Chronic disease program in Iran: Thalassemia control program

BACKGROUND: β-thalassemias (beta-thalassemia) is the most common genetic disorder; it is an inherited globinopathy which is transmitted to people due to a mutation in genes that create globin chain. In Iran, the disease gene is more common in the northern and southern regions. It is estimated that more than 60 mutations of the disease exist in different geographical areas of Iran. Iran has begun to adopt strategies to control the β-thalassemia for two decades; the most important of which is the screening of couples when they want to get marry. The present study aimed to review the thalassemia control program in Iran, the history of the disease, and the disease control strategies. METHODS: This review was conducted according to hand and electronic resources. Books, guidelines and document that exist in thalassemia control program were reviewed in the Iranian Ministry of Health, World Health Organization resources, PubMed, Google Scholar, SID (scientific information database), Magiran and, Iranmedex. RESULTS: Thalassemia program was appropriately structured and has been achieved successes. Reduction the numbers of new cases of β-thalassemia were notably. In some areas, thalassemia program has some defects and the program faced some cultural barriers. CONCLUSION: Due to the improvements in the social and economic situation of the people, it seems necessary to focus on prenatal diagnosis (PND) and pre-implantation genetic diagnosis (PNG) technique strategies and provide their necessary facilities

Diagnostic value of high sensitivity C-reactive protein levels in dedifferentiation of stable angina from unstable angina

BACKGROUND: Differentiation of stable angina from unstable angina is important because they need different approaches. Few studies have been conducted to assess the diagnostic value of high sensitive C-reactive protein (hs-CRP) in differentiating these two diseases. This study aimed to evaluate the diagnostic value of hs-CRP levels for differentiating stable angina from unstable angina. METHODS: After signing the consent form, patients with unstable angina who referred to Tohid Hospital emergency in Sanandaj, Iran, and patients with stable angina who referred to the special clinic of the hospital were evaluated. Disease was confirmed by a cardiologist. Morning serum hs-CRP was tested using MONOBIND laboratory kit (USA). Data were analyzed by SPSS using Student’s independent t-test, Mann-Whitney U, chi-square, Fisher exact test, and receiver operating characteristic curve. RESULTS: hs-CRP levels in patients with stable angina and unstable angina were 1.6 (± 1.18) and 2.35 (± 1.30) mg/l, respectively (P = 0.025). The hs-CRP level ≥ 2.31 mg/l was the best cut-off point for differentiating stable from unstable angina. At this cut-off point, the sensitivity and specificity were 56% and 73%, respectively. Area under the curve was calculated to be 0.679 (95% confidence interval: 0.54-0.81) (P = 0.017). CONCLUSION: hs-CRP level is helpful for differentiating patients with stable angina from those with unstable angina. It is recommended to consider the hs-CRP level of 2.31 mg/l as the best cut-off point

Comparison the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes: A double-blinded randomized controlled trial

BACKGROUND: Treating hot flushes in middle-aged women is an important health issue. Recently, Hypericum perforatum and vitex agnus-castus were investigated to decrease hot flushes. This study was conducted to compare the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes among menopausal women. METHODS: This was a randomized, double-blinded, controlled trial. The Hypericum perforatum group received 330 µg Hypericum perforatum and second group received vitex agnus-castus in the same tablet forms. Data were analyzed using repeated measurement for comparing Greene Climacteric Scale. RESULTS: Trend of Greene Climacteric Scale and hot flushness attack were decreased in both groups and it presented a decreasing trend within two months; however, no statistically significant difference was observed between the two groups. CONCLUSION: It seems that Hypericum perforatum and vitex agnus-castus could be similarly effective in decreasing hot flushes. These two medicines did not have any special severe side effects.

Diagnostic value of high sensitivity C-reactive protein in differentiating unstable angina from myocardial infarction

BACKGROUND: Differentiating between unstable angina and myocardial infarction (MI) is clinically important as they require different treatments. High sensitivity C-reactive protein (hs-CRP) has recently been recognized as prognostic factor in acute coronary syndrome. Since this biomarker may indicate the prognosis of heart disease, identifying its diagnostic value will be clinically important. This study investigated the diagnostic value of the level of hs-CRP in differentiating MI from unstable angina. METHODS: Blood samples were obtained from all patients with suspected MI or unstable angina at the time of referral. The patients were put in one of the two groups based on final diagnosis. The exclusion criteria were infectious diseases, immune system diseases, history of a recent surgery or trauma, kidney failure, liver failure, cancers, and use of anti-inflammatory drugs. Data was entered in SPSS and analyzed by independent t-test, Mann-Whitney U and chi-square or Fisher’s exact test. ROC curve was used to determine hs-CRP cut-off point. The sensitivity and specificity were calculated at the cut-off point. RESULTS: Overall, 60 patients (30 patients with MI and 30 patients with unstable angina) were studied. Hs-CRP level was 3.68 ± 0.86 mg/l in patients with MI and 2.35 ± 1.30 mg/l in patients with unstable angina (P < 0.001). The best cut-off point for differentiating unstable angina from MI was hs-CRP levels equal to or greater than 3.27 mg/l. At this cutoff point, the sensitivity and specificity were both 77%. CONCLUSION: Patients with MI had higher levels of hs-CRP than subjects with unstable angina. Hs-CRP levels equal to or higher than 3.27 mg/l are more likely to be associated with MI. It is recommended to test this biomarker in all patients with acute coronary syndrome

Chronic disease program in Iran: Thalassemia control program

BACKGROUND: β-thalassemias (beta-thalassemia) is the most common genetic disorder; it is an inherited globinopathy which is transmitted to people due to a mutation in genes that create globin chain. In Iran, the disease gene is more common in the northern and southern regions. It is estimated that more than 60 mutations of the disease exist in different geographical areas of Iran. Iran has begun to adopt strategies to control the β-thalassemia for two decades; the most important of which is the screening of couples when they want to get marry. The present study aimed to review the thalassemia control program in Iran, the history of the disease, and the disease control strategies. METHODS: This review was conducted according to hand and electronic resources. Books, guidelines and document that exist in thalassemia control program were reviewed in the Iranian Ministry of Health, World Health Organization resources, PubMed, Google Scholar, SID (scientific information database), Magiran and, Iranmedex. RESULTS: Thalassemia program was appropriately structured and has been achieved successes. Reduction the numbers of new cases of β-thalassemia were notably. In some areas, thalassemia program has some defects and the program faced some cultural barriers. CONCLUSION: Due to the improvements in the social and economic situation of the people, it seems necessary to focus on prenatal diagnosis (PND) and pre-implantation genetic diagnosis (PNG) technique strategies and provide their necessary facilities

The prevalence of female genital mutilation and related factors among women in Kamyaran, Iran

BACKGROUND: Female genital mutilation (FGM) is defined as an injury of the external female genitalia for cultural or non-therapeutic reasons. The aim of this study was to evaluate the prevalence of FGM and related factor among women in Kamyaran, Iran.METHODS: A cross-sectional study was carried out among women referring to health centers of Kamyaran in 2014. The sample size for the study was 380 women, and with regard to the possibility of dropping, 400 subjects were included. Data were collected by researchers' questionnaire containing two parts. The first part was demographic information, and the second was information associated with genital mutilation. Reliability was assessed by using Cronbach's alpha coefficient, which was 0.85. Data were analyzed by SPSS software using descriptive statistics, and chi-square, and logistic regression tests.RESULTS: The prevalence of FGM was 50.5%. In the age group of 21-30 years, there were 168 (42%) women. 263 women (65.8%) were married and 146 (36.5%) women had diploma. 328 women (82%) were Sunni and 249 (63.3%) were born in city. There was significant difference between FGM and women's age as well as religion of father and mother (P < 0.050). There was no significant difference between FGM and marital status, education of father and mother, and place of birth (P > 0.050).CONCLUSION: According to the results, FGM is a deep cultural problem in Kamyaran city and there is a need for programs to reduce its rate

The study of Self-care agency and some associated factors in patients with type 2 diabetes referred to the diabetes clinic of Tohid Hospital in Sanandaj in 2016

Background and Aims: Diabetes is considered as a major public health problem all over the world. Self-care behaviors is the most important strategy for controlling chronic diseases, such as diabetes. Therefore, this study was conducted to determine the self-care agency and some associated factors in patients with type 2 diabetes. Materials and Methods: This cross-sectional study was performed on a descriptive-analytic approach on 374 patients referring to the Diabetes Clinic of Tohid Hospital in Sanandaj, selected using systematic sampling. Data were collected using a questionnaire including demographic and background information questionnaire and a valid and reliable questionnaire for assessing the self-care agency of diabetic patients. Data were analyzed by using SPSS software version 16 and appropriate tests. All stages of the study were conducted according to moral standards. Results: The mean and standard deviation of self-care agency score was 58.40 ± 12.49 from 105, that is considered moderate. There was a significant difference in self-care agency of patients according to variables such as gender, ability to measure blood glucose, occupational status, history of education about diabetes, regular dental examinations and annual infusion of influenza vaccine (P<0.05). There was a significant and inverse correlation between the number of years elapsed since diabetes diagnosis and self-care agency (P<0.05 and r=0.24). Conclusion: Regarding the average self-care level in the majority of patients and the important role of self-care in controlling diabetes, the need to implement self-care education is increasingly felt in diabetic patients. Keywords: Self-care, Type 2 diabetes, Sananda

Comparison the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes: A double-blinded randomized controlled trial

BACKGROUND: Treating hot flushes in middle-aged women is an important health issue. Recently, Hypericum perforatum and vitex agnus-castus were investigated to decrease hot flushes. This study was conducted to compare the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes among menopausal women. METHODS: This was a randomized, double-blinded, controlled trial. The Hypericum perforatum group received 330 µg Hypericum perforatum and second group received vitex agnus-castus in the same tablet forms. Data were analyzed using repeated measurement for comparing Greene Climacteric Scale. RESULTS: Trend of Greene Climacteric Scale and hot flushness attack were decreased in both groups and it presented a decreasing trend within two months; however, no statistically significant difference was observed between the two groups. CONCLUSION: It seems that Hypericum perforatum and vitex agnus-castus could be similarly effective in decreasing hot flushes. These two medicines did not have any special severe side effects

Evaluation of life expectancy in Kurdistan Province, Iran, during the years 2006 and 2016

BACKGROUND: Life expectancy index is used in assessing changes in the health status of Kurdistan Province community, Iran, especially among the elderly, the difference in the health levels of women and men, and also the economic levels and the desired changes. This study aimed to evaluate the life expectancy in the age groups in Kurdistan Province using demographic information and mortality based on age and sex during the years 2006 and 2016.METHODS: In this study, life expectancy was used for calculating life table according to the World Health Organization (WHO). Death information was extracted based on age groups and using demographic data of the statistical centers; in addition, the raw mortality rate was extracted according to age groups and calculated using Chiang method in the stage of life expectancy by sex and location. To analyze the data, Stata 12 and Excel software packages were used for calculations.RESULTS: Life expectancy at birth in Kurdistan Province in the whole population was equal to 74.56 and 78.31 years in 2006 and 2016, respectively, and this rate was higher among women compared to men.CONCLUSION: Extensive factors including medical and health status, well-being, nutrition status and quality, etc., affect the life expectancy index in different societies, and promotion of each criterion increases the life expectancy. It is necessary to establish required fields for establishing these indicators at the provincial level by creating a complete and accurate record of mortality and illness

Diagnostic value of high sensitivity C-reactive protein levels in dedifferentiation of stable angina from unstable angina

BACKGROUND: Differentiation of stable angina from unstable angina is important because they need different approaches. Few studies have been conducted to assess the diagnostic value of high sensitive C-reactive protein (hs-CRP) in differentiating these two diseases. This study aimed to evaluate the diagnostic value of hs-CRP levels for differentiating stable angina from unstable angina. METHODS: After signing the consent form, patients with unstable angina who referred to Tohid Hospital emergency in Sanandaj, Iran, and patients with stable angina who referred to the special clinic of the hospital were evaluated. Disease was confirmed by a cardiologist. Morning serum hs-CRP was tested using MONOBIND laboratory kit (USA). Data were analyzed by SPSS using Student’s independent t-test, Mann-Whitney U, chi-square, Fisher exact test, and receiver operating characteristic curve. RESULTS: hs-CRP levels in patients with stable angina and unstable angina were 1.6 (± 1.18) and 2.35 (± 1.30) mg/l, respectively (P = 0.025). The hs-CRP level ≥ 2.31 mg/l was the best cut-off point for differentiating stable from unstable angina. At this cut-off point, the sensitivity and specificity were 56% and 73%, respectively. Area under the curve was calculated to be 0.679 (95% confidence interval: 0.54-0.81) (P = 0.017). CONCLUSION: hs-CRP level is helpful for differentiating patients with stable angina from those with unstable angina. It is recommended to consider the hs-CRP level of 2.31 mg/l as the best cut-off point