Journal of community health research

168-176

Authors: Sepideh Mahdavi, Mohammad Hassan Lotfi, Mohammad Kamalinejad, Majid Emtiazy, Mojgan Karimi- Zarchi, Mostafa Enayatrad Masomeh Naghshi, Fatemeh Sadat Faghih

Abstract Introduction: human papillomavirus (HPV) is the most common sexually transmitted disease (STD) throughout the world. The incidence of HPV has been increasing over recent years. Since scant information has been reported on the prevalence of HPV and its related risk factors in Yazd province, the present study aimed to evaluate effects of demographic characteristics as well as the risk factors associated with HPV in Yazd province, Iran. Materials & Methods: A total of 119 patients with genital warts entered this case series, who referred to Shahid Sadoughi hospital. Demographic information and productivity factors were collected using some questionnaires. Results: The mean age of the patients was (32.9) that most of the infected were between the ages of 31 to 35. Approximately, 58.8% of the patients started sex under the age of 20, and only 5% of the patients had more than one sex partner. Besides, almost 8 .4% of the participants were infected with other STDs. In 87.4% of cases, the diagnosis of genital warts is first appear in woman then their sex partner, and % 61.3 of the patients chose vaccination. Conclusion: The findings of the current study revealed that HPV is more prevalent within young adults, in particular those who are sexually active. As a result, further research seems to be demanded in regard with sexual health, relationship training, as well as HPV vaccines such as Gardasil for high-risk people.

194-202

Authors: Parastoo Yarmohammadi, Gholam Reza Sharifirad, Leila Azadbakht, ParisaYarmohammadi, Zohreh Rahaei, Vali Bahrevar, Zahra Khajeh

Abstract Introduction: Fast food consumption has greatly increased with in adolescents in recent years, which is linked with weight gain, poor dietary indexes and insulin resistance. Hence, the purpose of this study was to examine the association between demographic characteristics and fast food consumption with in high school students. Materials & Methods: In this descriptive-analytic study, a sample of 521 high school students aged 15-18 years were examined in Isfahan city, who were selected via multistage sampling method. The study data were collected using a questionnaire completed by the students. The present study probed to assess such items as frequency of fast food consumption, demographic characteristics, hours of television viewing, as well as high school students' knowledge and attitude. The collected data were analyzed using descriptive and inferential statistics. Result: Frequent intake of fast food (≥1 time/week) was reported 15.5% within females and 15.3% within males. A significant relationship was detected between parents’ high level of education and high income of the family with the fast food consumption. The predominate reasons for fast food consumption were stated as “enjoying tastes”, “eating at any place”,” inexpensive and economic”. Conclusion: The findings revealed that fast food consumption increased in families with high income and high education level, though these families needed to be educated on the harmful effects of fast food and how to choose the healthy foods. Therefore, some interventions may be regarded beneficial in order to reduce the exposure to the fast food and promote knowledge, attitude, and behavior change in regard with reducing consumption of fast food.

215-219

Authors: Fateme Akrami Mohajeri , Asieh Amiri, Hossein Khorramdel Azad, Zahra Ahmadi, Zahra Asadollahi, Mohsen Rezaeian , Aziz A. Fallah, Seyed Razi Ghalebi ,

Abstract Introduction: Aflatoxins, known as causative factors of hepatic and extra-hepatic carcinogenesis within humans, are extremely teratogenic, mutagenic, toxic, and carcinogenic compounds. Materials & Methods: This study was undertaken to determine the occurrence of aflatoxin M1 (AFM1) in 40 raw milk and 47 pasteurized milk samples collected during spring and winter. In order to analyze the samples, the Enzyme-linked Immunosorbent Assay (ELISA) procedure was used. The statistical methods used in this study were based on normal confidence intervals and analysis of variance (ANOVA). Results: Aflatoxin M1 was detected in 97.5% of the raw milk ranging from 6.52 to 68.17 ng/l and 95.7% of the pasteurized milk, ranging from 0.8 to 58.13 ng/l. Toxin levels in 10% of the raw milk and 2.1% of the pasteurized milk samples exceeded the Iranian national standard limit i.e. 50 ng/l. Due to seasonal variations, mean concentration of AFM1 in the samples collected in winter was significantly (P < 0.03) higher than those collected in the summer. Conclusion: Large amount of AFM1 in milk samples might be a potential hazard for the public health. Reducing the levels of AFB1 in animal feedstuffs can be regarded as the initial step to control the transfer of AFM1 to humans.

234-238

Authors: Sarvenaz Sadati, Ahmad Tamaddoni , Mohammad hossein baghianimoghadam

Introduction: Thalassemia is regarded as a genetic hematologic disease that affects various aspects of patients’ life. Measuring the health-related quality of life is a multidimensional concept that focuses on the disease as well as its treatment. Materials and methods: This cross-sectional study consisted of 50 adolescents aged 12-18 years suffering from Thalassemia major, out of which 30 were females and 20 were males with the mean (±SD) age of 15.38(±2) years old. The present study was carried out applying the Kidscreen-27 health-related questionnaire. Results: There was no statistically significant difference between urban and rural patients’ scores (P-value=0.22). Comparison of quality of life amongst female and male patients indicated male patients' better scores in regard with physical well-being, psychosocial well-being and the total score of quality of life compared to the females (P-value<0.05). The total score of quality of life within adolescents with higher educated fathers was reported to be slightly higher than that of the other groups. Conclusion: The study findings revealed that there was neither a significant difference between urban and rural patients with thalassemia major, nor a relation between adolescent patients' quality of life and their fathers’ education level. Nonetheless, male patients were demonstrated to have better quality of life than females.

91-98

Authors: Seyed Mostafa Shiryazdi, Mohammad Dehestani, Mohammad Forat Yazdi, Hamid Reza Soltani, Mansour Moghimi

Abstract Introduction: As a glycoprotein, Plasma Prostate-Specific Antigen (PSA) is mainly produced by prostate epithelial cells and is used as a major diagnostic tool for prostate cancer. A group of researchers relate the elevated number of estrogen receptors in breast cancer samples to the over-production of PSA in this type of cancer. The study aimed to determine the plasma PSA level of the participants of the study as a new biomarker for the primary diagnosis of breast cancer. Materials & Methods: Employing a historical cohort design, the study was conducted on 95 patients with breast masses. The participants were assigned to malignant (n=43) and benign (n=40) groups. Male participants and those undergoing a recent hormone therapy were excluded from the study. Independent-samples t-test and Fishers exact test were used to analyze the data using SPSS (Version 20). Resuls: Findings of the study indicated the sensitivity and specificity of the plasma PSA level in patients with breast cancer was 63.15% and 53.48 %, respectively. Also, it was found that the average plasma PSA levels for the benign and malignant groups were 0.047 ± 0.024 and 0.065 ± 0.054, respectively. There was no statistically significant relationship between the two groups. Moreover, no significant difference was observed )P>0.05( between the two groups when background factors were taken into consideration. Conclusion: Plasma PSA level is not a reliable biomarker to diagnose breast cancer although more comprehensive research evidence is required to consider other features of malignant samples and tumor sizes so as to evaluate the role of PSA in differentiating breast neoplastic lesions in a more meticulous way.

105-113

Authors: Farzaneh Vaziri 1, Ahmad Haerian 2, Mohammad Ali Morowati 3, Elaheh Amirian4

Abstract Introduction: Oral health related quality of life - United Kingdom (OHQoL-UK) questionnaire is one of the instrument which measure both positive and negative aspect of Oral Health related Quality of Life (OHQoL) at the same time. The aim of this study is to evaluate OHQoL with remaining teeth and other variable using OHQoL-UK questionnaire. Materials & Methods: This cross-sectional study was done on 150 patients referring to Yazd dental university and Khatamolanbia clinic; they were randomly asked to completeOHQoL-UK questionnaire. Number of teeth, present or absence of dental prosthesis (partial or fixed) was examined by the clinician. Then patients completed the OHQoL-UK questionnaire. Results: Sixty one male and 84 female completed the questionnaire. Male have higher mean quality of life score than female (68.8 in male and 67.9 in female) although it was not statistically significant (p=0.519). Quality of life score tended to decrease with age (p=0.214). Patients with more teeth have higher mean quality of life score (p= 0.002, rs=0.253). Mean quality of life score in patients with partial prosthesis was less than other patients but this relationship was not statistically significant (p=0.563). Patients with fixed prosthesis had higher mean quality of life score than others (p=0.05). Conclusion: According to the effect of dental condition on quality of life and effect of tooth loss on decreasing quality of life, required intervention should be done to improve dental condition and quality of life as a result.

128-137

Authors: Marzieh Valipour , Abbas Askari Nodushan

Abstract Introduction: Unintended pregnancy is associated with dangerous consequences for the mother's and baby's health as well as for the family and society. Hence, this study aimed to investigate the factors related to unintended gestation amongst pregnant women visiting healthcare centers in Yazd, Iran. Materials & Methods: The present study was conducted using a questionnaire as the data collection tool via multi-phase sampling method during June-July 2014. The statistical population size was 5925 among which, a sample size of 220 was selected Results: The current study results showed that the participants’ mean age was 27 years old and 90.9% of them were housewives. Participants’ mean of marriage age was reported 20.01, while mean number of their children was 0.85. Out of 220 women, who participated in this study, 28.6 % were reported to have unintended pregnancy. Moreover, based on the logistic regression model, variables of woman’s marriage age, type of contraception solution, and ideal number of children are three most effective factors on the unintended pregnancy. Existing variables in regression model justified 38.9% of the unintended pregnancies. Conclusion: The study findings revealed that improving quality level of consultancy and family regulation programs seem to be essential, specifically proper training in regard with usage methods of contraception devices.

148-158

Authors: Hassan Mozaffari-Khosravi, Maryam Asadi, Ali Dehghan, Hossein Soleimani Salehabadi, Mohammad Reza Sobhan Ardakani, Hossein Fallahzadeh Abarghoui

Abstract Introduction: The most prevalent type of arthritis is osteoarthritis which is known with the degenerative knee disease. Limited pieces of evidence have indicated that satureja with special phenol compounds is effective in inflammation reduction and pain alleviation. The aim of this study was to investigate the effect of Satureja Hortensis powder supplement on pain improvement and serum TNF-α in patients with knee osteoarthritis (OA). Materials & Methods: The present study was conducted as a placebo-controlled double-blind randomized clinical trial. 39 patients with OA with medium pain were randomly divided into two groups which received Satureja Hortensis powder (SG) and placebo (PG) These groups consumed three 200 mg capsules with the same size and form for two months which contained Satureja Hortensis powder and starch, respectively. Pain intensity was determined using visual analogue scale 5(VAS) at the beginning and end of the trial. Response to the treatment was defined as pain reduction by more than 1.5 scores. The concentration of TNF-α were measured with ELISA kit. Results: To distribute pain intensity before the intervention, there was no significant difference between the two groups. Before the intervention, all people had a pain score between 4 and 7. After the intervention, 95% of the SG and 84% of the PG were in this scope. These changes were not statistically different (p=0.12). There was no significant difference between the two groups in concentration of TNF-α before and after the intervention. Conclusion: Results of this study showed that Satureja Hortensis powder supplement with dose of 600 mg per day for 60 days was not effective on pain alleviation and concentration of TNF-α in patients with knee osteoarthritis

11-18

Authors: Saeid Hayati Kadijani, Mehrnoosh Jafari

Abstract Introduction: Increasing women's employment and economic activity increases social welfare, productivity and enhance the quality of life. The aim of this study was to investigate the role of women's employment and social health of families in Regions 1, 2, 19 and 20 in Tehran. Materials & Methods: This study was descriptive and causal - comparative or retrospective. The sample was selected using a multistage cluster sampling and by helping formulation Cochran was 384. Standardized questionnaire (Keyes) was used to measure social health. For data analysis, descriptive statistical criteria (mean, median, mode and standard deviation) and inferential statistics such as (chi-square test, t, and analysis of variance) were used. Results: Findings showed a significant positive relationship between women's employment and social health of the family. There are significantly and positively relation between Component of social health (social acceptance, social adaptation, social prosperity) and women's employment. There isn’t relationship between Women's employment and social cohesion and social participation. Conclusion: Woman employment affects family social health. Managers must have attention to woman employment in their strategic plan to creating healthy social.

29-37

Authors: Abbas Askari Nodoushan, Hossein Fallahzadeh Abarghoui, Hassan Fallah Madvari

Abstract Introduction: Provision, maintaining and improving health status of one year old and younger children as a vulnerable group has been considered as an important issue pertaining to healthcare and medical services. Index of mortality of under one year old children is among most important healthcare indices; and is known as the most important index of healthcare status of any society as well as the quality of life in any region. The present study aimed for examining causes of mortality amongst one year or younger children who were covered by health centers in Yazd city during 2011 to 2013 period. Materials & Methods: This descriptive-analytical study was conducted using control-test group method. All recorded cases of mortality for children in Yazd city during the first year of their life were included in statistical population, while for each case of mortality two cases of living children were examined as control group. The data were collected by direct visits on healthcare centers in the city and examining case files for children. Obtained data were analyzed using SPSS 20 software package. Results: 116 mortality cases were examined in total which included 41.4% boys and 58.6% girls. Some variables such as type of marriage between parents, mother and father’s education level, type of labor and number of previous pregnancies were significantly related to children’s mortality rate. Conclusion: suggest that paying specific attention to infants at the time of birth, improving knowledge level amongst mothers and families, providing standard level healthcare prior to pregnancy and after that, and also developing programs which aim for improving economic-social and cultural status amongst women and men would be effective on reducing children mortality rates.

47-54

Authors: Ali Fattahi Bafghi, Roya Anvari, Mohammad Hossein Anvari

Abstract: Introduction: Toxoplasmosis is Zoonoses among humans and animals with cosmopolitan distribution. Acquired form of the disease often has no symptoms or discomfort of swollen lymph nodes and associated Chorioretinitis. The congenital form of the disease is delivered via the placenta from mother to fetus. Congenital infection may cause abortion or damage to the central nervous system and eye disorders. The aim of this study was to determine toxoplasmosis Seroepidemiologyin serum of suspected patients referring to medical lab, in 2013. Materials & Methods: This study was cross- sectional. After physical examination, of the total cases 712 were diagnosed with suspected toxoplasmosis infection, and were referred for evaluation of serological diagnostic laboratories. Serum samples were collected from patients' in the laboratory using kits of anti-Toxoplasma gondii and Chorus Toxoplasma IgG, IgM antibodies were tested by ELISA method. Data on age, sex and time of the visit and laboratory test results were recorded in the Czech list, and then were analyzed using SPSS software. Results: From 712 sera tested, 649 (91.2%) were female while 63 ((8.8% were male. 171 (24.3%) of the antibody IgG and 25 ((3.5% in terms of IgM in serum were positive. In sex -wise distributed groups 159 female (93%)) and 12 male (7%) tested positive for IgG. and, 24 female (96%)) and 1 male (4%) were IgM positive. Most positive tests(9.5%) were observed in the group aged over 50 years. whereas The lowest percentage of positive tests were in the group with age less than 20 years (20%) and the highest was observed in patients above 60 years (8/47 percent). Conclusion: As a general conclusion, it can be stated that the frequency of specific IgM and IgG antibodies in toxoplasmosis, in the suspected-to-have toxoplasmosis and control groups were not statistically significant. Also, we can conclude that abortion is involved in the development of chronic toxoplasmosis.

65-73

Authors: Fatemeh Amiri, Mohammad Hasan Lotfi

Abstract Introduction: According to some studies in the western countries, %12.7 of total female cancers and %9.8 of all deaths resulted from cancers. And dead’s in females are due to genital system carcinoma. Materials & Methods: The present analytic cross sectional study was done on the cancer registry data of Yazd province for the evaluation of trend of genital carcinoma occurrence amongst females from 2006 to 2010. The trend of cancer incidence was calculated according to age, year of occurrence, family history, income, and job and residence place. Data was analyzed using student T-test and chi-square test. Results: Higher percentages of cancer were seen amongst age above 50 years, married women and householders. Majority of those had education level of primary (%40.5) and moderate income level (%49.6). The highest incidence rate was related to year 2010 (%30) and uterus cancers including body & endometrial was more common than others ( %42.7). The association between cancer incidence and age (p<.001) also disease occurrence and marital status (p=.03) were statistically significant. Cancers of uterus and cervix among subjects with age above 50 and cancer of ovary among females under 30 years was more common. Conclusion: our results showed that the incidence rate of genital carcinoma amongst Yazd females had an increasing trend from 2006 to 2010 and socio- economic factors had significant role in causing cancer. This is the same indicator coming from developing countries where community health is influencing from socio-economic and environmental changes.

226-231

Authors: Mohammad Hossien Salmani Nodoushan, Zinab Rezai , Valiallah Nassiri, Farokhlegha Servat, Mahdieh Delikhoon

Abstract Introduction: Zinc plays a vital role in various biological functions and physical growth. More than 300 enzymes in body need zinc for proper function. In this study, the concentration of the zinc micronutrient in breast milk was evaluated and analyzed at the first month of breastfeeding. Materials and Methods: This was a descriptive study of 150 breastfeeding mothers in the 2014 that had given birth in Yazd and were sampled in a simple way. Sampling was done exclusively in the health and treatment centers in the city, in the spring of 2014. 10- 20 ml samples of breast milk were taken manually in the morning and before infants' feeding, in 3 times of 5, 15 and 30 days after delivery, to measure the micronutrient of zinc. The concentration of zinc was measured by atomic absorption spectrophotometer. Data obtained by questionnaires and atomic absorption was analyzed by ANOVA test. Results: The average age of mothers was 27.40 ± 4.67 years. The average level of zinc in breast milk was 2.60 ± 0.35 mg/l. The zinc concentration of breast milk was at the bottom of the standard range of zinc in breast milk. There was no significant relationship between zinc averages in milk with education, age, BMI and mothers' job. But, there was a direct relationship between zinc levels of breast milk with mothers' BMI. Conclusion: According to the results of this study, it seems that addition of zinc to the diet of breastfeeding mothers helps to prevent zinc deficiency in mothers' blood serum as well as children's nutrition.

242-252

Authors: Rahil Emami , Mohammad Taghi Ghaneian, Ali Jebali , Seyed Hossein Hekmati Moghaddam, Mohammad Hasan Ehrampoush, Asghar MoslehArani

Abstract Introduction: Zhumeria majdae is an herbal plant which is only found in Hormozgan province. The aim of this study was to compare the antimicrobial property and toxicity of essential oil (EO) and encapsulated form of the essential oil (EFEO) of Zhumeria majdae. Materials and Methods: First, the plant was dried, grinded, and its EO extracted by hydrodistallation. Then, the EO was encapsulated by lecithin. Antimicrobial activity of EO and EFEO was evaluated by micro dilution broth method, and minimum inhibitory concentration (MIC) was determined.For toxicity test, serial concentrations of EO and EFEO were incubated with mouse skin cells, and then cell viability was calculated by MTT assay. Results: Based on atomic force microscopy results, the size distribution of EFEO was between 100-500 nm. Antimicrobial test showed that the MIC50 of both EO and EFEO was similar (0.6%). But, in case of Candida albicans, the MIC90 of EO and EFEO was 5% and 1.25%, respectively. It means that EFEO has greater effect on Candida albicans than EO. The results of MTT assay showed that the toxicity of EFEO was less than EO. Conclusion: It was found that in some cases, encapsulation could lead to better antimicrobial property and less toxicity. Because of high antimicrobial activity, both EO and EFEO of Zhumeria majdae might be used as powerfully antimicrobial agents.

261-269

Authors: Mohammad Ali Mooji, MasoumehTabatabaee

bstract Introduction: In this research mixed ZnO and TiO2 was used for degradation of an azo dye (Direct Blue 71). Material and Methods: In comparison with just TiO2 or ZnO as photocatalyst, mixed photocatalyst (ZnO/TiO2) is more efficient catalyst for degradation of dye under UV irradiation. The progress of the reactions was monitored spectrophotometrically by measuring the absorbance of dye at special wavelengths. The effects of various parameters such as ZnO/TiO2 ratio, amount of photocatalyst, pH,initial dye concentration and irradiation time on decolorization rate were systematically investigated. Results: Results show that approximately 90 % of Direct Blue 71 has been eliminated after 70 minutes and optimized condition.

278-287

Authors: Najib Allah Baeradeh, Mohammad Hassan Lotfi, Hossein Fallahzadeh, Saeed Kargar, Hassan Salman Roghani

Abstract Introduction: Cancers are the second cause of death in the world after cardiovascular diseases. Cancer of the stomach is one of the most important forms of cancer worldwide. It is the fourth most common form of cancer and the second most common cause of death in the world. There is a wide variation in the survival of gastric cancer among and even within countries. In this study we seek to investigate survival rate and the factors influencing the survival of gastric cancer in Yazd province. Materials and Methods: This is an observational (the analytical type) study which has been conducted using the methods of longitudinal and survival study. The study population includes all patients diagnosed with gastric cancer in Yazd province between the years 2006 to 2010. The samples were selected by the census method and all the patients diagnosed with gastric cancer between the years 1384 to 1388 (estimated to be about 136 cases) have been studied. After collecting the data and coding them, they were inserted to the software SPSS 16, STATA 12. To investigate the survival and the factors influencing the survival time of patients which are the main objective of this study, Kaplan-Meier method was used and Cox proportional hazards model was fitted to the data. To compare survival function in different subgroups, the log rank test or generalized Wilcoxon test was used. Results: From a total of 136 patients with gastric cancer, 91 cases were male (66.9%) and 45 females (33.1%), respectively. The mean age of patients was 62.33 ±1.45 years at the time of diagnosis. The Average (5% Trimmed Mean) and the median survival of patients with gastric cancer in both sexes were 26.16 and 19 months, respectively. The probability of survival at 1, 3 and 5 years after diagnosis of stomach cancer in both sexes using the Kaplan-Meier was 61.3, 31.2, %24.5, respectively. In multivariate analysis using Cox proportional hazards model, the variable of Job (P-value=0.03) was identified as the factor influencing the survival of patients with gastric cancer. Conclusion: Although the survival rate of patients with gastric cancer in Yazd province is desirable level, intervention measures can increase this amount