Determinant factors of survival time in a cohort study on HIV patient using by time-varying cox model: Fars province, south of Iran

Background and aims: The pandemic of AIDS is a global emergency and one of the biggest challenges in social and individual life. This study aimed to evaluate the survival time of HIV patients and its effective factors. Methods: This historical cohort study was conducted on the individuals infected with HIV in Fars province, south of Iran, during 2006 to 2013. The study data were obtained from information documented in the patients’ records. For statistical analysis, at first, Kaplan-Meier survival analysis was used as univariate method and then, time varying Cox regression model was applied as multiple analyses. Results: The findings of the present study implied that some variables could play the role of risk factors in HIV patients, and shorten the patients’ life span e.g. older age, female gender, unemployment, delay in HIV diagnosis, drug injection, and higher Hemoglobin (HGB) levels. Conclusion: Many factors affect HIV patients’ survival time. Some of these factors, such as gender and genetic factors, are irreversible. However, some others, including drug injection, are preventable. This implies that in order to slow down the speed of HIV conversion to AIDS and delay the occurrence of death, special attention must be paid to these factors and changing the patients’ conditions accordingly

Association between parity and obesity: A cross sectional study on 6447 Iranian Females

Objective: The aim of this study was to determine the relationship between parity and obesity in Iranian women.   Methods: In a cross-sectional study, a total of 6447 urban women aged 40-65  were studied. A face-to-face interview was conducted by trained personnel. Statistical associations between parity and obesity using the multivariate logistic regression model were examined.  Results: The mean age of the enrolled women was 48.4 ± 6.1 years. The mean BMI was 27.55 ± 4.5 Kg/m2. Of the total participants enrolled, 3517 (54.6%) had <3 parities, while 2930 (54.4%) had ≥3 parities. The prevalence of obesity (BMI ≥30 Kg/m2) and overweight (30> BMI ≥25) was 27.50 % (95% CI 26.85-28.15) and 43.70% (95% CI 42.98-44.42), respectively. After adjustment for potential confounders, women with ≥3 parities were at higher risk of being obese (OR 1.19, 95% CI 1.05-1.35).  Conclusion: There was a statistically significant positive association between higher parity and obesity. According to the results of this study, Body Mass Index (BMI) is associated with high parity in Iranian women. It is recommended that health policymakers plan appropriate weight loss programs for postpartum

Awareness, Treatment, and Control of Hypertension among 10663 Adults Based on the Baseline Data of the Kherameh Cohort Study

Background: A comprehensive strategy to reduce the complications of hypertension (HTN) should include prevention approaches, such as increasing awareness, early diagnosis, and adequate treatment. The present study aimed to assess awareness, treatment, and control of HTN and their related factors in Kherameh, Iran. Methods: This cross-sectional study was performed on 10 663 individuals aged between 40 and 70 years using the Kherameh cohort data. HTN was defined as either systolic/diastolic blood pressure ≥140/90 mmHg or taking medications. Logistic regression was used to investigate the relationship between awareness, treatment, and control of HTN and demographic factors, comorbidities, and a family history of diseases. Results: Out of 10 663 participants, 4719 (44.3%) were men, and the average age of the participants was 51.94±8.27 years. The rates of the prevalence, awareness, treatment, and control of HTN were 27.7% (95% CI, 26.86 to 28.54), 80.3% (95% CI, 79.56 to 81.04), 78% (95% CI, 77.22 to 78.78), and 53.6% (95% CI, 52.66 to 54.54), respectively. Age, gender, body mass index, and cardiovascular disease were associated with all the dependent variables in the regression model. Additionally, occupation, diabetes, chronic diseases, a history of cardiovascular disease in first and second-degree relatives and a history of chronic diseases in second-degree relatives were related to all the dependent variables except for treatment. Conclusion: A high percentage of the patients were aware of their disease, but a smaller proportion were on medication. Consequently, about half the patients had blood pressure below 140/90 mmHg

Effect of Behavioral Intention Model-based Education on Decrease the Rate of Caesarean Delivery among Pregnant Women

Caesarean section is considered as a major surgery which is accompanied by several complications. The present study aimed to determine the effect of behavioral intention model-based educational intervention on reducing the caesarean section among pregnant women. The present interventional study was conducted on 100 primiparous women in the third trimester of pregnancy who were covered by the health and treatment centers of Fasa city, placed in Fars province, Iran. The subjects were selected through simple random sampling and divided into an intervention and a control group. After the pre-test, the intervention group underwent exclusive training based on the behavioral intention model. Then, both groups took part in the post-test and the data were analyzed using paired t-test, independent t-test, and chi-square tests. The results of the study revealed a significant difference between the two groups regarding knowledge, evaluation of the outcomes, attitude, and intention (P<0.001). The results of the chi-square test also showed a significant difference between the two groups regarding their performance (P<0.001). According to the results, the present intervention was effective in increasing the pregnant women’s knowledge, evaluation of outcomes, attitude and strengthening their intention as well as performance. Thus, this model and other systematic trainings are suggested to be used for pregnant women in order to decrease the rate of caesarean section.

Socioeconomic status and child developmental delay: A prospective cohort study

Background: Children with developmental delays are at higher risk of poor health, and lower educational attainment and wellbe-ing than the normal ones. Objectives: As previous studies had contradictory results regarding the association between socioeconomic status (SES) and child development, the current study aimed at determining this association at the age of 60 months. Methods: The current prospective cohort study was conducted in Shiraz, Iran, from summer 2011 to the end of 2016. The study was conducted on 640 mothers registered in the Fars Birth Cohort study. A checklist comprised of social and economic parts was employed. The children’s communication development was also assessed using the ages and stages questionnaire for 60-month-old children. In addition, SES was determined using 25 variables. Data analysis was performed using SPSS version 19.0 and partitioning around medoid (PAM) clustering in R 3.5.0 software; P value < 0.05 was considered as the level of significance. Results: The majority of the subjects (79.1%) were categorized as the moderate level of SES; 106 (16.56%) children had a delay in at least one developmental domain. The current study results showed that the education level of parents and the occupational status of mothers were significantly associated with delayed communication skills in children (P < 0.05). Delay in communication skills was significantly more prevalent among children whose parents had a low education level (P < 0.05). After controlling other con-founders, the relative risk of delay in communication skills was 3.7 times higher among children in the moderate level of SES and almost 10 times higher among the ones in the low level of SES. Conclusions: Children brought up in families with low SES had the highest level of delay in communication skills, followed by the ones in families with moderate SES. Considering the importance of communication skills in children socialization, more attention should be paid to SES of the families with preschool kids. It seems quite reasonable if health policymakers put more emphasis on the communication skills of preschool children

A Ten-Year Study of Prostate Cancer: A Southern Iranian Experience

Background:Prostate canceris the most common malignancy among the male population in the United States and the 3rd most common non-skin cancer among men in Iran. Its prevalence has shown a rising trend in recent decades. The aim of this study was to report the epidemiological features of prostate cancer in patients referred for prostate biopsy in the south of Iran and to evaluate the accuracy of the levels of the prostate-specific antigen (PSA) and the PSA-density (PSAD) as well as the extension of the disease in the prediction of the biological behavior of prostate cancer. Methods:This is a retrospective study on the medical records of 1982 consecutive patients who underwent transrectal ultrasound-guided biopsy due to an abnormal digital rectal examination and/or an elevated PSA level following referral from the Urology Ward to the Radiology Department of ShahidFaghihi Hospital in Shiraz, southern Iran, between December 2003 and July 2014. Results:The overall cancer detection rate was 33.1%. Although the cancer was more prevalent among the elderly patients, a significant fraction (7%) of the patients were aged < 55 years. The sensitivity and specificity of the PSA were 97.4% and 8.7% and those of the PSAD were 82.9% and 52%, respectively. Of the 637 patients with prostate cancer, 250 (39.2%) had unilateral disease, 378 (59.4%) had bilateral disease, and 9 (1.4%) had inner-gland involvement. Most of the patients with bilateral involvement had high-grade Gleason scores. Conclusion: Our study underlines the relationship between age and the frequency of cancer; the levels of the PSA and the PSAD and the Gleason score; and the extent of tumor involvement and the grade of prostate cancer and also highlights the significance of screening, especially in younger patients

Mining hypertension predictors using decision tree: Baseline data of Kharameh cohort study

Background: Hypertension is a serious chronic disease and an important risk factor for many health problems. this study aimed to investigate the factors associated with hypertension using a decision-tree algorithm. Methods: this cross-sectional study was conducted in Kharameh city between 2014-2017 through census. The study included 2510 hypertensive and 7840 non-hypertensive individuals. 70% of the cases were randomly allocated to the training dataset for establishing the decision tree, while the remaining 30% were used as the testing dataset for performance evaluation of the decision-tree. Two models were assessed. In the first model (model I), 15 variables including age, gender, body mass index, years of education, Occupation status, marital status, family history of hypertension, physical activity, total energy, number of meals, salt, oil type, drug use, alcohol use and smoke entered in to the model. in the second model (model II) 16 variables including age, gender, BMI and Blood factors as HCT, MCHC, PLT, FBS, BUN, CERAT, TG, CHOL, ALP, HDL, GGT, LDL and SG were considered. a receiver operating characteristic (ROC) curve was applied to assess the validation of the models. Results: The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) are important metrics to evaluate the performance of a decision tree model. For model I, the accuracy, sensitivity, specificity and area under the ROC curve (AUC) value were 79.24%, 82.41%, 78.24% and 0.80, respectively. for model II, the corresponding values were 79.50%, 81.03%, 79.02% and 0.80, respectively. Conclusion: We have suggested a decision tree model to identify the risk factors associated with hypertension. This model can be useful for early screening and improving preventive and curative health services in health promotion

The Association between Dietary Antioxidant Indices and Cardiac Disease: Baseline Data of Kharameh Cohort Study

Abstract Background: Oxidative stress contributes to the development of cardiovascular disease. Tools for evaluating the anti-inflammatory and antioxidative characteristics of an individual’s diet as a whole may be valuable for assessing the combined effects of dietary antioxidants on health. This population-based study aimed to investigate the association between dietary antioxidants and cardiac disease. Methods: In this population-based cross-sectional study, 10439 individuals aged 40-70 years were recruited during 2014-2017 in Kherameh cohort study which is a part of the Prospective Epidemiological Research Studies in Iran (PERSIAN). The food frequency questionnaire (FFQ) with 130 food items was used to assess the dietary intakes. Vitamin A, E, C, selenium, zinc and Manganese intakes were used to compute dietary antioxidant index (DAI) and dietary antioxidant quality score (DAQs). Results: The participants’ mean age was 52.1± 8.3 years. Among all, 4356 (41.7%) were overweight and 1892 (18.1%) were obese. According to the results, odds of cardiac diseases decreased by increasing DAI score (OR=0.80, Pvalue <0.001). , Odds of cardiac diseases increased by lower DAQS after  adjusting for demographic variables including age, sex, BMI, Marital status and hypertension (OR=0.799, P value=0.002) Conclusion: The role of anti-oxidants in reducing the odds of cardiovascular disease is very important. Our results highlighted that DAQS and DAI had protective effect on the odds of cardiovascular disease. Therefore, it is suggested that anti-oxidants as zinc, manganese, selenium, and vitamins A, E and C should be taken through food to reduce the risk of the disease

The relationship between maternal mental health and communication skills in children in Shiraz, Iran.

OBJECTIVES: Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children's development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children. METHODS: This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children's communication development status using the Ages and Stages Questionnaire for 60-month old children. RESULTS: The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers' mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children's communication skills and the mothers' total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01). CONCLUSIONS: The study results confirmed that MMH had a significant impact on children's communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children. KEYWORDS: Child development; Iran; Mental health; Questionnair