The Status of the Surveillance System of Groups at Risk of Tubercolosis in Iran: AQualitative Study

Background: In order to achieve a dynamic surveillance system for the groups at risk of tuberculosis and to improve its quality, investigating its various aspects and benefiting from the opinions of the experts and experienced individuals in this field are very important. Hence, the objective of this study was to explore the status of the surveillance system for the groups at risk of tuberculosis in Iran. Methods: Data collection was carried out via interviews with 17 experts in the tuberculosis control program of Iran. In order to evaluate the validity and reliability of data, four criteria of credibility, transferability, dependability and confirmability were used. Frame analysis was used for data analysis. Results: Based on the interviewee's opinions, twelve major groups at risk of tuberculosis and seven challenges in the surveillance system were identified. For the majority of these at risk groups, there is no structured program and the status of case finding and treatment is similar to the public population. For some others (HIV/ AIDS patients, prisoners and people at exposure), there is a program, but its effectiveness is uncertain. Conclusion: Results indicate that groups at risk of tuberculosis are widespread and access to some of them is difficult; hence, these groups are the main challenges of the tuberculosis control program in Iran

Factors influencing low sexual desire and sexual distress in pregnancy: A cross-sectional study

Background: Sexual desire and sexual distress are determined by emotional, psychosocial, hormonal, and anatomical factors during pregnancy. Objective: To identify the factors contributing to female low sexual desire and sexual distress during pregnancy separately and concurrently. Materials and Methods: Overall, 295 pregnant women were enrolled in this cross-sectional study. Sexual desire and distress were assessed by the sexual interest and desire inventory-female (score ≤ 33.0 indicates low sexual desire) and the female sexual distress scale-revised (score ≥ 11 indicates sexual distress). Results: 56.3% and 17.3% of pregnant women met the clinical cut-off for low sexual desire and sexual distress, respectively. After adjusting for the effect of the confounding variables by logistic regression multivariate analysis, satisfaction with body image before and during pregnancy, frequency of sexual intercourse, and satisfaction with foreplay were found to be significantly associated with low sexual desire. Factors related to sexual distress were similar to those noted for common sexual desire, except for satisfaction with foreplay. Other factors related to sexual distress included increased age, fear of abortion, and pregnancy trimester. Factors linked to concurrent low sexual desire and sexual distress were similar to those found for sexual distress, except for pregnancy trimester. Conclusion: Low sexual desire and sexual distress are relatively common sexual experiences during pregnancy. Several factors could predict low sexual desire but were not associated with sexual distress, and conversely. Comprehensive attention to all of these factors is essential while screening for sexual health during pregnancy. Key words: Pregnancy, Sexual desire, Sexual distress, Sexual dysfunctions, Influencing factors

Does Tuberculosis Have a Seasonal Pattern among Migrant Population Entering Iran?

Background: There are few quantitative documents about the seasonal incidence of tuberculosis (TB) among immigrant populations. Concerning the significant role of recognizing seasonal changes of TB in improving the TB control program, this study determines the trend and seasonal temporal changes of TB among immigrants entering Iran. Methods:In this longitudinal study, data from the Iranian TB register Program (from 2005 to 2011) was used. The aggregated number of monthly and seasonal TB cases was obtained by adding the daily counts. Data was analyzed by Chi-square, Independent T-test, ANOVA, and Poisson regression using Stata 11 and SPSS 20 software. Results: Among 74,155 registered patients with TB, 14.3% (10,587) were non-Iranian who had immigrated to Iran from 29 different countries. The highest aggregated number of seasonal and monthly incidence of TB in immigrants was observed in spring (2824, P= 0.007) and in May (1037, P< 0.001). The number of non-Iranian patients with TB increased significantly over the years (β= 0.016, P= 0.001). Conclusion: This study shows that immigrants constitute a significant portion of TB patients recorded in Iran and this trend is increasing. Also, the peak incidence of this disease is the second month of the spring

The Existing Problems in the Tuberculosis Control Program of Iran: A Qualitative Study

Introduction: The TB control program in the world has encountered serious problems because of weakness in case detection, inadequate and improper treatment, drug resistance and the emerging and concurrent epidemic of HIV. Therefore, this qualitative study was conducted in order to gain a deep and better understanding of the problems and to suggest initiatives to improve the situation. Method: A qualitative content analysis study was carried out by semi-structured interviews with key informants of the tuberculosis control program in Iran. Participants were selected by purposeful sampling. The trustworthiness of the study was confirmed by the four criteria of credibility, dependability, confirmability and transferability. Data analysis was performed using framework analysis and the main themes and subthemes were identified. Results: Twenty four subthemes and six themes were identified as followings: 1) strategies and policies, 2) characteristics of human resources, 3) quality and quantity of resources, 4) the basis of the methods, 5) coordination and communication and 6) general public participation and social support. Conclusion: Different factors have led to the weakness of the program. In order to improve the current situation and alleviate the problem, it is necessary to improve the processes of diagnosis and treatment, TB reporting system, physician compliance to the National protocol of tuberculosis control, public education, recruitment of TB coordinator physicians, the practice of TB diagnosis laboratory staff and other diagnostic and treatment facilities. Keywords: Tuberculosis, Case finding, Treatment, Qualitative researc

Factors Related to Breast Cancer Screening in Women in the Northern Part of Iran: A Cross-Sectional Study

BACKGROUND: Breast cancer is the most common type of cancer in women and affects many women around the world each year. Breast cancer screening is one of the best strategies that can be used to reduce the death rate from the disease. Different factors influence the breast cancer screening rate. AIM: This study aimed to investigate the factors that affect the screening of women for breast cancer in the northern part of Iran. MATERIAL AND METHODS: This cross-sectional study was conducted in the Mazandaran Province of Iran in 2016 on 1,165 women who participate in breast cancer screening programs, using a cluster-sampling method. A valid and reliable researcher-made questionnaire was used to collect the data. The collected data were analysed using descriptive and inferential statistics via SPSS 21. RESULTS: In this study, 62% of the women had a history of breast self-examinations, 41.1% had breast examinations by healthcare staff, and 21.7% received mammography. The woman’s age, age at first marriage, age at onset of sexual intercourse, occupation, spouse’s occupation, household income, health status, history of infertility, smoking, and decision-maker on issues of sexual and reproductive health (SRH) were the best predictors of participation in screening for breast cancer (P &lt; 0.05). CONCLUSION: To encourage participation in breast cancer screening programs, women should be encouraged to seek preventive care. Also, factors that affect screening should be considered an appropriate educational method should be provided. ould be considered and appropriate educational methods should be provided

Determining the frequency of defensive medicine among general practitioners in Southeast Iran

Abstract Background: Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran. Methods: The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20. Results: The majority of participants were male (58.2%). The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P&lt; 0.001). Conclusion: The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo

Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review

How to Cite This Article: Nasehi MM, Sakhaei R, Moosazadeh M, Aliramzany M. Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review. Iran J Child Neurol. 2015 Winter;9(1):17-24 .AbstractObjectiveSeveral factors are involved in the etiology of febrile seizure (FS), among themis zinc (Zn), which has been discussed in various studies. The present systematic review compares Zn levels in children with FS and a control group.Materials &amp; MethodsWe searched keywords of febrile seizure, febrile convulsion, children, childhood,fever, trace elements, risk factor, predisposing, zinc, Zn, and epilepsy in thefollowing databases: SCOPUS, PubMed, and Google Scholar. The quality ofresearch papers was assessed using a checklist. Data was extracted from primarystudies based on demographic variables and amounts of Zn in case and controlgroups.ResultsTwenty primary studies were entered in the present study. Of which, eighteenstudies, reported that Zn serum levels were significantly lower in the case group(patients with FS) than the control group.ConclusionThe present systematic review indicated that Zn is one factor for predicting FS.A low level of this element among children can be regarded as a contributingfactor for FS, a conclusion with a high consensus among different studies carriedout in different parts of the world. ReferencesHeydarian F, Ashrafzadeh F, Ghasemian A. Serum ZINC level in Patients with simple febrile seizure. Iran J Child Neurology 2010; 14(2):41-44.Mahyar A, Pahlavan AA, Varasteh-Nejad A. Serum zinc level in children with febrile seizure. Acta Medica Iranica 2008; 46(6): 477-80.Kunda GK, Rabin F, Nandi ER, Sheikh N, Akhter S. Etiology and Risk Factors of Febrile Seizure – An Update. Bangladesh J Child Health 2010; 34 (3):103-112.Abbaskhaniyan A, Shokrzadeh M, Rafati MR, Mashhadiakabr M, Arab A, Yazdani J. Survey and Relation of Serum Magnesium Level in Children with Seizure. J Mazand Univ Med Sci 2012; 2(90): 43-49.Abaskhanian A, Vahid Shahi K, Parvinnejad N. The Association between Iron Deficiency and the First Episode of Febrile Seizure. J Babol Univ Med Sci 2009; 11(3):32-36.Amiri M, Farzin L, Moassesi ME, Sajadi F. Serum Trace Element Levels in Febrile Convulsion. Biol Trace Elem Res 2010; 135:38–44.Fetveit A. Assessment of febrile seizures in children. Euro J Pedia 2008; 167:17-27.Sadeghzadeh M, Khoshnevis P, Mahboubi E. Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years. Iran J Child Neurol 2012; 6(4):27-31.Salehiomran MR, Mahzari M. Zinc Status in Febrile Seizure: A Case-Control Study. Iran J Child Neurol. 2013; 7(4):20-23.Shiva S, Barzegar M, Zokaie N, Shiva Sh. Dose Supplemental Zinc Prevents Recurrence of Febrile Seizures?. Iran J Child Neurol 2011; 5(4):11-14.Sadeghzadeh M, Khoshnevis Asl P, Mousavinasab N, Koosha A, Norouzi M. The Relation Between Serum Zinc Level and Febrile Seizures in Children Admitted to Zanjan Valie-Asr Hospital. ZUMS Journal 2011; 19 (74):17-24.Waruiru C, Appleton R. febrile seizures: an update. Archive Dis Child 2004; 89: 751-6.Moosazadeh M, Nekoei-moghadam M, Emrani Z, Amiresmaili M. Prevalence of unwanted pregnancy in Iran: A systematic review and meta-analysis. Int J Health Plann Mgmt, 2013; Published online in Wiley Online Library, DOI: 10.1002/hpm.2184. available at: http://onlinelibrary.wiley.com/journal/10.1002/%28ISSN%291099-1751/earlyview.Elm EV, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke P, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Preventive medicine 2007; 45(4): 247-251.Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC medical research methodology 2007; 7(1):10.Garty BZ, Olomucki R, Lerman-Sagie T, Nitzan M. Cerebrospinal fluid zinc concentration in febrile children’s. Arch Dis Child 1995; 73(4):338-41.Papierkowski A, Mroczkowska-Juchkiewics A, Pawlowska KA, Pasternak K. Magnesium and zinc levels in blood serum and cerebrospinal fluid in children with febrile convulsions. Pol Merkuriusz Le 1999; 6(33): 138-40.Burhanoglu M, Tutuncuoglu S, Coker C, Tekgul H, Ozgur T. Hypozincemia in febrile convulsion. Eur J Pediatr 1996; 155(6):498-501.Kumar L, Chaurasiya OS, Gupta AH. Prospective Study of Level of Serum Zinc In Patients of Febrile Seizures, Idiopathic Epilepsy, and CNS Infections. People’s Journal of Scientific Research 2011; 4(2):1-4.Palliana RR, Singh DK, Borade A. ZINC deficiency as a risk factor febrile seizure. Pediatrics 2008; 121(2):358-365.Ehsanipour F, Talebitaher M, Vahid Harandi N, Kani K. Serum Zinc Level in Children with Febrile Convulsion and its Comparison with that of Control Group. Iran J Pediatr 2009; 19)1):65-68.Kafadar I, Akıncı AB, Pekun F, Adal E. The Role of Serum Zinc Level in Febrile Convulsion Etiology. J Pediatr Inf 2012; 6: 90-93.Lee JH, Kim JH. Comparison of Serum Zinc Levels Measured by Inductively Coupled Plasma Mass Spectrometry in Preschool Children with Febrile and Afebrile Seizures. Ann Lab Med 2012; 32:190-193.Margaretha L, Masloman N. Correlation between serum zinc level and simple febrile seizure in children. Paediatr Indones 2010; 50(6): 326-330.Mollah MAH, Rakshit SC, Anwar KS, Arslan MI, Saha N, Ahmed S, et al. Zinc concentration in serum and cerebrospinal fluid simultaneously decrease in children with febrile seizure: Findings from a prospective study in Bangladesh. Acta Pædiatrica 2008; 97:1707–1711.Mollah MAH, Ranjan DP, Tarafdar SA, et al. Zinc in CSF of patients with febrile convulsion. 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Determining the Frequency of Defensive Medicine Among General Practitioners in Southeast Iran

Background: Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran. Methods: The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20. Results: The majority of participants were male (58.2%). The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P< 0.001). Conclusion: The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo

Nurses’ Perspectives on the Impact of Marketing Mix Elements (7Ps) on Patients’ Tendency to Kind of Hospital

BACKGROUND: Marketing mix (7Ps) is a critical concept in healthcare management and health marketing. Hence, this study was conducted to investigating the role of 7Ps on patients’ disposition to the kind of hospital from nurses’ perspectives.METHODS: A cross-sectional study design was used in 2015. The study was conducted in one state in Iran (Mazandaran). The statistical population included nurses (n=235) in public and private hospitals were selected randomly through the list. Data were collected by questionnaire and were analyzed using SPSS software (version 22).RESULTS: The results showed that 38.6 percent of nurses were males and the others (61.4 percent) were females. Their mean age was 31.0±7.1 years, and the majority of them belonged to the 30-40 age group. The mean work experience of them was 11.42±6.5years. The findings showed that there were significant differences between nurses’ perspectives in public and private hospitals about the effect of 7Ps elements on patients’ tendency to the public and private hospitals (p&lt;0.05).CONCLUSIONS: According to the results, the officials of public hospitals should take more attention to the elements like product, place, promotion, people, physical assets and process management more than the past because these elements cause that the patients are disposed to the private hospitals while the government make more investment in public hospitals

Prevalence of smoking in northwest Iran: a meta-analysis

Background: Tobacco addiction is a major cause of preventable death worldwide. Thus, efforts to eliminate its use have the potential of producing significant health benefits. The purpose of this study was to conduct a meta-analysis to estimate the prevalence of cigarette smoking among people in the age range of 15 to 64. The specific objective of this meta-analysis was to provide valid data that policy makers can use to make evidence-based decisions. Methods: To determine the prevalence of smoking among the adult population in northwest Iran, we used reports published by the surveillance system used to assess the risk factors for non-communicable diseases in different provinces in northwest Iran for the years 2004 and 2006-2009. Several variables were extracted, including the years of study, gender, ages, and smoking prevalence. Based on the heterogeneity of the results, we used fixed or random effects models to estimate the overall prevalence of cigarette smoking. The analyses were performed using Stata 11 software. Results: A total of 28,436 subjects (14,248 males and 14,188 females) in five age groups, i.e., 15-24, 25-34, 35-44, 45-54, and 55-64, were interviewed. Meta-analysis in men showed that, across the age groups, the lowest prevalence was 22.9%, the highest prevalence was 26.5%, and the average prevalence was 24.7%. Among women, the lowest prevalence was 0.3%, the highest prevalence was 0.8%, and the average prevalence was 0.5%. Conclusion: We found that approximately one-fourth of males in the age range of 15-64 in northwest Iran smoked cigarettes daily. Therefore, it is necessary to conduct effective interventions to reduce the prevalence of addiction to tobacco in this area