Socioeconomic status and mortality after acute myocardial infarction: a study from Iran

<p>Abstract</p> <p>Background</p> <p>Studies have shown an inverse relationship between socioeconomic status (SES) and mortality due to coronary heart disease (CHD). Little is known about this association in Iran. This study aimed to investigate whether mortality after myocardial infarction (MI) varies by SES.</p> <p>Methods</p> <p>In a retrospective study, 1283 MI patients who hospitalized in Tehran Heart Center from March 2005 to March 2006 were followed up in March 2008. Demographic, clinical and SES data were collected from case records and by telephone interviews. Multiple logistic regression analysis was performed to estimate the predictive effect of socioeconomic factors on outcome.</p> <p>Results</p> <p>In all 664 patients were studied. Of these, 500 patients were alive and 164 were dead due to MI (64 died at hospital and 100 died at home). The results of regression analysis showed that in addition to treatment (OR = 9.52, 95%CI 4.84-18.7), having diabetes (OR = 1.78, 95% CI 1.12-2.81) or hyperlipidemia (OR = 1.82, 95% CI 1.14-2.90), socioeconomic variables including living area in square per person (lowest level vs. upper level OR = 4.92, 95% CI 2.11-11.4), unemployment (OR = 3.50, 95% CI 1.50-8.13) and education (OR for illiterate patients = 2.51, 95% CI 1.00-6.31) were the most significant contributing factors to increased mortality after MI.</p> <p>Conclusion</p> <p>Although the findings should be interpreted with caution, the study results indicated that socioeconomic variables were significant contributing factors to increased mortality after myocardial infarction. The underlying role of socioeconomic status on increased mortality after MI deserves further investigation.</p

The association between serum lipids profile and HbA1c in type 2 diabetes mellitus in Tehran, Iran

Background and aims: Dyslipidemia is one of the major factors implicated in the development of the vascular complications of diabetes. In this study, it was evaluated the association between serum lipids profile and Hemoglobin A1c (HbA1c) in type 2 diabetes mellitus. Methods: In this cross-sectional study, the serum lipid profile and HbA1c was studied on 562 Iranian patients who were older than 30 years and had type 2 diabetes identified from the diabetes and metabolic diseases clinic of endocrinology and metabolism research institute. A Multiple Linear Regression analysis was also done with the HbA1c as outcome variable and serum lipids profile as predictor variables; adjusted for potential confounders (age, sex, diabetes duration and Body Mass Index (BMI)). Results: In 1966, 6.34 of the national total population was over 60 years compared to mean age of the participants that was 61.6±10.4 years, with a range of 32 to 89 years. The results confirmed that the Triglyceride (TG) (β: 0.11, 95 CI: 0.000-0.004, P=0.01) and cholesterol (β: 0.13, 95 CI: 0.000-0.009, P=0.04) were correlated with the HbA1c value but there were no significant association between HDL and LDL. Conclusion: This study demonstrated that in persons with type 2 Diabetes Mellitus (DM), HbA1c value is a good predictor of lipid profile. Therefore, lipid profiling for all persons with type 2 DM should be a routine test

How within-city socioeconomic disparities affect life expectancy? Results of Urban HEART in Tehran, Iran

There is substantial lack of knowledge about the role of socioeconomic status (SES) indicators on life expectancy (LE) within-cities, especially within mega-cities. We aimed to investigate the disparities of LE within city districts of Tehran, Iran, and specify how SES inequalities play role on LE.; The death and population data for 2010 by different age, gender, and residency district were obtained from the main cemetery of Tehran and statistical centre of Iran, respectively. Age-specific mortality rates and consequently LE were calculated for all 22 districts by different genders. Finally, based on the results of first Tehran's Urban Health Equity Assessment and Response Tool (Urban HEART) project in 2008, the influence of social classes (SCs), total costs, and education indicators were analyzed on LE at birth (e0).; The e0 for total males and females in Tehran were calculated as 74.6 and 78.4 years for 2010, respectively. The maximum LE of 80 years was observed in females of northern part with higher SES, and the minimum e0 of 72.7 years observed in males of southern part with lower SES. The e0 gender gap among districts was 5.5 years for females and 3.7 years for males. The highest and lowest mean of e0 observed in SC1 (highest class) and SC5 (lowest class), were 77.6 and 76.0 years, respectively. The lowest mean of e0 observed in the first group of total costs indicator and was 76.2 years. In addition, the lowest observed mean of e0 was in the first category of education indicator (illiterate) and was 76.0 years.; RESULTS indicate substantial disparities in LE within city districts. This confirms that SES disparities within-cities would have direct influences on LE

The effect of quitting water pipe during pregnancy on anthropometric measurements at birth: A population-based prospective cohort study in the south of Iran

Background: Evidence regarding health effects of tobacco cessation during pregnancy is mainly restricted to cigarette while water pipe is the preferred method of tobacco smoking among women in the Middle-East. The present study aimed to assess the effects of cessation of water pipe during pregnancy on birth anthropometric measures in the south of Iran. Methods: Data on 1120 singleton pregnancies (response rate = 93.4) from a population-based prospective cohort study in suburban communities in Bandar Abbas city was used. Based on water pipe smoking status, the study subjects were categorized into: 1) those who never smoke water pipe (never smoker); 2) those who stopped water pipe during pregnancy and resumed it postpartum (quitters); 3) those who continued smoking water pipe during their pregnancy (always smokers). The Generalized Linear Models (GLMs) were utilized for the analyses. Results: Compared to never smokers, quitting water pipe in pregnancy decreased mean birthweight of infants by 99.30 g (β:-99.30, 95CI:-204.35,-5.75) and an additional decrease of 37.83 g occurred in infants of always smokers (β:-137.13;95CI:- 262.21,-12.05). Means of birth length did not significantly differ among the three water pipe groups. Means of head circumference, however, significantly increased by 0.79 cm in infants of always smokers (β:079,95CI:0.13,1.45). Conclusion: Quitting water pipe during pregnancy had positive effects on infant growth, especially birth weight. Awareness campaigns about health benefits of quitting water pipe during routine prenatal checkups and integration of active follow-up visits into prenatal care protocols for smoking mothers are provided. © 2020 The Author(s)

Assessing the knowledge, attitudes, and practices of students regarding Ebola virus disease outbreak

Background - The emergence and spread of Ebola outbreak is a growing problem worldwide, which represents a significant threat to public health. Evidence has shown that the level of knowledge, attitude, and practice of people in the society play major roles in controlling the spread of Ebola virus disease. This study was designed to determine knowledge, attitude and practice of students at School of Public Health, Tehran University of Medical Sciences towards Ebola. Methods - A cross-sectional survey was performed in Tehran, Iran in 2014 using a pretested self-administered questionnaire on a stratified sample of 400 students. Descriptive and multivariate analyses were used for statistical analysis. Results - All-in-all, 385 students returned the completed questionnaires making a response rate of 96.3%., 239 (62.2%) were females and 145 (37.8%) were males. The mean age of female and males were 28.44 and 30.3 years respectively. Of the 385 students, 83 (21.7%) were studying at PhD level, 210 (55.0%) at Masters Level (including MPH) and 89 (23.3%) at Bachelors level. knowledge of the students regarding EVD transmission was lowest among students of Department of Occupational Health (50.0%), followed by Health Education and Promotion Department (33.3%). Virology Department recorded the highest percentage of students who had selected correct answers regarding EVD prevention (100.0%) Conclusion - These findings will aid in the assessment of the adequacy of current students’ educational curriculum. Also, it will provide further insight in designing future multifaceted interventions to promote specific messages to change attitude and improve practice

Prevalence of Multidrug Resistance Mycobacterium Bovis in Human: A Systematic Review and Meta-Analysis

Introduction: Human infection with multidrug resistant mycobacterium bovis (MDR-M.bovis) is very rare.  Recently, infection with this type of bacteria has been described. The WHO strategy to end TB by 2035, recall for more efforts in the diagnosis and treatment of mycobacterium bovis particularly in resource limited countries. The aim of this systematic review was to determine the prevalence of multidrug resistant tuberculosis M.bovis infects human. Methods: International database including Medline, EMBASE, and Web of Sciences, Scopus, and ScienceDirect were searched for related literature. Google Scholar searching engines as well as references list were explored. Studies met the inclusion criteria were included in the systematic review. Random effects model was used to estimate the pooled prevalence. Results: A total number of (4275) studies were retrieved and nine studies were included in the meta analysis. The overall estimated prevalence of the multidrug resistant Mycobacterium bovis was 0.04 (95% CI: 0.02, 0.06). Based one study quality, time and area of study, subgroup analysis were conducted to check for heterogeneity. The prevalence of MDR-M bovis in low quality studies was 0.04 (95% CI: 0.00, 0.06), and in high quality studies was 0.05 (95% CI: 0.02, 0.08). Conclusions: The finding of this study indicated that the prevalence of multidrug resistant M.bovis in human is low. However, more attention is needed in the diagnosis and treatment of M.bovis infection in Human. Keywords: Tuberculosis, Multidrug-Resistant     Mycobacterium bovis     review  meta-analysis   Human DOI: 10.7176/JHMN/69-01 Publication date: December 31st 201

Molecular detection of prostate specific antigen in patients with prostate cancer or benign prostate hyperplasia the first investigation from Iran

Prostate cancer is the second common form of cancer in men. Detection of circulating Prostate Specific Antigen (PSA) transcripts has effectively been used for early diagnosis of prostate cancer cells. This investigation employed a reverse transcriptase polymerase chain reaction (RT-PCR) technique to distinguish the patients with either localized or metastatic prostate cancer (CaP) vs. Benign Prostate Hyperplasia (BPH) and control subjects, as compared with clinical and pathological records. With reservation of ethical issues, blood samples were collected from 60 cases. Based on pathological and clinical findings, 25 patients (20 with localized cancer, 5 with metastatic), 22 with BPH, and 13 healthy (including 3 females) subjects as negative controls, were selected from Shariati, Mehrad, Sina,, Khatam and Atie Hospitals in Tehran, Iran. RT-PCR for a 260 bp PSA transcript was then performed. Clinical and pathological records were used for the assessment and comparison of PSA RT-PCR results. None of the control subjects and BPH (with 7 exceptions) were found positive by RT-PCR (Relative specificity= 72.7). In patients with prostate cancer, 21 out of 25 were found PSA positive (Relative sensitivity= 83.4) and the remaining 3 have been shown to be PSA negative (Positive predictive value= 83.4). All of 5 metastatic patients (100) revealed PSA positive results. Our data reflects the clinical relevance and significance of RT-PCR results as assessed with clinical and pathological examinations. PSA RT-PCR might be used as a powerful means for diagnosis, even when either pathological or clinical findings are negative, and could be employed for further molecular epidemiology surveys

How addicts think about addiction and community problems?

Background: addiction and drug abuse have many risk factors in community and individual attitude; also causes much diversity in community perception and attitude toward addiction. Methods: in this study we assessed attitude toward an addict in 42 addict men and asked about problems in their community and recreational behaviors. They were residents of a rural area in Babol city. In the control group we assessed the same parameters in 268 non addicts in the same area. All of the addicts have been using opium more than many times a week at least for recent 6 months. Data collected via a semi structured questionnaire through conversation. Results: There was a significant difference between addicts’ attitude toward toward addiction compare to non-addicts’. Both addicts and non-addicts indicated that the first three community problems in their area were unemployment, lack of recreational facilities and addiction, in respective order. Answering questions about recreational activities, both groups indicated that there were no recreational facilities in the community. Conclusion: In planning a preventive approach, there is a major role for attitude toward addiction in any community. The conflict seen in this study between addicts’ attitudes toward an addicted person and addiction as a community problem has it’s interesting feature. Recreation and physical and cultural facilities need to pay more attention as indicated by our study participants. This seems to have an important impact in prevention of many community problems as well as addiction

Investigation of a foodborne outbreak in dormitory students affiliated to one medical university in Tehran: A case� control study

Background and Objectives: Food-borne diseases are serious problems in public health. Since the outbreaks can be prevented, we need to take action in the prevention of such infection. On 28 June, 2014 cases of gastroenteritis occurred in students living in dormitories of a medical university; therefore, this study aimed to investigate the outbreak of gastroenteritis to determine its risk factors. Methods: This case - control study was performed to evaluate students. A total of 70 patients with gastroenteritis in the outbreak of 16 June 2014 were selected. A total of 70 students without any gastrointestinal complaints in the weeks before the outbreak were also selected as the control group using convenient sampling. Results: The results of this study provided 4 main themes (challenges of access to the data of the surveillance system, challenges of access to the data of national surveys and ordered projects, challenges of access to the data of electronic health records, and challenges of access to confidential data) and 15 sub-themes. Conclusion: According to the results, having lunch prepared by the university on 16 June was the likely cause of the outbreak on 17 June in student living in dormitories. Hygiene in cooking and food storage, especially in public places such as schools and universities are important in the prevention of food-borne outbreaks. © 2017, Iranian Epidemiological Association. All rights reserved

Investigation of a foodborne outbreak in dormitory students affiliated to one medical university in Tehran: A case� control study

Background and Objectives: Food-borne diseases are serious problems in public health. Since the outbreaks can be prevented, we need to take action in the prevention of such infection. On 28 June, 2014 cases of gastroenteritis occurred in students living in dormitories of a medical university; therefore, this study aimed to investigate the outbreak of gastroenteritis to determine its risk factors. Methods: This case - control study was performed to evaluate students. A total of 70 patients with gastroenteritis in the outbreak of 16 June 2014 were selected. A total of 70 students without any gastrointestinal complaints in the weeks before the outbreak were also selected as the control group using convenient sampling. Results: The results of this study provided 4 main themes (challenges of access to the data of the surveillance system, challenges of access to the data of national surveys and ordered projects, challenges of access to the data of electronic health records, and challenges of access to confidential data) and 15 sub-themes. Conclusion: According to the results, having lunch prepared by the university on 16 June was the likely cause of the outbreak on 17 June in student living in dormitories. Hygiene in cooking and food storage, especially in public places such as schools and universities are important in the prevention of food-borne outbreaks. © 2017, Iranian Epidemiological Association. All rights reserved