Hossein Ansari

Prevalence of diabetic peripheral neuropathy in Iran: a systematic review and meta-analysis

Diabetic peripheral neuropathy (DPN) is an important microvascular complication of diabetes mellitus (DM). It is a major contributor to foot ulceration and lower limb amputation in persons with DM and have also a significant negative effect on patients quality of life. This meta-analysis reviews prevalence of DPN among patients with type 1 and 2 DM in Iran. Using PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS as the main international electronic data sources, and Iranmedex, Irandoc, and Scientific Information Database (SID), as the main domestic databases with systematic search capability, we systematically searched surveys, papers, and reports on the prevalence of DPN (between January 1991 to February 2013). Heterogeneity of reported prevalences between studies was assessed by the Chi-square-based Q test and due to heterogeneity; overall prevalence of DPN was estimated using random-effect meta-analysis model. We found 304 records; from them a total of 21 studies comprising 5540 diabetic patients were included. The prevalence of diabetic neuropathy (reported) from 16% to 87%. In overall the prevalence of DPN estimated 53% (95% CI: 41-65) by using random-effect. This study show that the prevalence of DPN seems very high among the population with diabetes in Iran and more than half of the patients with DM has any type of diabetic neuropathy.

Effects of predisposing, reinforcing and enabling factors on self-care behaviors of the patients with diabetes mellitus in the Minoodasht city, Iran

BackgroundTo control diabetes mellitus (DM) it is necessary to make overall changes in the life style of the patients. The aim of this study was to determine the effects of predisposing, reinforcing and enabling factors on self-care behaviors of the patients with DM in the Minoodasht city, Iran in 2012.MethodsIn this quasi-experimental study, 78 people with DM were selected by convenience sampling method. In the first stage of study, the educational program was compiled and executed on six information sessions. To present the informative content, a video projector and different lecturing methods including questions and answers, dynamic group discussion and different educational materials such as pamphlets and CDs were employed. After one month, the efficiency of the educational program was determined by using the same questioner. Data were analyzed using paired sample T-test and McNemar test.ResultsThe mean age of participants was 49 (SD: 3.27.) years old, 87.2% were married, and 19.2% were illiterate. The results showed that the enabling factors like adopting to go on a diet and the educational classes facilitated by the staff had significant effects on health care behavior of the patients. Furthermore 69.2% of the participants adopted to go on a diet before the educational sessions; that figure increased to 94.9% after the educational sessions. According to the results the mean scores for the knowledge, attitude, and behavior, reinforcement factors and enabling factors increased significantly after of the educational intervention (p- value >0.001).ConclusionPredisposing, enabling and reinforcement factors affected in taking self-care behavior in the patient with DM.

Trends in health burden of ambient particulate matter pollution in Iran, 1990–2010: findings from the global burden of disease study 2010

This paper aims to report the assessment of trends in deaths and disability-adjusted life years (DALYs) attributed to ambient particulate matter (PM) pollution from 1990 to 2010 by sex and age in Iran. We used the data of the Global Burden of Disease (GBD) 2010 Study, and then we extracted its data on Iran for the years 1990, 2005, and 2010. The proportion of deaths and the DALYs caused by specific risk factors were assessed by using the comparative risk assessment and calculating the attributed burden of exposure level to each risk factor compared with the theoretical minimum level of risk exposure. Uncertainties in distribution of exposure, relative risks, and relevant outcomes calculation were disseminated into the estimates of the attributable deaths and DALYs. We found that the age-standardized death rate attributed to ambient PM pollution decreased to 27.90 cases per 100,000 populations from 1990 to 2010 [86, 95xa0% uncertainty interval (UI) 76–97 to 62; 95xa0% UI 54–71 per 100,000 populations, respectively]. This was mainly because of greater decrease in cardiovascular diseases (CVDs) than in the other diseases attributed to PM pollution. Despite a decrease in the total DALYs and mortality rate attributed to PM pollution, the death percent increased by 6.94xa0%, 95xa0% UI 6.06–7.90xa0% from 1990 to 2010. The number of the DALYs and death in age groups of more than 70xa0years increased in 2010 compared to that in 1990. The median percent change of the DALYs and death for all age groups shows that the DALYs and death increased by 6xa0% (95xa0% UI 8–19xa0%) and 45xa0% (95xa0% UI 30–60xa0%), respectively, in 2010 in comparison to that in 1990. The increase in the DALYs and mortality attributable to PM pollution emphasizes the necessity of the effective interventions for improving air quality, as well as for increasing the public awareness to reduce the exposure of vulnerable age groups to PM pollution.

Are active and passive smoking associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study

Background: Smoking is an important risky behavior in adolescents worldwide. Active and passive smoking have adverse health effects at public and individual levels. Objective: This study aimed to evaluate the association of active and passive smoking with cardiometabolic risk factors in a national sample of Iranian adolescents. Methods: Participants consisted of 5625 students, aged 10–18 years, studied in the third survey of a national school-based surveillance system. Participants were classified into three groups based on smoking pattern: active smoker, passive smoker, and exposure to smoke (active or passive or both of them). Considering the Adult Treatment Panel III criteria modified for the paediatric age group, metabolic syndrome (MetS) was defined as the co-existence of three out of five components of abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and depressed high-density cholesterol (HDL-C) levels. Results: The mean (SD) age of participants was 14.7 (2.4) years. Mean level of HDL-C was significantly lower in all types of smoking compared to non-smokers. Low HDL-C and MetS had significant association with active smoking (OR 2.10, 95% CI 1.33–3.31 and OR 5.24, 95% CI 2.41–11.37), passive smoking (OR 1.19, 95% CI 1.01–1.43 and OR 1.79, 95% CI 1.09–2.96), and smoking exposure (OR 1.20, 95% CI 1.01–1.43 and OR 2.02, 95% CI 1.22–3.31), respectively. Conclusion: This study confirms that both smoking and exposure to smoke are associated with an increased risk of MetS and some of the cardiometabolic risk factors in adolescents. Preventive measures against passive smoking should be considered as a health priority in the paediatric age groups.

Diabetes mellitus, thyroid dysfunctions and osteoporosis: is there an association?

BackgroundOsteoporosis is the most common metabolic bone disease with complicated, multifactorial and heterogenic nature that has no known pathological cause. As the role of Diabetes Mellitus (DM) and thyroid dysfunctions in the prevalence of osteoporosis is not exactly known, therefore this study was designed to evaluate the probable association between osteoporosis with DM and thyroid dysfunctions in Iranian patients.MethodsIn this cross-sectional study, 300 subjects out of the total number of patients referring to Gorgan bone densitometry centers (3000subjects) were selected via random sampling method in 2009. Individual characteristics, DM, thyroid dysfunctions and densitometry results were collected from densitometry records. Data analysis was carried out by SPSS version 16 software and by using Chi square and T-test. The level of significance in all tests was considered 0.05.ResultsThe mean of T-score in lumbar and femoral areas of diabetic patients were -0.87u2009±u20091.08 and -1.94u2009±u20091.33 and in patient with thyroid dysfunctions was -0.80u2009±u20091.09 and -1.64u2009±u20091.24 respectively. The mean of BMD in lumbar and femoral areas of diabetic patients were 0.96u2009±u20090.19 and 0.75u2009±u20090.19 and in patient with thyroid dysfunctions were 0.96u2009±u20090.17 and 0.76 ±0.19 respectively. The mean of BMI in osteoporotic subjects in the lumbar and femoral areas were 25.94u2009±u20095.62 and 26.95u2009±u20095.20 respectively. The association between BMI and BMD in the lumbar and femoral areas were statistically significant, but the association between DM and thyroid dysfunctions with BMD and T-score in the femoral and lumbar areas was not statistically significant (P-valueu2009>u20090.05).ConclusionThe results of current study show that there is no association between DM and thyroid dysfunctions with osteoporosis.

The Prevalence and Risk Factors of Gallstone Among Adults in South-East of Iran: A Population-Based Study

Objective: The present study aimed to evaluate the prevalence and possible risk factors of gallstone disease in the general population. Patients and Methods: This cross sectional study was carried out on a total of 1522 males and females aged ≥30 years in Zahedan district, South-East of Iran. Data were collected by a validated questionnaire and gallstone diagnosis was assessed by an experienced radiologist using ultrasonography. Logistic regression model was used to identify the association between selected variables and gallstone disease. Results: The overall prevalence of gallstone in participants was 2.4%. The risk of gallstone was 2.60 times higher in people age 45 and older than those aged 30 - 44 years (Odds Ratio = 2.60, 95% CI; 1.22 - 5.55). Females were 2.73 (95% CI; 1.34 - 5.56) times more likely to have disease compared to males as well. The risk in unmarried individuals was also three times higher than married ones (OR = 2.99: 95% CI 1.02 - 9.16). Additionally, daily physical activity reduced the risk of gallstone disease by 66% (95% CI; 0.18 - 0.86). Conclusion: In conclusion, increasing age and female gender were risk factors, whereas daily physical activity and marriage identified as protective factors in aetiology of gallstone disease.

Association Between Lifestyle and Hypertension in Patients Referred to Health Care Centers of Ilam City in 2014

Introduction: Lifestyle is referred to an individual’s healthy and unhealthy behaviors that can affect their health statues. The present study aim was association between lifestyle and hypertension in patients referred to healthcare centers of Ilam city in 2014. Materials and Methods: This research study was a case-control study. The data were collected through a standard questionnaire of health-promoting lifestyle profile (HPLPII) as well as the researcher’s direct visit to the health care centers in the city of Ilam. After the questionnaires were collected and classified, the data were entered into SPSS software and analyzed by descriptive statistics, chi-square tests, T-Tests and logistic regression. Results: The mean and the standard deviation of the age of the main and the control groups were 57.1 (2.22) and 56.5 (2.99) years old, respectively. 10.9%of the control group and 25.5. % of the cases was smoking cigarettes or hookah. The results of the data analysis showed that the mean scores obtained by the main and the control groups on measures of physical activity, psychological growth, stress and total lifestyleare significantly different, so that the obtained score in the dimensions in patients with hypertension was significantly lower than the score obtained among the healthy individuals. Conclusions: According to the results it seems that educational interventions in the field of healthy lifestyle for individuals with hypertension risk can have an effect on controlling this disease and reducing its incidence.

The Prevalence of Hepatitis B Virus Among Municipal Solid Waste Workers: Necessity for Immunization of At-Risk Groups

Background Hepatitis B virus (HBV) is likely to be more prevalent in certain populations and occupational groups, such as municipal solid waste workers (MSWWs). Objectives The current study aimed to estimate the prevalence of HBV and its risk factors among MSWWs compared to other municipal employees not exposed to waste. Patients and Methods The current cross-sectional study included 654 municipal employees in Zahedan (south-eastern Iran). A sample of blood was taken from each participant and tested for HBsAg through the enzyme-linked immunosorbent assay (ELISA). Demographic and other data on high risk behaviors were also collected through in-depth interviews. Data were analyzed using chi-square test and multiple regression analysis by STATA. Results The overall prevalence of HBV among municipal employees was 3.06% (95% CI: 1.70 - 4.30); however, it varied among the different employee subgroups as follows: 6.20% (95% CI: 2.70 - 9.70) in MSWWs, 3.3% (95% CI: 0.08 - 5.80) in drivers and 1% among staff who were not exposed to waste. Multiple regression analysis showed that exposure to waste [OR = 9.36; 95% CI = 2.01 - 43.7], lack of vaccination against HBV [OR = 3.83; 95% CI = 1.86 - 25.2], jaundice [OR = 6.91; 95% CI = 1.51 - 31.5], history of endoscopy [OR = 2.86; 95% CI = 1.08 - 7.62], and high risk behaviors [OR = 4.80; 95% CI = 1.96 - 27.2] were independently associated with HBV. Conclusions Greater encouragement for immunization against HBV as well as better education on HBV transmission routes and work safety precautions should be implemented to reduce the prevalence of HBV in MSWWs.

The prevalence of phantom vibration/ringing syndromes and their related factors in Iranian’ students of medical sciences

BACKGROUND AND AIMnMobile phone abuse can cause pathologic stress that may lead to addictive behavior such as Phantom Vibration Syndrome (PVS) and Phantom Ringing Syndrome (PRS). The current study aimed to determine the PVS and PRS due to mobile phone use in students of Qom University of medical Sciences in Iran.nnnDESIGNnCross-sectional study.nnnPARTICIPANTSnThe participants were 380 students selected by proportional stratified random sampling method in each stratum.nnnMEASUREMENTSnData were collected by a self-administered questionnaire and analyzed by descriptive and analytic statistical methods including t-test, chi square and analysis of variance.nnnFINDINGSnThe prevalence of PVS and PRS due to mobile phones in students of medical sciences was estimated to be 54.3% and 49.3%, respectively. PVS was higher in female students than in males while the PRS was higher in male students. There was a significant relationship between PVS and using social networks such as Viber, WhatsApp, and Line. In addition, a significant association was observed between PVS and friend-finding, chatting and entertainment.nnnCONCLUSIONnStudies should be done in the future to assess the long-term complication of overusing mobile phones. In the current study, the prevalence of PVS and PRS in half of students is considerable.

Prevalence of Addiction and Smoking and Their Relationship With Blood Parameters Among Drivers in Zahedan.

Background Although smoking and drug use are the major causes of accidents and death of drivers, few studies have been conducted on the prevalence of smoking and its associated factors in this occupational group. Objectives The current study aimed to investigate the prevalence of smoking and its relationship with blood parameters among drivers in Zahedan city, Iran. Patients and Methods In this study, 1836 inner and intercity drivers were investigated in 2013 in terms of smoking and drug use and blood parameters. Data were obtained through in-depth interviews and necessary examinations and tests, and were analyzed by Stata.12 software using Chi-square, independent t-test, and multiple regression analysis at significance level of 0.05. Results Generally, four drivers were addicted to drugs and smoked as well. Two-hundred and eighty eight drivers (15.8%) reported daily smoking. Variables of age, education, and type of vehicle showed a significant relationship with smoking. No significant difference was found in blood parameters between the smokers and non-smokers. Conclusions Despite relatively high prevalence of smoking than drug use in Zahedan drivers, there are few reports of these behaviors. Laboratory tests cannot suitably measure substance use due to their interference with other substances. Considering adverse effects of smoking on health and driving, it is necessary to train drivers to reduce or stop smoking during driving.