in this high risk group, it can be concluded that multitransfusion is the only predictor for hepatitis C.</p> <p><strong>Keywords: </strong>Hemophilia, Hepatitis C, risk factors</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/539http://ijpm.mui.ac.ir/index.php/ijpm/article/download/539/420

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310540540ENProfessor, Integrative Functional Gastroenterology Research center, Isfahan University of Medical Sciences, Isfahan, IranFaculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, IranFaculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Liver cirrhosis can change many aspects of life of the patients and their family and effects society. We aimed to study the utility of cirrhosis from the point of view of the patients, their family, and their care takers to find appropriate interventions, and training and counselling programmes to support patients.</p> <p><strong>Methods: </strong>In this cross-sectional study with a goal-based sampling method, 66 individuals constructed of 30 decompensated patients with cirrhosis, 21 of the patients family members, and 15 care takers were included. The data were collected through face to face interview and completing of questionnaire consisted of demographic information (age, gender, marital status, and income), the duration of illness, and assessment of utility of cirrhosis using techniques of time trade, standard gamble, rating scale, and the willingness to pay.</p> <p><strong>Results: </strong>52% of participants were men and 48% women which consisted of 58 married, 4 single, and 4 divorced or widowed with the mean duration of having cirrhosis of 3.7 &plusmn; 1.4 years. The mean scores of utility of the three groups in all preference-based measures had significant differences (P &lt; 0.05). Different techniques of patient utility in this research from the highest to the lowest were standard gamble (0.55), willingness to pay (0.54), rating scale (0.25), and rating scale (0.05), respectively.</p> <p><strong>Conclusions: </strong>The results of the currents study suggested that the cirrhosis status has had the most negative effect on patients, and that patients had a lower utility rate than their family members and caretakers.</p> <strong>Keywords: </strong>Cirrhosis, Health-State, Family, Caretaker.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/540http://ijpm.mui.ac.ir/index.php/ijpm/article/download/540/449

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310541541ENInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Patients with Hepatitis C Virus infection are at high risk of getting hepatitis A virus. Hepatitis A virus is an important widespread virus that usually causes more severe medical consequences in patients with chronic liver disease. The purpose of this study was to evaluate prevalence of Hepatitis A Virus antibody in patients with chronic HCV in Isfahan province, Iran.</p> <p><strong>Methods: </strong>A cross-sectional study was carried out on 117 patients with chronic hepatitis C virus from spring 2010 to spring 2011. Subject&rsquo;s characteristics such as age, gender, education, genotype of HCV infection and history of intravenous drug use were collected by questionnaire and studied. Statistical analysis was done by SPSS software (version 19.0. 2010, SPSS) using Chi-square test, Fisher Exact tests and Cochran-Armitage trend test.</p> <p><strong>Results: </strong>The mean age of the subjects was 33.18 &plusmn; 10.97 years. The seroprevalence of HAV was 94.9% in patients with chronic HCV. The prevalence of anti-HAV increased nearly as age increased. But, there was no statistically significant difference in HAV positive rate according to the age groups (<em>P </em>= 0.242) and other patient&rsquo;s characteristics.</p> <p><strong>Conclusions: </strong>According to the high HAV immunity in our study and less severe form of HAV infection, vaccination was not required in these patients. However, hepatitis A vaccination program should be performed in HAV seronegative patients with HCV to produce an adequate immune response.</p> <strong>Keywords: </strong>Chronic liver diseases, Hepatitis A virus, Hepatitis C virus.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/541http://ijpm.mui.ac.ir/index.php/ijpm/article/download/541/418

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310542542ENDepartment of Community Medicine, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.Department of Community Medicine, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran20120310<p><strong>Background:</strong> Medical education and training can directly contribute to the development of psychological distress in medical students. This can lead to catastrophic consequences such as impaired academic performance, impaired competency, medical errors and attrition from medical school. This study aimed to assess the prevalence of psychological morbidity among Iranian medical students. <strong></strong></p><p><strong>Methods:</strong> This was a cross-sectional study. Samples of medical students in different levels of training (basic science, clinical clerkship, internship, and residency stage) were entered into the study. The 12-item General Health Questionnaire (GHQ-12) was used to measure psychological morbidity. Both univariate and multivariate analyses were used to report on findings. <strong></strong></p><p><strong>Results:</strong> In all, 220 medical students were invited to take part in the study. Of these, 192 students agreed to fill in the questionnaire. The mean age of respondents was 25.4 (SD = 5.2) and 53% were female. Overall 49.5% of the students scored above the threshold on the GHQ-12 (score &gt; 3.5). The results obtained from logistic regression analysis indicated that female gender and level of training were the most significant contributing factors to increased psychological distress [OR for female gender = 2.99; OR for the basic science group = 6.73]. <strong></strong></p><p><strong>Discussion:</strong> Psychological distress appears to be common in medical students and significantly varies by gender and level of training. The psychological well-being of medical students needs to be more carefully addressed, and closer attention to eliminating the risk factors is critical to prevent consequent adverse outcomes.</p> <strong>Keywords: </strong>Mental health, Medical Students, Iranhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/542http://ijpm.mui.ac.ir/index.php/ijpm/article/download/542/430

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310543543ENMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTechnical Manager, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center. Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Background and Aims: </strong>Juveniles in custody are affected by blood borne viruses due to high rates of risk behaviors. Therefore, they have a disproportionate burden of infectious diseases, such as hepatitis C virus (HCV) infection. The purpose of the present study was to determine prevalence and associated characteristics of hepatitis C infection in inmates of a correctional center in Isfahan, Iran.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of HCV infection in 160 youths, who were admitted to correctional center in Isfahan during 2008-2009. Subjects were asked questions regarding behaviors that might put them at high risk for acquiring HCV and blood was drawn for this test. Sera were analyzed for HCV Ab and RIBA test was performed on antibody-positive HCV. We used Chi-square test and logistic regression model to analyze data and <em>P </em>&lt; 0.05 was considered statistically significant. <strong></strong></p><p><strong>Results: </strong>A total of 160 young prisoners (147 boys and 13 girls) were studied. The mean age of the inmates was 16.59 &plusmn; 1.24 year. A history of intravenous drug addiction was reported in 3.8% of them. HCV infection was detected in 7 (4.4%) subjects. This study revealed that history of IDU was the main risk factor for HCV (OR, 134.44; 95% confidence interval [CI], 7.29-2481.03).</p><p><strong>Conclusion:</strong> To prevent HCV transmission, proper drug prevention educations should be performed in young age prisoners.</p> <p>&nbsp;<strong>Keywords:</strong> Correctional center, HCV, Isfahan</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/543http://ijpm.mui.ac.ir/index.php/ijpm/article/download/543/432

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310544544ENAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of Microbiology, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastroenterology, Integrative Functional Gastroenterology Research center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Background:</strong> Hepatitis C virus (HCV) is the major cause of post-transfusion hepatitis infection (PTH). Patients with thalassemia major are at high risk of hepatitis C due to the blood transfusion from donors infected by HCV. The aim of this study was to detect the prevalence of anti-HCV antibodies and risk factors in multitransfused thalassemic patients in Isfahan-Iran to establish more preventive strategies. <strong></strong></p> <p><strong>Methods:</strong> This study was conducted to assess the patients with beta-thalassemia in Isfahan hospitals during 1996-2011 for HCV infection. A structured interview questionnaire was developed by the trained researcher to collect the demographic and risk factors. Statistical analysis was done by Chi-square test, Mann-Withney and multiple logistic regressions using SPSS software, version 15.</p> <p><strong>Results:</strong> 466 patients with major thalassemia participated in this study. The mean age of patients was 17.46 &plusmn; 8.3. Two hundred and seventy (58.3%) and 193 (41.7%) of participants were male and female, respectively. The prevalence of HCV was estimated 8% among thalassemia patients. History of surgery, history of dental procedure, number of units transfused per month, number of transfusion per month and duration of transfusion had significant association with HCV seropositivity in univariate analysis. There were no statistical significant risk factors for HCV seropositivity in multiple logistic regression models.</p> <p><strong>Conclusion:</strong> Our findings revealed that blood transfusion was the main risk factors for HCV infection among beta-thalassemic patients. Therefore, more blood donor screening programs and effective screening techniques are needed to prevent transmission of HCV infection among beta-thalassemic patients.</p> <p><strong>Keywords</strong>: Beta-thalassemia, HCV infection, Iran</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/544http://ijpm.mui.ac.ir/index.php/ijpm/article/download/544/408

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310545545ENDepartment of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Science, Isfahan University of Technology, Isfahan, IranDepartment of Food Science and Technology, Isfahan University of Technology, Isfahan, Iran.Department of Food Science and Technology, Isfahan University of Technology, Isfahan, IranDepartment of Food Science and Technology, Isfahan University of Technology, Isfahan, IranSchool of Medicine, Isfahan University of Medical Science, Isfahan, Iran.20120310<p>After iron deficiency, zinc deficiency is the major micronutrient deficiency in developing countries, and staple food fortification is an effective strategy to prevent and improve it among at-risk-populations. No action has been taken to reduce zinc deficiency via flour fortification so far in Iran, and little is known about the influence of zinc fortification of flour on serum zinc and the iron status, and also about the optimum and effective amount of zinc compound that is used in food fortification. The objective of this study is to evaluate the influence of consuming zinc-fortified breads on the zinc and iron status in the blood serum. In this study, three types of bread were prepared from non-fortified and fortified flours, with 50 and 100 ppm elemental zinc in the form of sulfate. Eighty zinc-deficient women aged 19 to 49 years were randomly assigned to three groups; The volunteers received, daily, (1) a non-fortified bread, (2) a high-zinc bread, and (3) a low-zinc bread for one month. Serum zinc and iron were measured by Atomic Absorption before and after the study. Results showed a significant increase in serum zinc and iron levels in all groups (p &lt; 0.001) except in the control (p &gt; 0.05). Absorption of zinc and iron in the group that consumed high-zinc bread was significantly greater than that in the group that received low-zinc bread (p &lt; 0.01). It was concluded that fortification of flour with 50&ndash;100 ppm zinc was an effective way to achieve adequate zinc intake and absorption in zinc-deficient people. It also appeared that consuming zinc-fortified bread improved iron absorption</p> <p><strong>&nbsp;</strong><strong>Key Words: </strong>Bread fortification, serum iron, serum zinc, zinc deficiency, zinc sulfate</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/545http://ijpm.mui.ac.ir/index.php/ijpm/article/download/545/429

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310546546ENMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMD, Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastroenterology, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center. Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTechnical Manager, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of Microbiology, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Hepatitis C virus (HCV) is one of the major public health problems worldwide which is transmitted through contact with infected blood or blood products. One of the most prevalent modes of HCV transmission is injecting drug with unclean needles or syringes. Therefore intravenous drug users (IVDUs) are the most important group who should be considered. The aim of this study was to evaluate seroprevalence and risk factors of hepatitis C virus in IVDUs population.</p> <p><strong>Methods: </strong>The cross-sectional study was carried out on intravenous drug users who attended health and social care Drop-in centers during November 2008 to February 2009 in Isfahan province, Iran. Data was gathered using interviewer-administered questionnaire including demographic characteristics and main risk factors for HCV infection. 5ml venous blood sample was obtained from each subject. The HCV-Ab test was performed on all blood samples by ELISA. The data was analyzed using descriptive statistical methods and multiple logistic regressions by SPSS software, version 15.</p> <p><strong>Results: </strong>The mean age of participants was 31.77 &plusmn; 8.51. 503 (94.7%) were men and 28 (5.3%) were women. HCV seroprevalence was 47.1% (95% CI: 42.9, 51.3). The multiple logistic regressions demonstrated that history of tattooing (OR 1.72, 95% CI 1.02-2.90), history of imprisonment (OR 2.49, 95% CI 1.40-4.42) and sharing needles/syringes (OR 2.76, 95% CI 1.54-4.95) are significant predictors of risk of HCV in IVDU population.</p> <p><strong>Conclusions: </strong>In conclusion, according to the high prevalence of HCV infection among IVDUs and high adds of HCV infection from tattooing, sharing of needles/syringes and imprisonment, effective harm reduction programs should be expanded among IVDUs to prevent new HCV infections.</p> <strong>Keywords: </strong>Hepatitis C virus, High-risky behaviors, Intravenous drug users, Risk factorshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/546http://ijpm.mui.ac.ir/index.php/ijpm/article/download/546/431

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310547547ENDepartment of Community Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Community Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, IranMental health group, Chaharmahal and Bakhtyari Provincial Health Center, Medical School, Shahrekord University of Medical Sciences, Shahrekord, Iran20120310<p><strong>Objectives: </strong>This study was conducted on the estimation of the efficiency of mental health program in primary health care in Chaharmahal and Bakhtyari province, situated in center of the Islamic Republic of Iran, from 1999 to 2009.</p> <p><strong>Methods: </strong>One of the important objectives of mental health program is screening of mental health disorders and follow up. According to the prescription of mental health program, General Practitioners (GPs) were appointed to screen under-covered individuals, treat patients and also follow-up the patients with mental health disorders who needs referring to psychiatric clinics. Diagnostic criteria of mental disorders were based on American Psychiatry Association (DSM IV1994). Patients were categorized in four groups as follows: 1 - Severe mental disorders, such as major depression, schizophrenia, bipolar disorders, etc., 2 - Mild mental disorders, such as neurosis, anxiety, etc., 3 &ndash; Convulsive disorders and 4 - Behavioral disorders. The convulsive disorders and their types were diagnosed by physical examination and electroencephalography. In order to screen mental retardation, intelligence scale (IQ) score &lt; 70 was considered as mental retardation. During the 10 years (1999 to 2009) of conducting program, all new diagnosed cases were confirmed by psychiatrists. All data was recorded in health files by trained GPs and they were assessed and justified by psychiatrists.</p> <p><strong>Results: </strong>During 10 years after conducting and stabilizing integrated mental health in primary health care, 13514 patients overall were newly detected and followed. Ten years incidence of total psychiatric disorders was estimated in about 15.9 per 1000 populations.</p> <p><strong>Conclusions: </strong>Integrated mental health care offers the opportunity to increase access and develop efficiency of the mental health cares.</p> <strong>Keywords: </strong>Mental health, Integration, Efficiency, Primary health care.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/547http://ijpm.mui.ac.ir/index.php/ijpm/article/download/547/433

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310548548ENMSc of Microbiology, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of Clinical Immunology, University of Medical Sciences, Isfahan, IranMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTechnical Manager, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Clinical laboratory health care workers can become infected through their occupation with blood-borne pathogens by percutanous injuries and mucocutaneous blood contacts such as cuts, needle sticks, splashes to mucous membranes or other body injuries. The purpose of this study was to determine the seroprevalence of, Hepatitis C virus (HCV), and some of the risk factors in medical laboratory health care workers.</p> <p><strong>Methods: </strong>Through a descriptive cross sectional study, 203 participants employed in the clinical laboratories of the city of Isfahan, composed of medical laboratory technologists, technicians and cleaning staff were studied. Participant data were obtained through a self-reporting questionnaire and the level of anti-HCV antibody was measured by enzyme linked immunosorbent assay (ELISA). Chi-square test was used to determine risk factors associated with infection.</p> <p><strong>Results: </strong>The mean age of the individuals (n = 203) was 35.8 &plusmn; 9.54 years. There were 115 women (56.7%) and 88 men (43.3%). All of the subjects were negative for HCV Ab.</p> <p><strong>Conclusions: </strong>Hepatitis C infection is infrequent in laboratory health care workers in Isfahan province.</p> <strong>Keywords: </strong>Anti HCV antibody, health care workers, occupational exposure<em></em>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/548http://ijpm.mui.ac.ir/index.php/ijpm/article/download/548/419

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310549549ENDepartment of Anesthesiology and Intensive Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMD .Department of Anesthesiology and Intensive Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranProfessor Department of Anesthesiology and Intensive Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy.</p> <p><strong>Methods: </strong>In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg) or rectal acetaminophen (20 mg / kg) at the end of surgery. The children's Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours.</p> <p><strong>Results: </strong>The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 &plusmn; 0.8, 7.4 &plusmn; 1 vs. 7.1 &plusmn; 1.2, 7.8 &plusmn; 1.2 in the acetaminophen group, P &lt; 0.05) and one hour and two hours in the ward (7.2 &plusmn; 0.7, 7 &plusmn; 0.5 vs. 7.9 &plusmn; 1.2, 7.5 &plusmn; 1.2 in the acetaminophen group, P &lt; 0.05), with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 <strong>&plusmn; </strong>7.9 vs. 99.8 <strong>&plusmn; </strong>7.7 in the acetaminophen group) and nystagmus was reported only in the ketamine group (14.2%). Other side effects were equivalent in both the groups.</p> <p><strong>Conclusions: </strong>With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.</p> <strong>Keywords: </strong>Postoperative pain, Preventive analgesic, Rectal acetaminophen, Rectal ketamine, Tonsillectomyhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/549http://ijpm.mui.ac.ir/index.php/ijpm/article/download/549/413

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310550550ENMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastrology, Infectious and Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Health, Prison Organization, Isfahan, IranTechnical Manager, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of Microbiology, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of biostatics, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranCommunity and Preventive Medicine Specialist, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Hepatitis C virus (HCV) infection is a major public health problem worldwide with serious complications. According to the importance of intravenous drug use (IDU) as the main risk factor for HCV infection and transmission and prison as the main source of risky behaviors, this study conducted to define HCV infection and related risk factors in prison inmates with history of IDU in Isfahan province, Iran.</p> <p><strong>Methods: </strong>This is a cross &ndash;sectional study which the prison inmates with IDU history in voluntary basis were enrolled. A validated questionnaire was asked and blood sample was obtained from each subject for the presence of HCV antibody. Odds ratio and logistic regression were used for data analysis and <em>P</em>-value &lt; 0.05 considered significant.</p> <p><strong>Results: </strong>I943 inmates with history of IDU participated in the study. The overall prevalence of HCV antibody was 41.6%. The main independent risk factors were number of injection in the month [OR: 1.006 (1.002- 1.011)], Length of drug addiction [OR: 1.05 (1.004-1.098)], multiple incarceration [OR: 1.15 (1.05-1.23)] and use of needle/syringe share inside prison [OR: 4.19 (2.22-7.9)]. In our study, marriage was a protective factor for HCV infection [OR: 0.34 (0.18-0.64)] as well.</p> <p><strong>Conclusions: </strong>According to relatively high prevalence of HCV infection and associated risk factors which observed in this study it is important to primary prevention in prisons through syringe/needle exchange and counsel with imprisoned IDUs.</p> <strong>Keywords: </strong>HCV, IDU, Prisonhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/550http://ijpm.mui.ac.ir/index.php/ijpm/article/download/550/415

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310551551ENPhD, Professor, Department of Pharmacology, School of Pharmacy and Isfahan Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, IranPharm D, School of Pharmacy and Pharmaceutical Sciences, Isfahan, Iran.MD, Associate Professor, Department of Pathology, School of Medicine, Isfahan, Iran20120310<p><strong>Objectives: </strong>Iron chelators, such as maltol and kojic acid, have antioxidant and anti-inflammatory properties. They may have beneficial effects on inflammatory bowel disease (IBD) because iron can develop and aggravate inflammation in IBD. In the present study, the effect of selected iron chelators and anti-oxidants were evaluated on a model of trinitrobenzene sulfonic acid (TNBS)-induced colitis.</p> <p><strong>Methods: </strong>Colitis was induced with instillation of 75 mg/kg TNBS in 0.25 ml ethanol 50% via the anus in fasted male Wistar rats. The animals were assigned randomly to 12 groups (<em>n </em>= 6) and treated once daily, started 2 hours before colitis induction, with normal saline (5 ml/kg), maltol (70, 140, 280 mg/kg), kojic acid (75, 150, 300 mg/kg), vitamin E (400 mg/kg), deferiprone (L1) (150 mg/kg) and prednisolone (4 mg/kg) orally and deferoxamine (50 mg/kg) intraperitoneally for 5 days. In the sixth day, rats were scarified and colon tissues were assessed macroscopically and pathologically.</p> <p><strong>Results: </strong>Maltol (280 mg/kg) was able to reduce colon weight / length ratio, ulcer index and total colitis index similar to prednisolone, deferoxamine and deferiprone as positive controls. However, kojic acid and vitamin E could not significantly alleviate macroscopic and/or pathologic features of inflammation in comparison to normal saline.</p> <p><strong>Conclusions: </strong>Maltol with the highest test dose was capable to protect against experimentally induced colitis. Kojic acid and vitamin E were not effective in this animal model of colon inflammation. More detailed studies are warranted to explore the mechanisms involved in anti-colitic property of maltol and to explain ineffectiveness of kojic acid and vitamin E.</p> <strong>Keywords: </strong>Anti-oxidant, Inflammatory bowel disease, Iron chelator, Kojic acid, Maltolhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/551http://ijpm.mui.ac.ir/index.php/ijpm/article/download/551/416

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310552552ENSpecialist in Infections Diseases, Disease Control Unit, Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, IranMD, Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssistant Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranIsfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Research Assistant, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc of Microbiology, Infectious Diseases and Tropical Medicine Research Center. Isfahan University of Medical Sciences, Isfahan, IranqTechnical Manager, Infectious Diseases and Tropical Medicine Research Center. Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Department of Gastroenterology, Integrative Functional Gastroenterology Research center, Isfahan University of Medical Sciences, Isfahan, Iran20120310<p><strong>Objectives: </strong>Injection drug use plays the most important role in transmission of hepatitis C. In Iran, surveys have been conducted on various high risk groups but this is the first announcement based study for hepatitis C virus HCV prevalence among cases with history of intravenous drug using (IVDU) in the country.</p> <p><strong>Methods: </strong>The announcement-based detection and follow-up of patients with anti-HCV positive project in volunteers with history of intravenous drug using was conducted in Isfahan province. At the first step, six focus groups were conducted and 2 pilot studies were carried out in two cities to design the main study. Comprehensive community announcement was done in all of public places and for physicians. The volunteers were invited to Isfahan reference laboratories and the serum samples were sent to Infectious Diseases Research Center Laboratory in standard conditions and HCV-Ab was tested by ELISA method.</p> <p><strong>Results: </strong>In this study, 1,747 individuals that are estimated 50% of all expected intravenous drug users in the community were presented themselves. The most important reasons of success in recruiting volunteers in this study were the perfect propaganda, appropriate cooperation of lab staffs, continuous evaluation and good cooperation in Isfahan province administrations. HCV-Ab was detected in 34% of them and the HCV-Ab positives were sent for further follow-up procedures including confirmatory test, education, and treatment.</p> <p><strong>Conclusions: </strong>In spite of some limitations to select real cases, this study was considered as a successful experience. Compared to the surveys in Iran on HCV prevalence in intravenous drug users, the results of this study, which was based on volunteers by announcement seems to be noteworthy.</p> <strong>Keywords: </strong>Announcement, Community, Hepatitis C, Intravenous drug usinghttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/552http://ijpm.mui.ac.ir/index.php/ijpm/article/download/552/410

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310553553ENTarbiat Moallem University of Tehran, Department of Engineering, Shahid Mofatteh St, Tehran, IranIsfahan University of Medical Sciences, Azadi Sq, Isfahan, IranIslamic Azad University of Khorasgan, Department of Management, Arqavanieh Blvd, Isfahan, IranTehran University, Department of Environmental Engineering, Qods St, Tehran, Iran20120310<p><strong>Objectives: </strong>Infected hospital wastes are among hazardous wastes, and special treatment methods are needed for their disposal. Having information about present status of medical waste management systems is of great importance in finding weak, and for future planning. Such studies have not been done for most of the hospitals in Iran.</p> <p><strong>Methods: </strong>This paper reports the results of a study on the present status of medical waste management in Isfahan hospitals. A ten page researcher made questionnaire was used to collect data in terms of collection, transportation, segregation, treatment and disposal. For assessment of autoclaves, standard tests including TST (Time, Steam, and Temperature) strip test and spore tests were used. Samples were made of stack gases of incinerators. Quantity and composition of hospital wastes in Isfahan were also measured manually.</p> <p><strong>Results: </strong>Of all wastes in selected hospitals, 40% were infected wastes (1.59 kg/day/bed), which is 15 to 20% higher than World Health Organization (WHO) standards. TST and Spore test results were negative in all samples. Stack gases analysis showed high concentration of CO in some samples. Besides, the combustion efficiency in some samples is less than 99.5%, which is the standard criterion in Iran.</p> <p><strong>Conclusions: </strong>This study may create awareness regarding the magnitude of the problem of waste management in hospitals of Isfahan and may stimulate interests for systematic control efforts for hospital waste disposal. Hospital waste management cannot succeed without documented plans, certain equipment, defined staff trainings, and periodic evaluations.</p> <strong>Keywords: </strong>Autoclave, Hospital, Incineration, Infected wastes, Isfahan, medical waste managementhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/553http://ijpm.mui.ac.ir/index.php/ijpm/article/download/553/411

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310555555ENDepartment of Clinical Nutrition, School of Nutrition and Food Sciences,Food Security Research CenterFaculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Nutrition, School of Nutrition and Food Sciences,Food Security Research CenterDepartment of Clinical Nutrition, School of Nutrition and Food Sciences20120310<p><strong>Objectives: </strong>Elevated total plasma homocysteine has been established as an independent risk factor for CVD. A strong relationship between plasma homocysteine levels and mortality has been reported in patients with CAD. Interference with folate and homocysteine metabolism by some drugs, may lead to increased plasma homocysteine levels. The object of the study was to examine the effect of AEDs on the serum concentrations of folic acid.</p> <p><strong>Methods: </strong>A total of 22, older than 18-year-old, epileptic patients, admitted in the Neurology Clinic, who were treated with AED at least for one year were selected. Twenty-two sex- and age-range-matched controls were enrolled in the study. Concentrations of total homocysteine and folic acid in the serum were measured in a fasted status. Demographic and medicine information was collected via a questionnaire. Data were analyzed by spss16 software.</p> <p><strong>Results: </strong>Mean of serum Hcy concentration in the patients was significantly higher compared to that in the controls (p = 0.04). Serum folic acid had a nonsignificant negative correlation with the dose of drug used (p = 0.2). Serum homocysteine was not significantly correlated with the dose and duration of drug consumption (p values were 0.4, 0.24, respectively). Serum homocysteine was not significantly correlated with the kind of drug (p = 0.4), but folic acid concentration was significantly lower in the monotherapy group than in the poly therapy group (p = 0.02).</p> <p><strong>Conclusions: </strong>Homocysteine (Hcy) was not different between the epileptic and nonepileptic groups<strong>, </strong>although the means of the serum folic acid were similar. Possible mechanisms by which AEDs could cause hyper-homocysteinemia might be through the dysfunction of homocysteine metabolism, the acceleration of vitamin metabolism, and the interference in the metabolism of folic acid coenzymes.</p> <strong>Keywords: </strong>Antiepileptic drug, Folic acid, Homocysteinehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/555http://ijpm.mui.ac.ir/index.php/ijpm/article/download/555/421

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120310556556ENDepartment of midwifery, Isfahan university of medical sciences, Isfahan, IranDepartment of nursing, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, Iran20120310<p><strong>Objectives: </strong>This study is carried out with the aim of describing the pattern of health-promoting behaviors (HPBs) among middle-aged women and its relevant factors in Iran as a Muslim developing country.</p> <p><strong>Methods: </strong>In a cross-sectional study, 483 middle-aged women were selected using cluster random sampling from Yazd city in Central Iran. An adjusted Persian version of Health Promoting Lifestyle Profile II was used for measuring HPBs. The demographic data were collected too.</p> <p><strong>Results: </strong>The average score of middle-aged women HPBs was 2.73 &plusmn; 0.36 (2.69 &plusmn; 2.76, %95). Spiritual growth and physical activity had the highest and the lowest score in HPBs' dimensions, respectively. HPBs had a positive significant correlation with age (p=0.02) and education level (p=0.001) and a negative significant correlation with number of children (p=0.005). HPBs had a higher level in retired women than employees and housewives.</p> <p><strong>Conclusions: </strong>In spite of a desirable level of HPBs in spiritual growth and interpersonal relationship dimensions among this group, their level of HPBs in physical activity and health responsibility dimensions was undesirable. It means that the feature of health among Iranian middleaged women in a Muslim developing country is different from the industrialized developed and also the non-Muslim countries; hence, they need a different intervention programs.</p> <strong>Keywords: </strong>Health behavior, Health promotion, HPLP II, Iran, Middleage, Womenhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/556http://ijpm.mui.ac.ir/index.php/ijpm/article/download/556/409

International Journal of Preventive Medicine (Int J Prev Med)2008-780233(S)20120311567567ENMD, Professor of Ophthalmology, Isfahan Eye Research Center (IERC), Feiz Hospital & Ophthalmology Ward, Feiz Hospital, Isfahan, IranMD, Resident of Ophthalmology, Isfahan Eye Research Center (IERC), Feiz Hospital & Ophthalmology Ward, Feiz Hospital, Isfahan, IranMD, Ophthalmologist, Isfahan Eye Research Center (IERC), Feiz Hospital &Ophthalmology Ward, Feiz Hospital, Isfahan, IranOphthalmology researcher, Isfahan Medical Students Research Committee (IMSRC), Medical School, Isfahan, IranMD, Resident of Ophthalmology, Isfahan Eye Research Center (IERC), Feiz Hospital & Ophthalmology Ward, Feiz Hospital, , Isfahan, IranEpidemiologist, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.Student, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.20120311<p><strong>Objectives: </strong>To compare the efficacy of a single dose of topical diclofenac 0.1% and ketorolac 0.5%, with placebo and with each other in the prevention of post-PRK pain and discomfort.</p> <p><strong>Methods: </strong>In this randomized double-masked trial, adults undergoing bilateral PRK surgery were assigned to two arms. The first arm received a single dose diclofenac 0.1%, randomly in either the right, or left eye, and artificial tear (as the placebo) in the other eye. The second arm received ketorolac 0.5%, by the same pattern. The primary outcome of this study was ocular[1] pain assessed by visual analogue scale (VAS), and,[2] discomfort including itching, foreign body sensation, tearing and photophobia which were questioned in 4 degrees.</p> <p><strong>Results: </strong>In the final analysis, 47 and 36 subjects remained in the diclofenac and ketorolac treated arms, respectively. In both arms, on the first and second post-operation days, VAS scores were significantly lower in the pretreated eye. Moreover, on the first post-operation day, the intensity of all ocular discomfort items was statistically lower in the pretreated eyes; whereas, on the second day, such a difference was only observed for foreign body sensation and itching in the diclofenac treated arm and for photophobia in ketorolac treated arm. Comparison of the two arms (diclofenac pretreated eyes vs. ketorolac pretreated eyes) on both first and second post-operation days showed no significant difference neither in the VAS scores nor the ocular discomfort items.</p> <p><strong>Conclusions: </strong>Either diclofenac or ketorolac instilled at a dose of one drop 30 minutes in advance of the operation would be equally beneficial in the short-term prevention of post-PRK pain and discomfort.</p> <strong>Keywords: </strong>Photorefractive keratectomy, Diclofenac, Ketorolac, Pain, Discomfort, Preventionhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/567http://ijpm.mui.ac.ir/index.php/ijpm/article/download/567/435