Does the multiple sclerosis (MS) map need to change again? An update of MS prevalence in Mazandaran province of Iran in 2018

Background: Information of Previous studies on the prevalence of MS, including our study conducted 12 years ago, used to shape global prevalence map of MS. According to those results, Iran placed in medium-prevalence MS region in the world Atlas of MS 2013.This study aimed to investigate the prevalence of MS in Mazandaran province after 12 years and the need for possible changes in the global map of the prevalence of MS. Methods: We included all MS patients living in Mazandaran province in 2018 in this descriptive cross-sectional study. We updated our pre-existing registration questionnaires which included demographic information and medical data of MS patients by interview. We obtained the demographic profile of Mazandaran province from the most recent census in 2016 and the National Civil Registry of the Mazandaran province for calculating prevalence of MS. Results: The total number of MS patients in Mazandaran was 2418 (25.8 male and 74.2 female) with a female to male ratio of 2.9. Based on the local population of 3,332,556, (50.4 male and 49.6 female), this study showed a prevalence of 72.5 per 100,000 for MS in this region. The prevalence of this disease by gender was 37.1 per 100,000 for men and 108.5 per 100,000 for women. The mean (SD) age of the patients at the time of the study was 38.5 (10.1) years with a minimum of 15 and a maximum of 75 years. The most common type of MS was Relapsing-Remitting MS with 86. Conclusions: All recent studies showed significant upward trend in the prevalence of MS around the world. Based on the results of our study and many other studies in Iran, the Atlas of MS prevalence map needs to be update. Iran's status should be changed to the high-prevalence of MS in the new Atlas. Due to the increasing prevalence of MS, we suggest an adjustment in the Global MS Prevalence Scale. © 2020 The Author(s)

Association between social capital, health-related quality of life, and mental health: A structural-equation modeling approach

Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, healthrelated quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76 (95 confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health

Prevalence of cigarette smoking and associated factors among male citizens in Tehran, Iran

Background: Cigarette smoking is as the leading cause of cancer mortality and other chronic diseases in males worldwide. The prevalence of cigarette smoking is different across and within countries by age, education level, occupation, and so on. This study aimed to determine the prevalence of cigarette smoking and its relationship with individuals' demographic factors and BMI in adolescent men living in Tehran, Iran. Materials and Methods: This study involved secondary analysis of the 'Urban Health Equity Assessment and Response Tool-2' survey conducted in Tehran, Iran, among men aged 20+, 2011-2012. Using a multistage sampling method, 45,990 men were included in the study. The cigarette smoking status, BMI and demographic factors measured through a self-administered questionnaire. Chi-square, t-test, and logistic regression model were used to examine the relationships between the independents variables and cigarette smoking behavior, using SPSS software version 21. Results: In the total of 45,990 men, the overall prevalence of cigarette smoking was 14.6 (CI 95: 14.29-14.94). Age (OR=0.96; CI 95:0.94-0.98), house ownership (OR=0.68; CI 95: 0.64-0.72), job status (OR=0.60; CI 95: 0.46-0.86), marital status (OR=0.42; CI 95: 0.39-0.47) and educational levels (OR=0.50; CI95: 0.45-0.54) were associated with the prevalence of cigarette smoking. However, associations with BMI, family size, residency years, and district were not statistically significant. Conclusions: Given the relatively high prevalence of cigarette smoking in the study population, policy interventions are required to address this major public health issue, with a focus on the population demographic influences

Evaluation of essential depression in patients with physical complaints hospitalized in Akhavan Hospital in 1999

History and Objectives: Considering the incidence of essential depression in patients with physical complaints and lack of precise information in this field, this study was conducted in Akhavan hospital in 1999. Materials and Methods: The descriptive strategy of this study was carried out on 300 male and female patients. All of the hospitalized patients were randomly divided into control (n=150) and case (n=150) groups and their personal characteristics were recorded. Then, Beck test was applied and for those patients with marks higher than 11, a psychiatric interview was arranged according to DSM-IV diagnostic criteria. The statistical X² test was used for analysis. Results: Case group consists of 35 male and 115 female patients and control groups comprised of 83 male and 67 female patients. The highest frequency was that from women with an approximate age of 40 years. The incidence of essential depression was 80% and 27.3% in case and control groups respectively. The most common complaints were those from head and neck (35.5%), musculoskeletal (33.7%), gastrointestinal (18.4%) and cardiovascular and respiratory (12.4%) systems. In addition, there was a relationship between essential depression and physical complaints (P<0.0001). Conclusion and Recommendations: With regard to the high incidence of essential depression, it is recommended to conduct more studies in this field

Reduction of radiation risks in patients undergoing some X-ray examinations by using optimal projections: A Monte Carlo program-based mathematical calculation

The objectives of this paper were calculation and comparison of the effective doses, the risks of exposure-induced cancer, and dose reduction in the gonads for male and female patients in different projections of some X-ray examinations. Radiographies of lumbar spine [in the eight projections of anteroposterior (AP), posteroanterior (PA), right lateral (RLAT), left lateral (LLAT), right anterior-posterior oblique (RAO), left anterior-posterior oblique (LAO), right posterior-anterior oblique (RPO), and left posterior-anterior oblique (LPO)], abdomen (in the two projections of AP and PA), and pelvis (in the two projections of AP and PA) were investigated. A solid-state dosimeter was used for the measuring of the entrance skin exposure. A Monte Carlo program was used for calculation of effective doses, the risks of radiation-induced cancer, and doses to the gonads related to the different projections. Results of this study showed that PA projection of abdomen, lumbar spine, and pelvis radiographies caused 50%-57% lower effective doses than AP projection and 50%-60% reduction in radiation risks. Also use of LAO projection of lumbar spine X-ray examination caused 53% lower effective dose than RPO projection and 56% and 63% reduction in radiation risk for male and female, respectively, and RAO projection caused 28% lower effective dose than LPO projection and 52% and 39% reduction in radiation risk for males and females, respectively. About dose reduction in the gonads, using of the PA position rather than AP in the radiographies of the abdomen, lumbar spine, and pelvis can result in reduction of the ovaries doses in women, 38%, 31%, and 25%, respectively and reduction of the testicles doses in males, 76%, 86%, and 94%, respectively. Also for oblique projections of lumbar spine X-ray examination, with employment of LAO rather than RPO and also RAO rather than LPO, demonstrated 22% and 13% reductions to the ovaries doses and 66% and 54% reductions in the testicles doses, respectively

Self-confidence among male high school students in Kashan, 1996-97

History and Objectives: Due to the importance of self-confidence on the carrier, social, family and psychological well being of adolescents, due to the lack of information on the self-confidence among adolescents, the present study was undertaken in order to determine the rate of self-confidence among male high school students in 1996-1997 school year. Materials and Methods: A descriptive study on 400 cases was performed. Self-confidence was assessed on the basis of Eyseneck method and divided into 3 high (Score higher than 21), fair (Score between 14-21) and low self esteem (Lower than 14). In addition, personal records including birth ranks in the family, family size and age were recorded. The prevalence of low self-esteem in the samples with 95 confidence of interval was obtained. Results: Low self-confidence was observed among 21.5 whereas 71.3 individuals had fair self-confidence and 7.3 had high self-confidence. High self-confidence was observed with family size of 5 or higher and among older children in a given family. Conclusion: Since low self-confidence is prevalent among adolescents in Kashan, further analytical research is required to find the underlying causes of low self-confidence

The relationship between type D personality and perceived social support in myocardial infarction patients

BACKGROUND: Type D personality is based on two global and stable personality traits, including negative affectivity (NA) and social inhibition (SI). The aim of this study was to examine the relationship between type D personality and perceived social support in post myocardial infarction (MI) patients. METHODS: One hundred seventy six consecutive patients following MI admitted to the cardiac care unit (CCU) of nine hospitals in Isfahan, Iran from April to September 2006 were selected based on the inclusive and exclusive criteria. The patients completed the Persian version of type D personality scale and the Persian version of multidimensional scale of perceived social support (MSPSS). Also, demographic and medical questionnaire was completed for each patient. Chisquared test, t-test and MANOVA were used to analyze the data. RESULTS: The findings indicated that 35.8 patients (35.8 ) were classified as type D. The results of MANOVA showed that type D patients were significantly different from non-type D patients (F = 8.72, p = 0.0001) on MSPSS scores and on all dimensions including family subscale (F = 11.52, p = 0.001), friends subscale (F= 16.16, p = 0.0001) and significant others subscale (F = 5.04, p = 0.026). CONCLUSIONS: Type D personality substantially affects the way MI patients perceive availability of social support from different sources including family, friends, and significant others. One implication of this finding may be to develop tailor-made interventions for MI patients with type D

Disabled Iranian Veterans: Issues with Health Insurance Coverage and Policy

Background: Health services provided to disabled veterans and families of martyrs play a key role in the health status of this group. Objectives: The current study aimed at investigating the insurance problems faced by veterans and their families. Methods: In 2015, the study was started as a Delphi method with a stratified random sampling of 30 participants among experts and managers of Foundation of Martyr and Veterans Affairs of Tehran, Iran. After data collection, encoding and classification, health insurance problems encountered by veterans were identified. Results: The major medical problems faced by veterans were issues related to insurance company policies, financial partnership, insurance coverage, decision-makers, service systems, and the evaluation and monitoring of insurance claims. Conclusions: It is necessary to design and introduce an intra-organisational and independent insurance system under the category of 'health insurance for veterans and their dependents' to provide preventive and remedial health services for the targeted group

Health-Related Quality of Life and Socioeconomic Status: Inequalities among Adults in West of Iran

Background: Socioeconomic status (SES) is one of the main determinants of health-related quality of life (HRQoL), where people with lower SES experience more health problems, have a lower quality of life, and are exposed to have a greater number of health-related risk factors. Objectives: This study aimed to examine the relationships between HRQoL, SES, and several demographic factors among the residents of the city of Ilam (located at theWest of Iran). Methods: This cross sectional study was conducted on 400 households from 3 districts of the city of Ilam in 2015. The participants were selected on the basis of the multistage sampling method. The second version of the 12-item Short-Form Health Survey (SF-12v2) questionnaire and theWealth Index were used to measure HRQoL and SES, respectively. Results: The mean scores of the physical component summary (PCS) and the mental component summary (MCS) were 46.32 +/- 9.69 and 42.12 +/- 9.11, respectively. The findings indicated that PCS (P = 0.01) and MCS (P = 0.01) were significantly related to SES (wealth index). The demographic variables of age, gender, education level, marital status, job status, and home ownership (P < 0.05) were also significantly related to both PCS and MCS. Conclusions: HRQoL is directly related to SES, in that HRQoL is higher in families with higher SES. Similarly, HRQL is higher in younger people, men, and those with a university degree. A decrease in socio-economic inequalities and the gap between the rich and the poor can enhance the individuals' health status and HRQoL within a community