Secular Trend of Birth Height and Weight in a Population of Iranian Neonates during 1991 and 2011

Background: The secular trend in growth is a well-documented and recurrent phenomenon in many developed and developing countries. In this study, we examined the secular trends in birth length and weight among Iranian neonates.Methods: This cross-sectional population-based survey was conducted between 1991 and 2011. Using a two-stage stratified cluster sampling, the birth weights and heights of neonates born in Shahroud, Iran were studied using health records from different households. The mean birth weights and heights for neonates were calculated every year. Secular trends were analyzed using linear regression models and joinpoint regression.Results: A random sample of 11,165 neonates was evaluated, and the mean birth weight of neonates during the investigation period was calculated. The mean birth weight changed from 3232.1±444.1 g in 1991 to 3204.1±436.9 g in 2011, and the mean birth height changed from 49.5±2.2 cm to 49.3±1.9 cm. The mean birth weights and heights between 1991 and 2011 were not significantly different; however, the birth weight increased by 6.75 g annually between 2000 and 2011 (P < 0.021), and the mean birth height increased by 0.03 cm annually between 2003–2011 and 1991–2003 (P = 0.009).Conclusions: The mean birth height and weight of neonates in Shahroud did not change significantly from 1991 to 2011; however, we found a significant improvement after 2000

Secular Trend of Birth Height and Weight in a Population of Iranian Neonates during 1991 and 2011

Background: The secular trend in growth is a well-documented and recurrent phenomenon in many developed and developing countries. In this study, we examined the secular trends in birth length and weight among Iranian neonates.Methods: This cross-sectional population-based survey was conducted between 1991 and 2011. Using a two-stage stratified cluster sampling, the birth weights and heights of neonates born in Shahroud, Iran were studied using health records from different households. The mean birth weights and heights for neonates were calculated every year. Secular trends were analyzed using linear regression models and joinpoint regression.Results: A random sample of 11,165 neonates was evaluated, and the mean birth weight of neonates during the investigation period was calculated. The mean birth weight changed from 3232.1±444.1 g in 1991 to 3204.1±436.9 g in 2011, and the mean birth height changed from 49.5±2.2 cm to 49.3±1.9 cm. The mean birth weights and heights between 1991 and 2011 were not significantly different; however, the birth weight increased by 6.75 g annually between 2000 and 2011 (P < 0.021), and the mean birth height increased by 0.03 cm annually between 2003–2011 and 1991–2003 (P = 0.009).Conclusions: The mean birth height and weight of neonates in Shahroud did not change significantly from 1991 to 2011; however, we found a significant improvement after 2000

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study

OBJECTIVES The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification

The prevalence of ptosis in an Iranian adult population

AbstractPurposeTo determine upper eyelid ptosis prevalence and some related factors in 44- to 69-year-olds of Shahroud in the north of Iran.MethodsIn 2009, using multi-stage cluster sampling, 300 clusters of 40–64-year-olds were selected in Shahroud city, and all 5190 participants were invited to be re-examined in 5 years (2014). The current report is the second phase of the study in which 4737 (91.3%) people participated and underwent vision tests, slit lamp examination, biometry, and ophthalmoscopy in 2014. Upper eyelid ptosis was determined by an ophthalmologist.ResultsThe prevalence of upper eyelid ptosis was 4.7% [95% confidence interval (CI): 4.1–5.4]; 5.2% in women and in 4.0% in men. The prevalence of bilateral and unilateral ptosis was 1.3% (95% CI: 1.0–1.7) and 3.4% (95% CI: 2.8–4.0), respectively. The observed prevalence of ptosis was 3.1% in the 45- to 49-year age group and 5.8% in 65- to 69-year-olds. The prevalence of ptosis increased with age. In the multiple logistic regression model, ptosis prevalence correlated with older age, diabetes (odds ratio = 1.53, 95% CI: 1.16–2.02) and hypertension (odds ratio = 1.41, 95% CI: 1.03–2.92). Mean corneal astigmatism was 1.02 (95%C]: 0.87–1.18) diopter in ptotic eyes and 0.87 (95% CI: 0.84–0.89) diopter in non-ptotic eyes (p = 0.013).ConclusionsThe present report provides valuable information on the prevalence of ptosis in a population of 45-to 69-year-olds. The prevalence of ptosis in this study was considerably high and significantly increased with age

Quality of Services in Substance Abuse Treatment Centers in Shahroud, Iran

Background: Standard cares in Substance Abuse Treatment Centers (SATC) have an important role in treatment success achievement. Patients’ views will provide valuable information to improve the performance of these centers. The purpose of current study was to determine patients’ comments on quality of addiction treatment at SATCs.Methods: This cross-sectional study was conducted in 2013. The study population consisted of addicted patients receiving methadone maintenance treatment (MMT) in SATCs of Shahroud. Using stratified sampling method, a total of 250 individuals were randomly selected from the SATCs. The SERVQUAL service quality model was used to measure service quality in five dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Using paired samples t-test the gap between patients’ expectations of a service offering and the patients’ perceptions of the service received was analyzed by 5-dimensional structure of service qualityResults: Overall, the score of patients’ expectations of service quality (4.45±0.67) was higher than that of their perceptions (4.24±0.0.76). For the dimensions of tangibles, reliability, responsiveness, assurance, and empathy, the mean difference between patients’ perceptions and expectations of the quality of addiction treatment services was -0.34, -0.17, -0.19, -0.14, and -0.24 respectively. All differences were statistically significant.Conclusions: Although the mean score of patients’ perceptions was good, the patients were not satisfied with the quality of addiction treatment services in the SATCs at Shahroud. The results showed that there is a gap between the current state and the desired state in terms of service quality in SATCs and this gap can be reduced by proper planning, management and training

Quality of Services in Substance Abuse Treatment Centers in Shahroud, Iran

Background: Standard cares in Substance Abuse Treatment Centers (SATC) have an important role in treatment success achievement. Patients’ views will provide valuable information to improve the performance of these centers. The purpose of current study was to determine patients’ comments on quality of addiction treatment at SATCs.Methods: This cross-sectional study was conducted in 2013. The study population consisted of addicted patients receiving methadone maintenance treatment (MMT) in SATCs of Shahroud. Using stratified sampling method, a total of 250 individuals were randomly selected from the SATCs. The SERVQUAL service quality model was used to measure service quality in five dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Using paired samples t-test the gap between patients’ expectations of a service offering and the patients’ perceptions of the service received was analyzed by 5-dimensional structure of service qualityResults: Overall, the score of patients’ expectations of service quality (4.45±0.67) was higher than that of their perceptions (4.24±0.0.76). For the dimensions of tangibles, reliability, responsiveness, assurance, and empathy, the mean difference between patients’ perceptions and expectations of the quality of addiction treatment services was -0.34, -0.17, -0.19, -0.14, and -0.24 respectively. All differences were statistically significant.Conclusions: Although the mean score of patients’ perceptions was good, the patients were not satisfied with the quality of addiction treatment services in the SATCs at Shahroud. The results showed that there is a gap between the current state and the desired state in terms of service quality in SATCs and this gap can be reduced by proper planning, management and training

Acute respiratory tract infection symptoms and the uptake of dual influenza and pneumococcal vaccines among Hajj pilgrims

Background: Hajj pilgrims are encouraged to take influenza and pneumococcal vaccines prior to their travelto safeguard against acute respiratory tract infections (ARTIs). It is unclear whether dual immunisationwith influenza and pneumococcal vaccines have had any impact on ARTI symptoms. To this end, we haveexamined the data of the last several years to assess whether combined influenza and pneumococcalvaccination has affected the rate of ARTI symptoms among Hajj pilgrims.Materials and methods: Hajj pilgrims from United Kingdom, Australia, Saudi Arabia and Qatar who attendedthe congregation between 2005 and 2015 were included in this study. Data from surveillance studiesor clinical trials involving Hajj pilgrims were used. In this analysis we have made use of the raw data toconstruct a trend line graph with the prevalence of combined cough and fever (as a proxy for ARTI) againstthe uptake of combined influenza and pneumococcal vaccines, and to estimate the relative risk (RR) ofARTI with 95% confidence interval (95% CI).Results: Data of a pooled sample of 9350 pilgrims, aged 0.5–90 years with a male to female ratio of 1.1, wereanalysed. Although vaccination uptake did not rise significantly over the years, there was also no observed meaningfulbenefit of combined vaccination (RR = 1.1; 95% CI 0.8–1.4), the rates of ARTI symptoms demonstrateda decline over the last several years. The findings of this analysis highlight that the prevalence of ‘cough and fever’among Hajj pilgrims is on decline but the uptake of combined influenza and pneumococcal vaccines remainsunchanged over years, and the decline can not be attributed to dual influenza and pneumococcal vaccination.Conclusions: Acute respiratory tract infections among Hajj pilgrims are decreasing, it is unclear if thereduction is due to vaccine uptake, but the data and analysis have some limitations

Economic Inequality in Presenting Vision in Shahroud, Iran: Two Decomposition Methods

Abstract Background: Visual acuity, like many other health-related problems, does not have an equal distribution in terms of socio-economic factors. We conducted this study to estimate and decompose economic inequality in presenting visual acuity using two methods and to compare their results in a population aged 40-64 years in Shahroud, Iran. Methods: The data of 5188 participants in the first phase of the Shahroud Cohort Eye Study, performed in 2009, were used for this study. Our outcome variable was presenting vision acuity (PVA) that was measured using LogMAR (logarithm of the minimum angle of resolution). The living standard variable used for estimation of inequality was the economic status and was constructed by principal component analysis on home assets. Inequality indices were concentration index and the gap between low and high economic groups. We decomposed these indices by the concentration index and BlinderOaxaca decomposition approaches respectively and compared the results. Results: The concentration index of PVA was -0.245 (95% CI: -0.278, -0.212). The PVA gap between groups with a high and low economic status was 0.0705 and was in favor of the high economic group. Education, economic status, and age were the most important contributors of inequality in both concentration index and Blinder-Oaxaca decomposition. Percent contribution of these three factors in the concentration index and Blinder-Oaxaca decomposition was 41.1% vs. 43.4%, 25.4% vs. 19.1% and 15.2% vs. 16.2%, respectively. Other factors including gender, marital status, employment status and diabetes had minor contributions. Conclusion: This study showed that individuals with poorer visual acuity were more concentrated among people with a lower economic status. The main contributors of this inequality were similar in concentration index and Blinder-Oaxaca decomposition. So, it can be concluded that setting appropriate interventions to promote the literacy and income level in people with low economic status, formulating policies to address economic problems in the elderly, and paying more attention to their vision problems can help to alleviate economic inequality in visual acuity

Social Support among the Elderly Living in Shahroud, Iran

Background: Social support is one of the key aspects of social health among the elderly, significantly affecting other aspects of health. This study attempted to explore the extent to which the elderly benefit from social support and the contributing factors among the elderly living in Shahroud, northeastern Iran.Methods: During 2015-2016,a total of 496 elderly residents of Shahroud were selected through randomcluster sampling method. Data were collected by a questionnaire for capturing demographic variables (age, sex, marital status, educational level, number of children and grandchildren, economic status, health status, diseases) and Lubben Social Network Scale (LSNS). The data were analyzed through independent t-test, simple and multiple linear regressions, and ANOVA.Results:Of the 496 elderly participants in the study, 273 (55.3%) were female with a mean age of 67.9±7.84 years old. The mean score of social support achieved by the elderly was 9.0, ranging from 8.19-9.81 at the confidence interval of 95%. There was no significant relationship between age and social support (p=0.9). However, there was a significant relationship between social support and marital status. The difference in the average score of social support in married elderly was significantly less than that of single, widow(er), and divorced elderly (p<0.001).Conclusion: The elderly in Shahroud were poorly covered by social support. In order to improve this situation, it is crucial to devise appropriate plans on family to population scale.