Socioeconomic inequalities of hypercholesterolemia in Kurdistan Province, Iran, in 2005

BACKGROUND: Hypercholesterolemia is one of the main risk factors for many non-communicable diseases (NCDs). Many deaths caused by hypercholesterolemia usually occur in low and middle income countries. The aim of the present study was to determine the socioeconomic inequality in the distribution of hypercholesterolemia in Kurdistan Province, Iran, in 2005. METHODS: The data used in this study were obtained from the results of the Non-Communicable Disease Surveillance Survey (NCDSS) conducted in 2005 in Kurdistan Province. In this study, the socioeconomic status (SES) of participants was determined based on their assets and residential location and using the principal component analysis (PCA) statistical method. The levels of inequality in 5 different socioeconomic groups were determined by calculating the concentration index, comparing odds ratio (OR), and through using logistic regression method. RESULTS: The prevalence of hypercholesterolemia in the studied subjects was 38.5% [confidence interval (95% CI): 36, 41]. The concentration index of hypercholesterolemia was -0.031 (95% CI: -0.070, 0.009). Moreover, the OR of hypercholesterolemia in the richest group, compared with the poorest, was 0.82 (0.59 to -1.13). CONCLUSION: In this study, the relationship between socioeconomic status and risk of hypercholesterolemia was not statistically significant; however, usually, SES is associated with hypercholesterolemia. In the comparison of different countries, distribution of hypercholesterolemia in different SES levels depends on the level of development, gross national product (GNP) per capita, and level of income in each country. Inequalities in the distribution of risk factors for hypercholesterolemia can be reduced through increasing disadvantaged groups’ access to health care services and planning special programs for inequality reduction.

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

Socioeconomic Inequalities in Tobacco Smoking in Women Aged 15-54 in Iran: A multilevel model

Significant evidence suggests an inverse relationship between socioeconomic status and tobacco smoking, where inequality is visible among different social and economic strata. The aim of this study was to investigate the prevalence and economic and social inequalities in tobacco smoking in women aged 15-54 in Iran. This study is a cross-sectional study. Sampling in this study was a randomized clustered multistage sampling with equal clusters. A total of 35,305 women aged 15-55 enrolled in the study. Data analysis was in two stages. In the first stage, the social and economic inequalities were investigated using the concentration index and concentration curve method, and in the second method, and multilevel method was used to identify the determinants. The prevalence of tobacco smoking in women was 12.24%. The concentration index for smoking was CI = -0.07 [95% CI (-0.09, -0.05)], which represents smoking in people with low socioeconomic status. The results of the multilevel analysis indicated that the marital status of people over the age of 35 and the economic class was related to smoking in women. Inequality in tobacco smoking in women is to the interest of the well-off group, and this inequality varies in different provinces. Marital status, place of residence, age and socioeconomic status of women are factors influencing the prevalence of tobacco smoking in women, and these issues should be noticed to reduce inequalities

Incidence of Cerebrovascular Accidents Following Brain Tumor Surgery

Background and Purpose: Cancer and cerebrovascular accidents (CVA) are two most common causes of mortality and morbidity in the elderly. Patients with brain tumor can be highly affected by postsurgical stroke. CVA may be the first manifestation in these patients . Therefore, we aimed to assess the epidemiological factors affecting CVA after brain surgery.Methods: In this cross-sectional study we enrolled 241 patients admitted for brain surgery due to a brain tumor during April 2009 to March 2013 in Tohid Hospital, Sanandaj, Iran, using the convenient sampling method.Results: The mean±SD age of the patients was 48.1±21.3 years. 5 patients (2%) were complicated with CVAs(4ischemic stroke and one haemorrhagic). The frequency of CVA was not different regarding age,sex,type of tumor, tumor site,hypertension, diabetes mellitus, smoking, and type of intervention.Type of tumor was meningioma in 2 patients, Oligodendroglioma in 2 patients, and metastatic cancer in 1 patient. Of the 5 patients with CVA, 2 were in middle fossa (1.9% of middle fossa tumors), 2 in anterior fossa (2.5%), and one in the meningeal membrane (3.3%).Conclusion:Despit low incidence of stroke in this study,it seems there is a considerable rate of mortality and morbidity of cerebral vascular diseases, especially in people with underlying chronic medical conditions such as brain tumors necessitates regular follow-up of patients with brain tumors for assessing risk factors to be able to increase survival rate and reduce disease-related complications

Situation of linkage between sexual and reproductive health and HIV-related policies in Islamic Republic of Iran – a rapid assessment in 2011–2

The number of sexual transmission of HIV is increasing globally. Sexual and Reproductive Health (SRH) issues and HIV/AIDS related problems are rooted in common grounds such as poverty, gender inequality, and social exclusion. As a result, international health organizations have suggested the integration of SRH services with HIV/AIDS services as a strategy to control HIV and to improve people’s access to SRH services. The aim of this study was to evaluate the relationship between reproductive health and HIV/AIDS services at policy-making level in Islamic Republic of Iran (IRI). This study was conducted in 2011–2 and was a rapid assessment based on guidelines provided by the World Health Organization (WHO), United Nations Programme on HIV/AIDS (UNAIDS), Family Health International Association, and some other international organizations. In this rapid assessment we used different methods such as a review of literature and documents, visiting and interviewing professionals and experts in family health and HIV/AIDS programs, and experts working in some Non- Governmental Organizations (NGOs). Overall, based on the results obtained in this study, in most cases there was not much linkage between HIV/AIDS policies and SRH policies in Iran. Since integration of HIV/AIDS services and SRH services is recommended as a model and an appropriate response to HIV epidemics worldwide, likewise to control the HIV/AIDS epidemic in Iran it is required to integrate HIV/AIDS and SRH services at all levels, particularly at the policy-making leve

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

Maternal risk factors for low birth weight infants: A nested case-control study of rural areas in Kurdistan (western of Iran)

Infant mortality is among the most important indicators of health and development in global communities. One of the causes of neonatal mortality is low birth weight. This study aims at evaluating the risk factors for LBW in infants.This study was carried out using a nested case-control study in rural areas of Kurdistan province in western Iran in 2015. The selection of case and control groups was based on the nesting using the risk set sampling approach. In total, 182 and 364 subjects were selected for the case group and the control group respectively. Data analysis was performed using the Stata-12 software with the point and spatial estimation of OR using the conditional logistic regression method.The multivariate logistic regression analysis performed shows that the maternal gestational age, the mother’s health history during pregnancy, any medication abuse by the mother, any mental stress during pregnancy, are LBW risk factors (P <0.05). Prevention of LBW is possible by identifying effective factors and performing appropriate interventions in infants with low birth weight. The causes of LBW in global communities are changing rapidly. Mothers with the risk factors reported in this study should be identified and specially treated

Comparison of pulmonary arterial pressure in patients under chronic hemodialysis with and without arteriovenous fistula

BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive disorder and a newly-discovered disease in people with end stage renal disease (ESRD). In patients who are hemodialyzed through arteriovenous fistula (AVF), the incidence of pulmonary hypertension (PHT) is highly probable. Regarding the main role of the AVF in the pathogenesis of PAH and the fact that AVF is the main method of vascular access in patients undergoing dialysis, we decided to investigate pulmonary artery pressure (PAP) in patients under chronic hemodialysis.METHODS: This was a cross-sectional study. All patients with chronic hemodialysis were divided into two groups according to the status of the fistula. The number of cases examined included 100 patients and data were analyzed by SPSS software.RESULTS: The most common cause of ESRD was hypertension (HTN) followed by diabetes mellitus (DM), polycystic kidney disease (PKD), urologic disorders, DM and HTN, combined blood pressure (BP) and PKD, renal stones, and other items ultimately. The average creatinine level was 8.59 mg/dl. Therefore, the mean creatinine level of patients, although relative to mode and median, was in any case significantly higher than the mean, which was predictable according to the ESRD community studied. The mean phosphate level was 5.66 mg/dl, and the mean hemoglobin (Hb) was 11.56 g/dl. The mean parathyroid hormone (PTH) and PAP were 558.68 and 27.33 mmHg, respectively, and the mean of ejection fraction (EF) was 50.75%. There was a significant difference between the mean PAP in the two groups (P = 0.048), as it was higher in the AVF group.CONCLUSION: Results of this study showed that AVF and ESRD both were risk factors for high PAP and PHT

Pomegranate MR image analysis using fuzzy clustering algorithms

In this paper, the process of the pomegranate magnetic resonance (MR) images was studied.  Its internal structure is composed of tissue and seeds, which indicate the dependency between the maturity and internal quality.  The latter properties are important in pomegranate’s sorting and cannot be measured manually.  In this paper, an automatic algorithm was proposed to segment the internal structure of pomegranates.  Since the intensities of the calyx and stem of the pomegranate MR image are closely related to that of the soft tissue, their corresponding pixels are therefore labeled in the same class of the internal soft tissues.  In order to solve this problem, the exact shape of the pomegranate is first extracted from the background of the image using active contour models (ACMs).  Then, the stem and calyx are removed using morphological filters.  We have also proposed an improved version of the fuzzy c-means algorithm (FCM), the spatial FCM (SFCM), for segmentation of MR images of pomegranate.  SFCM is realized by incorporating the spatial neighborhood information into the standard FCM and modifying the membership weighting of each cluster.  SFCM employs spatial information of adjacent pixels leading to an improvement of the results.  It thus outperforms other techniques like FCM, even in the presence of Gaussian, salt and pepper, and speckle noises. Keywords: MRI, pomegranate, image segmentation, spatial fuzzy c-means, morphological filter&nbsp