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Background: The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. Methods: For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. Results: The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. Conclusion: The INBPMC was successful and accomplished its objectives.

Background: The relationship between strong immune response to infections and trace elements such as selenium (Se) and copper (Cu) is well documented. Furthermore, Se and Cu behave as negative and positive acute phase reactants under infectious conditions, respectively. Since SARS-CoV-2 causes systemic inflammation, this study was conducted to evaluate the association of Se and Cu serum levels with symptoms and immune response to SARS-CoV-2, and then assess the Cu/Se ratio in this matter.Methods: Blood samples and nasopharyngeal swabs were obtained from 126 SARS-CoV-2 participants with mild and severe clinical symptoms. The SARS-CoV-2 infection and immune response to the virus were confirmed by RT-PCR and anti-SARS-CoV-2 IgG, respectively. The measurement of Se and Cu serum levels were analyzed by atomic absorption spectrophotometry and colorimetric assay, respectively. Finally, data were analyzed and a P-value < 0.05 was considered statistically significant.Results: The mean Se levels were higher in patients with mild symptoms (108.73 ± 5.38 μg/L, P-value = 0.0012) and IgG non-responders (110.33 ± 3.38 μg/L, P-value < 0.001), whereas, the mean Cu was higher in participants with severe symptoms (111.055 ± 11.98 μg/dL, P-value = 0.045) and IgG responders (112 ± 9.98 μg/dL, P-value = 0.0058). The Cu/Se ratio was lower (ratio < 1) in participants with no immune responses to infection and mild symptoms versus immune responder patients with severe symptoms (P-value < 0.001).Conclusion: Our results suggest that Cu/Se ratio may be considered as a nutritional biomarker of severity and immune response in SARS-CoV-2-infected patients.

Introduction Novel coronavirus spread seems mysterious enough for convincing us to double check the indices being used to predict its transmission. Serological analysis was applied for assessing some metric epidemiological aspects of the infection and its transmissibility among people who were in contact with SARA-CoV-2 patients. Methods In this contact tracing prospective cohort study, 453 contact cases of forty COVID 19 patients were followed for three months. SARS-CoV-2 patients were diagnosed by real time polymerase chain reaction testing of nasopharyngeal samples. The history of infectiousness was detected by serological testing of IgG and IgM. Trained expert team completed two questionnaires and blood samples were taken by experts in laboratory. Data were analyzed using SPSS (Ver.21) and R software. Some important epidemiological characteristics of the infection were calculated. Results Mean age of SARS-CoV-2 patients and contact cases were 53.0±18.2 and 30.8±19.3 years, respectively. Overall R0 of the infection was 2.56. Household and non-household secondary attack rates (SAR) were 20% (95%CI; 12.7 – 27.3) and 11.3% (95%CI; 6.1-16.5), respectively. Transmission probability in each contact was 0.0205 and the serial interval was 6.4±4.6 (95% CI; 5.2–7.6) days. SAR among contact cases who exposed asymptomatic primary cases (28%, 95%CI; 10-46%) was higher than that (13.8%, 95%CI;9.4-18.2) among contact cases exposing to symptomatic patients. Conclusions We concluded a herd immunity between 60 and 65% is needed in human communities. Findings demonstrated how much reduction in infection R0 is predicted based on both clinical and public health interventions.

Background Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. Methods A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. Results Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. Conclusion A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

Owning the largest human-made jungle of pistachio, the second largest copper mine, and being located on the trade route of opium transit, distinguish Rafsanjan from many other cities in Iran. The environmental exposures and lifestyle factors associated with these characteristics of Rafsanjan, have raised concern about possible health outcomes for individuals living in and around this city. Thus, local health authorities initiated the Rafsanjan Cohort Study (RCS), as part of the prospective epidemiological research studies in IrAN (PERSIAN). RCS is a population-based prospective cohort of men and women aged 35–70 years, launched in August 2015. Individuals from diverse socioeconomic levels and lifestyles were recruited from four urban and suburban areas of Rafsanjan (participation rate 67.42%). Questionnaire-based interviews regarding demographics, dietary and environmental exposures, medical and occupational history, as well as anthropometric measurements were completed for all participants. Additionally, bio-specimens (blood, urine, hair, and nail) were collected, and dental and eye examinations were performed. The enrollment phase ended in December 2017, and a 15-year follow-up is planned. A total of 9990 individuals were enrolled in RCS (53.41% females). About 26% of men are pistachio farmers. The baseline prevalence of major non-communicable disease (NCD) risk factors such as cigarette smoking, alcohol consumption and opium use were 25.45%, 10.02%, and 23.81%, respectively. The mean ± SD of other common risk factors are as follows: body mass index (27.83 ± 4.89 mm Hg), systolic blood pressure (107.18 ± 17.56 mm Hg) diastolic blood pressure (71.13 ± 10.83), fasting blood sugar (113.27 ± 39.11 mg/dL) and plasma cholesterol (198.78 ± 41.89 mg/dL). These results indicate a concerning prevalence of NCD risk factors in Rafsanjan city, warranting further detailed investigations, particularly regarding the association of NDC with agricultural/industrial pollutants and drug abuse.

Background: In Iran, cancer kills 30,000 people, annually. The epidemiology of cancer is gradually changing as a result of the demographic and epidemiological transition in Iran. This study aimed at presenting a geographical distribution of cancer mortality in Southeast area of Iran, and comparing proportional mortality and age-adjusted mortality rates. Methods: The present study was a descriptive study that was performed on mortality data recorded in the Center for Statistics Management of Health Ministry at Kerman and Rafsanjan Universities of Medical Sciences in the period 2012-2016. This information was used to determine the age-standardized mortality rate per 100,000 people and proportional mortality for each district in Kerman Province. Results: The proportional mortality for all cancers in Kerman and Rafsanjan Universities were 11.54% and 18%, respectively. Standardized mortality rates for all cancers in males in Kerman and Rafsanjan universities were also 81.9 and 81.3 per 100,000, respectively, while for females, it was 57.3 and 51.6 per 100,000 people, respectively. Conclusion: Our results presented a general picture of the mortality due to cancer in one of the widest provinces of the country with more than 1.5 million habitants .Standardized mortality rates for all cancers in males and females in Rafsanjan universities was lower than Kerman. In spite of higher proportional mortality in Rafsanjan, the rate of death by cancer in Rafsanjan was lower than Kerman.

Background: Gastrointestinal cancers are among the most common cancers in different communities. Gastrointestinal tract cancer is the most common cancer among Iranian men and the second common cancer among Iranian women. Due to the impact of environmental factors on the risk of gastrointestinal cancer and the increasing use of agricultural pesticides, this study aimed to investigate the effects of exposure to pesticides on gastrointestinal cancer among pistachio farmers, Rafsanjan, Iran Materials and Methods: In this case-control study, 79 patients with gastrointestinal cancer (cases) and 143 healthy people (controls) were studied. For each case, two people were selected as controls for each case from their neighbors and relatives. Data were collected using the study checklist which included demographic information and specific items related to their exposure. Data were analyzed using independent t-test, chi-square test, Fishers exact test, and logistic regression. Results: The risk of gastrointestinal cancer after controlling some confounding factors among individuals who were exposed to spraying pesticides for less than 10 days per year was 1.38 (CI: 0.70-2.71), and in individuals who were exposed to it for between 10 to 20 days per year was 1.71 (CI: 0.79-3.7). The difference was not statistically significant . However, for individuals who had this exposure for more than 20 days per year, the risk was increased to 8.53 (CI: 2.1-34.7) which was statistically significant (P = 0.004). Unexpected exposure to agricultural pesticides and living close to pistachio gardens, both significantly (P less-than 0.05) increased the risk of gastrointestinal cancers by 8.67 (CI: 1-75.71) and 2.7 (CI: 1.43-5.1), respectively. Among subjects who used protective equipment, the risk of gastrointestinal cancer was statistically lower (OR = 0.18, 95%CI: 0.042-0.85) than this risk among people who did not use this equipment (P = 0.03). Conclusions: Our findings showed that exposure to pesticides, in particular for long time, increased the risk of gastrointestinal cancer among pistachio farmers. Further studies in this area are recommended.

Introduction: In recent years non-communicable diseases (NCDs) risk factors such as tobacco consumption and high blood pressure (BP) have been increased. This study aimed to determine the frequency of risk factors of the main NCDs among inhabitants of Rafsanjan city. Methods: Our study is a part of NCD surveillance in Iran (SuRF NCD). A total of 640 people enrolled and divided in four age groups in urban and rural areas in Rafsanjan (a city in Kerman province). Data were collected using the standardized stepwise protocol for NCD risk factor surveillance of the World Health Organization (WHO). This study focused on hypertension (HTN) and smoking. Results: A total of 640 people (46.9% male and 53.1% female) participated in this cross-sectional study. The prevalence of HTN was 198 per 1000 population. 4.8% of those were below the age of 44, and 15% between 45 and 70 years old. Mean systolic BP was 127 ± 15.6 in male and 118 ± 19.65 in female and the statistical difference was significant (t = 5.55, P

Received: May 2012, Accepted: September 2012 Background : The majoritiy of abortion risk factors has been classified as environmental and vary from one place to another. This study aimed to explore the relationship between exposure to pesticides and spontaneous abortion among female pistachio farmers in Rafsanjan, Iran. Materials and Methods : In this case-control study, 50 women with spontaneous abortion and 50 women without this history who were matched based on some factors were recruited. Cases and controls were recruited through the list of all pregnant women who were registered in the rural health centers of the county. A written consent form was taken. Dependent and independent variables were experiencing spontaneous abortion and had been exposed to pistachio farms pesticides, respectively. Data were analyzed using descriptive statistics. Odds ratio was also calculated to measure the level of risk for spontaneous abortion after exposing to pistachio pesticides and 95% confidence interval was reported. Results : About 72% and 22% of mothers with and without spontaneous abortion had experienced working in pistachio farms during their pregnancy, respectively. There was a significant level of risk for mothers who had worked in pistachio farms (during their pregnancy) to experience spontaneous abortion compared to those mothers who did not (Odds Ratio= 9.1, 95%CI=3.7-22.6). Odds ratio showed an increasing risk of spontaneous abortion among those who helped with spraying pesticides in pistachio farms compared to those mothers who did not (OR= 9.3, 95%CI=2.0-43.7). Conclusion: Exposure to pesticides has been a major risk for causing spontaneous abortion among pregnant pistachio farmers in the area of this research. Further investigations are recommended.

BACKGROUND Vitamin D is essential for maintiiining bone health and growth throughout life. Vitamin D deficiency not only leads to bone metabolic diseases in children and adults but may increase the risk of many chronic diseases. The aim of this study was to evaluate the prevalence of vitamin D deficiency and its relation with vitamin D receptor (VDR) gene polymorphism. In addition the study included the evaluation of known risk factors and their correlation to the vitamin D status among girls aged 11 - 17 years in Rafsanjan during the winter of 2009. METHODS In a cross-sectional study, 250 healthy female students (age range, 11 - 17 years) were selected by random sampling method. Fasting blood samples were collected and the concentration of serum 25 (OH) vitamin D3, PTH, ionized Ca, P, ALP, and VDR gene polymorphism (exon 9) were evaluated. Values of 20 nmol/L were considered severe, 20.1 - 37.5 nmol/L moderate, 37.6 - 50 nmol/L mild deficiency, and 25 (OH) vitamin D3 levels higher than 50 nmol/L were considered normal. RESULTS The results showed 59.6% of students suffered from vitamin D deficiency (14.4% severe, 24.4% moderate, and 20.8% mild deficiency). There was a significant relationship between serum levels of vitamin D with ionized Ca, PTH, ALP, type of clothing, and egg consumption, while no significant relationship was found between serum levels of vitamin D with age, residency, menstruation status, skin color, sun light exposure, body mass index, waist to hip ratio, exercise, physical activity, fish consumption, and polymorphisms in exon 9 of VDR gene. CONCLUSIONS This study indicated a high prevalence of vitamin D deficiency in female students in a sunny city, Rafsanjan in winter. Low sun light exposure, coverage especially veil, and low intake vitamin D are important factors in vitamin D deficiency in studied subjects.