Journal of School of Public Health and

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Background and Aim: The normal plasma fatty acid (FA) composition changes in hypertriglyceridemic obese and overweight indiuviduals. The objective of this study was to determine the plasma fatty acid composition in hypertriglyceridemic obese or overweight subjects with different FABP2 genotypes.

Methods and Materials: Forty-six hypertriglyceridemic subjects (33 men and 13 women, 25-60 years old) referred to the Endocrinology and Metabolism Research Center (EMRC), Shariaty Hospital in Thehran, between Mehr and Esfand 1386 (September 2007-March 2008), were genotyped for FABP2 polymorphism by PCR-RFLP. In addition, their blood lipid profile was determind enzymetically, photometrically and immunoturbidometrically, and their plasma fatty acid composition by gas-choromatography. Also, body weights and heights were measured and body mass index calculated.

Results: Positive associations were observed between Thr54 polymorphism in FABP2 protein and plasma lipid fractions (SFA, PUFA, ω-6-, ω-3- and total fatty acids (P<0.001 )). No significant differences were observed between PPARα polymorphism and plasma fatty acid composition, except for ω-3 fatty acids,

Conclusion: In obese or overweight hypertriglyceridemic subjects the plasma fatty acid compositions are different. The levels of some fatty acids are higher, while those of some others are lower, in different FABP2 genotypes. On the whole, higher levels of SFA, PUFA, ω-6, ω-3, and total fatty acids were more pronounced in Thr54- than in Ala54-carrieres.

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Background and Aim: The district health information system (DHIS) converts raw data into useful manegerial information. The main purpose of DHIS is to improve quality of health services in service delivery points. This study was conducted to investigate the DHIS performance.

Materials and Methods: A total of 200 health service-delivery units were selected by systematic random sampling, and the calculation of 47 primary health care indicators was assessed by the provincial health center statistics supervisor.

Results: On the average, 41.9% of the indicators had been calculated in each unit. In the district health center, the proportions of outcome measures and process performance indicators calculated were 50% and 5.6%, respectively. On the basis of the indicators obtainable from the vital horoscope, 79% of the indicators in the district health center and 66% of those in the health service-delivery units had been calculated. Finally, there were 97 disease-surveillance forms, 35 environment-health forms, 21 family-health forms, and 23 other forms at the district level.

Conclusion: Re-designing the structure of the health information management process and determining indicator packages at the district and service-delivery level are vital steps for improving the health information system at the district level.

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Background and Aim: Recently the use of heterotrophic plate count (HPC) has received much attention as a supplementary indicator of the MPN test in water quality control. The US Environmental Protection Agency (USEPA) has declared 500 cfu/mL as the maximum acceptable level for heterotrophic bacteria in distribution networks. Currently the HPC determination is not among the routine control items in Tabriz city and there is no published information on the presence of heterotrophic bacteria in that city's potable water. In this study the presence of HPC in potable water main was determined in Tabriz city, Iran.
Materials and Methods: A total of 50 water samples, representing drinking water of the whole city of Tabriz, were taken randomly from different districts of Tabriz city and their HPC, coliform, residual chlorine, turbidity, temperature, and pH were measured. For the heterotrophic bacteria the R2A and Nutrients Agar culture media were used, while the spread plate count method was used for the HPC test. The statistical tests used for data analysis were the t-test and regression.
Results: In 50% of the samples heterotrophic bacteria were present. In 6 districts the HPC was higher than 500 cfu/mL. Based on Nutrient Agar and R2A, the HPC indicator in Tabriz drinking water was 184±340 and 154±315 cfu/mL, respectively, the growth rate being higher in the former medium. There was a significant correlation between the HPC and residual chlorine in both media (for Nutrients Agar, p<0.05 R= -0.347, and for R2A, p<0.05 R= -0.312). Also, there was a significant positive correlation between the HPC and pH (p<0.05). Further analysis of the data showed that the correlation between HPC values in both media was also significant (p<0.95, R= 0.95).
Conclusion: The presence of heterotrophic bacteria in 50% of the water samples tested indicates that drinking water contamination with these bacteria is a public health problem in Tabriz city. As a result, monitoring of HPC at least once every 6 or, at least, 12 months, together with coliform bacteria, and the comparison of the results over time can help to better determine water quality in the distribution system, as well as boost the system operation and ensure drinking water with a high quality.

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Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged ≤ 12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran.

Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment.

Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000.

Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas.

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Background and Aim: Coronary artery disease (CAD) and its complications at a low age are more serious and more progressive than at higher age. Because of this difference in the natural history of the disease as a function of age, this study was conducted to compare CAD risk factors between two age groups, namely people below and above 45 years old.

Materials and Methods: Two groups of 200 hospitalized CAD patients each, one below, and one above, 45 years old were selected by simple random sampling between 2005 and 2007. Two groups were similar with regard to dates and duration of hospitalization. The following data were collected from the patients' hospital files and analyzed using SPSS/Win: age, sex and marital status area of residence a history of smoking, diabetes, and hypertension a family history of early-onset cardiovascular disease (CVD) weight and height and lipid profile. The logistic regression test was used to compare the variables between the two groups.

Results: The following variables were found to be positively associated with CAD in the under-45 year group: smoking history (OR=2.54 p=0.009), a history of early-onset CVD (OR=3.15 p=0.009), low high- density lipoprotein cholesterol (HDLc) (OR=5.53 p<0.001), and high blood cholesterol (OR=3.96 p<0.006).

Conclusion: The most important coronary heart disease risk factors at a lower age are smoking, a history of early-onset CVD, low blood HDLc, and high total blood cholesterol.

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  Background and Aim: A ssociations between air pollution and morbidity have been reported in several studies. Due to limited publications in the literature for Iran, this study aimed to determine the association between air pollution and hospital admissions of respiratory disease patients in Tabriz, Iran.

  Materials and Methods: The methodology used in this study was case -crossover and the artificial neural network model. The variables of the model included air quality, hospital admission and air pollutants. Daily hospital admission data were collected from five hospitals in Tabriz, Iran based on the International Classification of Diseases (ICD-10) , air quality data including NO₂, SO₂, CO, PM₁₀ and O₃ from the six fixed online air quality monitoring stations, and the daily mean temperature and relative humidity data for the same period from the East Azerbaijan Meteorological Bureau.

  Results : P articulate matter with a median aerometric diameter <10 μm (PM₁₀) was found to be the most important pollutant affecting respiratory hospital admissions. The ANNs data showed that the most important causes of hospital admissions were for COPD NO₂, NO and CO, for respiratory infections PM_10, and for asthma PM₁₀, O₃ and CO. The highest associations were observed between hospital admissions due to COPD and asthma in females and those due to respiratory infections in males. The elderly (individuals over 65 years old) were at the highest risk.

  Conclusion: The results show a significant relation between air pollutants and respiratory hospital admissions in Tabriz, Iran. The importance and necessity of enforcement of existing regulations and enacting laws to prevent and control the adverse health effects of air pollution are confirmed.

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  Background and Aim : Milk and dairy products provide more than 50% of the calcium requirement in the daily diet of Iranians. In order to promote adolescents’ health and prevent the devastating effects of osteoporosis in adulthood, appropriate action should be taken to increase milk consumption among adolescents. The objective of this study was to increase milk and dairy products consumption among eighth-grade girl-pupils in Kamyaran City, Iran through designing and implementing an educational program based on the theory of planned behavior (TPB).

  

  Materials and Methods : This was a quasi-experimental study conducted in 2014, including a total of 168 eighth-grade girl-pupils from two (out of six) schools, one as the intervention and the other as the control group, selected randomly by cluster sampling. The intervention group received education in 4 sessions, the educational tools being a pamphlet and a poster. Data were collected on the TPB constructs, food intake (by 24-hour dietary recall), and frequency of milk and dairy product intakes during the previous 3 days. All the participants completed the questionnaires at the beginning and 3 months after the intervention. The data were analyzed using the SPSS-18 software, the statistical tests being chi-square, independent-t and paired t-tests.

  Results : The intervention brought about statistically significant increases in the mean scores of behavior intention, attitude, subjective norms, and perceived behavioral control (p<0/001). In addition, an increase was observed in the frequency of milk and dairy product intake, which was 0.36 units per day initially (p<0/001).

  

  Conclusion : Considering the effectiveness and low cost of this intervention, expanding this program can potentially lead to a rise in milk and dairy products consumption among the pupils.

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Background and Aim: The content of the hygiene education and health promotion course in schools is crucial for raising the awareness of, and development of hygiene culture in, pupils. In this study we aimed to develop a hygiene education course with a fully suitable content.

Materials and Methods: In this research the content analysis technic using the "Shannon Entropy" method was used, in which data processing in discussing the content analysis is done with a new approach both quantitatively and qualitatively. In the information theory entropy is an index to measure the uncertainty which is expressed by a likelihood distribution. The content was investigated considering the respondents’ perspectives (all textbooks of elementary school sixth grade) and 12 main elements and 58 sub-elements related to hygiene education and health promotion.

Results: The results of content analysis based on the Shannon Entropy showed that the element of mental health with 732 items and physical activity with 735 items had the maximum frequencies, while the control and prevention of diseases with 6 items had the minimum frequency.

Conclusion: In the official textbooks some elements of health education are treated insufficiently or not at all, despite the fact that health is the most important factor in the progress of the society and a guarantee for survival. Thus, designing, implementation and management of the health component of national development plans are extremely vital.

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Background and Aim: Developing appropriate programs for community problem solving and community development and prosperity will be possible only after realistic identification of the community’s problems. Community health assessment is a process by which researchers and community members understand the health care system and community concerns through data collection and analysis, determining strengths and weaknesses and defining the community’s resources and demands. Basmenj is a town located 10 kilometer from the metropolitan City of Tabriz, Iran and on the verge of adjoining this metropolis. This paper reports results of the community assessment of this town.
Materials and Methods: This study was conducted in autumn 2017. The methodology used for community assessment was based on the eight-stage model of North Carolina. In the first seven stages the Basmenj community problems were identified and prioritized, followed, in the eighth stage, by developing an action plan for solving the problems in order of priority.
Results: Approximately 100 different problems were identified at the end of the first stage. Based on the Hanlon classification model, the top prioritized problems of the region were found to be, in that order, youth addiction, urban trashes, stray dogs, environmental pollution caused by Pars Color Company, narrowness of the main street, inner-city livestock farming, early marriage among girls, wastewater problems, youth unemployment, and high consumption and self-administration of anti-biotics.
From among these problems, the urban trashes problem was studied briefly. Factors playing a role in its causation were found to be as follows: lack of waste reduction and waste sorting programs, low citizens’ knowledge about trash gathering, absence of an appropriate urbane wastewater system, and, finally, lack of participation of citizens and the private sector in trash gathering and burying
Conclusion: A wide range of social, cultural and economic problems was identified.  The top priority was found to be focusing on problems related to urban trashes. However, it should be noted that solving all the community problems identified requires the co-operation and support of all the governmental organizations, as well as involvement of the community at large.

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Background and Aim: The promotion of the health of the members of a society is based on the assessment of the situation of that society. This study was conducted in the Soufian district of Shabestar city with the aim of identifying and prioritizing its problems and needs with the direct participation of the people.
Materials and Methods: This was a cross-sectional study conducted in the Sufian District of Shabestar city in 2019, the methodology used being based the 8-phases model of North Carolina. The community health assessment was performed in 8 phases. The first seven phases included identifying and prioritizing the problems of the District, and the eighth was developing operational plans to solve its priority problems.
Results: A total of 23 different problems were identified. Prioritizing the problems according to the Hanlon method showed the ten main and priority problems to be, in a descending order, as follows: marriage of girls at an early age (21.01), excessive use of chemical fertilizers in farmlands (20.89), lack of social security clinics (20.51), unemployment (20.38), severe air pollution caused by incineration of industrial waste (20.01), accumulation of municipal waste in the city (19.89), high hardness of city water (19.76), lack of property deeds (19.63), lack of a specific unit in the industrial town to separate waste (19.38), and lack of a gas supply to Mehr Housing and lack of asphalted roads (19.28). Marriage of girls at an early age was identified as the main problem and with the first priority, and a general preliminary study was done on it; it was found that in about 43% of all marriages registered between 2014 and the first half of 2021 the ages of girls were under 18 years. Factors causing and increasing marriage of girls at an early age were identified to be as follows: low awareness of girls' families and girls themselves of the consequences of early marriage, social acceptance of early marriage in the area and low parental literacy.
Conclusion: In this study a wide range of social, cultural, economic and health problems were identified in the population studied. Marriage of girls at an early age is an important social problem with serious undesirable consequences. In an attempt to solve this problem it is essential to consider, in addition to legal and legislative strategies and actions, appropriate scientific, social, cultural and economic strategies and applied research.