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Introduction: Life expectancy is one of the summary measures of population health, whose values and trend of changes over time show the main outcome of health system performance. Estimation of life expectancy is performed with direct or model-based methods. In this study direct estimation of life expectancy for Iran’s population in year 2003 is performed. Materials and Methods: In an ecologic study, for calculation of abridged period life table for 23 out of 28 provinces of Iran in year 2003, numbers of registered deaths for age and sex specific groups in these 23 provinces by death registration system of Ministry of Health (MOH) were used. Undernumeration of over-four year's deaths was estimated and corrected with Brass Growth-Balance method. For mortality rates of under-one and 1-4 years, similar rates from Demographic and Health Survey (DHS) 2000 with live births denominators were substituted. For total number of population of 23 provinces, information from MOH was used. Distribution of population by age and sex was taken similar to that from DHS 2003 results, and also taken as result of graduation of whole country population from 1375 census. Population of these 23 provinces was equal to 73% of total population of country in year 2003. Life expectancy was estimated by age and sex with the obtained population and death numbers. It was assumed that distributions of population and death in 23 provinces were similar to those for the whole 28 provinces of Iran in year 2003 and hence, the estimated life expectancy for 23 provinces is equal to that for all 28 provinces in 2003. Sensitivity of the results to assumptions was analyzed. Confidence intervals were calculated with Monte Carlo method. Results: Life expectancy at birth was estimated as 71.56 years for total population (95% CI: 71.52 – 71.62), 70.09 years for males (70.02 – 70.16), and 73.17 (73.10 – 73.24) for females of Iran in year 2003. Sensitivity of results to assumptions was less than 0.5%. Conclusion: Values of life expectancy estimates for year 2003 with direct method are higher than those based on statistical modeling approaches performed by Statistical Center of Iran and by different United Nations agencies, due to difference in estimation methods for age and sex specific mortality rates.

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Background: According to the report of Iranian Center of Disease Control, in the summer of 2005 an outbreak of cholera (Inaba serotype) occurred in Iran. The outbreak lasted the mid of September. The aim of this study was to use the result of different studies performed during this period to determine source of infection. Methods and Materials: This is a meta-analysis study, which studies performed in Qum, Arak, Karaj, Golestan and Ghazvin were eligible. All of these studies were case control ones performed during the August 2005. The total of cases were 531. Pooled odds ratios was used to estimate by fixed and random method. All computations were performed by Stata 8 software. Results: The estimated pooled odds ratios resulted from 5 differemt studies were used in the meta-analysis as the following: travelling (1.64 95% CI: 0.98-1.88), non-pasteurized ice cream (0.88 95%CI: 0.48-1.61), post toilet hand washing (3.72 95% CI: 0.86-16.05), eating meal outside home (2.38 95% CI: 1.46-3.90), raw fruit eating (0.98 95% CI: 0.42-2.18) and raw vegetables use (5.36 95%CI: 2.4-12). Conclusion: According to the results of this study raw vegetable use and having meal outside home were significantly associated to the cholera in mentioned provinc

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Abstract Background: Side effects of drugs were increased with intractable consumption and this fact is more important in women during pregnancy and lactation period. The aim of this study has been determined the effect of education based on Health Belief Model on self-medication in mothers referring to health centers of Arak. Materials and Methods: In this clinical trial study, 300 mothers referring to health centers of Arak were participated. Data were collected with a questionnaire based on Health Belief Model and a performance checklist about drugs intractable consumption. Before educational intervention, questionnaires and checklists for both groups were completed and then intervention was done during 1 month in 4 sessions, 60 minutes. Data again were collected and then analyzed 3 month after intervention in both groups. Results: Before educational intervention, the rate of knowledge, perceived susceptibility, severity, and benefit of self medication were in the mediate level and the mother's performance about drug intractable consumption were more than mediate. After educational intervention, between two groups had significant difference in all variables and mothers performance in self-medication was reduced (p<0.05). Conclusion: By increasing in mean score of Health Belief Model parts, including: knowledge, perceived susceptibility, severity, and benefit, performance in field of self-medication was reduced. Recommended, training based on this model carried out in other health centers for reducing drugs intractable consumption.

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Abstract Background: Prevalence of urolithiasis is increasing in children and maybe hematury is only sign. This study was conducted to investigate clinical manifestation and etiology of urolithiasis in children younger than 14 year-old. Materials and Methods: This descriptive and case-series study was carried out on 100 patients referring to Sahamie Pediatric hospital in Qom in 2007-8. Age, sex, family history, clinical manifestation (fever, dysuria and Pain) and laboratory tests (Na, K, Ca, P, urea, Cr, Albumin, Alkaline phosphates of serum ABG, urine sediment, urine culture Na, K, Ca, P, Cr, oxalate and citrate of urine/24h and cysteine in random sample of urine) were determined. Ceratenin correcting formula was used for adequacy controlling of urine collecting. Results: Hypocitraturia (56.8%), hypercalciuria (29.4%), hyperuricosuria (26.3%), hyperoxaluria (14.7%), phosphaturia (8.4%) and cystinuria (6.3%) were detected. Also, 54% patients had urinary tract infection. Pain (27.7%), fever (33.3%), irritability and dysuria (62.2%) and hematuria (77.7%) were seen. Positive family history was reported in 23% of patients. Conclusion: Most common clinical manifestations in children with stone were hematuria, dysuria, fever and pain. The common etiology of urolithiasis respectively was hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria, phosphaturia and cystinuria.

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Abstract Background: Educational decline is one of the most important problems in educational institutes. There for, present study was aimed to survey frequency of educational decline and some effective factors of student’s opinion in Arak University of Medical sciences, 2009. Materials and Methods: In a analytical cross sectional study, 600 students passing at least one term of their course in Arak university of medical science in 2009, were determined by questionnaire and interview. After data gathering, students divided two groups, successful and non successful base n educational average and failed terms and then data were analyzed and determined frequency and some effective factors on it. Results: Decline education frequency is 19% and there were significant difference between sex, marital status, average score diploma, educational level of father, hesitancy, gap between diploma and university admission and course satisfaction between two groups of successful and unsuccessful students (P<0/05). However, no significant correlation observed in age, course, family economic status and mother’s job (p>0/05). Also, most of effective problem solutions in student’s viewpoint are included admission in university base on diploma average score and use of expert consular. Conclusion: Educational managers should be considering effective variables on performance and educational decline in students, in order to identifying high risk students and providing better facilities for them by appropriate consulting.

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Background: Noticing the sensitivity and restlessness of medical centers, aggression in the workplace as an agitating factor is one of the dangers of medical profession that is threatening to the health and hygiene of the society. The aim of this study was to determine the types and contributing factors of aggression toward physicians and students of medicine in hospitals of Arak in 2009. Materials and Methods: This descriptive-cross-sectional study was conducted on 400 of accessible physicians and students of medicine working in hospitals of Arak in 2009. A self-made questionnaire, containing 14 questions which surveyed the status of aggressions, was used. Results: On the whole, 205 individuals returned the forms. Most of them (71.7%) had faced a form of oral, physical, or sexual aggression and had been violated by a male companion of patients. They also viewed the use of drugs or alcohol by patients or their companions, lack of security facilities, patients’ death, and lack of educational possibilities for the prevention, as influential factors in the occurrence of aggression. The majority of participants saw increasing the security personnel, presence of psychological counselors and psychologists of the ward, increasing the rest hours, decreasing the work hours of the physicians, and having a codified program for the prevention of aggression, as anti-aggression factors. Conclusion: Oral and then physical aggression toward physicians are quite prevalent. Hence, taking immediate actions and providing useful instructions for prevention are of priority in designing effective programs.

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Background: Hospital wastewater usually contains pathogenic micro-organisms, drugs, radio active materials, and toxic chemical elements that in case of being disposed without filtration, will result in pollution and spread of diseases. Therefore, evaluating the status of wastewater disposal in hospitals is necessary for proper planning. Materials and Methods: In a cross-sectional descriptive study in 2008, data collection was done by means of interviews, observations, and questionnaires in all hospitals of Markazi Province. Noticing the 33 items in the questionnaire, the overall conditions of the hospitals and the methods of using the sewage system were studied, and at the same time, filtration installations and wastewater disposal systems were inspected. Results: Of all the 19 hospitals, 10 used a conventional method of direct disposal of sewage to subterranean shafts, and of the 4 hospitals with filtration installations, three were practically out of order or were not efficient. Five of the hospitals were directly linked to the city sewage system without any pre-filtration. None of the hospitals had a specialized operator of sewage filtration and disposal system. Conclusion: Wastewater disposal in hospitals of Markazi Province is not desirable therefore, such acts as conducting more specific surveys, creating a positive attitude in planners, and providing sufficient funds for filtering wastewater in some of the hospitals are suggested.

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Background: Studies have revealed that nonclinical individuals who have mixed-handedness obtain higher scores in schizotypy, but investigations in Asian countries have indicated contradictory results. The aim of this study was to identify the relationship between mixed-handedness and schizotypy in a nonclinical Iranian population. Materials and Methods:One hundred fifty normal students from two different high schools, 94 girls (%62.7) and 56 boys (%37.3) ranging in age from 14 to 17 (15.5±0.67), participated in this descriptive study. Participants filled out Schizotypal Trait Questionnaire (STA) and answered handedness questions. The causal relationship between schizotypy and handedness was determined through linear regression. Results: In this study, parallel to other studies conducted in Asia, no significant associations were found between mixed-handedness, schizotypy and schizotypy factors. Conclusion: Noticing that Asian people, due to cultural pressure, have less tolerant attitudes toward left-handedness, utilizing handedness scales that incorporate cultural values is essential for revealing the real association between schizotypy and mixed-handedness.

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Background: Brucellosis is one of the zoonotic diseases that has always been considered a health problem in Iran. Since this disease is endemic in Arak and Markazi Province, this study was done to investigate its epidemiology during 2001-2010. Materials and Methods: In this epidemiological study, data on patients with brucellosis were obtained from the medical records in Arak Health Center during 2001-2010. The collected data were analyzed by SPSS software version 16. Results: During this period, 3880 new cases were reported. The mean incidence rate of brucellosis was 60 per 100000 people during 2001-2010. The greatest incidence was in 2004 (111.5 per 100000 people), whereas the lowest incidence was in 2006 (40.5 per 100000 people). Overall, 72% of the patients lived in villages, and 60% of them were male. The majority of the patients were in the second decade of their lives (10-19 years old). The majority of the patients had Wright test titer=1:320 and 2ME titer=1:80 in serology titration. Conclusion: Arak is one of the regions with high incidence of brucellosis. In this region, the patients are mostly male, live in villages, and age 10-19.

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Background: Brucellosis, especially if caused by Brucella melitensis, remains one of the most common zoonotic diseases worldwide with more than 500,000 human cases reported annually. In Iran, brucellosis was first recognized in 1932 and control of small ruminant brucellosis began in 1963. The aim of this study is to give an overview of the National Sheep and Goat Brucellosis Control Program in Iran. Materials and Methods: In this cross-sectional study, data were collected from Iran Veterinary Organization over a period of 45 years. The national control program was based on kid and lamb vaccination and testing and slaughtering infected animals. Results: B.melitensis biotype I in sheep, goat, and man was the predominant local infective biotype. This disease was reported in sheep, goat, cattle, horse, camel, and human. In addition, the prevalence of small ruminant brucellosis was estimated around 2.1%. Conclusion: Prevention of brucellosis is dependent upon increasing public awareness of ranchers through health education programs and more active co-operation between health and veterinary medicine organizations as well as animal movement control in the borders.

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Background: IFN-&lambda3 (IL-28B) is a new cytokine from the type III interferons. Its role in several biologic activities, such as regulation of immune responses, tumor and metastasis, or its functions in HBV and HCV diseases, has been shown. The present study evaluated the frequency of rs8099917 allele polymorphism in IFN-&lambda3 gene in Iranian population.

Materials and Methods: In this laboratory-experimental study, after collecting blood samples from 118 unrelated Iranian subjects, DNA extraction was performed according to the kit protocols. Evaluation of rs8099917 allele polymorphism was done by Nested-PCR and RFLP method using BsrDI and Tsp451 restriction enzymes.

Results: After running the tests and data analysis, the frequencies of GG genotype (2.5%), GT genotype (31.4%), and TT genotype (66.1%) were obtained. Allele frequencies were 71.22% for G allele and 81.78% for T allele.

Conclusion: The results of this study showed that TT genotype and T allele are the dominant frequencies of rs8099917 allele of IFN-&lambda3 gene in Iranian population. Regarding the different established functions of IFN-&lambda3, frequency determination of this variant can be helpful in different studies, designs, evaluations, and treatment procedures in some diseases, such as tumors and hepatitis, in Iranian patients.

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background: Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province.

Materials and Methods: In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012,127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH&ge5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment.

Results: From127112 screened neonates, 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was . Recall rate was 4.8%. In 94.4% of patients, treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program.

Conclusion: Recall rate and the incidence of CH were higher than those in other studies, both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.

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Background: Schizophrenia is a widespread neurodegenerative disorder, which affects approximately 1% of the world population. It is a multifactorial and a highly heritable disease to which genetic factors contribute up to approximately 80%. Nowadays, multitude of genes have been discovered that relate to this disorder mostly by affecting the performance and levels of neurotransmitters in neural systems. Since PAI-1 is a considerable gene in the performance of neural systems, the present study dealt with the relationship between -675 4G/5G polymorphism in PAI-1 gene and schizophrenia among Iranian patients.

Materials and  Methods: This case-control study was carried out on 106 blood samples collected from individuals suffering from schizophrenia and 122 healthy controls. DNA was extracted from the samples and the frequency of the polymorphisms was analyzed using ARMS-PCR method. Finally, the products were detected on 2% agarose gel electrophoresis.

Results: The analysis of the data for -675 4G/5G polymorphism showed that 17.9% of the patients and 1.6% of the controls were mutant homozygous and 65.1% of the patients and 45.9% of controls were heterozygous. Also, 17% of the patients and 52.5% of the controls were normal homozygous.

Conclusion: There was a significant relationship between PAI-1 4G/5G polymorphism and the incidence of schizophrenia. To the best of our knowledge, this is the first study in Iran that assesses the frequency of the polymorphism among Iranian patients. However, further studies with more samples are necessary.

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Background: Cancer is one of the most common causes of deaths in the world. Cancer incidence and prevalence is increasing in the world. There is no clear trend is available on incidence of these cancers in Iran, therefore, this study aimed to determine the incidence of 10 common cancers among Iranian women from 2003 to 2009.

Materials and Methods: A cross-sectional study was conducted by analyzing existing data. Data from a national registry of cancer cases were received. Data included the records from the cancer registry system in Iranian women during 2003 to 2009. The incidence rates were then standardized using direct method. We used Cochrane Armitage Test for linear trend by Winpepi software to determine the variation in the incidence of cancers.

Results: The results show that the proportion of all cancers is rising in women as compared to all population. Breast, skin, colorectal, gastric, esophageal, thyroid, leukemia, ovary, brain and uterus were the most common cancer among Iranian women. During the years of the survey, these cancers are significantly increased.

Conclusion: The results of this study showed that the incidence of cancer in women is increased. screening programs can be useful in reducing the cancers.

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Background: Cancer in the elderly is rising increasingly. According to the population structure in Iran, it is necessary to conduct a study to examine the epidemiology and trends in cancer incidence in the elderly in Iran. So, the aim of this study was to investigate the epidemiology and trends in cancer incidence in Iranian elderly from 2003 to 2009.

Materials and Methods: This cross-sectional study was conducted by analyzing existing data obtained from the National Cancer Registry System in Iran. In this stucly, all records of elderly cancer cases in Iran during 2003 to 2009 were investigated. The age- specific incidence rates of reported cases were estimated by using direct standardization method and the world standard population. We used Cochrane Armitage Test for linear trend by Winpepi software to study the trends in cancer incidence.

Results: stuolying statistics of Cancer Registry center shows that the incidence of cancer increases with age and most cases of cancer occur commonly in elderly people (aged over 60), so that, the highest number of cancer cases diagnosed in people aged 80-84, but it decreases after the age of 85. The most common cancer among the elders, in this period (2003-2009), was the skin cancer. Also, according to the statistics, cancers are more prevalent among older men than older women.

Conclusion: with due attention to the results, the trend of incidence of cancer and its various types in the elders is increasing with age. The implementation of screening programs and necessary trainings in the field of early detection and the avoidance of exposure to risk factors to reduce the risk of cancer in Iranian elderly can be useful.

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Background: Niemann-Pick disease (NPD) refers to a group of lysosomal storage diseases that causes abnormal metabolism of lipids. One of the genes that play a role in the pathogenesis of this disease is SMPD1. To date, more than hundred disease- causing mutations have been identified in SMPD1 gene. Due to the large number of mutations in this gene, direct analysis of the mutations is costly and time-consuming. Therefore, indirect linkage analysis using polymorphic markers as an alternative method for molecular diagnosis of the mutations has been recommended. In the present study, allele frequency of rs1542705 genetic marker was analyzed in the Iranian population. The aim was to determine the polymorphic information content (PIC) and the possibility of its application in indirect diagnosing of NPD.

Materials and Methods: After bioinformatics analysis of the SMPD1 gene region, rs1542705 marker was selected for genotyping in Isfahan population. In order to calculate the allele and genotype frequency of the marker, molecular tests were done on 113 DNA samples of unrelated healthy individuals by using ARMS-PCR technique. Finally, the information related to the genotype of the individuals was statistically analyzed using Powermarker and Genepop software.

Results: The analyses showed that the studied population was in accordance with Hardy-Weinberg equilibrium. Allele frequency of rs1542705 marker for T and C alleles was 71.24% and 28.76%, respectively, and the heterozygosity of the marker was 43.36%. Also, polymorphic information content (PIC) was 0.325.

Conclusion: The results of this study showed that rs1542705 marker could be considered as an informative marker for molecular diagnosis of Niemann- Pick disease using linkage analysis in the studied population.

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Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with broad clinical manifestations, but unclear etiology. Extensive tissue damage occurs due to the production of auto-antibody against nuclear and cytoplasmic antigens. Regarding the involvement of GADD45A gene in cell cycle control, T-cell proliferation suppression, and genome epigenetic regulation, this case-control study was done for the first time to evaluate the association of rs581000 polymorphism in 5’ near gene with the risk of SLE among patients in south of Iran.

Materials and Methods: This study was performed on 102 patients with SLE in comparison with 118 healthy controls. Genotyping of the GADD45A rs581000 polymorphism was performed using T-ARMS PCR.

Results: The T allele was significantly more frequent in the controls (0.13) than in the patients (0.01) with SLE (p<0.001). The frequency of genotypes carrying at least one C allele (CC+CG) was higher in control group (14.4%) compared to patient group (1%), and this allele showed protective effect against the risk of SLE (p<0.001, CI: 0.009-0.5, OR=0.06)

Conclusion: It seems that GADD45A rs581000 polymorphism involved in the SLE pathogenesis.

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Abstract

Background: Heart attacks are the cause of 40% of deaths in Iran and due to its upswing in Iran and the world, the determination of its short-term survival rate in order to assess treatment methods is of great importance. The purpose of this study is to estimate patients’ short-term survival rate after heart attacks by Meta-analysis method.

Materials and Methods: This study is a systematic review. The analysis was based on data extracted from English and Persian data bases. To analyze the information obtained, including the average age of patients, and one-month and one-year short-term survival rates, the STATA 11.2 and the random effect model were used.

Results: The results of the study on 18 studies entering the Meta-analysis including 62486 patients, demonstrated that one-month and one-year short-term survival rate in Iran are respectively 87.7 and 85.2 percent and no significant difference was observed between the two genders. The average age of patients was reported 62.43 years and no significant difference was observed between the two genders in the occurance of health attack.

Conclusion: The results of this Meta-analysis showed that although the survival rate of an Iranian patient after a myocardial Infarction is the same as patients in developed countries, the average age of the patients in Iran is lower, which indicates that the load of disease in Iran is greater than in other countries regarding the years lost to the disease.

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Toxocariasis is human infection caused by larval stage of Toxocara helminthes. The adult Toxocara helminthes live in intestine of dog and cat, but if the human accidentally ingests the egg, the larva is released into the intestine and then penetrating to mucosal capillaries and by blood stream migrates to various organs. Considering to the larva of parasite cannot be adult in human body and finally is destroyed, but its placement in the organs leads to irritation and inflammation of the tissue and appearance of signs and symptoms. The parasite   affects liver, lung and central nervous system more than other organs. The most obvious symptoms of this disease are irregular fever, liver enlargement and sever eosinophilia. Other symptoms depend on the final location of the parasite, for example, respiratory symptoms (similar to asthma) will occur at the time of parasite settling in the lung and nervous disorder when the parasite is deployed in the nervous system (1). Sever clinical symptoms due to the disease is more common in 2 to 7 years old children, because of contacting with polluted playground soil or stray dog and cat, that the chance of them getting disease is increased (2). In developing countries including Iran, the diagnosis of the disease is done by collecting signs and symptoms, evaluating risk factor and laboratory results. Laboratory results which is considered on this disease containing eosinophilia, hypergammaglobulinemia and increasing of isohemagglutinin A and B. The serological test by ELISA technique was used for diagnosis of anti-parasite antibody in European countries and USA, the sensitivity and specificity of this test was 78 and 98%, respectively. There is no definitive guideline to the treatment of the disease but the most common treatment plan is 400 mg albendazole and 100 to 200 mg mebendazole, twice a day for 5 days (1). In recent years the number of dogs and cats in the human environment has been increased in our country and consequently the rate of soil contamination to eggs of Toxocara has been increased. The consequence of this phenomenon is an increasing chance of human contact the egg of this parasite and onset of toxocariasis. The studies in Iran is reported the rate of soil contamination to this parasite is minimum 3.9% (Urmia) to maximum 63.3% (Khoramabad), while the rate of contamination in soil of Arak parks is 26.6% (3-5). In addition, the results of serological study showed that the prevalence of toxocariasis in 5 to 15 years old asthmatic patients was 1.8%, in Arak (6). But the results of a review study showed that the prevalence of toxocariasis in general population of Iran was 15.8% and this rate is increasing (7). Changes in Ecosystem and abundance of garbage in Iranian cities have led to overabundance of dogs and cats in human environment. On the other hand, accepting some of cultural western lifestyle such as keeping pets, apart from their social and legal responsibility has been caused increasing risk of infectious disease transmitted by animals such as toxocariasis.  Due to the relatively high prevalence of Toxocara infection among dogs and cats in Iran, the need to pay attention to the disease caused by this parasite is felt as a potential medical and health hazard in the country. In this condition, holding workshops for remembering of symptoms, diagnosis method, treatment and prevention of the disease for clinician associate with infected patients, would has an important role for quick diagnosis and remedy of the patients and would reduce the corporal and psychological load of them. Also, performing the research studies would help to know current epidemiological situation and changes that have taken place in various parts of Iran. In the other side, encouraging scholars for isolation, purification and examine excretory-secretory antigens of this parasite that used for producing the serological diagnostic kits could increase accuracy and reduce cost of diagnosis test of disease and finally improve the level of health in community.