Journal of School of Public Health and

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Background and Aim: Designing, presenting and implementing a model for assessing work-related risk factors for musculoskeletal disorders and subjective pain, using a combination of Quick Exposure Check (QEC) and the Body Mapping Questionnaire in Babol city in 1382. Nowadays, Work-Related (WMSDs) are considered to be the most common occupational disorders in Iran. Because of their debilitating potential, it is necessary to find a quick, user-friendly and valid technique to assess risk factors for WMSDs in this country. The city of Babol has a larger number of industrial centers in comparison with other cities in Mazandaran province. Therefore, it is surprising that there are virtually no reports of WMSD cases in the city. There is a need for a tool capable of showing the real number of cases and evaluate WMSDs in the city.
Material and Methods: It is hoped that the Quick Exposure Check and the Body Mapping Questionnaire, when used in combination, will constitute a highly effective tool for the detection and prevention of a wide range of work-related musculoskeletal disorders. In this survey we try to show the utility and usability of a designed job assessing combination model in a factory in Babol city with at least three results.
Results: 1) We show that not only the number of WMSD cases in the city is not zero, but that there is indeed a substantial amount of disease among industrial workers. 2) According to these findings and other subjective findings of pain, it is urgent to determine the severity of the problem and to recommend appropriate ergonomic interventions (according to QEC’s action level score) accompanied by Body mapping Questionnaire as soon as possible. 3) Considering the significant correlation between QEC action level and subjective findings of pain in the Body Mapping Questionnaire, (Spearman’s rho > 0.5), the model is very useful in periodic examination of workers in factories.
Conclusion: We hope that this highly valid model (QEC/Body mapping) will prove useful in improving the health and thus the quality of the current workforce in the country.

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Background and Aim: Infectious complications after renal transplantation are associated with significant morbidity and mortality. We evaluated post-transplant complications due to infections and their relationship with graft function, immunosuppressive drugs and mortality.
Materials and Methods: Over a 2-year period (2002-2004), 179 renal transplantations were performed in our center. Of these, 142 cases were followed for a period of one year. The immunosuppressive regimen included cyclosporin A, mycophenolate mofetil and prednisolone. Each patient was assessed through regular visits and according to the ward protocol. Results of the investigations (infections and their relationship with age, sex, donor type, creatinine level, acute rejection, immunosuppressive drugs, graft and patient survival) were recorded and analyzed.
Results: The overall incidence of infection was 54%. The most common sites were lower urinary tract (42%) and respiratory tract (6%). The most frequent causes were Klebsiella (24%) and Cytomegalovirus (18%). Wound infection occurred in 5% of the patients. The overall mortality was 7.7%, and almost half of the death cases (3.5%) involved sepsis development. Graft loss occurred in 16 (11%) of the cases: 2 developed Cytomegalovirus infection, 2 experienced urinary tract infection (UTI) and 5 developed sepsis (and expired). Mycobacterial and hepatitis C infections were noticeably low compared to other studies. The hazard rate in occurrence of UTI, CMV, acute rejection and mortality were higher in cadaveric transplant recipients than in others.
Conclusion: This study identifies infections as a major cause of morbidity and mortality in the post-transplant period. Patients having higher creatinine levels and those receiving high doses of drugs at discharge are considered to be at high risk and should be evaluated thoroughly.

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Background and Aim: At the outset of the third millennium, vitamin D deficiency is still a common and serious health problem among women of reproductive age and their infants in developing countries. Precise information on the vitamin D status of urban lactating women in Islamabad -Gharb is not available. But it seems that, like in other areas of Iran, vitamin D deficiency may be common in this region. The aim of this study was to determine the vitamin D status in urban lactating women and its association with the following variables: number of pregnancies, total duration of lactation, length of exposure to sunlight, and literacy.
Materials and Methods: Using a simple random sampling technique, a total of 155 lactating women with children under the age of 1 year were selected from 8 urban health clinics. In the interview, the subjects answered questions on the above-mentioned independent variables and fasting blood samples were taken for analysis. The concentration of 25-hydroxyvitamin D in serum was measured by a chemiluminescence method. Normal status was defined as concentration of 25-Hydroxyvitamin D serum ≥ 10 ng/ml, moderate deficiency as concentration ≥ 6ng/ml and <10 ng/ml, and severe vitamin D deficiency as concentration of 25-Hydroxyvitamin D < 6 ng/ml.
Results: The results indicate that only 8.4% of women were normal, 18.7% had moderate deficiency, and 72.9% had severe vitamin D deficiency. The vitamin D status had a statistically significantly negative association with the number of pregnancies and the total duration of lactation.
Conclusion: The vitamin D status of urban lactating women is very poor and needs immediate attention.

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Background and Aim: Lack of quantitative and qualitative data on the current status and the possible adverse effect of poor illumination necessitate the evaluation of the illumination system in the industrial section. To perform quantitative and qualitative assessments of illumination conditions in factories located in the west of Tehran and to look at the adverse consequences of insufficient illumination.
Materials and Methods: Data were collected through objective measurements and interviews with 616 factory workers. We used a structured questionnaire for data collection.
Results: Out of the total number of work sites inspected, 19.8% sufficient illumination, 46.1% had moderate illumination, and 29.7% work sites had illumination levels considered to be inadequate for precise tasks. Among those who worked in places with moderate illumination, 56.7% belonged to the 16-20 years age group 86.7% of individuals within this age group had to perform very precise tasks. Besides, 46.4% of the female workers and 45.7% of the males worked in places with moderate illumination .Work site observations and interviews revealed that those working under moderate and insufficient light commonly inhaled hazardous fumes and suffered from headaches and glare.
Conclusion: Factory work entails a variety of visual tasks. Besides creating a pleasant working environment, illumination of the workplace should provide sufficient amounts of light, visibility, luminance and contrast.

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Background and Aim: To describe the trends in research articles in the field of mental health.
Materials and Methods: The articles that we reviewed belonged to the fields of psychiatry, psychology, and neuroscience. We limited the search to the literature published over the 30-year period from 1973 to 2002. The following types of data were extracted: areas of research, specific topics, study design, location for data collection, funding sources, and the different types of working relationship among the authors.
Results: Analysis of publication trends in 3031 articles showed a marked increase in the total number of publications with time, especially over the last 5 years. As for different research areas, we detected a growing proportion of articles in the field of neuroscience and a decline in articles dealing with mental health. The volume of research in the fields of psychology, epidemiology and clinical sciences remained relatively constant. There was a rise in the proportion of cross-sectional studies and clinical trials in the second half of the 30-year period.
Conclusion: It is important to find the reasons and implications for the waning interest in mental health. Our results could provide an empirical basis in policy making and strategic planning for research in this area

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Background and Aim: In breach of all international conventions, Iraq frequently used chemical weapons against both military and civilian targets in its 8-year war with Iran. The most frequently used agent was sulfur mustard. The effects of mustard gas may be divided into early and late categories. Late lesions, due to the agent's mutagenic and carcinogenic potential, are mainly the results of its action on intracellular particles, probably nucleic acids. Although the occurrence of cancer has been proved following long-term exposure, the presence of a carcinogenic effect in acute, short-term contact is still in doubt.
Materials and Methods: To determine the relationship between cancer and acute exposure to mustard gas, a historical cohort study was carried out in Isfahan province, involving 500 chemically-injured soldiers with at least one episode of exposure to mustard gas. The incidence of cancer and the death rates in these subjects were compared with similar rates from i) 500 unexposed soldiers in the same area and ii) nationwide figures.
Results: All the subjects were male. The mean age in the exposed and unexposed groups were 41(±10.8), and 40(±7.6) years respectively. Within the exposed group, the mean age at first exposure was 24.1(±13) years the mean age at first injury in the unexposed group was 23(±11) years. Eighty-one percent of the cases lived in cities and 19% in rural areas. For 395 persons (84.5%) in the exposed group, education was at high school level or below. Within the same group, 481 subjects (96.2%) were married. Sixty-three people (12.6%) were servicemen and 366 (73.2%) had civilian jobs. Three cases of cancer were observed in those exposed to mustard gas. No cases occurred in the unexposed group. Ten people in exposed group and 7 in the unexposed group were dead at the time of the study. Relative risks for cancer and death were estimated at 4.02 (CI 95% = 0.45-36.1) and 1.44 (CI 95% = 0.54-3.81) respectively.
Conclusion: The results failed to show a statistically significant relationship between cancer incidence and acute exposure to sulfur mustard.

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Background and Aim: With growing emphasis on cost containment, optimal use of resources and increased productivity, the health sector is now adopting an increasingly customer-oriented approach within its administrative and managerial structure. One way to assess hospital performance and service quality would be to measure the level of satisfaction in hospital inpatients, as this group comprises the principal users of medical services within any health care system.
Materials and Methods: In this descriptive-analytic study we explored the factors affecting patient satisfaction. Our sample consisted of 400 randomly-selected inpatients who answered the research questionnaire at the time of discharge. We used univariate statistical analysis to examine the effects of various factors on patient satisfaction. 
Results: Of a total of 13 variables that were analyzed, 9 showed a statistically significant relationship with the outcome variable. These were age, education, marital status, occupation, hospital where interview is performed, hospital type (specialized versus general), type of ward, costs borne by the patient, and system of payment.  
Conclusion: The strongest effects were observed for marital status, education, hospital type, type of ward, and cost borne by the patient. Results from this study could help to recognize the current flaws within the hospital management system and thus can aid decisions aimed at optimizing hospital services and maximizing patient satisfaction.

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Background and Aim: Pap smear test is considered the best screening method for cervical disease, especially for malignant lesions. The crucial factor here is obtaining high-quality samples, as poorly-prepared ones cause a great deal of confusion for patients and physicians alike. Attempts to define an ideal sampling technique have been going on for many years, and in this study we compare three different sampling methods to determine which one provides the best quality.
Materials and Methods: This interventional study was performed in a private obstetrics-gynecology clinic and involved 600 women who met the criteria for cervical screening. The Pap test was done by three different methods: "Swab spatula", "Cytobrush – spatula" and "Spatula only".
Results: Each method was performed on 200 randomly-selected patients. Cytopathologic examination was done by a single pathologist and in a blind fashion. For each specimen, a quality rating was reported as "satisfactory" or "unsatisfactory". Among the 200 samples obtained by the "Swabspatula” method, 150 (75%) were of satisfactory quality and the remaining 50 cases (25%) were rated as unsatisfactory. As for the cytobrush–spatula group, 88 samples (94%) were satisfactory and 12 (6%) were unsatisfactory. Finally, 179 samples (88%) in “Spatula-only” group were satisfactory and 24 (12%) were unsatisfactory. The difference in the proportion of good-quality samples was significant in pairwise comparisons between the three methods: swab-spatula versus spatula-only (P = 0.0013), swab-spatula versus cytobrush-spatula (P = 0.0001) and cytobrush-spatula versus spatula-only (P = 0.036).
Conclusion: The study revealed that the cytobrush-spatula sampling method yielded the highest proportion of high-quality samples. Hence, it would be desirable to familiarize physicians, midwives and other health care workers in this country with the technique of cytobrush cervical sampling and its potential advantages. However, financial and cultural aspects must be taken into account before adopting the procedure for routine cervical screening in Iran.

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Background and Aim: One of the most important responsibilities of managers is leadership. Leadership styles are the constant behavioral models used by managers when working with others in organizations. The main purpose in this research was gaining an insight into the leadership styles of hospital managers (manager and chief) and to see if there is relationship between managers and employers' personality traits and the style of leadership adopted by the hospital manager.
Materials and Methods: This was a cross-sectional study involving all the hospital managers and 385 hospital staff in the province of Qom. We gathered data through a questionnaire based on the Likert system. We thus recognized four different styles of leadership: Exploitive-Authoritative, Benevolent – Authoritative, Consultative, and Participative. Data were analyzed using the SPSS software package.
Results: 1-Overall, the managers’ leadership styles were found to be mostly of the consultative type but the staff regarded their managers’ style of leadership as mainly Benevolent – Authoritative, 2- There was no statistically significant relationship between the managers’ personal characteristics and their leadership styles, 3- There is a significant association between the staff members’ characteristics and their perception of the manager’s leadership styles.
Conclusion: The managers’ personal traits do not appear to have an effect on their leadership styles but the same traits in employees can have a bearing on how they perceive leadership in their managers.

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Background and Aim: Cholera is one of the most important endemic and epidemic diseases in our country. Therefore, keeping track of the changes in antibiotic resistance patterns and continuous genotyping and serotyping of the isolates is essential.
Materials and Methods: One hundred stool samples were collected from the patients with cholera in different cities, including Tehran, Kashan, Kermanshah and Ahwaz. The specimens were subjected to a series of diagnostic tests. Strains were identified by serotyping and their antibiotic resistance profiles were defined through susceptibility tests. We also used a polymerase chain reaction (PCR) assay to identify the hly A gene.
Results: Group-specific antisera were used for identification of Ogawa, Inaba, Hikojima and NAG (Non-agglutinable ) strains, which constituted 74% , 3% , 0% and 23% of the isolated strains respectively. Antibiotic susceptibility tests showed that all the strains were sensitive to ciprofloxacin, gentamicin and doxycyclin, but there was widespread resistance to Co-trimoxazol (74%), erythromycin (64%) and tetracycline (53%). Vibrio cholerae El tor isolates were 100% positive for hly A gene amplification, but hemolytic activity was seen in 95% of the cases on blood agar.
Conclusion: Compared to previous studies, there appears to be a higher degree of resistance to tetracycline, hence there may be a need to switch to other agents for the treatment of cholera. The predominant serotype and the antibiotic resistance pattern in Kashan were different from those seen in other cities.

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Background and Aim: There is a close relationship between working posture and workstation design so that the postural problems appear to be largely caused by improperly designed workstation. There can be no more fundamental aspect of occupational ergonomics than the concern with the design of the workstation. There is general agreement that health, well-being and productivity of workers are strongly dependent on the success of workstation design. In ergonomic design of workstation, different factors should be taken into consideration, above all posture determinant factors. Regarding this, factorial design is a very useful methodology for identifying posture determinant factors. By this methodology, workstation variables which affect working posture can be identified. Then, optimum values of these variables are determined for working posture improvement. By this means, workstation design guidelines can be developed. In this paper, which has been prepared with the aim of introducing factorial design in ergonomic studies, an example of factorial design application in developing workstation design guidelines for weaving operation is presented.
Materials and Methods: In a factorial design of 3×3, nine sets of experimental conditions were tested. The nine sets of experimental conditions consisted of different combinations of seats and weaving heights. Thirty professional weavers participated in the experiments and performed their normal weaving task in 9 experimental sessions. The effects of weaving height and seat type on postural variables were tested by Analysis of Variance (ANOVA) for Repeated Measures.
Results: The results obtained in the nine settings were compared and the setting in which optimum working posture adapted was determined. Based on the results, weaving workstation guidelines were developed.
Conclusion: It is believed that the recommended workstation improves working posture and results in reduced postural stress on weavers’ bodies and, consequently, reduced prevalence of MSDs symptoms.

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Background and Aim: The purpose of this study was the assessment of inappropriate admissions and hospital stays and reasons for this in the hospitals affiliated to Tehran university of Medical Sciences.
Materials and Methods: We used the Appropriateness Evaluation Protocol (AEP) to evaluate the appropriateness of 258 admissions to Dr. Shariati and Imam Khomeini hospitals and 1732 days of hospital stay for the same patients. Findings indicate that on the whole, 22.8% of admissions were inappropriate and the length of stay for patients who were inappropriately admitted was significantly shorter than for those whose admission was judged to be appropriate.
Results: Results show that 8.6% of the total number of patient stay days were unnecessary the figures differ significantly between the two hospitals. The most frequent reason for inappropriate hospital stay was the delay in the discharge process .Consultations and delay in surgical operations were other causes of inappropriate patient stay.
Conclusion: A substantial proportion of hospital admissions and stays were found to be inappropriate due to hospital procedures and inadequacies in the lower levels of healthcare. Efficient use of hospital resources should be promoted by modifying procedures, improving the performance of the healthcare system and revising insurance policies.

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Background and Aim: In 1991, the world health organization initiated a project to simultaneously develop an instrument for measuring quality of life in 15 countries. The study yielded two questionnaires, namely WHOQOL-100 and WHOQOL-BREF. These were intended as generic QOL measurement tools to be used in a broad range of diseases, for different degrees of disease severity, and in various cultural subgroups. The objective of the current study was to evaluate the Iranian version of the WHOQOL-BREF. This 26-item instrument comprises four domains: Physical Health, Psychological, Social Relationship, Environment and the overall QOL/health.
Material and Methods: We administered the questionnaire to 1167 adults in Tehran. The stratified sample consisted of 476 diseased subjects and 700 healthy ones. We tested the instrument's reliability (internal consistency, test-retest), discriminant validity and factorial structure.
Results: The participants had an age mean of 36.3 years (SD = 13.2) and had an average 11.5 years of education. Using Cronbach's α and intraclass correlation, all domains met the minimum reliability standards, with the exception of social relationship domain (α = 0.55). The latter could be attributed the small number of questions in this domain and the sensitive nature of the questions themselves. Since 83% of the questions show maximum correlation with their original domain, the factorial structure of the questionnaire was regarded as acceptable. The questionnaire has the ability to discriminate different groups after adjustment for confounding factors in regression analysis.
Conclusion: This study demonstrated good to excellent reliability and acceptable validity in various groups of subjects in Iran. The instrument may be used in future studies, albeit with minor modifications in the domain of social relations, as determined by expert opinion.

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Background and Aim: Nowadays, community health and different methods for health service delivery are among the most important public health issues in many countries. Most developing nations are trying to establish a health care system capable of meeting their basic needs.Hospitals are the most important service delivery points, and they need skilled manpower and adequate equipment for efficient performance of their medical care and educational functions. Today, the health of the mankind is facing greater hazards and challenges than at any other time in history, and within this context, hospitals are supposed to provide service of the highest standards and with minimum delay. Emergency wards are the sections where these principles apply more than anywhere else. These are rightly regarded as the "heart" of any hospital and a quick, efficient workflow in the emergency room can literally save lives.
Material and Methods: This was a cross–sectional (descriptive/analytic) performed in 2005 to assess the structure, process & performance in the emergency wards of 12 teaching hospitals affiliated to Tehran University of Medical Sciences.
Results: 33.3% of the ward chiefs were women the rest were men they were all more than 30 years of age. The average rate for implementing proper managerial standards was 90.6%. The "manpower index" was 69.1%, and the "facilities & equipment" index was 44/5%. The "directions index" and "activities index" were 66.97% and 93.5%, respectively.
Conclusion: The findings show that there is a positive and significant relationship between standards of management at the emergency department and the facilities and equipment index. Also, there are positive correlations between the emergency department's "manpower and rules" index instructions, activities, and years of service in hospitals.

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Background and aim: The chromium mist generator is an essential tool for research and for making evidence-based recommendations in evaluating air pollution and its control systems. The purpose of this study was to design and construct a homogeneous chromium mist generator and to look at the effects of factors such as sampling height and distance between samplers in side-by-side sampling on the chromium mist sampling method.
Material and Methods: First we developed a mist generator, using a chromium electroplating bath in pilot scale. Concentrations of CrO3 and sulfuric acid in plating solution were 125 g L-1 and 1.25 g L-1, respectively. To set up permanent air sampling locations, a Plexiglas cylindrical chamber (75 cm height, 55 cm i.d) was installed as the bath overhead. Sixty holes were made on the chamber in 3 rows (20 in each row). The distance between rows and holes was 15 and 7.5 cm, respectively. Homogeneity and the related factors were studied using a side-by-side air sampling method. Forty-eight clusters of samples were collected on polyvinyl chloride (PVC) filters contained in sampling closed-face cassettes. Cassettes were located 35, 50, and 65 cm above the solution surface with < 7.5 and/or 7.5-15 cm distance between heads. All samples were analyzed by the NIOSH method 7600.
Results: ANOVA tests showed no significant differences between locations in side-by-side sampling (P=0.82) or between different sampling heights or sampler distances (P=0.86 and 0.86, respectively). However, there were notable differences between means of coefficients of variation (CV) in various heights and distances.
Conclusion: We conclude that the most chromium mist homogeneity could be obtained at a height of 50 cm from the bath solution surface and with a distance of < 7.5 cm between samplers.

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Backgroun and Aim: Differential diagnosis of Entamoeba histolytica and Entamoeba dispar is important in clinical and epidemiological studies. The two organisms are morphologically identical but they differ in their genetics, biochemistry, and pathogenicity. The present study was carried out with the aim of distinguishing the two species and determining the prevalence of each organism in the rural areas of Ahwaz and Hamidieh.
Material and Methods: A total of 782 stool specimens were randomly collected and examined by formalin-ether concentration and direct methods. Twenty-one isolates of E. histolytica/ E. dispar were successfully cultured on Robinson's medium. DNA was extracted by the phenol/chloroform method and identified by PCR-RFLP after digestion with HinfI.
Results: Over 75% of the individuals were infected with at least one of the intestinal parasites. Entamoeba coli infection rates were very high (51.9%) among the population, while only 0.76% of individuals were positive for Dientamoeba fragilis. Sixty-five individual (8/3%) were infected with E. histolytica /E. dispar. The PCR-RFLP showed that 19 samples (90.48%) were positive for E. dispar one sample (4.76%) was positive for E. histolytica and another sample (4.76%) showed mixed infection.
Conclusion: These findings show that the nonpathogenic E. dispar is predominant in Ahwaz and Hamidieh rural area.

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Background and Aim: Visceral leishmaniasis (kala-azar), the most dangerous form of leishmaniasis, is endemic in some parts of Iran, e.g. Ardabil, Fars, East Azerbaijan, Bushehr and Qom provinces. In recent years, the incidence of VL has increased in the Nourabad-Mamassani district in Fars Province. This study was carried out to detect VL vectors and infection rates in this region over the 2003-2004 period.
Material and Methods: Sand flies were captured in the selected villages by means of sticky traps, aspirators and CDC miniature light traps. Heads and distal abdominal segments were used for species identification and other body parts were used for DNA extraction. We employed a semi-nested PCR technique to detect Leishmania, with specific kDNA primers (LIN R4 - LIN 17 – LIN19). Some specimens were dissected for leptomonad infection.
Results: A total of 12688 sand flies were collected. Phlebotomus (Paraphlebotomus) alexandri was the second most prevalent species (17.34%). The anthropophilic index of this species was 32.5%. Five cases (4.17%) of L. infantum infection were detected among the 120 P. alexandri examined by PCR method. We also observed two cases of leptomonad infection among the 112 dissected specimens.
Conclusion: High prevalence rates and anthropophilic index of P. alexandri plus its natural infection with L. infantum provide enough evidence to implicate this species as the main vector species of VL in the region and the second proven kala-azar vector in Iran. Besides, the Mahoor-Milaty district of Noorabad-Mamassani was identified as a new endemic focus.

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Background and Aim: Yersinia is an important water- and food-borne bacterium causing gastroenteritis in humans.
Material and Methods: From December 2002 to July 2003, a total of 250 samples -including 158 meat samples and 92 chicken samples- were taken from butcheries and poultry shops operating under the supervision of Tehran University of Medical Sciences. We used a two-step enrichment procedure: phosphate buffer saline was used as primary enrichment within 3 weeks in refrigerator (cold enrichment). Then we applied KOH treatment as secondary enrichment and performed cultures on CIN agar.
Results: In this study, 44.4% of all samples showed Yersinia contamination. The prevalence of Yersinia was 29.1% in meat and 70.7% in poultry. Of the 155 Yersinia isolates, 53 (34.2%) were identified as Y. enterocolitica, 47(30.3%) as Y. intermedia, 42 (27%) as Y. fredriksenii and one (0,6%) as Y. kristensenii. Biotyping of Y. enterocolitica showed that 51 strains (39.7%) corresponded to biotype 1A, 13 strains (24.6%) to biotype 1B, one (1.8%) to biotype 2, three (5,7%) to biotype 3 and one (1.8%) to biotype 4. Fourteen strains (26.4%) could not be classified.
Conclusion: The high prevalence rates in meat and poultry implies that these products could be widely contaminated with Yersinia, thus serving as important vehicles for transmission to humans.

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Background and Aim: Human herpes virus 8 (HHV-8), also known as Kaposi sarcoma-associated herpes virus, is believed to be the infectious trigger for Kaposi sarcoma. HHV-8 transmission takes place via different routes such as saliva, sexual intercourse, mucosal contact and possibly blood transfusion. The objective of this study was to determine HHV-8 seroprevalence in otherwise healthy blood donors as immunocompetent hosts, in HIV positive individuals (immunocompromised hosts), and in hemodialysis patients as multi-transfused patients. This is the first time that research of this magnitude on HHV-8 prevalence is conducted in Iran.
Material and Methods: The study method was analytic-observational. We measured HHV-8 antibody levels in 118 hemodialysis patients, 35 HIV positive subjects and 256 healthy blood donors. The primary test method was ELISA positive results were confirmed by IFA (immunofluorescence assay). Subjects with positive results on both ELISA and IFA were regarded as HHV-8 cases.
Results: Overall, 20 hemodialysis patients (16.9%), 16 HIV individuals (45.7%) and 5 blood donors (2%) had HHV-8 antibodies. Analysis with χ2 tests did not show any significant association with sex (p=0.24), blood transfusion or the number of transfused blood units (p=0.36 and 0.73, respectively). But there was positive correlation between age and the presence of antibodies (P=0.01).
Conclusion: Serologic prevalence of HHV-8 in blood donors (as apparently healthy individuals) proved to be lower than in other studies and, in some cases, equal to the figures from other countries. The high prevalence of HHV-8 antibodies in HIV positive individuals may be partly attributed to high-risk sexual behavior and repeated exposure to pathogenic agents. The higher prevalence of HHV-8 antibodies in hemodialysis patients as compared to blood donors (normal individuals) may be related to specific dialysis procedures or multiple transfusions with the resulting potential for infection.

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Background and Aim: The Razi Petrochemical Complex is one of the greatest factories producing nitrogen and phosphate fertilizers and various other chemicals. The site, comprising 17 production units with a total surface area of around 100 hectares, is located on the outskirts of Imam Khomeini port. The ammonia (1) section of the plant, with its production capacity of 1000 tons/year, was selected as the setting for this research on the feasibility of waste minimization programs.
Material and Methods: This study was conducted form October 2003 to May 2005, and it involved more than 20 visits to the site to gather data. We covered areas such as quality and quantity of liquid waste, reasons for waste generation and the production period. We also studied the current system of waste management. The materials were subsequently classified according to method proposed by the United Nations. Finally, strategies were proposed to minimize waste production.
Results: Results showed that the unit produced 305509.38 cubic meters of liquid waste annually, and water used for cooling accounted for 62.35% of the total volume. The main reasons for the production of liquid waste were problems with the production. Over 95% of the waste was produced on a permanent basis. After classification, it emerged that 18.02% of the material was dangerous. Currently, 85.65% of the liquid waste in this factory is disposed of in the surrounding environment, and 14.35% is recycled.
Conclusion: The proposed strategies for minimizing the liquid waste production materials in the factory are: recycling and re-use (95%), production process modifications (4.79%), and volume reduction (0.01%). With the use of waste minimization methods, we can avoid the dumping of huge amounts of waste into the environment, reduce the loss of raw material, and make out a strong case for the efficiency of waste minimization efforts.