Parameters of lower extremities alignment view in Iranian adult population

Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery. © 2015 Tehran University of Medical Sciences. All rights reserved

Parameters of lower extremities alignment view in Iranian adult population

Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery

Prevalence of physical violence against pregnant women and effects on maternal and birth outcomes

Violence and the threat of violence against pregnant women are main barriers to women's empowerment and equal participation in society. When stress and violence increase in developing societies, women's safety in the home, workplace and community is often seriously affected. To determine the prevalence of physical abuse in pregnant women and to assess association between physical violence during pregnancy and maternal complications and birth outcomes, we used clinic-based data from a sample of 403 women who delivered live born infants during the summer of 2002 in our hospital. Data of physical violence against women's during pregnancy and 3 months before that were based on questionnaire and interview. Outcomes data including antenatal hospitalization, labor and delivery complications were obtained from the records. Prevalence of physical violence during pregnancy was reported as 10.7. Prevalence of experience of physical abuse 3 months before pregnancy was 11.9. Women who experienced physical violence compared with those not reporting abuse were more likely to be smoker and hospitalized before delivery for maternal complications such as preterm labor, kidney infections, premature rupture of membranes and vaginal bleeding with pain. There was a significant association between physical violence and low birth weight and mother's education. Physical violence during pregnancy is common and is associated with maternal complications and adverse birth outcomes. We suggest including methods to determine frequency of violence during pregnancy and assessment of violence in pregnancy by a screening program integrated in prenatal care. ©2006 Tehran University of Medical Sciences. All rights reserved

Quality of life, Work ability and other important indicators of women's occupational health

Objectives: Work ability may be considered as an important aspect of well-being and health status. One of the most important factors in association with work ability is health-related quality of life (HRQoL). The aim of this study has been to determine the association between work ability, individual characteristics and HRQoL of female workers. Material and Methods: The design of this study has been cross-sectional. The work ability index (WAI) and Short-Form General Health Survey (SF-12) questionnaires were used to collect data. Three hundred and twenty female workers were selected from food supplier factories in Karaj. One-way analysis of variance, Pearson's correlation analysis, independent sample t-test and multiple linear regression methods were used to analyze data. Results: Mean (M) and standard deviation (SD) of the WAI stood at 35.02 and 5.57, respectively. The categories of the WAI for women being as follows: 8.8 poor, 62 moderate, 25.4 good and 3.7 excellent. Mean±SD for the physical component summary (PCS) and mental component summary (MCS) of quality of life was 58.84±11.12 and 57.45±9.94, respectively. There was a positive significant association between the PCS and MCS with the WAI (p = 0.0001). Workers with higher education had a better work ability (p = 0.002) and shift-work workers had a worse work ability (p = 0.03). Conclusions: Work ability of majority of women was moderate. Considering mean age of studied women (27.6 years old), this work ability is not satisfactory. Physical and mental components of the HRQoL were the important factors associated with work ability

Suicide Prevention and Follow-Up Services: A Narrative Review

Previous suicide attempt is the most important predictor of death by suicide. Thus preventive interventions after attempting to suicide is essential to prevent reattempts. This paper attempts to determine whether phone preventive interventions or other vehicles (postal cards, email and case management) are effective in reattempt prevention and health promotion after discharge by providing an overview of studies on suicide reattempts. The research investigated in this review conducted from 1995 to 2014. A total of 26 cases related to the aim of this research were derived from 36 English articles with the aforementioned keywords Research shows that providing comprehensive aids, social support, and follow-up after discharge can significantly prevent suicide reattempts. Several studies showed that follow-up support (phone calls, crisis cards, mails, postal cards.) after discharge can significantly decrease the risk of suicide. More randomized controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods

Alcohol Abuse and Suicide Attempt in Iran: A Case-Crossover Study

Alcohol use and its disorders are associated with increased risk of suicidal behaviors Research has shown that 6-8 of those who use alcohol have a history of suicide attempt. Given the prohibition of alcohol use legally, the increased alcohol consumption, and the lack of strong evidence in favor of its use associated with suicide in Iran, this study was conducted to determine the link between suicide attempt and alcohol abuse. The case-crossover method was used in this research. Out of 305 referrals to the emergency room due to a suicide attempt, 100 reported drinking alcohol up to six hours before their attempt. Paired Matching and Usual Frequency were employed to analyze the data with STATA 12.0. The probability of attempting suicide up to six hours after drinking alcohol appeared increased by 27 times (95 CI: 8.1-60.4). Separate analysis for each of these hours from the first to the sixth hour after alcohol use was also performed. Fifty percent of attempted suicides happened one hour after alcohol use. Relative risk for the first and second hour was 10 and 5 respectively. Alcohol use is a strong proximal risk factor for attempted suicide among Iranian subjects. Prevention of alcohol use should be considered in setting up of the national Suicide attempt prevention program

Health system responsiveness for outpatient care in people with diabetes Mellitus in Tehran

Background: World Health Organization (WHO) defines three goals to assess the performance of a health system: the state of health, fairness in financial contribution and responsiveness. We assessed the responsiveness of health system for patients with diabetes in a defined population cohort in Tehran, Iran. Methods: Total responsiveness and eight domains (prompt attention, dignity, communication, autonomy, confidentiality, choice, basic amenities and discrimination) were assessed in 150 patients with diabetes as a representative sample from the Tehran Glucose and Lipid Study (TLGS) population cohort. We used the WHO questionnaire and methods for analysis of responsiveness. Results: With respect to outpatient services, 67 (n=100) were classified as Good for total responsiveness. The best and the worse performing results were related to information confidentiality (84 good responsiveness) and autonomy (51 good responsiveness), respectively. About 61 chose "communication" as the most important domain of responsiveness; it was on the 4th rank of performance. The proportions of poor responsiveness were higher in women, individuals with lower income, lower level of education, and longer history of diabetes. "Discrimination" was considered discrimination as the cause of inappropriate services by 15, and 29 had limited access to services because of financial unaffordability. Conclusion: Health system responsiveness is not appropriate for diabetic patients. Improvement of responsiveness needs comprehensive planning to improve attitudes of healthcare providers and system behavior. Activities should be prioritized through considering weaker domains of performance and more important domains from the patients' perspective

Obesity among university students, Tehran, Iran

Evaluating the nutritional status of individuals and population groups is an important tool in public health and a feasible indicator of standards of living. The objective of this study was to determine the frequency of obesity and present nutritional status of university students of Iran University of Medical Sciences in Tehran. The survey was conducted between Oct 2004 and June 2005. The statistical population included all students from School of medicine, nursing and midwifery, health services, management, science, and rehabilitation. The method of sampling was multistage random. The sample size for the survey was 1150 students. We used a self-administered 24h food recall questionnaire. We categorized BMI to two groups in bivariate analysis (BMI �25 kg m -2 as obese and less than 25 kg m -2 as non-obese). Mean BMI for all subjects was 21.7 ± 2.9 kg m -2. Almost 88 of the subjects were classified into a non-obese group (BMI <25 kg m -2). About 10 were underweight and 12.4 of the students had a BMI more than 25 kg m -2. A significant difference was observed for BMI between males and females; 7.9 of males versus 22.5 of females had BMIs over 25. About 18 of students aged 23 years and over had BMIs over 25 versus 7.7 of students aged under 18. Intakes of fiber, pre-vitamin A, folacin and iron were significantly different between BMI groups. Intakes of these nutrients were higher in the obese students than the students with BMIs less than 25 kg m -2. Our results indicate that about 12.4 of the students had a BMI more than 25 kg m -2. There was a significant association between BMI, and smoking habits, age, sex, place of resident and having specific dietary regimen

Vitreopapillary traction in nonarteritic anterior ischemic optic neuropathy

Purpose: To describe the association between vitreous traction on the optic disc and nonarteritic anterior ischemic optic neuropathy (NAION). Methods: Eighty three eyes of 83 patients with NAION were evaluated by optical coherence tomography (OCT) for detecting vitreous adhesion to the optic nerve head with separation from the adjacent retina (partial posterior vitreous detachment). Eyes which were negative for such adhesion underwent ultrasonography to detect complete posterior vitreous detachment (PVD). Results: Fifty male and 33 female subjects with mean age of 51.9±10 years were studied. Partial PVD with optic nerve head adhesion was found in 54 patients (65.1) using OCT. Ultrasonography detected complete PVD in all other eyes with optically empty spaces on OCT. Conclusion: Vitreous traction on the optic nerve head from partial PVD may play a causative role in some cases of NAION. This traction may impair vascular supply and/or axoplasmic flow leading to signs and symptoms of NAION

Integration of suicide prevention program into primary health care network: A field clinical trial in Iran

Background: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds. Methods: This work as a field trial study was conducted in Nahavand and Savojbolagh from April 2010 to March 2011 (12 months). A screening tool was designed. Required capacities such as treatment, referral and registration system were provided six months before the main study. The intervention phase (for one year) including the treatment process and five consultation sessions was conducted to identify depressed people and individuals with high risk of suicide. The data were analyzed by Chi square test. Results: After one year of intervention, the rate of committing suicide became 4.98 and 3.36 per one hundred thousand population in Nahavand and Savojbolagh, respectively (16 and 1.6 per 100,000 in the year of before intervention respectively, 2009-2010). The female: male ratio of committing suicide was 2:1 in Nahavand and 1:1 in Savojbolagh. The most common method of committing suicide was drug intoxication in both cities. The identified cases by health workers at rural setting were 33 to 44 per 1000, in which 1.3 cases per 1000 population had been approved by general physicians. Conclusion: This study approved the feasibility and efficacy of integration of suicide prevention program into PHC. The increased rate of suicide in Savojbolagh could be related to low rate of screening and lack of treatment facilities (hospitalization and electroconvulsive therapy (ECT), and part-time psychiatrist. Increasing the PHC capacities could improve the health network efficiency to identify and manage depressed and at risk of suicide individuals. Screening tool/s and method have to be improved to provide better results