Vitamin D: Shining A Light on Clinical and Sex Specific Effects in Multiple Sclerosis?

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130511Vitamin D: Shining A Light on Clinical and Sex Specific Effects in Multiple Sclerosis?499500ENIsfahan Research Committee of Multiple Sclerosis, Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Physiology, Anatomy and Genetics, University of Oxford, John Radcliffe Hospital, Oxford, UKIsfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, IranMedical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, IranIsfahan Research Committee of Multiple Sclerosis, Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20130511-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1193http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1193/1043

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520121030Antibiotics for the Treatment of Leptospirosis: Systematic Review and Meta‑analysis of Controlled Trials501510ENDepartment of Pharmacology, Government Medical College, Surat, IndiaDepartment of Epidemiology, Indian Institute of Public Health, Gandhinagar, Gujarat, IndiaDepartment of Microbiology, Government Medical College, Surat, IndiaDepartment of Pharmacology, Government Medical College, Surat, India20121030Background: Leptospirosis is a zoonotic disease prevalent mainly in developing countries and is associated with high case fatality. Antibiotics especially penicillin are the mainstay of treatment for a suspected or confirm case of leptospirosis but role of Penicillin has not been evaluated systematically in the light of current evidence. The present systematic review and meta‑analysis is done to evaluate the role of antibiotics in the treatment of leptospirosis. Methods: Parallel group clinical trials involving use of penicillin in treatment of leptospirosis were searched from all available sources. Ten clinical trials were found suitable as per laid inclusion criteria eligible for present systematic review and five clinical trials were included in meta‑analysis. Clinical trials included for meta‑analysis were compared on the basis of mortality, fever days, numbers of patients presenting with oliguria, and number of patients undergoing need‑based dialysis. Analysis was done by comprehensive meta‑analysis software 2. Qualitative outcomes are summarized as odds ratio and quantitative outcomes are summarized as standard mean difference with 95% confidence interval. Random and fixed models are used for analysis. Results: There was no significant difference between penicillin group and controlled group for mortality (Odds ratio 1.59 (95% CI 0.59-4.29), P = 0.35), fever days (std difference in mean = −0.223 (95% CI 0.394-0.995), P = 0.358), number of patients presenting with oliguria (Odds ratio 1.795 (95% CI 0.325-9.929), P = 0.502), and number of patients who underwent need based dialysis (Odds ratio 1.587 (95% CI 0.919-2.731), P = 0.098). Conclusions: Role of various antibiotics in treatment of leptospirosis is uncertain, and can be attributed to nonavailability of adequate clinical trials. Role of penicillin in the treatment of leptospirosis can be debated. Keywords: Antibiotics, doxycycline, leptospirosis, penicillin, weils diseasehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/977http://ijpm.mui.ac.ir/index.php/ijpm/article/download/977/1047

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130216Durability of Effect of Massage Therapy on Blood Pressure511516ENDepartment of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran20130216Background: Pre‑hypertension is considered as a cardiovascular disease predicator. Management of pre‑hypertension is an appropriate objective for clinicians in a wide range of medical centers. Treatment of pre‑hypertension is primarily non‑pharmacological, one of which is massage therapy that is used to control the BP. This study aimed to evaluate the survival effect of Swedish massage (face, neck, shoulders, and chest) on BP of the women with pre‑hypertension. Methods: This was a single‑blind clinical trial study. Fifty pre‑hypertensive women selected by simple random sampling which divided into control and test groups. The test group (25 patients) received Swedish massage 10‑15 min, 3 times a week for 10 sessions and the control groups (25 patients) also were relaxed at the same environment with receiving no massage. Their BP was measured before and after each session and 72 h after finishing the massage therapy. Analyzing the data was done using descriptive and inferential statistical methods (Chi‑ square, Mann‑Whitney, paired t‑test and Student t‑test) through SPSS software. Results: The results indicated that mean systolic and diastolic BP in the massage group was significantly lower in comparison with the control group (P < 0.001). Evaluation of durability of the massage effects on BP also indicated that 72 h after finishing the study, still there was a significant difference between the test and control groups in systolic and diastolic BP (P < 0.001). Conclusions: Findings of the study indicated that massage therapy was a safe, effective, applicable and cost‑effective intervention in controlling BP of the pre‑hypertension women and it can be used in the health care centers and even at home. Keywords: Durability, massage therapy, pre‑hypertensionhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1064http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1064/1050

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120915Association of Polymorphism of Ser311cys Paraoxonase‑2 Gene with Type 2 Diabetes Mellitus in Iran517523ENNeurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, IranPhysiology Reseach Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pharmacology, School of Medicine, Guilan University of Medical Sciences, Rasht, IranDepartment of Pharmaceutical Biotechnology, Isfahan Pharmaceutical Sciences Research Center and, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, IranPhysiology Reseach Center, Isfahan University of Medical Sciences, Isfahan, IranSedigheh Tahereh Research Complex, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Genetics, Tehran Medical Branch, Islamic Azad University, Tehran, Iran20120915Background: It is believed that paraoxonase‑2 gene polymorphism is associated with type 2 diabetes. This study is aimed to investigate the association between paraoxonase‑2 gene polymorphism and type 2 diabetes in an Iranian population. Methods: This study was performed on 200 individuals including 100 diabetics and 100 healthy subjects. Genomic DNA was extracted from peripheral blood leukocytes, and PCR‑RFLP was carried out. Palindromic sequence in PON2 gene was recognized by Dde1 restriction endonuclease. In order to visualize restriction products, electrophoresis was carried out using polyacrylamide gel (8%) and ethidium bromide staining. Results: The expected PCR product of 331 bp was obtained. Digestion of this product with DdeI showed four Ser homozygotes, three Cys homozygotes, and five Ser311 Cys heterozygotes. The gene frequency of Cys (C) in diabetic subjects was significantly higher than in healthy subjects. Conclusions: This study suggests that an association exists between Ser311 Cys polymorphism and type 2 diabetes mellitus. Keywords: Iranian population, paraxonase‑2 gene, polymorphism, type 2 diabeteshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/910http://ijpm.mui.ac.ir/index.php/ijpm/article/download/910/1045

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130224Underweight, Overweight and Obesity Among Zaboli Adolescents: A Comparison Between International and Iranians’ National Criteria524530ENFood Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Biochemistry, School of Medicine, Kordestan University of Medical Sciences, Sanandaj, IranZabol University of Medical Sciences, Zabol, IranFood Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran20130224Background: Obesity and overweight are the major health problems in Iran. The aim of this study was to determine the prevalence of overweight and obesity among adolescents living in Zabol settled in Sistan va Baluchistan, one of economically underprivileged provinces in South Eastern of Iran, based on four different definitions. Method: This cross‑sectional study was accomplished among a sample of 837 Zaboli adolescents (483 males; 354 females) aged 11‑15 years. Anthropometric measurements including weight and height were measured and body mass index (BMI) was calculated. Sex‑specific BMI‑for‑age reference data of the Iranian national data, Centers for Disease Control data (CDC 2000), International Obesity Task Force data (IOTF) and recent World Health Organization (WHO) data was used to define overweight and obesity. Results: Mean age of the studied population was 13.14 year. Underweight was prevalent among almost 18.7% and 18.4% of adolescents by the use of WHO 2007 and CDC 2000 cut‑off points. The prevalence rates reached 25.8% and 27.2% by IOTF and Iranian national criteria, respectively. The highest prevalence of overweight was obtained by IOTF cut‑points (10.8%) followed by CDC 2000 criteria (9.4%), WHO 2007 (8.8%) while national Iranian cut‑points resulted in the lowest prevalence (2.4%). 7.5% of the studied population were found to be obese by WHO 2007 definition, while this rate was 2.2%, 3.4% and 1.5% by IOTF, CDC 2000 and national Iranian cut‑points. Conclusions: Almost all definitions revealed coexistence of underweight, overweight, and obesity among Zaboli adolescents. Huge differences exist between different criteria. To understand the best appropriate criteria for Iranian adolescents, future studies should focus on the predictability of obesity‑related co‑morbidities by these criteria. Keywords: Adolescents, body mass index, Iran, obesity, overweight, prevalence, Zabolhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1082http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1082/1051

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130226Effect of a Probiotic and Metformin on Liver Aminotransferases in Non‑alcoholic Steatohepatitis: A Double Blind Randomized Clinical Trial531537ENDepartment of Gastroenterology and Liver Disease, Isfahan University of Medical Science, Isfahan, IranDepartment of Gastroenterology and Liver Disease, Isfahan University of Medical Science, Isfahan, IranDepartment of Gastroenterology and Liver Disease, Isfahan University of Medical Science, Isfahan, IranNorth Khorasan University of Medical Sciences, Bojnurd, Iran,Department of Clinical Nutrition and Dietetics, Shahid Beheshti University of Medical Science, Tehran, IranInstitute for Science and Technology in Medicine, Faculty of Health, University of Keele, Staffordshire, United Kingdom20130226Background: Non‑alcoholic steatohepatitis (NASH) is a clinicopathological entity that is being recognized more frequently in recent years. This study aimed to evaluate the effects of Metformin, with and without a probiotic supplement on liver aminotransferases in patients with NASH. Methods: Sixty four patients 18-75 years with NASH confirmed by biopsy and histological assessment were enrolled to study. Patients were randomized to one of the following treatments for 6 months: Group I, probiotic (Protexin two tablets per day) plus Metformin 500 mg two tablets per day (Met/Pro), or group II, Metformin 500 mg two tablets per day plus two placebo tablet (Met/P). After 6 month alanine aminotransferase (ALT), aspartate aminotransferase, and ultrasound grading of NASH were assessed. Results: In group I, serum alanine aminotransferase (ALT: 133.7 ± 70 vs. 45.2 ± 32.5; P < 0.00), and aspartate aminotransferase activity (AST: 123.1 ± 72 vs. 44.2 ± 33.9; P < 0.001), and ultrasound grading of NASH (P < 0.001) all decreased significantly by the end of the treatment period. In group II, while serum alanine aminotransferase (ALT) was not significantly reduced (118.4 ± 67.9 vs. 112.5 ± 68.7; P < 0.064), aspartate aminotransferase activity (AST: 125.3 ± 71 vs. 113.4 ± 71; P < 0.001), and ultrasound grading of NASH did fall significantly (P < 0.01). Body mass index (BMI), fasting blood sugar (FBS), cholesterol, and triglyceride fell significantly in both groups. Conclusions: Probiotic combination with Metformin improves liver aminotransferases better than metformin alone in patients with NASH. Keywords: Aminotransferase, insulin resistance, nonalcoholic steatohepatitis, non‑alcoholic fatty liver disease, probiotic, randomized clinical trialhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1086http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1086/1053

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130217Evaluation of the Effect of Noise on the Rate of Errors and Speed of Work by the Ergonomic Test of Two‑Hand Co‑Ordination538545ENDepartment of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Epidemiology and Statistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran20130217Background: Among the most important and effective factors affecting the efficiency of the human workforce are accuracy, promptness, and ability. In the context of promoting levels and quality of productivity, the aim of this study was to investigate the effects of exposure to noise on the rate of errors, speed of work, and capability in performing manual activities. Methods: This experimental study was conducted on 96 students (52 female and 44 male) of the Isfahan Medical Science University with the average and standard deviations of age, height, and weight of 22.81 (3.04) years, 171.67 (8.51) cm, and 65.05 (13.13) kg, respectively. Sampling was conducted with a randomized block design. Along with controlling for intervening factors, a combination of sound pressure levels [65 dB (A), 85 dB (A), and 95 dB (A)] and exposure times (0, 20, and 40) were used for evaluation of precision and speed of action of the participants, in the ergonomic test of two‑hand coordination. Data was analyzed by SPSS18 software using a descriptive and analytical statistical method by analysis of covariance (ANCOVA) repeated measures. Results: The results of this study showed that increasing sound pressure level from 65 to 95 dB in network ‘A’ increased the speed of work (P < 0.05). Increase in the exposure time (0 to 40 min of exposure) and gender showed no significant differences statistically in speed of work (P > 0.05). Male participants got annoyed from the noise more than females. Also, increase in sound pressure level increased the rate of error (P < 0.05). Conclusions: According to the results of this research, increasing the sound pressure level decreased efficiency and increased the errors and in exposure to sounds less than 85 dB in the beginning, the efficiency decreased initially and then increased in a mild slope. Keywords: Ergonomics, noise, rate of error, speed of work, two‑hand coordination.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1071http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1071/1054

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130307Association of Proteinuria with Various Clinical Findings and Morphologic Variables of Oxford Classification in Immunoglobulin A Nephropathy Patients546551ENDepartment of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pathology, Isfahan University of Medical Sciences, Isfahan, IranMedical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IranMedical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran20130307Background: Immunoglobulin A nephropathy (IgAN) with nephrotic syndrome is an uncommon form of IgAN. Clinical and morphological characteristics of proteinuria in IgAN, especially when is in nephrotic range have not yet been fully examined. This study was aimed to correlate morphologic variables of the Oxford classification, and various clinical data with proteinuria in IgAN patients. We also aimed to demonstrate the significance of prevention of proteinuria as one of the important factors in progression of this disease. Methods: In an observational study conducted on IgAN patients, total of 114 biopsies were entered in the study. IgAN was diagnosed by light and immunofluorescence study. Results: Of 114 patients 70.2% were male. Mean age of patients was 37.7 ± 13.6 years. The mean of proteinuria was 1742 ± 1324 mg/day. Also mean of serum creatinine (Cr) was 1.6 ± 1.5 mg/dL. Of 114 patients, 11(9.6%) had nephrotic range proteinuria. In this study, there was a positive correlation between proteinuria and serum Cr, peri-glomerular fibrosis or interstitial fibrosis. There was a positive association between proteinuria and totally sclerotic glomeruli too. There was also a positive association between the amount of fibrous crescents and the level of proteinuria. Nephrotic proteinuria could just be seen in male patients. Also, nephrotic syndrome had a positive association with the number of crescents. Conclusions: Our findings firstly support the prognostic value of crescent due to its association with proteinuria and secondly imply the importance of treatment of proteinuria to prevent progression of IgAN. Keywords: Crescent, immunoglobulin A nephropathy, nephrotic syndrome, Oxford classification, proteinuriahttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1096http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1096/1036

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130127Can Selection of Mechanical Ventilation Mode Prevent Increased Intra‑Abdominal Pressure in Patients Admitted to the Intensive Care Unit?552556ENDepartment of Anesthesiology, AJA University of Medical Sciences, Emam Reza Hospital, Tehran, IranDepartment of Anesthesiology and Critical Care, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Radiology, AJA University of Medical Sciences, Emam Reza Hospital, Tehran, IranDepartment of Anesthesiology, AJA University of Medical Sciences, Emam Reza Hospital, Tehran, IranDepartment of Anesthesiology and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran20130127Background: Increased intra‑abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. Methods: In a cohort study, a total of 60 patients aged 20‑70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure (BIPAP) group, synchronize intermittent mandatory ventilation (SIMV) group, or continuous positive airway pressure (CPAP) group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Results: Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age (64.5 ± 4, P = 0.1), gender (male/female 31/29, P = 0.63), and body mass index (24 ± 1.2, P = 0.11). Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes (P = 0.01). There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure (P < 0.05). Tube feeding tolerance through NG‑tube was lower in SIMV group, followed by BIPAP and CPAP groups (P < 0.05). Conclusions: There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra‑abdominal hypertension. Keywords: Abdominal compartment syndrome, intra‑abdominal pressure, mechanical ventilation modehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1046http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1046/1035

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120915Cigarette Smoking, Knowledge, Attitude and Prediction of Smoking Between Male Students, Teachers and Clergymen in Tehran, Iran, 2009557564ENTobacco Prevention and Control Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical SciencesDepartment of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, IranDepartment of Public Health, Shahid Beheshti University, Tehran, IranClinical Tuberculosis Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University, Medical Sciences, Tehran, Iran20120915Background: Students, clergymen and teachers as role models can be very important in encouragement or prevention of cigarette smoking in young people. The aim of this study was to compare prevalence of smoking in 3 male groups of teachers, clergymen and university students. Also, study their knowledge and attitude towards it and the prediction of their future consumption. Methods: In a cross sectional study in 2009 in Tehran, Iran, 1,271 male students, 549 clergymen and 551 teachers were randomly enrolled. Each participant completed the global adult tobacco survey questionnaire. Knowledge, attitude and prediction of smoking for the next 5 years were questioned in these 3 groups. Chi‑squared test and logistic regression were used for analysis. P < 0.05 was considered significant. Results: Prevalence of cigarette smoking was 31.1%, 21.9% and 27.2% among students, clergymen and teachers, respectively. Smoking in students was not associated with poor knowledge but were in teachers and clergymen. The odds ratio of smoking in students, clergymen and teachers was higher among those with having inappropriate attitude towards it (OR = 1.6, 6.1 and 4.5). Those with poor knowledge had an inappropriate attitude and predicted higher chance of cigarette consumption in the next 5 years (P < 0.0001). Inappropriate attitude in all 3 groups resulted in higher prediction of future smoking (P = 0.008). Conclusions: This study revealed that the prevalence of smoking among male students and teachers was higher than general population and clergymen who equally smoked. Also, level of knowledge and attitude of students were lower than teachers and clergymen. Keywords: Attitude, cigarette smoking, clergymen, knowledge, student, teacherhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/913http://ijpm.mui.ac.ir/index.php/ijpm/article/download/913/1044

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130304The Combating Obesity in Māori and Pasifika Adolescent School‑children Study: COMPASS Methodology and Study Protocol565579ENSchool of Sport and Exercise, Massey University, Wellington, New ZealandInstitute of Food Nutrition and Human Health, Massey University, New ZealandDepartment of Medicine, University of Otago, Wellington, New ZealandDepartment of Medicine, University of Otago, Wellington, New ZealandInstitute of Food Nutrition and Human Health, Massey University, New ZealandSchool of Sport, Performing Arts and Leisure, Wolverhampton University, United KingdomSchool of Sport and Exercise, Massey University, Palmerston North, New Zealand, Boston, MA, USASchool of Sport and Exercise, Massey University, Wellington, New ZealandDepartment of Epidemiology, Harvard School of Public Health, Boston, MA, USA20130304Background: Lifestyle modifications including, physical activity can reduce obesity‑related morbidity and subsequent cardiovascular disease in youth. This study will investigate the efficacy of a culturally‑sensitive, non‑contact, boxing‑orientated training program on obesity and related cardio‑metabolic conditions in Māori and Pasifika adolescents. Details of the methodological aspects of recruitment, inclusion criteria, randomization, cultural sensitivity, intervention program, assessments, process evaluation, and statistical analyses are described. Methods: This study will be a community based, New Zealand, randomized control trial (RCT). Male and female obese (body mass index >95th percentile) Māori and Pasifika adolescents aged 14‑16 years will be recruited and the sample size will be confirmed through a feasibility study. Combating Obesity in Māori and Pasifika Adolescent School‑children Study (COMPASS) is a 6‑month, theory‑based program, conducted 3‑times/week in a culturally appropriate setting. Each session includes 40 min boxing‑orientated training and 30 min resistance training. Assessments will be made at baseline, 3‑months, 6‑months, 12‑months, and 24‑months. Main outcomes include abdominal obesity, endothelial function, and insulin resistance. Other outcomes include arterial stiffness, lipid profile, inflammatory biomarkers, well‑being, and aerobic fitness. Control measures include physical activity, sleep behavior, and dietary intake. Analysis will by intention to treat Results: As a protocol paper there are no specific results to present, our purpose is to share our RCT design with the scientific community. Conclusions: COMPASS will be used to provide direction for exercise prescription policy in at‑risk Māori and Pasifika adolescents. Keywords: Cardiovascular, exercise, indigenous, lifestyle, metabolic syndrome, pediatricshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1094http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1094/1052

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120227Diabetes Distress and its Association with Depression in Patients with Type 2 Diabetes in Iran580584ENInstitute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, IranInstitute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, IranInstitute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, IranTehran Psychiatric Institute, Tran University of Medical Sciences, IranInstitute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran201108022012022020120220Background: Patients with diabetes experience some level of emotional distress varying from disease-specific distress to general symptoms of anxiety and depression. Since empirical data about symptom distress in relation to diabetes are sparse in Iran, this study was designed to assess the diabetes-specific distress in Iranian population. Methods: Persian version of Diabetes Distress Scale (DDS) questionnaire was completed by volunteer outpatients on a consecutive basis between February 2009 and July 2010, in Endocrine Research Center (Firouzgar Hospital). Then, scheduled appointments were made with a psychiatrist in the same week following completion of the questionnaire. The psychiatrist was not aware about the results of this questionnaire and patients were interviewed based on DSM-IV criteria. Results: One hundred and eighty-five patients completed the questionnaire and were interviewed by a psychiatrist. Fifty-two percent of the patients were females. The mean age was 56.06 (SD=9.5) years and the mean of duration of diabetes was 9.7 (SD=7.3) years. Sixty-five (35%) had distress. Among the patients with distress, 55% were females and 64% had lower grade of education. Eighty patients were diagnosed as having Major Depressive Disorder. There was a relation between Emotional Burden subscale and age (P=0.004), employment status (P=0.03), and also diabetes duration (P=0.02). The physician-related distress subscale was also related to the type of medication (P=0.009) and marital status (P=0.01). It has been shown that the regimen-related distress subscale was also related to age (P=0.003) and duration of diabetes (P=0.005). Conclusions: High prevalence rate of distress in the study highlights the significance of the need for identifying distress and also other mental health conditions in patients with diabetes in order to take collaborative care approaches. Key words: Type 2 diabetes, distress, depression, anxietyhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/292http://ijpm.mui.ac.ir/index.php/ijpm/article/download/292/1039

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120402Vitamin D3 Concentration Correlates with the Severity of Multiple Sclerosis585591ENJondishapour Neurology Clinic, Shaheed Beheshti University of Medical Sciences and Health Services (SUMS), Tehran, IranShaheed Beheshti University of Medical Sciences and Health Services (SUMS), Tehran, IranFiroozgar Clinical Research Development Center (FCRDC), Tehran University of Medical Sciences (TUMS), Tehran, IranJondishapour Neurology Clinic, Tehran University of Medical Sciences (TUMS),Tehran, IranTehran University of Medical Sciences (TUMS), Tehran, IranJondishapour Neurology Clinic, Tehran, Iran201107152012031320120218Aims: To investigate the possible association between serum 25(OH) vitamin D3 concentration and the severity of disease in Iranian patients with multiple sclerosis (MS) and to compare this concentration with a matched control group. Methods: This was an analytical cross‑sectional study performed at Jondishapour Neurology Clinic in Tehran, Iran. Patients with relapsing– remitting MS were categorized by disease severity: mild [0≤ Expanded Disability Status Scale (EDSS) ≤3], moderate (3.5≤EDSS≤5.5), and severe (6≤EDSS). Serum concentrations of 25(OH) vitamin D3, calcium, phosphorus, magnesium, and parathyroid hormone were measured in 98 MS patients and 17 healthy age‑ and sex‑matched controls. Fisher’s exact, Kruskal–Wallis, Mann–Whitney U test, and independent t and Spearman rank correlation tests were used. Results: Serum 25(OH) vitamin D3 concentration was significantly lower in patients with MS, especially in the severe MS subgroup, compared with healthy controls (P=0.047). There was a statistically significant inverse correlation between 25(OH) vitamin D3 concentration and EDSS score (P=0.049, R=–0.168 by Spearman rank correlation test), which was observed in women only (P=0.044, R=–0.199). Conclusions: Our findings not only further disclose the lower level of vitamin D in MS patients in comparison with healthy controls, but also support the association between vitamin D and disease severity in MS. Key words: 25(OH) vitamin D3, disease severity, multiple sclerosishttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/261http://ijpm.mui.ac.ir/index.php/ijpm/article/download/261/1038

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120408Clinical Risk Assessment in Intensive Care Unit592598ENQazvin Research Center for Social Determinants of Health, Qazvin University of Medical Sciences, Qazvin, IranHealth Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, IranSchool of Health, Qazvin University of Medical Sciences, Qazvin, IranHealth in disaster and Emergencies, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran201201312012040420120404Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin’s Social Security Hospital (Razi Hospital) through Failure Mode and Effect Analysis (FMEA). Methods: This was a qualitative‑quantitative research by Focus Discussion Group (FDG) performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN) was in respiratory care “Ventilator’s alarm malfunction (no alarm)” with the score 288, and the lowest was in gastrointestinal “not washing the NG‑Tube” with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care. Keywords: Risk assessment, failure mode and effect analysis, intensive care unithttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/471http://ijpm.mui.ac.ir/index.php/ijpm/article/download/471/1042

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130209Comparing the Outcomes of Physiologic Delivery with Non‑Physiologic Delivery Group607610ENDepartment of Gynecology, Kurdistan University of Medical Sciences, Kurdistan, IranDepartment of Gynecology, Kurdistan University of Medical Sciences, Kurdistan, IranDepartment of Gynecology, Kurdistan University of Medical Sciences, Kurdistan, IranDepartment of Gynecology, Kurdistan University of Medical Sciences, Kurdistan, Iran20130209Background: The main purpose of physiologic delivery is to rely on mother’s body for childbirth. In physiologic delivery method pregnant women attend delivery preparation classes and they learn how to overcome fear and pain. Objectives: This study compares delivery outcomes among women who participated in physiologic delivery with those who had undergone non‑physiologic delivery. Methods: All patients referred for physiologic delivery were assessed. Exclusion criteria were lack of PROM, post date, cephalopelvic disproportion, multi‑fetal pregnancy, Meconium stain, blood pressure above 90/140, placenta previa and previous record of cesarean. Data was entered in SPSS 16 software and Fisher and Chi‑square tests were used to compare vaginal laceration, episiotomy and Apgar score between two groups. Results: Twelve out of 73 pregnant women (16.4%) in physiologic delivery group and 27 out of 69 pregnant women (39.1%) in non‑physiologic delivery group needed episiotomy (P = 0.002). Ten patients (13.7%) in physiologic delivery group and seven persons (10.1%) in the non‑physiologic delivery group were suffering from vaginal laceration (P = 0.51). There was no significant statistical difference between newborns’ Apgar score in two groups. Conclusions: Physiologic delivery can reduce the need for episiotomy without any further complications. Keywords: Episiotomy, natural vaginal delivery, physiologic deliveryhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1056http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1056/1048

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130126Risk of Contamination of Different Areas of Dentist’s Face During Dental Practices611615ENDental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, IranDental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, IranDental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, IranTorabinejad Dental Research Center, Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, Iran20130126Background: Dental practice presents opportunities for cross‑contamination. The dentist’s face is at high‑risk of infection transmission. The purpose of this study was to evaluate the risk of contamination in different areas of dentist’s face during dental practices. Methods: The visible splashes of materials that accumulated on cellulose face shields during 144 prosthetics and periodontal procedures were evaluated. The splashes were detected on 14 areas (each 1 cm2) of the dentist’s face including around nose, mouth, eyes, and zygoma by a magnifier (×2). One way analysis of variance, Duncan and t‑test were used for data analysis (α = 0.05). Results: Contamination of different areas of dentist’s face was significantly different (P < 0.05). The areas around nose and the inner corner of eyes were the most contaminated areas. Zygoma was the least contaminated area. The contaminated areas during periodontal treatments were significantly more than prosthetic treatments (P < 0.05). There was no significant difference between contamination on left and right sides of the face. Conclusions: During dental practice, central areas of the face such as inner part of the eyes and around the nose were most contaminated areas. These parts are the important areas for transmission of infection. It is recommended to use protective means like glasses, mask, and protective shield, which have more protection field in these areas. Keywords: Aerosols, dentists, infection control, riskhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1042http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1042/1049

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120704Bird Fancier’s Disease Due to Exposure to Birds Via a Desert Cooler599602ENDepartment of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, YazdDepartment of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, YazdDepartment of Occupational Medicine, Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran20120704Hypersensitivity pneumonitis (HP) is an immunologically mediated pulmonary disease caused by various organic particles and some non‑organic chemicals. HP is mostly associated with some occupations such as farming and bird breeding. We report a case of hypersensitivity pneumonitis in a housewife without any prior history of occupational exposures. The disease was developed due to indirect exposure of the patient to doves antigens via a desert cooler ducts. Keywords: Bird fanciers’ disease, housewife, hypersensitivity pneumonitis, organic particleshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/779http://ijpm.mui.ac.ir/index.php/ijpm/article/download/779/1037

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520120915Poor Dental Hygiene in Pregnancy Leading to Submandibular Cellulitis and Intrauterine Fetal Demise: Case Report and Literature Review603606ENDepartment of Obstetrics and Gynecology, MGMMC and MY Hospital, Indore, Madhya Pradesh, India, Department of Obstetrics and Gynecology, University Hospital, Cardiff, Wales, United KingdomDepartment of Obstetrics and Gynecology, MGMMC and MY Hospital, Indore, Madhya Pradesh, India20120915Ludwig’s angina is an infectious process involving submandibular, sublingual, and submental spaces that can rapidly progress to hemodynamic instability and airway obstruction. A 38‑year‑old unbooked multipara of low socioeconomic status with a poor oral and dental hygiene presented with bilateral submandibular cellulitis and intrauterine fetal demise. She delivered vaginally, and subsequently drainage was done for cellulitis. The report highlights the importance of dental hygiene during pregnancy, lest life‑threatening complications like Ludwig’s angina occur, complicating the course of pregnancy. Keywords: Cellulitis in pregnancy, intrauterine fetal demise, periodontal diseasehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/909http://ijpm.mui.ac.ir/index.php/ijpm/article/download/909/1046

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130226Multilevel Approach to Intimate Partner Violence Research and Prevention616617ENCenter for Research on Ethnicity, Culture and Health, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, USA20130226-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1085http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1085/1040

International Journal of Preventive Medicine (Int J Prev Med)2008-78024520130408Commentary on: Effects of Cinnamon Consumption on Glycemic Status, Lipid Profile and Body Composition in Type 2 Diabetic Patients618619ENDepartment of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20130408-http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1136http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1136/1041