Showing 23 results for Risk Factors
E Mohammadi, Ha Abedi, F Gofranipour, F Jalali, A Kazemnejad,
Volume 16, Issue 1 (5-2002)
Abstract
High blood pressure control (HBPC) is a common goal of WHO and the
world hypertension league (WHL). The two important strategies in HBPC are
identifying cardiovascular (CVD) risk factors and planning to modify controllable
factors. This study was accomplished to determine the CVD risk factors in
high blood pressure (HBP) patients of the rural population, residing in the Babol
region, north of Iran, in the year 2000. This study was a cross-sectional research.
150 hypertensive patients were selected by cluster random sampling method. The
data were collected with two questionnaires (demographic characters and behavioral
habits questionnaire and Eschpel Burger's anxiety record) and laboratory
tests. The data analysis has indicated that the rate of most risk factors such as
cholesterol leve1, body mass index, anxiety score and other factors is highly elevated.
The results demonstrated that the rates of CVD risk factors were higher in
Iranian hypertensive patients compared to other countries. Probably, because of
this, the maximum rate of achievement of high blood pressure control was only
18.4%
M Jafari Shobeiri, Halimi, Dastranj, Shahamphar,
Volume 21, Issue 1 (5-2007)
Abstract
Abstract
Background: Cervical cancer is the most common female genital tract malignancy and
is the major cause of death from gynecologic cancer worldwide. The majority of cervical
cancers develop through a series of gradual, precancerous lesions. Screening asymptomatic
women with regular Pap smears allows diagnosis of the readily treatable preinvasive phase.
We performed this study to determine the prevalence of precancerous lesions and assess the
effect of demographic, pathologic and family economic factors on developing lesions.
Methods: This cross-sectional, descriptive, analytic study was carried out on 6024
women under coverage of Tabriz health care centers. Pap smear was done in all subjects and
questionnaires were filled by health providers. The data were analyzed with SPSS statistical
software (version 12) and statistical methods such as chi-square and t-test.
Results: Of 6024 Pap smears, 62 (1.02%) demonstrated precancerous lesions of which
41(0.68%) were atypical squamous cell of undetermined significance (ASC-US), 11
(0.18%) were low grade squamous intraepithelial lesion (LSIL) and 10 (0.16%) were high
grade squamous intraepithelial lesion (HSIL). No invasive cancer case was observed in this
study. According to our observation, the following factors increased the risk of precancerous
lesions: multiparity > 3, abortion > 1, gravida >3, husband marriage >1. The protective
effect of condom as a barrier contraceptive was observed.
Conclusion: According to this study it is imperative to make readily available facilities
for screening asymptomatic women all over Iran.
Parvaneh Mohammadkhani, E. Rezaei Dogaheh, S.a. Forouzan, H. Azadmehr, H. Jafari,
Volume 21, Issue 2 (8-2007)
Abstract
Abstract
Background: The aim of this study was to investigate the modelling of different processes that could account for the link between psychopathology, cognitive social and demographic risk factors and enacting assault by husband.
Method: This article reports a test using data on 230 males who participated in a family violence survey study. The sample was selected by a multiclustral sampling method from 4 different randomized regions of Tehran. All participants completed Conflict Tactic Scales, Personal and Relationship Profile, Marital Attitude Survey Questionnaire, Symptoms Checklist Inventory, Social and Demographic Measure. Logistics regression was used to estimate spouse abuse model for men.
Results: The findings were consistent with the theoretical model. The path from social- demographic, cognitive and psychopathological risk factors to enacting spouse abuse was demonstrated.
Conclusion: The implications of the findings for understanding spouse assaults, cognitive, psychopathological, social and demographic differences in male population are discussed.
Alphonsus N. Onyiriuka, Olasimbo O. Peter, Louis C. Onyiriuka, Patience O. Awaebe, Fidelis U. Onyiriuka,
Volume 26, Issue 2 (5-2012)
Abstract
Abstract
Background: Hypoglycaemia
is a well recognized complication of falciparum malaria in children but its
diagnosis may be overlooked because all the clinical features may be mimicked
by severe malaria. To determine the prevalence of hypoglycaemia at the point of
hospital admission of under-fives with falciparum malaria and identify its risk
factors in patients seen in a Nigerian secondary-health-care institution.
Methods: During a 12-month
period and at the point of hospital admission, venous blood sample was
collected into an appropriate sample bottle (fluoride-oxalate bottle) from 502
children who were below 5 years of age with positive falciparum malaria
parasitaemia. The blood sample was analysed using the glucose-oxidase method.
The duration of illness, degree of parasitaemia and time of last meal were
noted for each child.
Results: Ninety two
(18.3%) out of 502 children below five years old with falciparum malaria had
hypoglycaemia ( blood glucose below 2.6 mmol/L or 50 mg/dl) at the point of hospital
admission. Twenty three percent (78 out of 339) of children below 36 months old
were hypoglycaemic compared to 8.6% (14 out of 163) children aged 36 months and
above (p=0.01). Prevalence of hypoglycaemia was higher in girls (20.7%) than boys
(16.3%) [Odd ratio, OR = 0.75 (95% Confidence Interval, CI = 0.48-1.18)]. Forty
(13.1%) out of 305 children whose time of last meal was 12 hours and below had
hypoglycaemia compared to 52(26.4%) out of 197 whose time of last meal was
greater than 12 hours (p=0.02). Hypoglycaemia at admission point was
associated with a significant increase in mortality rate (p=0.00). The
duration of illness and the degree of parasitaemia did not have significant
difference with the prevalence of hypoglycaemia.
Conclusion: In falciparum
malaria, a greater interval (between 2 meals) than 12 hours in children below
36 months old predisposed them to hypoglycaemia. Routine monitoring of blood
glucose at the admission point is suggested in malaria endemic region.
Ali A Jamebozorgi, Azam Kavoosi, Zahra Shafiee, Amir H Kahlaee, Mehdi Raei,
Volume 27, Issue 1 (2-2013)
Abstract
Background: Prevalence of fall-related mortality is rising in the elderly population. Falling is one of the causes of the murderous and non-murderous injuries in the elderly population which can lead to disability, dependence and decline of quality of life. Fractures constitute a major part of the fall-related injuries. The present study is designed to investigate the prevalence of fall-related risk factors of fractures in the Iranian elderly population. Methods: This descriptive study was performed on 240 elderly adults (aged 72.24±8.81 years) referred to Tehran hospitals in 2011 with wrist, femoral and proximal humeral fractures, using a questionnaire designed for this purpose.
Results: Ninety four (39.2%) cases were males and 146 (60.8%) were females. Slipping was the most prevalent mechanism of falling with the rate of 26.9% followed by falling from height and falling outdoors. Femur was the most frequently injured site (57.5%) while wrist and humerus were the next sites to be injured. Only 7.5% of the cases lived in a safe environment while in 37.2% and 55.2% cases, home environment was partly safe and non-safe, respectively. Conclusion: Fall-related fractures in the studied population is related to cardiovascular and musculoskeletal disorders, low level of physical activity and ignorance of safety principles but, the prevalence of neurologic diseases and drug and alcohol abuse, which have been mentioned as relevant risk factors in some studies, was very low in this population.
Mohsen Saberi Isfeedvajani, Ali Akbar Karimi Zarchi, Abbas Musavi Heris, Fatema Sajjadi, Ali Mehrabi Tavana,
Volume 28, Issue 1 (1-2014)
Abstract
Background : Hypertension is a risk factor for life threatening diseases such as cerebrovascular accidents, coronary artery diseases, congestive heart failure and chronic renal failure. The prevalence of non-communicable diseases such as hypertension and diabetes including obesity has increased over the past few years in Iran. The first step for modification of cardiovascular diseases in a defined population is to assess the prevalence of their risk factors. This study was conduceted to assess personnel blood pressure and its risk factors in one of the medical universities of Tehran in the Health Day of 2013.
Methods : This cross sectional study was performed from May 19, 2013 to May 24, 2013 (I.R. of Iran’s Health Weak) in one of the medical universities of Tehran. Participants completed voluntarily a researcher-made questionnaire which composed of demographic characteristics and variables about risk factors and preventive factors of cardiovascular diseases such as smoking, history of diabetes, history of hypertension, physical exercise status and so on. Blood pressure was measured by mercury sphygmomanometer and weight and height were measured by a ground analogue scale.
Results : Of 195 persons participated in this study, 180 persons (92.3%) were male. The mean age of participants was 33.75 (±9.87) yr. The mean of systolic and diastolic blood pressure was 114.44 (±8.67) mmHg and 73.06 (±8.45) mmHg, respectively. The prevalence of overweight, obesity, prehypertension and hypertension was 41.7%, 17.8%, 40.4% and 11.7% respectively. Only 8 persons (5.6%) were cigarette smokers.
Conclusion : Despite the low prevalence of hypertension in our samples, the high prevalence of pre-hypertension and overweight need great attention. Interventions like life style modification could be effective in prevention of hypertension.
Alireza Ahmadvand, Farshad Farzadfar, Hamid Reza Jamshidi, Naser Mohammadi, Kourosh Holakouie-Naieni,
Volume 29, Issue 1 (1-2015)
Abstract
Background: Statins have been effective medications in lowering serum total cholesterol (TC) concentrations across populations over time. The aim of this study was to estimate national and provincial trends in atorvastatin sales in Iran, to systematically quantify its relationship with socio-economic indicators, and changes in TC level.
Methods : In this retrospective ecological study, conducted in Iran, we examined trends in atorvastatin sales, the wealth index (WI) as a validly-available socio-economic indicator, and TC level between 2004 and 2011. The main outcome variable was mean atorvastatin sold in defined daily dose per 100,000 people per day (DPD). We analyzed the relationship between WI and DPD and between DPD and mean TC across time and space.
Results : At national level, both mean WI and mean DPD showed increasing trend over time, while we observed decreasing trend for TC. Mean WI and DPD in 2011 was nearly 5 and 50 time that of their respective figures in 2004, while the mean TC decreased for nearly 10%. Increases in both WI and DPD had happened in every province, but with different patterns. The maximum and minimum changes in DPD versus WI were seen in Gilan and North Khorasan respectively.
Conclusion : A striking increase occurred in the sales for atorvastatin in Iran from 2004-2012 in most provinces examined. The wealthier a province became, the more sales were seen for atorvastatin. TC optimistically decreased from 2005 to 2011 and its decrease was positively correlated with increasing sales for atorvastatin.
Kamyar Mansori, Hamid Soori, Fariba Farnaghi, Sohila Khodakarim, Shiva Mansouri Hanis, Mahmoud Khodadost,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Poisoning is a major public health problem and is one of the most frequent causes of emergency hospital admissions. The aim of this study was to identify the main risk factors for unintentional childhood poisoning in Tehran, Iran and to suggest possible causes and preventative measures.
Methods: In this case-control study (case, n=140; control, n=280), two controls were selected for every case. Controls were matched by age, sex, and date of hospital attendance. All children and their guardians were then interviewed by the same person using a standard questionnaire that covered the demographic, behavioral, and risk factors associated with accidental poisonings.
Results: The most common type of poisoning was related to narcotics (58.6%); and among the narcotics, methadone was the most prevalent poisoning agent (74.7%). Multivariate conditional logistic regression model revealed that addiction in the family (OR=14.6; 95% CI:6.2-34.6), previous poisoning (OR=7; 95% CI:2.4-20.2), maternal occupation (OR=4; 95% CI:1.3- 12.3), and inaccessibility of poisoning products (OR=0.03; 95% CI:0.01- 0.12) were the main risk factors in unintentional childhood poisoning.
Conclusion: Addiction in the family as a risk factor and inaccessibility of poisoning products as a protecting factor were recognized to have the highest correlation with the unintentional child poisoning. These two factors were considered as priorities in health education programs.
Mashallah Aghilinejad, Ali Asghar Ehsani, Atefeh Talebi, Jalil Koohpayehzadeh, Naser Dehghan,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Musculoskeletal symptoms are the main cause of loss of working time, and increase in labor costs. Poor posture is the most important risk factor for work-related musculoskeletal symptoms. This study aimed at evaluating the role of ergonomic risk factors in different surgical (open surgery, laparoscopy, and microsurgery) in the frequency or resonance frequency of musculoskeletal symptoms.
Methods: This descriptive-analytic study was conducted on 81 surgeons in a hospital in Tehran. In this study, the prevalence of musculoskeletal symptoms was evaluated using the Nordic Questionnaire. Moreover, Workplace ergonomic risk assessment method (WERA) was used to evaluate ergonomic risk factors in 3 types of open surgery, laparoscopy, and microsurgery.
Results: The results revealed that the prevalence of musculoskeletal symptoms of the neck, back, shoulder, and arm is high in surgeons (over 75%). The mean final score of WERA was 40.11, representing the high risk of the 3 types of surgery for the prevalence of musculoskeletal symptoms. Results revealed that the prevalence of musculoskeletal symptoms in the neck, waist and wrists had a significant relationship with the body posture in the 3 types of open surgery, laparoscopy, and microsurgery (p<0.05).
Conclusion: In the present study, the prevalence of musculoskeletal symptoms was high in the neck, waist, and hands surgeries. Depending on the type of surgery, teaching correct working methods, using proper seats and ergonomic equipment are the best strategies to reduce musculoskeletal symptoms in the surgical profession.
Hammad Shah, Afrasyab Altaf, Momin Salahuddin, Muneeb Ullah Jan, Adnan Khan,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Hypertension was considered as a disease of the elderly but due to unhealthy dietary and lifestyle changes its incidence has increased in younger population. Smoking and obesity are emerging concerns the world is facing globally in younger age groups. This study is therefore aimed to identify these cardiovascular risk factors among Pathan and Persian young adults.
Methods: It was a cross-sectional study carried out at multiple undergraduate, postgraduate educational institutes and hospitals using non-probability convenient sampling among young adults aged between 15 to 40 years for a period of six months from Apr 1st, 2017 to Sep 30th, 2017. Mean±SD was calculated for continuous variables and categorical variables were expressed as frequencies. Chi-square test and Fisher exact test were used for statistical analysis.
Results: A total of 708 subjects were included. Mean±SD age was 26.12±3.7 years. Out of 708, 300(42.37%) were smokers with 209 (29.52%) active and 91 (12.85%) passive smokers. Among smokers, 216 (30.5%) were males while 84 (11.87%) were females. A total of 432 (61.02%) subjects were not doing any exercise, and 636 (89.83%) were consuming junk food. A total of 165 (23.3%) subjects were overweight, and 15 (2.1%) were obese. Stage-1 hypertension was present in 72 (10.2%), while 16 (2.25%) subjects had stage-2 hypertension.
Conclusion: There is an increased prevalence of cardiovascular risk factors which includes hypertension, smoking, and obesity among Pathan and Persian young adults.
Kamyar Mansori, Masoud Solaymani-Dodaran, Alireza Mosavi-Jarrahi, Ali Ganbary Motlagh, Masoud Salehi, Alireza Delavari, Ali Hosseini, Mohsen Asadi-Lari,
Volume 33, Issue 1 (2-2019)
Abstract
Background: This study aimed to determine effective factors on geographic distribution of the Incidence of Colorectal Cancer (CRC) in Tehran, Iran using Geographically Weighted Poisson Regression Model.
Methods: This ecological study was carried out at neighborhood level of Tehran in 2017-2018. Data for CRC incidence was extracted from the population-based cancer registry data of Iran. The socioeconomic variables, risk factors and health costs were extracted from the Urban HEART Study in Tehran. Geographically weighted Poisson regression model was used for determination of the association between these variables with CRC incidence. GWR 4, Stata 14 and ArcGIS 10.3 software systems were used for statistical analysis.
Results: The total number of incident CRC cases were 2815 in Tehran from 2008 to 2011, of whom, 2491 cases were successfully geocoded to the neighborhood. The median IRR for local variables were : unemployed people over 15 year old (median IRR: 1.17), women aged 17 years or older with university education (median IRR: 1.17), women head of household (median IRR: 1.06), people without insurance coverage (median IRR: 1.10), households without daily consumption of milk (median IRR: 0.85), smoking households (median IRR: 1.07), household’s health expenditure (median IRR: 1.39), disease diagnosis costs (median IRR: 1.03), medicines costs of households (median IRR: 1.05), cost of the hospital (median IRR: 1.09), cost of medical visits (median IRR: 1.27).
Conclusion: The spatial variability was observed for most socioeconomic variables, risk factors and health costs that had effects on CRC incidence in Tehran. Spatial variability is necessary when interpreting the results and utterly helpful for implementation of prevention programs.
Alireza Rai, Mehran Babanejad, Samira Sanadgol, Hosein Karim, Parisa Janjani, Amir Reza Rai, Afshar Shahmohammadi,
Volume 34, Issue 1 (2-2020)
Abstract
Background: Anemia is one of the symptoms of hospital patients suffering from ST-elevation myocardial infarction (STEMI), which may have a predictive role in short- or long-term complications. This study aimed to identify anemia risk factors and related short- or long-term outcomes in STEMI patients.
Methods: This was a prospective study of patients older than 18 years diagnosed with STEMI who admitted to Imam Ali hospital from 2014 to 2015. To collect demographic and clinical information related to anemia, a questionnaire compiled by researchers was administered. The collected data were analyzed by SPSS (version 20); also, independent t test and multiple logistic regression analyses were applied to find related risk factors of anemia in STEMI patients. Significance level was set at p < 0.05 for all statistical tests.
Results: In total, 49 (11.7%) out of 423 patients suffered from anemia. STEMI patients with anemia were more likely to be female (OR = 2.92; CI 95% = 1.58-5. 38), diabetic (OR = 2.5; CI 95% = 1.32- 4.74), ≥ 60 years old (OR = 2.42; CI 95% = 1.24-4.73), nonsmokers (OR = 2.18; CI 95% = 1.07- 4.4), and susceptible to require in-hospital cardiopulmonary resuscitation (CPR), (OR = 3.12; CI 95% = 1.35- 7.1). In the final analysis, using the Forward Wald model in logistic regression, anemia remained significantly related to female gender (OR = 2.76; CI 95% = 1.42-5.36), diabetes mellitus (OR = 2.38; CI 95% = 1.2-4. 74), and a history of MI (OR = 2.5; CI 95% = 1.04-6.11).
Conclusion: STEMI patients with anemia are more susceptible to have in-hospital outcomes. Furthermore, female gender, hyperglycemia, and history of MI were factors related to anemia that might have major role in the complications of STEMI.
Khalid Mahmood, Ramsha Riaz, Muhammad Salman Ul Haq, Khizar Hamid, Hassaan Jawed,
Volume 34, Issue 1 (2-2020)
Abstract
Background: Irritable Bowel Syndrome (IBS) is one of the most commonly diagnosed gastrointestinal disorders, and its etiology is believed to be multifactorial. The role of smoking in the pathophysiology of IBS still remains inconclusive. Hence, we aim to investigate whether or not an association exists between smoking and IBS.
Methods: A cross-sectional study was conducted in a tertiary care hospital of Karachi. A sample size of 200 smokers and 200 non-smokers was selected. A two-part self-reported questionnaire was administered to the participants and the diagnosis of IBS was based on the Rome III diagnostic criteria. All data were analyzed using the Statistical Package for the Social Sciences version 17. Statistical tests employed were Independent samples t-test, chi-square test, and binary logistic regression analysis to obtain Odds Ratio (OR) for various variables. A P-value <0.05 was considered statistically significant.
Results: Overall prevalence of IBS based on Rome III criteria was 9.5% (95% CI 9.45-9.60). Smoking was significantly found to be associated with IBS (P=0.002). Binary logistic regression analysis indicated that non-smokers were more likely to have IBS (Crude OR: 3.00, 95% CI 1.23-7.30) than smokers, and females were more likely to have IBS (Crude OR: 3.73, 95% CI 1.56-7.69) than males. Age, BMI, and food groups were not found to be significantly associated with IBS.
Conclusion: Our study concludes that IBS was more prevalent among non-smokers and amongst females. Further studies are required to firmly establish the role of smoking in IBS.
Jamshid Mehrzad, Mahdieh Dayyani, Mohammadreza Erfanian-Korasani,
Volume 34, Issue 1 (2-2020)
Abstract
Background: Several environmental and genetic factors have contributed to the development of colorectal cancer (CRC). We aimed to investigate the independent and combined effects of some selected risk factors and Arg399Gln XRCC1 polymorphism on CRC.
Methods: A total of 180 patients with CRC and 160 healthy individuals who were matched for sex, age, and place of residence (Northeast of Iran) participated in this case-control study. Before collecting blood samples and filling out questionnaires, a written consent form was obtained from all participants. Genotypes were determined by RFLP-PCR. The comparison of genotype and allele frequencies was performed using p value based on the results of chi-square test. The odds ratios (OR) and 95% confidence intervals (CI) were calculated by employing a logistic regression model. All statistical calculations were performed using SPSS. Each of the 2-sided p values less than 0.05 were considered statistically significant.
Results: The level of literacy, physical activity, consumption of vegetables and fruits, and tea intake of the patients were significantly lower than healthy individuals, but gastrointestinal disorders, family history of cancer, BMI, and fast food consumption were significantly higher in cases than in controls. No significant difference was observed between the 2 groups regarding smoking, opioid addiction, alcohol consumption, diet, fish consumption, and liquid intake, using the kitchen hood, diabetes, and cardiovascular disease. Arg/Gln + Gln/Gln and Arg/Gln genotypes were involved in increased CRC risk (The crude OR =1.781 with a 95% CI of 1.156-2.744 and OR = 1.690 with a 95% CI of 0.787-3.630). Also, Gln/Gln genotype was more frequent in CRC group than in control group. However, none of the risk factors interacted with polymorphism, and thus did not have an effect on CRC.
Conclusion: Some risk factors, such as reducing the consumption of vegetables and fruits or reducing physical activity as well as polymorphism of the XRCC1 Arg399Gln alone, increase the risk of CRC, but they do not interact with each other.
Babak Eshrati, Hamid Reza Baradaran, Saeed Erfanpoor, Arash Mohazzab, Yousef Moradi,
Volume 34, Issue 1 (2-2020)
Abstract
Background: As hospitalized patients with COVID-19, especially those who are admitted to ICU or die afterwards, generally have comorbidities, the aim of this study was to determine the factors affecting the survival rate of COVID-19 patients in Iran using a retrospective cohort.
Methods: This retrospective cohort study was conducted on patients with COVID-19 who referred to medical centers under the supervision of Iran University of Medical Sciences, Tehran, Iran, from February 22 to March 25, 2020. The final date of follow-up was April 19, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Clinical laboratory, radiological, treatment, and demographic data were collected and analyzed. The associations among gender, immune disease, diabetes, liver disease, cardiovascular disease, kidney disease, chronic pulmonary disease, cancer, chronic nervous disease, type of treatment, and risk of death were analyzed. The Kaplan-Meier and Log-rank tests were used to estimate survival rate and compare survival rates, respectively.
Results: The total number of deaths or desired event in the study was 329 (10.3%).The risk of death in the age groups of 50-60 years, 60-70 years, and >70 years compared to the 30-40 age group was 2.17 (95% CI: 1.03, 4.55; p: 0.040); 3.72 (95 % CI: 1.80, 7.68; p: 0.001) and 5.09 (95 % CI: 2.49, 10.40; p: 0.001), respectively. The results showed men had 11.5% more risk of deaths than women (HR: 1.11; 95 % CI: 0.89, 1.39; p: 0.341). Kidney disease increased the risk of death by 52.3% in these patients, which was not statistically significant (HR: 1.78; 95 % CI: 1.04, 3.04; p: 0.035). Also, chronic pulmonary diseases and diabetes increased the risk of death in COVID-19 patients by 89.5% and 41.3% compared to COVID-19 patients without chronic pulmonary diseases and diabetes [(HR: 1.89; 95 % CI: 1.17, 3.04; p: 0.008), (HR: 1.41; 95 % CI: 1.01, 1.96; p: 0.038)].
Conclusion: Based on the results of this study, more attention and care should be paid to COVID-19 patients with underlying diseases, such as chronic obstructive pulmonary disease, diabetes, and kidney disease to reduce the number of deaths.
Mehran Asadi-Aliabadi, Arash Tehrani-Banihashemi, Fariba Mirbaha-Hashemi, Leila Janani, Ebrahim Babaee, Seyed M Karimi, Marzieh Nojomi, Maziar Moradi-Lakeh,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Risk factors of noncommunicable diseases (NCD) are increasingly contributing to morbidity and mortality in Iran. Health care providers’ competencies and motivation are essential factors for the success and efficiency of primary health care. This field trial aims to evaluate the impact of a results-based motivating system on population level of the NCD risk factors field trial (IRPONT) in Iran.
Methods: Population groups of 24 rural or urban catchment areas from 3 provinces were randomized to 1 of the 4 types of study groups. The groups were defined based on a set of 4 intervention packages. Extra 8 rural or urban catchment areas in a separate city were considered as independent nonintervention (control) group. Population levels of major NCD risk factors in all 32 population groups were measured at the beginning of the trial, at the end of the first year, and will be measured in the second year through standardized population surveys. As the outcome measure, the difference in population levels of the risk factors will be compared among the study groups. Study group IV will be compared with combined control groups (study groups I, II, and III). Also, we will conduct subgroup analysis to determine the effects of interventions 2, 3, and 4.
Ethics: This trial has received ethical approval from National Institute for Medical Research Development in Iran (IR.NIMAD.REC.1396.084) in 2017.
Trial Registration Number: This trial has been registered on the Iranian Registry of Clinical Trials (identifier: IRCT20081205001488N2). Registered on 3 June 2018 and updated on 12 April 2020.
amirhossein Yazdi, Farnaz Fariba, Fateme Karimian, Nasrin Jiriaee,
Volume 36, Issue 1 (1-2022)
Abstract
Background: The coronary artery calcium score has been established as a highly specific feature of coronary atherosclerosis. The present study aimed to assess the possible association of coronary artery risk factors involving atherosclerosis with the coronary artery calcification (CAC) scores using coronary computed tomographic angiography (CCTA).
Methods: The present cross-sectional study, performed on 252 patients in need of CCTA during April 2019 and September 2019 at Farshchian hospital in Hamadan, Iran. The demographic information and risk factors were acquired from the files of patients. Furthermore, the CACs of patients were calculated and expressed as the Agatston score. Based on the Agatston scale, participants were divided into 4 CAC scores: zero (CAC = 0), mild (CAC = 1-99), moderate (CAC = 100-399), and severe (CAC ≥400). The association between possible coronary artery disease (CAD) risk variables and the CAC score was investigated using multinomial logistic regression.
Results: Of 252 participants, approximately 40% of studied patients had a positive CAC score (CAC > 0). CAC significantly shifts toward higher scores in smokers, patients with diabetes, hypertension, and older patients. Mild (CAC = 1-99) and moderate CAC (100-399) were significantly associated with diabetes (odds ratio [OR], 3.26; 95% CI, 1.48-7.17) and (OR, 12; 95% CI, 4.40-32.71) for mild and moderate CAC, respectively. However, the strongest predictor for severe CAC was diabetes (OR, 7.72; 95% CI, 2.10-28.35).
Conclusion: Coronary artery calcium scoring is a marker for risk factors associated with atherosclerosis. In this study, more than half of patients in CAC screening had CAC = 0. The strongest predictor of severe CAC>0 was smoking and diabetes. Regarding this association between health condition and CAC, determining the CAC can prevent major coronary heart disease events in these patients.
Behrooz Banivaheb, Parmida Shahbazi, Nima Hemmati, Ashkan Yahyavi, Pegah Derakhshan, Seyed Mohammad Tabatabaei Jabali, Ali Kabir,
Volume 36, Issue 1 (1-2022)
Abstract
Background: This study aims to provide information on the success rate of CPR in COVID-19 patients and some probable risk factors of mortality in these cases.
Methods: In this historical cohort design, the CPR success rate probable risk factors of 737 critically ill patients during the COVID-19 pandemic in 17 hospitals in the catchment area of Iran University of Medical Sciences, Tehran, Iran, was evaluated between Feb and Apr 2020. Data were extracted from a database that is a part of a national integrated care electronic health record system and analyzed with logistic and Cox regression models.
Results: COVID-19 cases were 341 (46.3%). The mean age in COVID-19 cases and non-COVID-19 patients were 70.0±14.6 and 63.0±19.3 years, respectively (P<0.001). The mortality was significantly higher in COVID-19 patients (99.1% vs. 74%, OR: 39.6, 95%CI: 12.4, 126.2). Cardiovascular diseases were the most frequent underlying disease (46.3% of COVID-19 cases and 35.1% of non-COVID-19 patients). Being a COVID-19 case (OR: 29.0, 95%CI: 8.9, 93.2), Intensive care unit admission (OR: 2.6, 95%CI: 1.5, 4.6) and age for each ten-year increase (OR: 1.2, 95%CI: 1.1, 1.4) were observed to be independent risk factors of mortality following CPR. The hazard ratio of being a COVID-19 patient was HR= 1.8 (95%CI: 1.5, 2.1).
Conclusion: Critically ill COVID-19 patients who undergo CPR have a decreased chance of survival in comparison to non-COVID-19 patients.
Ahmad Hajebi, Ali Asadi, Seyyed Ebrahim Ghoddousi, Tahereh Ziadlou, Maryam Mehrabi, Zahra Vaezi, Amirali Hajebi, Maryam Abbasinejad,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Mental disorders have a high prevalence and significant burden among all health conditions across the world and in Iran. Therefore, some targets in the field of mental health and substance and alcohol use prevention have been included in the National Action Plan for Prevention and Control of Non-communicable Diseases and Related Risk Factors.
Methods: Keeping in mind the key priorities, important strategies have been considered for attaining the main targets in this field. These strategies fall under four categories of governance, prevention and reduction of risk factors, health care, and surveillance, and monitoring and evaluation strategies.
Conclusion: The success of mental health and substance and alcohol use prevention programs in Iran can be partly related to the evidence-based approach adopted and also to the commitment of high-rank officials of the Ministry of Health and Medical Education to the principal strategy of increasing access to the general population to basic mental health services, among all other non-communicable diseases.
Mehdi Mokhtari, Davood Khalili, Farshad Farzadfar, Rajabali Daroudi, Mohsen Asadi Lari,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Cardiovascular diseases (CVDs) contribute to over 30% of deaths worldwide and more than 40% in Iran in 2019. Establishing a cost-effective program to control cardiovascular diseases is essential for any country. This study aimed to estimate the cost-effectiveness of the primary prevention program (IraPEN) for cardiovascular diseases in Iran.
Methods: This methodological cost-effectiveness study was performed to estimate the cost-effectiveness of the IraPEN program by modifying cardiovascular disease risk factors in the IraPEN program. We calculated the economic burden of CVDs risk factors from 2016 to 2018 in 4 pilot cities in Iran. We observed 160,833 individuals for 2 years to measure the economic burden of cardiovascular diseases. To estimate the variation of the 1-year risk of cardiovascular illnesses, and according to the study's goal of estimating the 1-year risk of cardiovascular disease, only 36,631 people remained in the study who compiled the program's instruction for 1 year. Propensity scores were used to consider the effect of those excluded from the study. The 10-year risk of CVDs was estimated by the laboratory tests and information registered in the population’s electronic records. To evaluate the effect of the IraPEN program in reducing the risk factors for cardiovascular diseases, major CVD risk factors were studied by the World Health Organization formula (whocvdrisk) and cardiovascular diseases risk scoring. We used the 10-year risk for CVDs to conduct a cost-effectiveness analysis in terms of cost per disability-adjusted life-year (DALY) saved.
Results: According to estimates of the 1-year relative risk reduction in cardiovascular disease, the results showed that relative risk reductions for men and women were 0.74 and 0.65, respectively. Hence, about 174,088 annual acute CVDs events reduction would be expected; this decrease is predicted for men (93,034) more than women (81,054) for the total population of Iran. The total cost of treatment for people with cardiovascular diseases was 165 USD for coronary heart disease or stroke per individual. All risk factors were further reduced in women than men, except for smoking. DALYs averted was 1057.66 for samples who were in the study for a year (36631 samples). The total cost per averted DALY was 47.16.
Conclusion: Estimating the costs associated with disease prevention programs is more important in developing countries. The most cost-effective strategies have been preventive therapies that target high-risk individuals. PEN risk reduction programs for primary prevention such as Ira-pen are highly cost-effective and efficient in low- and middle-income countries.
