International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160402The Effect of Diabetes Mellitus on Apoptosis in Hippocampus: Cellular and Molecular Aspects16811681ENDepartment of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Anatomical Sciences, School of Medicine, Birjand University of Medical Sciences, BirjandDepartment of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Genetic Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan20160402<p><strong>Background:</strong> Diabetes mellitus is associated with cognitive deficits in humans and animals. These deficits are paralleled by neurophysiological and structural changes in brain. In diabetic<br />animals, impairments of spatial learning, memory, and cognition occur in association with distinct changes in hippocampus, a key brain area for many forms of learning and memory and are<br />particularly sensitive to changes in glucose homeostasis. However, the multifactorial pathogenesis of diabetic encephalopathy is not yet completely understood. Apoptosis plays a crucial role in diabetes‑induce neuronal loss in hippocampus.</p><p><strong>Methods:</strong> The effects of diabetes on hippocampus and cognitive/behavioral dysfunctions in experimental models of diabetes are reviewed, with a focus on the negative impact on increased neuronal apoptosis and related cellular and molecular mechanisms.</p><p><strong>Results:</strong> Of all articles that were assessed, most of the experimental studies clearly showed that diabetes causes neuronal apoptosis in hippocampus through multiple mechanisms, including oxidative stress, inhibition of caspases, disturbance in expression of apoptosis regulator genes, as well as deficits in mitochondrial function. The balance between pro‑apoptotic and anti‑apoptotic signaling may determine the neuronal apoptotic outcome in vitro and in vivo models of experimental diabetes.</p><p><strong>Conclusions:</strong> Dissecting out the mechanisms responsible for diabetes‑related changes in the hippocampal cell apoptosis helps improve treatment of impaired cognitive and memory functions<br />in diabetic individuals.</p><p><strong>Keywords:</strong> Apoptosis, central nervous system complication, diabetes mellitus, hippocampus</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1681http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1681/1974International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Meta‑analysis of the Prevalence of Helicobacter Pylori Infection among Children and Adults of Iran16721672ENHealth Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, SariHealth Policy Research Center, Shiraz University of Medical Sciences, ShirazDepartment of Community Medicine, Zabol University of Medical Sciences, Zabol20160305<p>Helicobacter pylori infection is a common health problem related to many gastrointestinal disorders. This study aims to estimate the total and age specific prevalence of Helicobacter Pylori infection in Iran. We systematically reviewed all national and international databases and finally identified 21 studies were eligible for meta-analysis. Each of them were assigned a<br />quality score using STROBE checklist. Due to significant heterogeneity of the results, random effects model was used to estimate the pooled prevalence and 95% confidence interval of<br />Helicobacter Pylori infection. All statistical analyses were performed using STATA. V11 software. The pooled prevalence (95% confidence interval) of Helicobacter Pylori infection among all population, children and adults were estimated as 54% (53%- 55%), 42% (41%- 44%) and 62% (61%- 64%) respectively. Helicobacter Pylori, has infected more than half of Iranian people<br />during the last decade. Preventive strategies as well as taking into account this infection during clinical visits should be emphasized to reduce its transmission and prevalence within<br />the community.</p><p><strong>Keywords:</strong> Helicobacter, Iran, meta‑analysis, prevalence</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1672http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1672/1958International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160402The Effect of Symbiotic Supplementation on Liver Enzymes, C‑reactive Protein and Ultrasound Findings in Patients with Non‑alcoholic Fatty Liver Disease: A Clinical Trial16831683ENDepartment of Community Nutrition, Food Security Research Centre, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan & Treatment Affair, Shahrekord University of Medical Sciences, ShahrekordDepartment of Community Nutrition, Food Security Research Centre, School of Nutrition and Food Science & Endocrine and Metabolism Research Centre, Isfahan University of Medical
Sciences, IsfahanDepartment of Community Nutrition, Food Security Research Centre, School of Nutrition and Food Science, Isfahan University of Medical Sciences, IsfahanDepartment of Community Nutrition, Food Security Research Centre, School of Nutrition and Food Science & Endocrine and Metabolism Research Centre, Isfahan University of Medical
Sciences, IsfahanDepartment of Community Nutrition, Food Security Research Centre, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan20160402<p><strong>Background:</strong> Regarding to the growing prevalence of nonalcoholic fatty liver disease (NAFLD), concentrating on various strategies to its prevention and management seems necessary. The aim of this study was to determine the effects of symbiotic on C‑reactive protein (CRP), liver enzymes, and ultrasound findings in patients with NAFLD.</p><p><strong>Methods:</strong> Eighty NAFLD patients were enrolled in this randomized, double‑blind, placebo‑controlled clinical trial. Participants received symbiotic in form of a 500 mg capsule (containing seven species of probiotic bacteria and fructooligosaccharides) or a placebo capsule daily for 8 weeks. Ultrasound grading, CRP, and liver enzymes were evaluated at the baseline and the end of the study.</p><p><strong>Results:</strong> In the symbiotic group, ultrasound grade decreased significantly compared to baseline (P < 0.005) but symbiotic supplementation was not associated with changes in alanine<br />aminotransferase (ALT) and aspartate transaminase (AST) levels. In the placebo group, there was no significant change in steatosis grade whereas ALT and AST levels were significantly<br />increased (P = 0.002, P = 0.02, respectively). CRP values remained static in either group.</p><p><strong>Conclusions:</strong> Symbiotic supplementation improved steatosis in NAFLD patients and might be useful in the management of NAFLD or protective against its progression.</p><p><strong>Keywords:</strong> Liver steatosis, nonalcoholic fatty liver disease, symbiotic</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1683http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1683/1971International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160402Assessing the Risk Factors for Multiple Sclerosis in Women of Reproductive Age Suffering the Disease in Isfahan Province16821682ENDepartment of Bio‑statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, IsfahanDepartment of Bio‑statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, IsfahanDepartment of Bio‑statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, IsfahanDepartment of Neurology, Medical School,
Isfahan Research Committee of Multiple Sclerosis, Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan20160402<p><strong>Background:</strong> Multiple sclerosis (MS) is an autoimmune disease of the central nervous system. Etiology of the disease is not well understood; however, it is more common in women than in<br />men and occurs mainly during reproductive age. The aim of this study was to evaluate some risk factors in women of childbearing age with MS in Isfahan Province.</p><p><strong>Methods</strong>: This analytic case–control study was conducted in MS Clinic in Isfahan, 2014. The study was done on 200 patients with MS and 200 nonpatients (matched controls) that were randomly selected for inclusion in the study. The data collection tool was a researcher‑designed questionnaire consisting of three parts: Demographics, disease characteristics, and some risk factors related to reproductive age. Data were analyzed by SPSS version 20, using descriptive and inferential statistics.</p><p><strong>Results:</strong> The results showed that risk of MS had a significant relationship with age at menarche (P < 0.001), prior use of oral contraceptives (OCs) (P = 0.002), duration of use of<br />OCs (P = 0.008), and number of pregnancies (P < 0.001). However, there was no significant relationship between age of onset of use of OCs (P = 0.80) and age at the first pregnancy (P = 0.45) with the risk of MS.</p><p><strong>Conclusions:</strong> Results of this research determined that the following risk factors were associated with developing MS, age at menarche, history, and duration of use of OCs and number of<br />pregnancies.</p><p><strong>Keywords:</strong> Menarche, multiple sclerosis, oral contraceptive, pregnancy, reproductive age, women</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1682http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1682/1972http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1682/1973International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160312Application of Sonoelastography in Differential Diagnosis of Benign and Malignant Thyroid Nodules16791679ENDepartment of Endocrinology, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, TehranDepartment of Radiology,
Medical Imaging Center, Advanced Diagnostic and Interventional Radiology Research Center, Imam Hospital, Tehran University of Medical Sciences, TehranBrain and Spinal Injury Research Center, Tehran University of Medical Sciences, TehranDepartment of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, TehranDepartment of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, TehranDepartment of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran20160312<p><strong>Background:</strong> Sonoelastography is a new ultrasound method which could be helpful to determine which thyroid nodule is malignant. We designed this study to evaluate the accuracy of<br />sonoelastography in differentiating of benign and malignant thyroid nodules in Iranian patients.</p><p><strong>Methods:</strong> Forty thyroid nodules in forty consecutive patients who had been referred for sonography‑guided fine‑needle aspiration biopsy were evaluated. Gray scale ultrasound and<br />elastosonography by real‑time, freehand technique applied for all patients. Elastography findings were classified into four groups. Nodules which were classified as patterns 1 or 2 in elastogram evaluation were classified as benign and probably malignant if elastogram scans were patterns<br />3 and 4 of elastogram scan.</p><p><strong>Results:</strong> Mean age ± standard deviation (SD) was 42.2 ± 12.6 years, and mean ± SD thyroid‑stimulating hormone level was 1.4 ± 1.9 IU/ml. Thirty‑five cases (87.5%) were female and 5 (12.5%) were male. Histological examination indicated 27 (67.5%) benign and 13 (32.5%) malignant nodules. The most<br />elastogram score was 2 (50%) followed by score 3. The cut‑off point of 2 considered as the best value to differentiate benign and malignant thyroid nodules with sensitivity and specificity of 61% and 78% (area under the curve = 0.76, 95% confidence interval: 0.6–0.92, P = 0.007).</p><p><strong>Conclusions:</strong> Sonoelastography could help to differentiate benign and malignant thyroid nodules. As our sample size was limited, larger studies are recommended.</p><p><strong>Keywords:</strong> Iran, nodule, sonoelastography, thyroid</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1679http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1679/1969International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160312Physical Activity Level Improves the Predictive Accuracy of Cardiovascular Disease Risk Score: The ATTICA Study (2002–2012)16761676ENDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, AthensDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, AthensDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, AthensDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, AthensDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens & Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, ARHippokration Hospital, First Cardiology Clinic, School of Medicine, University of
Athens, AthensHippokration Hospital, First Cardiology Clinic, School of Medicine, University of
Athens, AthensHippokration Hospital, First Cardiology Clinic, School of Medicine, University of
Athens, AthensHippokration Hospital, First Cardiology Clinic, School of Medicine, University of
Athens, AthensHippokration Hospital, First Cardiology Clinic, School of Medicine, University of
Athens, Athens20160312<p><strong>Background:</strong> Although physical activity (PA) has long been associated with cardiovascular disease (CVD), assessment of PA status has never been used as a part of CVD risk prediction<br />tools. The aim of the present work was to examine whether the inclusion of PA status in a CVD risk model improves its predictive accuracy.</p><p><strong>Methods:</strong> Data from the 10‑year follow‑up (2002–2012) of the n = 2020 participants (aged 18–89 years) of the ATTICA prospective study were used to test the research hypothesis. The<br />HellenicSCORE (that incorporates age, sex, smoking, total cholesterol, and systolic blood pressure levels) was calculated to estimate the baseline 10‑year CVD risk; assessment of PA status was based on the International Physical Activity Questionnaire. The estimated CVD risk was tested against the observed 10‑year incidence (i.e., development of acute coronary syndromes, stroke, or other CVD according to the World Health Organization [WHO]‑International Classification of Diseases [ICD]‑10 criteria). Changes in the predictive ability of the nested CVD risk model that contained the HellenicSCORE plus PA assessment were evaluated using Harrell’s C and net reclassification index.</p><p><strong>Results:</strong> Both HellenicSCORE and PA status were predictors of future CVD events (P < 0.05). However, the estimating classification bias of the model that included only the HellenicSCORE was significantly reduced when PA assessment was included (Harrel’s C = 0.012, P = 0.032); this reduction remained significant even when adjusted for diabetes mellitus and dietary habits (P < 0.05).</p><p><strong>Conclusions:</strong> CVD risk scores seem to be more accurate by incorporating individuals’ PA status; thus, may be more effective tools in primary prevention by efficiently allocating CVD candidates.</p><p><strong>Keywords:</strong> Cardiovascular disease, diet, physical activity, prevention, risk prediction</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1676http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1676/1968International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Cyclophosphamide‑induced Hepatotoxicity in Wistar Rats: The Modulatory Role of Gallic Acid as a Hepatoprotective and Chemopreventive Phytochemical16751675ENDepartment of Veterinary Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, University of IbadanDepartment of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, IbadanDepartment of Veterinary Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, University of IbadanDepartment of Veterinary Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, University of IbadanDepartment of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, IbadanDepartment of Veterinary Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, University of Ibadan20160305<p><strong>Background:</strong> Gallic acid (GA) is an endogenous plant phenol known to have antioxidant, free radical scavenging ability, anti‑inflammatory, anti‑cancer, and anti‑fungal properties. The aim of this study was to assess the protective effect of GA on cyclophosphamide (CPA)‑induced hepatotoxicity in male Wistar rats.</p><p><strong>Methods:</strong> Sixty rats were grouped into six groups of 10 rats per group. Group 1 received distilled water. Group 2 received CPA at 200 mg/kg single dose intraperitoneally on day 1. Groups 3 and<br />4 received a single dose of CPA (200 mg/kg) intraperitoneally on day 1 and then were treated with GA at 60 and 120 mg/kg body weight for 14 days, respectively. Rats in Groups 5 and 6 only<br />received GA at 60 and 120 mg/kg body weight for 14 days, respectively. GA was administered orally.</p><p><strong>Results: </strong>CPA induced hepatic damage as indicated by significant elevation (P < 0.05) in aspartate aminotransferase, organ weight, and evidence by the histological study. CPA also induced hepatic oxidative stress as indicated by significant elevation (P < 0.05) in malondialdehyde content, hydrogen peroxide (H2O2) generation, nitrite level, and the level of glutathione (GSH) peroxidase crashed in the CPA‑treated group. GA enhanced the antioxidant defense system as indicated by significant elevation (P < 0.05) in GSH level, catalase activity, and GSH‑S‑transferase activity.</p><p><strong>Conclusions:</strong> Taken together, the result of this present study shows that GA has a protective effect on CPA‑induced hepatotoxicity.</p><p><strong>Keywords:</strong> Antioxidant, cyclophosphamide, gallic acid, hepatotoxicity, oxidative stress</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1675http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1675/1963International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305The Effect of a Pedometer‑based Program Improvement of Physical Activity in Tabriz University Employees16741674ENDepartment of Public Health, Faculty of Health, Shahid Sadoughi University, YazdDepartment of Public Health, Faculty of Health, Shahid Sadoughi University, YazdDepartment of Health Education and Promotion, Faculty of Health, Tabriz
University of Medical Sciences, TabrizRoad Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences,
TabrizDepartment of Sport Physiology, Faculty of Sport Sciences, Tabriz University, TabrizDepartment of Reproductive Health, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz20160305<p><strong>Background:</strong> Regular physical activity (PA) has been shown to reduce risk of morbidity and overall mortality. A study has displayed that achieving 10,000 steps/day is associated with<br />important health outcomes and have been used to promote PA. Pedometers are a popular tool for PA interventions in different setting. This study investigated the effects on pedometer‑based<br />and self‑reported PA among Tabriz University employees.</p><p><strong>Methods:</strong> This experimental study assessed the effects of 16 weeks pedometer‑based workplace intervention. Participants (n = 154) were employees of two worksites. Pedometer‑based and<br />self‑reported PA from one intervention worksite was compared with the data of a comparison workplace. International Physical Activity Questionnaire (IPAQ) for self‑reported measure of PA,<br />and demographic (age, marital status, educational level, employment status, and stage of change)<br />variables were obtained. To measure PA objectively pedometer was used.</p><p><strong>Results: </strong>Participants reported to increase the step counts from baseline (end of summer) to posttest (winter). The intervention effect revealed significant increase in the intervention<br />group (8279 ± 2759 steps/day than in the comparison work place (4118 ± 1136). Self‑reported based on IPAQ concluded women in intervention worksite had a significant increase in the leisure time domain, but similar finding was not found in the comparison worksite.</p><p><strong>Conclusions:</strong> Pedometer used might rather benefit those individuals who want feedback on their current PA, also walking should be considered to increase PA in employee women.</p><p><strong>Keywords:</strong> Employees, pedometer‑based program, physical activity</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1674http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1674/1960International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Calcium‑Vitamin D Co‑supplementation Affects Metabolic Profiles, but not Pregnancy Outcomes, in Healthy Pregnant Women16731673ENResearch Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, KashanDepartment of Gynecology and
Obstetrics, School of Medicine, Kashan University of Medical Sciences, KashanDepartment of Gynecology and Obstetrics, School of Medicine, Qazvin University of Medical Sciences, QazvinDepartment of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, TehranDepartment of Gynecology and
Obstetrics, School of Medicine, Kashan University of Medical Sciences, KashanDepartment of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, TehranEndocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak & Department of Gynecology and Obstetrics, School of Medicine,
Arak University of Medical Sciences, ArakFood Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran & Department of Community
Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan & Department of Community Nutrition, School of Nutritional
Sciences and Dietetics, Tehran University of Medical Sciences, Tehran20160305<p><strong>Background:</strong> Pregnancy is associated with unfavorable metabolic profile, which might in turn result in adverse pregnancy outcomes. The current study was designed to evaluate the effects of calcium plus Vitamin D administration on metabolic status and pregnancy outcomes in healthy pregnant women.</p><p><strong>Methods:</strong> This randomized double‑blind placebo‑controlled clinical trial was performed among 42 pregnant women aged 18–40 years who were at week 25 of gestation. Subjects were randomly<br />allocated to consume either 500 mg calcium‑200 IU cholecalciferol supplements (n = 21) or placebo (n = 21) for 9 weeks. Blood samples were obtained at the onset of the study and after 9‑week trial to determine related markers. Post‑delivery, the newborn’s weight, length, and head circumference were measured during the first 24 h after birth.</p><p><strong>Results:</strong> Consumption of calcium‑Vitamin D co-supplements resulted in a significant reduction of serum high‑sensitivity C‑reactive protein levels compared with placebo (−1856.8 ± 2657.7 vs.707.1 ± 3139.4 μg/mL, P = 0.006). We also found a significant elevation of plasma total antioxidant capacity (89.3 ± 118.0 vs. −9.4 ± 164.9 mmol/L, P = 0.03), serum 25‑hydroxyvitamin D (2.5 ± 3.5 vs. −1.7 ± 1.7 ng/mL, P < 0.0001), and calcium levels (0.6 ± 0.6 vs. −0.1 ± 0.4 mg/dL, P < 0.0001). The supplementation led to a significant decrease in diastolic blood pressure (−1.9 ± 8.3 vs. 3.1 ± 5.2 mmHg, P = 0.02) compared with placebo. No significant effect of calcium‑Vitamin D co-supplements was seen on other metabolic<br />profiles. We saw no significant change of the co‑supplementation on pregnancy outcomes as well.</p><p><strong>Conclusions:</strong> Although calcium‑Vitamin D co‑supplementation for 9 weeks in pregnant women resulted in improved metabolic profiles, it did not affect pregnancy outcomes.</p><p><strong>Keywords:</strong> Calcium‑Vitamin D supplementation, high sensitivity C‑reactive protein, insulin resistance, oxidative stress, pregnancy outcome</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1673http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1673/1959International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Designing of the Cooling Vest from Paraffin Compounds and Evaluation of its Impact Under Laboratory Hot Conditions16711671ENDepartment of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, IsfahanDepartment of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan20160305<p><strong>Background:</strong> The phase change materials (PCMs) have the appropriate properties for controlling heat strain. One of the well-known PCMs is paraffin. This study aimed to design the cooling vest from the cheap commercial paraffin compound and evaluation of its effectiveness under laboratory hot conditions.</p><p><strong>Methods:</strong> the cooling vest was made of the polyester fabric and it had 17 aluminum packs. The each of aluminum packs was filled by 135 g of prepared paraffin with a proper melting point in the range of 15–35°C. an experimental study was conducted on ten male students under warm conditions (air temperature = 40°C, relative humidity = 40%) in a climatic chamber. Each participant was tested without cooling vest and with cooling in two activities rate on treadmill to include: light (2.8 km/h)<br />and moderate (4.8 km/h). The time of this test was 30 min in each stage. During the test, the heart rate, the oral temperature, the skin temperature were measured every 4 min. Finally, data were analyzed using the Kolmogrov–Smirnov and repeated measurement ANOVA test in SPSS 16.</p><p><strong>Results:</strong> The latent heat of the prepared paraffin compound and the peak of the melting point were 108 kJ/kg and 30°C, respectively. The mean and standard deviation of heart rate, oral temperature, and skin temperature with cooling vest in light activity were 103.9 (12.12) beat/min, 36.77 (0.32)°C, and 31.01 (1.96)°C and in moderate activity were 109.5 (12.57) beat/min, 36.79 (0.20)°C, and 29.69 (2.23)°C, respectively. There is a significant difference between parameters with a cooling vest and without cooling (P < 0.05).</p><p><strong>Conclusions:</strong> The designed cooling vest with low cost can be used to prevent thermal strain and to increase the physiological stability against the heat. However, the latent heat of this cooling vest was low.</p><p><strong>Keywords:</strong> Cooling vest, heat strain, hot and dry conditions, paraffin</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1671http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1671/1964International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Applications of Text Messaging, and Bibliotherapy for Treatment of Patients Affected by Depressive Symptoms16701670ENDepartment of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Pediatrics, Child Growth and
Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, IsfahanDepartment of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan20160305<p><strong>Background:</strong> Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging,<br />which aimed at amelioration of patient’s behavior and consciousness, which could lead to suicide<br />prevention.</p><p><strong>Methods:</strong> This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, <18 years, and cell phone accessibility. Mental retardation, drug and alcohol abuse, visual disability, dementia, suicide attempt history, electrotherapy, and receiving<br />psychological interventions were our not met criteria. Our patient outcomes comprised intensity of depressive symptom and treatment compliance. The first two trials were requested to study instructive booklets in 30 days while the second cohort was demanded to study the booklet in accordance with the daily delivered text messaging.</p><p><strong>Results:</strong> Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction<br />(F = 12.30, P < 0.001). Based on treatment compliance, the interactive effect of group factor and the time factor was statistically significant.</p><p><strong>Conclusions:</strong> It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary<br />methodology aiming depression treatment.</p><p><strong>Keywords:</strong> Behavior therapy, bibliotherapy, cognitive therapy, depressive symptom, psychotherapy, text messaging</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1670http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1670/1961International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Amblyopia Prevention Screening Program in Northwest Iran (Ardabil)16691669ENDepartment of Ophthalmology, Faculty of Medicine, Ardabil University of Medical Sciences, ArdabilDepartment of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, AhvazDepartment of Ophthalmology, Faculty of Medicine, Ardabil University of Medical Sciences, ArdabilMedical Student Research Committee and Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, AhvazDepartment of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil20160305<p><strong>Background:</strong> The aim of this study was to evaluate the results of amblyopia screening in Ardabil Province in three examination levels by kindergarten teacher, optometrist, and ophthalmologist.</p><p><strong>Methods:</strong> In a cross‑sectional study, the results of the national amblyopic prevention program in 2–6 years old children in Ardabil Province were investigated in 2012. The results pertained to the examinations of children participating in this research were collected in the national approved forms. The data were entered into the computer and were analyzed using statistical methods in SPSS 18.</p><p><strong>Results:</strong> Around 38,844 children (51.7%) out of 75173 with 2–6 years old qualified children participated in the screening program in Ardabil Province. In the first stage of screening, 1068<br />children (33.1%) are visually impaired in one eye and 2160 children (66.9%) are visually impaired in two eyes. In the second stage, the results related to the examinations by optometrists indicated that the prevalence of refractive errors, strabismus, and others were 70%, 27.8%, and 2.2%, respectively. Refractive errors problem was most prevalent in Ardabil city (72.6%).The prevalence of refractive errors, strabismus, and other reasons in amblyopic children was 51.3%, 23.9%, and 24.8%; respectively.</p><p><strong>Conclusions:</strong> The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.</p><p><strong>Keywords:</strong> Amblyopia, Ardabil, children, prevention, screening, strabismus</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1669http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1669/1965International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Psychometric Properties of the Iranian Version of the Diabetes Numeracy Test‑1516671667ENEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, TehranEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, TehranEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran20160305<p><strong>Background:</strong> Low health literacy (HL) of patients has obtained more attention as a risk factor for poor adherence to treatment and adverse outcomes in chronic disease’s management particular in diabetes care. Diabetes Numeracy Test‑15 (DNT‑15) has been developed specifically for this purpose. The objective of the current study is to evaluate psychometric properties of Iranian (Persian) version of the DNT‑15.</p><p><strong>Methods:</strong> The shortened version of the DNT (15‑items) was completed by 120 patients with diabetes. The Kuder–Richardson Formula 20 for internal consistency was conducted. Content<br />validity, criterion‑related validity, and construct validity were also evaluated.</p><p><strong>Results:</strong> The average score on the DNT was 72% and took an average of 25 minutes to complete. The DNT‑15 had a very good internal reliability (KR‑20 = 0.90) and also content validity (content validity ratio: 089 and content validity index: 0.86).</p><p><strong>Conclusions:</strong> The DNT‑15 (Persian version) is a reliable and valid measure of diabetes‑related numeracy skills for Iranian patients with diabetes; however, additional studies are needed to further explore the association between diabetes‑specific numeracy and acculturation and their impact on diabetes‑related outcomes in Iranian population.</p><p><strong>Keywords:</strong> Diabetes, health literacy, Iran, validity and reliability</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1667http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1667/1956International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Cardiovascular Risk in Men Aged Over 40 in Boa Vista, Brazil16661666ENDepartment of Urology, Coronel Mota Hospital, Roraima & Cathedral College, RoraimaFederal Institute of Roraima, RoraimaCathedral College, Roraima20160305<p><strong>Background:</strong> Cardiovascular disease is the most common cause of disease in the developed world. Early detection and risk prediction are a key component in reducing cardiovascular mortality. The Framingham Risk Score uses age, sex, cholesterol, blood pressure, diabetes, and smoking to calculate the 10‑year risk probability of developing cardiovascular disease for a given patient. The aim of this study was to examine cardiovascular disease risk in men aged over 40 years in Boa Vista, Brazil and identify socioeconomic factors contributing to the risk.</p><p><strong>Methods:</strong> This was an epidemiological, cross‑sectional, descriptive study. Physical examination and questionnaire survey were conducted on the participants.</p><p><strong>Results:</strong> Of the 598 participants (average age = 55.38 ± 10.77 years), 346 completed all the examinations and answered the survey, while 252 completed the survey and the physical examinations but did not undertake the laboratory tests. A large proportion of participants were overweight (42.6%) or obese (23.6%), 14.5% were hypertensive, and 71.9% were prehypertensive. Consumption of red meat and junk food was high, while participation in the exercise was low. Framingham scores ranged from −3 to 13 (mean score: 3.86 ± 3.16). A total of 204 participants (34.1%) had a low risk of cardiovascular disease, 98 (16.4%) had a medium risk, and 44 (7.4%) possessed high risk. Increased abdominal circumference (P = 0.013), resting pulse (P = 0.002), and prostate‑specific antigen levels (P < 0.001) were associated with increased risk of cardiovascular disease.</p><p><strong>Conclusions:</strong> Our study highlights a worrying trend in increasing obesity and hypertension, most likely associated with increasingly poor diet and reduced participation in exercises. As the Brazilian population ages, this will drive increasing rates of cardiovascular mortality unless these trends are reversed. This study suggests that such campaigns should focus on men over the age of 40, who are married or divorced and of lower income.</p><p><strong>Keywords:</strong> Cardiovascular disease risk, Framingham score, hypertension, obesity, socioeconomic factors</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1666http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1666/1957International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160305Availability and Continuity of Care for Maternal Health Services in the Primary Health Centres in Nnewi, Nigeria (January - March 2010)16681668ENDepartment of HIV Care and Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra StateDepartment of Community
Medicine, NAU/NAUTH, Nnewi, Anambra StateDepartment of Community Medicine, Imo State University Teaching Hospital, Imo State,Department of Community Medicine, University of Abuja Teaching Hospital, GwagwaladaDepartment of Community
Medicine, NAU/NAUTH, Nnewi, Anambra StateDepartment of Community
Medicine, NAU/NAUTH, Nnewi, Anambra State20160305<p><strong>Background:</strong> In some primary health care settings, even where the health services are not available, provisions are not made to ensure continuity of care. This study aimed to determine<br />the availability and level of continuity of care for maternal health services in the primary health centers (PHCs) in Nnewi, Nigeria.</p><p><strong>Methods:</strong> This was a cross‑sectional survey. Using multistage sampling technique, 280 women utilizing maternal health services from four randomly selected public PHCs in Nnewi, Nigeria were chosen for the study. Data collection employed a mix of quantitative and qualitative methods.</p><p><strong>Results:</strong> The mean ± standard deviation for age of the respondents was 29.2 ± 5.9 years. The facilities studied provided out‑patient services, but the only in‑patient services provided was for women who delivered or those in labor. None of the facilities is equipped to provide even basic essential obstetric care services. None had standardized a protocol for referring clients, referral forms, a transport system, or a community loan scheme in place. Forty‑four (15.7%) women were referred for care outside of the PHCs for the following reasons: Lack of drugs and supplies (9.1%); lack of equipment (90.9%), lack of skilled personnel (45.5%) among others.</p><p><strong>Conclusions: </strong>This study showed that despite the unavailability of some services, appropriate strategies were not in place to ensure the coherent pattern of services within and between the<br />PHCs and other levels of care. Delivery to the clients of comprehensive and integrated maternal health services, and efficient referral systems are thus recommended.</p><p><strong>Keywords:</strong> Availability, level of continuity, maternal health services, Nnewi Nigeria, primary<br />health care level</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1668http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1668/1962International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160402Pheochromocytoma after Cesarean Section16841684ENDepartment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan20160402<p>Pheochromocytoma is a catecholamine‑producing tumor. There are a very few reported cases of clinical pheochromocytoma. Here, we report a 27‑year‑old woman para 1 live 1 with chief complaint of headache, confusion, nausea, and vomiting 2 days after cesarean section. She was anxious and had palpitation. On physical examination, fever, tachycardia, tachypnea, high blood pressure, and right thyroid nodule were found. She was managed as pregnancy‑induced hypertension at first. In laboratory data, epinephrine, norepinephrine, metanephrine, normetanephrine, and vanillylmandelic acid were increased in 24 h urine collection. An adrenal mass was detected in abdominal computed tomography. Regarding clinical and paraclinical findings, pheochromocytoma was diagnosed. The patient received medical treatment, but it was not effective; hence, she underwent adrenalectomy.</p><p><strong>Keywords:</strong> Adrenal gland neoplasm, cesarean section, pheochromocytoma, pregnancy</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1684http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1684/1970International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160402Medicinal Plants in Type 2 Diabetes: Therapeutic and Economical Aspects16801680ENDepartment of Endocrinology, Diabetology and Nutrition, University Hospital of FezDepartment of Endocrinology, Diabetology and Nutrition, University Hospital of FezDepartment of Endocrinology, Diabetology and Nutrition, University Hospital of FezDepartment of Biophysics and Clinical MRI Methods, Faculty of Medicine & The Clinical Neurosciences Laboratory, Faculty of Medicine, University of FezDepartment of Pharmacology and
Pharmacovigilance & Medicines Sciences Team, Biomedical and Translational Research Center, Faculty of Medicine, University
of FezDepartment of Endocrinology, Diabetology and Nutrition & Medicines Sciences Team, Biomedical and Translational Research Center, Faculty of Medicine, University
of Fez20160402---http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1680http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1680/1975International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160312World Health Organization Recommends Cost‑effective Interventions to Control the Rise in Incidence of Noncommunicable Diseases in Low‑resource Settings16781678ENDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil NaduDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil NaduDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu20160312---http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1678http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1678/1967International Journal of Preventive Medicine (Int J Prev Med)2008-78021320160312Time to Improve the Outcome of Preterm Births in Middle and Low‑income Nations16771677ENDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil NaduDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil NaduDepartment of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu20160312--http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1677http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1677/1966