The Study of Epidemiology of Tuberculosis in Bane (Kurdistan) between 2003 and 2010

Background and purpose: Tuberculosis is a bacterial infection that is commonly caused by Mycobacterium Tuberculosis. As Kurdistan province is close to Iraq (risky due to political instability in recent years), the Bane city had high interaction with Iraq, so the aim of this study was to evaluate the prevalence of tuberculosis in Bane (Kurdistan) between 2003 and 2010. Materials and Methods: This descriptive longitudinal study was done from 2003 to 2010. The number of people with TB was 94 cases taken from the registry. The data included age, sex, type of disease, age and place of registration. The data were analyzed using descriptive and inferential statistical methods through SPSS 20 software. Results: Among the 94 cases recorded in this analysis, the women had higher percentage than men (41.49 percent and 58.51 for men and women, respectively) and the incidence rates were found to be 7.93 in men and 11.64 in women 100000 persons therefore, there were significant differences between men and women (a p-value <0.01) in all patients in this study. Fifty five percent were from the urban and some others the rural areas and 98.9 percent of them were from Iran. Conclusion: The incidence rate of tuberculosis in females is higher than males. In addition, the average delay time of symptoms to diagnosis was 191 days, so this time, it is relatively high because TB is an infectious disease

Application of Parametric Models of Survival Analysis in Determining the Cancer Influencing Factors in Patients with Thyroid Nodules

Background & aim: One of the most common clinical problems among individuals is thyroid nodule diseases which are characterized by one or more nodules in the thyroid and are usually benign. It can be said that thyroid cancer is the most common endocrine cancer worldwide. This study aimed to determine the risk factors for cancer in patients with thyroid nodule in Mazandaran province,Iran, using parametric survival analysis. Methods: In the present historical cohort study, 26,730 patients with thyroid nodules who were referred to health care centers from July 2002 to March 2008 were identified. Parametric log-normal and log-logistic models were compared with and without taking frailty into account. The criterion for comparing models was Akaike's criterion. All calculations were performed with the SPSS software and the significance level was considered 0.05. Results: The mean time of the conversion of thyroid nodules to cancer in patients was found to be 29.32 months. Using Kaplan-Meier method, survival rates of one year, five years and ten years of nodule conversion to cancer was calculated 94.6, 88.6 and respectively. According to the log rank test age (p=0.03), hypothyroidism (p=0.01), bilateral nodules (p <0.001), a multi-nodular goiter (p <0.001), TSH hormone (p <0.001), T4 hormones (p = 0.005), cholesterol (p = 0.03), creatinin levels (p = 0.001) a significant relationship was seen. Based on the Akaike's criterion, the lognormal model which takes frailty into account best fits to the data. Conclusion: Based on the log-normal model with frailty, It can be concluded that the thyroid nodule patients with abnormal TSH hormone are 6.55 times more likely to develop risk of thyroid cancer than patients who had normal TSH hormone overall. This model also indicated that patients who had heart palpitations are 5.52 times more likely to develop risk of cancer than patients who did not have heart palpitations

Epidemiology of the Mortality, Calculation of Life Expectancy and Years of Lost Life: The Case of Bane, North West of Iran Epidemiology of the Mortality, Calculation of Life Expectancy and Years of Lost Life IJHS 2014; 2(1): 90

Abstract Background and purpose: Mortality Statistics and rates show the development of a country in the world. These statistics are very important for determining the distribution of risk factors of mortality (in age and gender groups, ethnicity and so on); and they are useful for improving health and preventing from important diseases in future planning of countries in societies. Materials and Methods: This article is a longitudinal descriptive study. All registered deaths in Bane which occurred during 2006-2010, regardless of the cause, were collected from the department of health in Kurdistan University of Medical Sciences, and they were assigned into 21 categories based on Disease Category (ICD10) of WHO. Then the life table for every year was prepared and Life expectancy was computed for each age and sex and total lost years of life for all chapters of ICD10 were calculated. Results: Based on the ICD10, four chapters with the highest frequencies include circulatory diseases by 1008 cases (32.5%), external causes of death by 522 cases (16.7%), cancers by 480 cases (15.3%), and prenatal death by 382 cases (12.2%). Overall, these chapters include 76.4% of total death. The most years of lost life were reported for prenatal period, external causes, diseases of the circulatory system and cancers. Conclusion: Cardiovascular diseases, incidents and accidents, and cancers are the most important causes of death. Among the main reasons of death in the first group are high blood pressures, lack of movement, smoking, not consuming enough fruits, vegetables. In the second group the reasons include not obeying the traffic rules, high speed and so on. Since the sum years of lost life were the highest in the prenatal period, it is necessary to improve pregnancy care and teach mothers prior to pregnancy

Analysis of the Results of Cardiovascular Disease Risk Assessment Program

BACKGROUND AND OBJECTIVE: Risk assessment is one of the most important strategies in estimating the risk of cardiovascular disease and controlling the risk factors. In Iran, half of all deaths and 79% of deaths due to non-communicable diseases are attributed to cardiovascular diseases. The aim of this study was to analyze the results of cardiovascular disease risk assessment program in Mazandaran province. METHODS: This cross-sectional study was performed in 2019 on 600 patients referred to comprehensive health centers of Noor and Mahmoudabad cities in Mazandaran province. The data collection tool was a checklist containing the risk factors studied in the SIB system. Descriptive statistics such as mean, standard deviation, frequency and percentage as well as analytical statistical tests such as chi-square, regression and analysis of variance were used using SPSS software version 19. FINDINGS: The prevalence of risk factors for cardiovascular disease including history of diabetes, history of hypertension, obesity, high cholesterol, family history of diabetes and heart disease were 36.5%, 45.5%, 42.3%, 34.8%, 23.5% and 10%, respectively. The four variables of age, history of diabetes and hypertension, and blood cholesterol levels were significantly associated with the 10-year risk of cardiovascular disease. With increasing one year of age, the 10-year risk level increased by 15% (p<0.001), and by seven times in people with a history of diabetes (p<0.001) and increased by 83% in people with a history of high blood pressure compared to others individuals (p=0.022). CONCLUSION: The results of the study showed that in Mazandaran province, four variables of age, history of diabetes and hypertension and cholesterol levels are the most common factors that are associated with 10-year risk of cardiovascular disease

Epidemiologic study of pulmonary tuberculosis in golestan province, iran 2007-2016

Background and purpose: Despite appropriate prevention and therapeutic activities in recent years, Pulmonary Tuberculosis (TB) is still one of the top ten causes of mortality in the world. The purpose of this study was to analyze the distribution of pulmonary tuberculosis in cities of Golestan province, Iran and identifying the major determinants of this disease. Materials and methods: from 8374 TB cases was recorded in TB Registry Program in Golestan province between 2007 and 2016 we analyzed the information of 5648 new cases. Data was analyzed in SPSS 24 and Stata 13. Mean ± SD and frequency table were applied for quantitative and qualitative variables, respectively. Results: The standardized incidence rate of TB in 100,000 population in Golestan province was 41.29 and in males and females it was 41.40 and 41.22, respectively, indicating no significant differences between them (p< 0.34). TB hazard ratio was found to be 62 higher in rural areas (p<0.001). The standardized incidence rates in urban and rural areas were 31.63 and 51.36 in 100,000 population, respectively. Ramyan and Gomishan had the highest and lowest incidence rats of TB, respectively (77.68 and 14.88 in 100,000 population, respectively). Conclusion: According to current findings, screening for TB in rural areas in Golestan province is highly recommended. Eastern regions of the province are at greater risk for TB infection due to their ethnic composition (Sistan and Baluchestan immigrants). © 2018, Mazandaran University of Medical Sciences. All rights reserved

Indoor and ambient air concentrations of respirable particles between two hospitals in Kashan (2014-2015)

Background: The hospital environment requires special attention to provide healthful indoor air quality for protecting patients and healthcare workers against the occupational diseases. The aim of this study was to determine the concentrations of respirable particles indoor and ambient air of two hospitals in Kashan. Materials and Method: This cross-sectional study was conducted during 3 months (Marth 2014 to May 2015). Indoor and outdoor PM10 and PM2.5 concentrations were measured four times a week in the operating room, pediatric and ICU2 (Intensive Care Unit) wards using a real time dust monitor at two hospitals. A total number of 480 samples (80 samples indoors and 40 outdoors) from wards were collected. Results: The highest mean PM2.5 and PM10 for indoors were determined 57.61&plusmn; 68.57 &micro;g m-3 and 212.36&plusmn;295.49 &micro;g m-3, respectively. The results showed a significant relationship between PM2.5 and PM10 in the indoor and ambient air of two hospitals (P&lt;0.05). PM2.5 and PM10 concentrations were different in all of the selected wards (P&lt;0.05). Conclusion: The respirable particle concentrations in the indoor and ambient air in both hospitals were higher than the 24-hours WHO and US-EPA standards. Thence, utilizing sufficient and efficient air conditioning systems in hospitals can be useful in improving indoor air quality and reducing the respirable particle concentrations

The effect of computer-based tests on nursing students' test anxiety: A quasi-experimental study

Background: Test anxiety often leads to poor academic performance. This study aimed to determine the effect of computer-based tests on nursing students' test anxiety. Methods: This quasi-experimental study was conducted in 2016 on 39 nursing student with anxiety score under 128 on Spielberger's State-Trait Inventory (STAI). They were randomly allocated to computer-based tests (CBT) and paper-based test (PBT) group. Prior to exam, all students completed Sarason's Test Anxiety Scale (TAS). We administered CBT for students in experimental group. Data were analyzed using independent t-test and one-way ANOVA. Results: Students mean test anxiety score was 11.94 and 11.32 in CBT and PBT groups, respectively. 47.4 of students in CBT group and 29.4 of those in PBT group experienced higher test anxiety, while the difference was not significant (p=0.56). Conclusions: Despite, there was no significant difference between anxiety score of two groups; but students' test anxiety score was higher in CBT group. With the current increase in computer-based assessment, educational administrators must be aware of and plan for the possible unfavorable effects of computer assisted testing, such an anxiety. Future studies are needed to evaluate and compare the effect of different type of student testing such as distance testing or CBTs using new information technologies such as laptop, tablet or mobile phone on students' test anxiety and performance. © 2018 Shohreh Kolagari, Mahnaz Modanloo, Reza Rahmati, Zahra Sabzi, Ali Jannati Ataee

Evaluation of Influential Factors in the Incidence Period of Cytomegalovirus after Renal Transplantation

BACKGROUND AND OBJECTIVES: Cytomegalovirus (CMV) infection is one of the most frequent infectious complications, which results in renal transplant failure. In this study, we aimed to evaluate the demographic characteristics and risk factors associated with the incidence period of CMV infection after renal transplant. METHODS: This cross-sectional study was conducted in renal transplant recipients during 2010-2015 in kidney transplant unit of Shahid Beheshti Hospital of Babol, Iran. The evaluated demographics included body mass index (BMI), smoking status, type of underlying disease leading to end-stage renal disease, hepatitis B, hepatitis C, and type of dialysis. Data analysis was performed using Kaplan-Meier estimator, log-rank test, and Cox regression. FINDINGS: In total, 242 patients received renal transplant, among whom 73 (30.2%) cases had CMV infection with median and mean survival of 41 and 48.09±23.50, respectively. In this study, there was no correlation between demographic variables (e.g., gender, place of residence, marital status, educational level, BMI, smoking status, hepatitis B, and type of dialysis) and incidence period of CMV. However, a significant relationship was observed between the incidence period of CMV and age (mean: 45 years, P=0.04), as well as etiology of ESRD urology (P=0.03). CONCLUSION: The prevalence of CMV infection is reported to be high in elderly patients with history of urologic diseases. Therefore, performing short-term follow-ups four months after transplantation, with emphasis on the first two months is recommended

Diagnosis of allergic bronchopulmonary aspergillosis in patients with persistent allergic asthma using three different diagnostic algorithms

Background: Allergic bronchopulmonary aspergillosis (ABPA) has been reported in various degrees among patients with persistent allergic asthma (PAA). Currently, there is no gold standard approach for diagnosis of ABPA. Objectives: In the current study, we aimed the evaluation of three different mainly used algorithms as Rosenberg & Patterson (A), ISHAM Working Group (B) and Greenberger (C) for diagnosis of ABPA in 200 patients with underlying PAA. Methods: All patients were evaluated using Aspergillus skin prick test (SPTAf), Aspergillus-specific IgE (sIgEAf) and IgG (sIgGAf), total IgE (tIgE), pulmonary function tests, radiological findings and peripheral blood eosinophil count. The prevalence rate of ABPA in PAA patients was estimated by three diagnostic criteria. We used Latent Class Analysis for the evaluation of different diagnostic parameters in different applied ABPA diagnostic algorithms. Results: Aspergillus sensitisation was observed in 30 (15.0) patients. According to algorithms A, B and C, nine (4.5), six (3.0) and 11 (5.5) of patients were diagnosed with ABPA, respectively. The sensitivity and specificity of criteria B and C were (55.6 and 99.5) and (100.0 and 98.9) respectively. sIgEAf and sIgGAf showed the high significant sensitivity. The performance of algorithm A, in terms of sensitivity and specificity, was somewhat better than algorithm B. Conclusion: Our study demonstrated that the sensitivity of different diagnostic algorithms could change the prevalence rate of ABPA. We also found that all of three criteria resulted an adequate specificity for ABPA diagnosis. A consensus patterns combining elements of all three criteria may warrant a better diagnostic algorithm. © 2020 Wiley-VCH Gmb

Diversity Assessment and the effect of Temperature and Humidity on the Relative Abundance of Medically Important Fly Species in Fouladshahr, Isfahan Province

Background & aim: Due to their close connection with humans, flies are able to mechanically transmit many pathogenic agents and thus cause various diseases. Knowing and determining the species of flies is necessary to know the current situation and plan for their control. Therefore, the purpose of the present study was to determine and investigate the species diversity and relative abundance of medically important flies in Fouladshahr, Isfahan province. Methods: The present study was of a descriptive-analytical type. Sampling was done from April to March 2018 for one year and twice a month in selected stations in Fouladshahr, Iran. The collection of adult flies was done using insect nets and using inverted cone plastic bottles traps. In order to try to obtain the maximum diversity of species, sampling was done in four seasons and six times in each season, twice a month and once in each region. The sampling location was selected based on the proximity to the places where flies grow and develop, such as around the hospital, garbage collection, health and treatment centers, and animal places with the possibility of flies. Daily average temperature, humidity and wind speed were recorded. After catching the flies, they were transported to the laboratory and mounted. A that point they were identified using a valid identification key. The collected data were analyzed using Spearman's correlation and GEE regression statistical tests. Results: In the present study, 6030 flies from three species, Musidae, Calliphoridae and Sarcophagidae, were caught. The highest number of flies belonged to the species Musca domestica (72%) and Sarcophaga aegypti (0.08%) had the lowest frequency. The highest abundance of flies was in the month of July and the lowest amount was respectively in the months of January and February in Fouladshahr. Correlation results indicated that with the decrease in humidity, the population of flies increased (P˂0.004) and with the increase in temperature, the abundance of flies increased (P˂0.0001). Conclusion: Considering the abundance of flies and their health importance in the study area, it seems necessary to adopt appropriate methods to manage resources and use existing capacities to control the population of flies in the study area