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Introduction: Today the rate of human beings exposed to electromagnetic fields is increasing deliriously and human beings are being more drowned in the ocean of electromagnetic fields each day. It has been a long time that the effects of electromagnetic fields on organisms has been studied by researchers and due to the long-term researches and the slow impact of fields on life-cycle processes, in a lot of cases a final opinion is impossible. Considering the detrimental effects of being exposed to electromagnetic radiations, this study aimed to determine the relation between electromagnetic radiations and the level of Melatonin and Cortisol hormones of serum (blood) of the male employees of the 230kV substations in Golestan Province. Materials and Methods: this study has been accomplished with the cross sectional method (descriptive-analytic) on male employees of the 230 kilo-Volt substations in Golestan Province(1396). The results achieved from the serum sample of the case and control groups have been compared, and the measurements and the relation between them has been analyzed, using Spss22 software. Results: 100 % of the measured electric field intensity and magnetic flux density of the 230kV substations in Golestan Province is less than Iran’s occupational limits. There was no significant difference between the average of the level of Cortisol hormone in the case and control groups. The average of the level of Cortisol in the substation job group was not significantly different. There is no significant difference in the average of Cortisol level and age category and work place Conclusion: Electromagnetic radiations do not affect the level of Cortisol hormones of the male employees of the 230 kV substations in Golestan province and the electric and magnetic fields intensity of substations is in the occupational limits of Iran.

This study aimed to determine the trends in outpatient cataract surgery and its determinants in the Islamic Republic of Iran between 2006 and 2010. In this cross-sectional study, 106 cataract surgery centres were selected in all provinces by multistage randomized cluster sampling. The number of centres in each province was determined from the number of cataract operations and the number of patient charts examined in each centre was proportionate to the number of cataract operations in that centre. The prevalence of outpatient surgery increased from 46.0% (95% CI, 35.3-56.8) in 2006 to 51.4% (95% CI, 40.2-62.7) in 2010 (P = 0.549). Patients stayed in hospital for more than one night after 10.5% (95% CI, 6.9-14.1) of operations. Use of phacoemulsification and topical anaesthesia increased the prevalence of outpatient surgery and decreased intraoperative complications. Although outpatient cataract surgery increased by 11.7%, use of methods such as phacoemulsification is not widespread, and more attention should be paid to the barriers to outpatient cataract surgery in the Islamic Republic of Iran.الاتجاهات السائدة في جراحة الكتاركت في العيادات الخارجية في جمهورية إيران الإسلامية، 2006-2010.حسن هاشمي، أكر فتوحي، فرهاد رضوان، حميد رضا جياسي، سهيلا عسغري، سامان مهذب - ترابي، كوروش اعتاد، عباس عي يكتا، مهدي خباز خوب.هدفت هذه الدراسة إلى تحديد الاتجاهات السائدة في جراحة الكتاركت (المياه البيضاء) في العيادات الخارجية ومحدِّداتها في جمهورية إيران الإسامية بن عامي 2006 و 2010. فانتُقيتْ في هذه الدراسة المقطعية 106 مراكز لجراحة الكتاركت في جميع المحافظات عن طريق اختيار العينة العنقودي العشوائي متعدد المراحل وحُدِّد عدد من المراكز في كل محافظة من خال عدد عمليات الكتاركت، وكان عدد مخططات المرضى التي فحصت في كل مركز متناسباً مع عدد عمليات الكتاركت في ذلك المركز. لقد ازداد انتشار جراحة العيادات الخارجية من (%95 CI 35.3-56.8) %46.0% في عام 2006 إلى 51.4% (%95 CI 40.2-62.7) في عام 2010 (p = 0.549). ومكث المرضى في المستشفى أكثر من ليلة واحدة بعد %10.5 (%95 CI 6.9-14.1) من العمليات. ولقد أدى استخدام استحلاب العدسة والتخدير الموضعي إلى زيادة انتشار جراحة العيادات الخارجية وإلى التقليل من حدوث المضاعفات أثناء العملية. عى الرغم من أن جراحة الكتاركت في العيادات الخارجية ازدادت بنسبة %11.7 فإن استخدام بعض الطرق – مثل استحلاب العدسة – ليس منتراً عى نطاق واسع، وينبغي إياء المزيد من الاهتام بالعوائق التي تحول دون إجراء جراحة الكتاركت في العيادات الخارجية في جمهورية إيران الإسامية.Tendances de la chirurgie ambulatoire de la cataracte en République islamique d’Iran, 2006-2010.La présente étude avait pour objectif de déterminer les tendances de la chirurgie de la cataracte en ambulatoire et ses déterminants en République islamique d’Iran entre 2006 et 2010. Dans cette étude transversale, 106 centres de chirurgie de la cataracte ont été sélectionnés dans toutes les provinces par échantillonnage aléatoire en grappes à plusieurs degrés. Le nombre de centres dans chaque province a été déterminé sur la base du nombre d’opérations de la cataracte et le nombre de dossiers de patients examinés dans chaque centre était proportionnel au nombre de chirurgies de la cataracte pratiquées dans ce centre. La prévalence des chirurgies de la cataracte est passée de 46 % (IC à 95 %, 35,3-56,8) en 2006 à 51,4 % (IC à 95 %, 40-62,7) en 2010 (p = 0,549). Les patients sont restés plus d’une nuit à l’hôpital après 10,5 % (IC à 95 %, 6,9-14,1) des opérations. Le recours à la phaco-émulsification et l’anesthésie topique faisait augmenter la prévalence de la chirurgie ambulatoire et réduisait les complications intra-opératoires. Bien que la chirurgie de la cataracte en ambulatoire ait augmenté de 11,7 %, l’utilisation de méthodes telles que la phaco-émusification n’est pas répandue, et davantage d’attention devrait être apportée aux obstacles qui s’opposent à la chirurgie de la cataracte en ambulatoire en République islamique d’Iran.

Background and aims: Cardiovascular diseases are the main cause of mortality among men and women so that the difference in acute myocardial infarction (AMI) symptoms between men and women can affect diagnosis and time of decision making for treatment and consequently disease outcomes. Therefore, knowledge of different symptoms affects the prognosis of the disease according to the gender. This study was conducted to determine the difference in clinical manifestations of MI between men and women. Methods: In this cross-sectional, descriptive-analytical study all patients with primary diagnosis of AMI (n: 33831) in Iran in 2014-2015 were included. Data analysis was done by Stata. For descriptive data, central indices and distribution were used, and for investigation of the association among the variables, independent t-test and logistic regression were used. Results: Overall, 33831 patients were included in this study, of whom, 24532 (51.72%) were male and the rest were female. Mean age at MI incidence was 80.0 7.59 years in men and 13.66 13.0 in women. Being female increased the likelihood of dyspnea by 3.1 times, vomiting by 31.1 times, and jaw pain by 21.1 times. No significant difference was seen in left arm pain, chest pain, nausea, and sweating between men and women (P>0.05). Conclusion: Atypical symptoms, particularly in women, may cause the delay in referring the patients and also delay in decision making for diagnosis and treatment by the medical team. Hence, staff and patients of ICUs need more special information about AMI symptoms, especially with regard to gender.

Purpose. To determine the prevalence and types of intraoperative complications of cataract surgery and examine potential risk factors. Methods. Data were obtained from the 2011 Iranian Cataract Surgery Survey in which information about cataract surgeries throughout the nation was collected. In the Province of Tehran, 55 centers and 1 week per season per center were randomly selected for sampling. In each center, the charts of all patients who underwent cataract surgery during the selected weeks (total of 20 weeks per center) were reviewed for data extraction. The prevalence of different types of intraoperative cataract surgery complications were determined, and their relationships with age, sex, surgical method, surgeon, and hospitalization time were examined. Results. The prevalence of intraoperative complications of cataract surgery was 4.15 (95 confidence interval, 0.94 to 7.36). The prevalence of posterior capsular rupture with vitreous loss, posterior capsular rupture without vitreous loss, retrobulbar hemorrhage, suprachoroidal effusion/hemorrhage, intraocular lens drop, and nucleus drop was 2.86, 0.69, 0.06, 0.39, 0.03, and 0.11, respectively. The prevalence of cataract surgery complications decreased from 6.95 in 2006 to 3.07 in 2010. The results of multiple logistic regression showed that surgery by residents, nonphacoemulsification methods of surgery, and patient age less than 10 years and more than 70 years were the risk factors for complications. Conclusions. This study evaluated the prevalence of intraoperative complications of cataract surgery for the first time in Tehran Province. The prevalence of complications was high in this study. To achieve the goals of the Vision 2020 Initiative and improve surgical quality, it is necessary to minimize complication rates. Factors to note for decreasing complication rates include type of surgery, surgeon experience, and patient age. Copyright A�© 2016 American Academy of Optometry.

To determine intraoperative complications of cataract surgery over the period 2006 to 2010.In this cross-sectional study, 106 of 272 cataract surgical centers in Iran were selected through multistage random cluster sampling from all provinces. In each province, the selected number of centers was proportionate to the number of cataract surgeries, and in each center, the selected number of charts was proportionate to the center's number of cataract surgeries, from which we retrieved intraoperative complications.The prevalence of intraoperative complications of cataract surgery was 5.04% (95% confidence interval, CI, 3.53-6.54%) in 2006, which decreased significantly to 3.44% (95% CI 1.84-5.04%) in 2010. The most common complication was posterior capsular rupture/vitreous loss which decreased from 4.29% (95% CI 2.93-5.66%) in 2006 to 2.81% (95% CI 1.3-4.31%) in 2010. The next most common complication was suprachoroidal hemorrhage at 0.56% (95% CI 0.25-0.87%) in 2006 and 0.46% (95% CI 0.3-0.62%) in 2010. The least common complication concerned intraocular lens (IOL)-drop. Complications were seen most with lensectomy, while phacoemulsification caused the least complications. Mean hospitalization time in uncomplicated cases was 0.59 days (95% CI 0.58-0.61 days) and in complicated cases 1.14 days (95% CI 1.07-1.20 days; p0.001).Complications of cataract surgery in Iran had a decreasing trend during 2006-2010. However, results from 2010 indicate that cataract surgical complications still need to be focused on. Hospitalization was longer for cases with complications, and further reducing this could help decrease costs of cataract surgery.

To determine the distribution of the cataract surgical number per million population per year (CSR), the CSR in the population older than 50 years (CSR 50+) in the provinces of Iran, and their economic inequality in 2010.As part of the cross-sectional 2011 CSR survey, the provincial CSR and CSR 50+ were calculated as the total number of surgeries in major and minor centers divided by the total population and the population older than 50 years in each province. Economic inequality was determined using the average province income, the average urban and rural household incomes, and the percentage of urban and rural population in each province.Tehran and Ilam provinces had the highest and lowest CSR (12,465 vs. 359), respectively. Fars and Ilam provinces had the highest and lowest CSR 50+ (71,381 vs. 2481), respectively. Low CSR (3000) was detected in 9 provinces where 2.4 to 735.7% increase is needed to reach the minimum required. High CSR (5000) was observed in 14 provinces (45.2%) where rates were 0.6 to 59.9% higher than the global target. Cataract surgical rate increased at higher economic quintiles. Differences between the first, second, and fifth (poorest) quintiles were statistically significant. The CSR concentration index was 0.1964 (95% confidence interval, 0.0964 to 0.2964).In line with the goals of the Vision 2020 initiative to eliminate cataract blindness, more than 70% of geographic areas in Iran have achieved the minimum CSR of 3000 or more. However, a large gap still exists in less than 30% of areas, mainly attributed to the economic status.

Background Handling the growing epidemic of coronary heart disease in developing nations hinges on primary prevention, which logistically requires directing preventive interventions to those at the highest risk. Therefore, implementing cardiovascular risk assessment profiles is crucial to distinguish high risk groups who truly need extensive preventive measures. We aimed to draw a picture of the cardiovascular risk profiles in the Iranian adult population for the first time. Methods Demographic, anthropometric, and laboratory data as well as blood pressure and smoking status of 3944 subjects participating in the 2011 national surveillance of risk factors for non-communicable diseases were used to calculate the mean estimated risk of coronary artery disease and the relative frequency of low-, medium- and high-risk subjects based on FRS and SCORE indices in general population as well as different age, sex, and residence subgroups. Results The average 10-year risk of coronary artery disease (FRS) and 10-year risk of fatal coronary and cerebrovascular accidents (SCORE) in the 25 to 64 year-old population was 13.82 and 0.72 respectively. The relative frequency of the intermediate- and high- risk subjects was 25.8 and 22.6% based on FRS and 9.2 and 1.8% based on SCORE respectively. Average FRS and SCORE were significantly higher among men than women, but were not significantly different among urban and rural residents. Conclusions A significant proportion of the Iranian population, based on FRS model, will be at moderate to high risk of coronary events in the next 10 years. Urgent preventive plans are needed at the national level.

Purpose: To determine changes in cataract surgical rate (CSR) in Fars Province from 2006 to 2010 and identify the contributions of public and private sectors. Methods: This descriptive report is part of the Iranian Cataract Surgery Survey. To determine the provincial CSR, weights of major (>3000 annual surgeries) and minor (≤3000) centers were calculated based on the number of centers chosen for each year and multiplied by their numbers of surgeries. To determine public and private sectors' contributions, the numbers of surgeries in each sector were estimated based on the number of sampled centers. Results: Overall, CSR improved by 25%; the number of CS decreased by 16% in the public sector and increased by 157% in the private sector. In 2006, the public sector contributed to 69% of the CSR, and by 2010, this rate had decreased to 43%. Conclusion: The decreasing contribution of the public sector calls for studies to identify causes and remove potential barriers.

Osteoporosis is becoming a health concern worldwide. Considering the fact that prevention plays an important role in reducing the burden of this silent disease and in view of the limited resources available, many countries have adopted certain programs to fight osteoporosis through shifting their attention towards at-risk individuals. The Iranian Multicenter Osteoporosis Study (IMOS) is one of these programs. The program aims to assess bone health and the prevalence of vitamin D deficiency in different parts of Iran with various altitudes, latitudes and lifestyle habits in a way that the results could be generalized to the country.The present article presents the protocol used in the third phase of the study. It was designed based on the experiences gathered in the previous phases to overcome the shortcomings particularly subject loss. The questionnaire applied in this study was developed based on a thorough literature review of the risk factors and secondary causes of osteoporosis and was approved by an expert panel.While the majority of the existing studies aim to study a certain aspect of osteoporosis, the present protocol provides the information needed for policy makers and researchers to study different osteoporosis-related issues.The authors believe the protocol, to be implemented with small modifications, can help policymakers in different parts of the world, particularly developing countries, gather accurate information on different aspects of bone health at the national level.

This study determined trends in the contributions of the public and private sectors to the cataract surgery output in the Islamic Republic of Iran. Data about cataract surgeries performed at surgical centres throughout the nation were extracted from patient charts for a 5-year period from 2006 to 2010. Of the total 516 273 surgeries performed in 2010, more were done in public sector centres (61.7%) than private ones (38.3%). The total number of surgeries increased by 59.1% between 2006 and 2010. Analysis of the relative contributions of the public and private sectors showed a 41.0% increase in surgeries in public centres and 100.5% in private centres over the 5-year period. Thus the rate of growth of cataract surgery in the private sector was 2.7 times greater than that in the public sector. Despite a smaller contribution to the total number of cataract surgeries, the private sector has experienced a substantial rate of growth.مساهمات القطاعين العام والخاص في نِتاج جراحات الكاتاركت في إيران.حسن هاشمي، فرهاد رضوان، أكر فتوحي، مهدي خبازخوب، حميد رضا غياسي، كوروش اعتاد، عي رضا مهدوي، سهيلا عسغري.لقد حَددت هذه الدراسة الاتجاهات السائدة في مساهمات القطاعن العام والخاص في نتاج جراحات الكاتاركت في جمهورية إيران الإسامية. لقد تم استخراج البيانات المتعلقة بجراحات الكاتاركت التي أجريت في المراكز الجراحية في جميع أنحاء الباد من سجلات المرضى لمدة 5 سنوات، (من عام 2006 وحتى عام 2010). بالنسبة للعمليات التي أجريت في عام 2010 والتي بلغ مجموعها 516 273، وجد أن ما أجري منها في مراكز القطاع العام (61.7%) أكثر مما أجري في مراكز القطاع الخاص (38.3%). كا وجد أن العدد الكلي للعمليات ارتفع بنسبة 59.1% بن عامي 2006 و 2010 . وأظهر تحليل المساهمات النسبية للقطاعن العام والخاص زيادة قدرها 41% في المراكز العامة و 100.5% في المراكز الخاصة خال فرة ال 5 سنوات. وبالتالي، فإن معدل نمو جراحات الكاتاركت كان في القطاع الخاص 2.7 أضعاف مثيله في القطاع العام. فعى الرغم من أن مساهمة القطاع الخاص في العدد الإجمالي لجراحات الكاتاركت كانت أصغر إلا أنه شهد زيادة كبرة في معدل النمو.Contribution des secteurs public et privé au nombre de chirurgies de la cataracte en Iran.La présente étude a déterminé les tendances dans la contribution des secteurs public et privé au nombre de chirurgies de la cataracte en République islamique d’Iran. Les données sur les chirurgies de la cataracte réalisées dans des centres chirurgicaux de l’ensemble du pays ont été extraites des dossiers des patients sur une période de 5 ans, de 2006 à 2010. Sur un total de 516 273 chirurgies de la cataracte réalisées en 2010, 61,7 % l'ont été réalisées dans des centres publics contre 38,3 % dans le privé. Le nombre total de chirurgies a augmenté de 59,1 % entre 2006 et 2010. L’analyse de la contribution relative des secteurs public et privé a révélé une hausse de 41,0 % dans les centres publics et de 100,5 % dans les centres privés sur cinq ans. Le taux d'augmenter de la chirurgie de la cataracte dans le secteur privé était donc 2,7 fois supérieur à celui du secteur public. Malgré une contribution moindre au nombre total de chirurgies de la cataracte, le secteur privé a connu un taux d'augmentation important en la matière.

Purpose. To determine the cataract surgical rate (CSR) between 2006 and 2010 in Iran. Methods. In this cross-sectional study, sampling was done from surgical centers throughout Iran. Centers throughout all of Iran with more than 3000 surgeries per year were grouped as major centers and the rest were grouped as minor centers. All major centers and a percentage of minor centers were selected from each province. For each center, we determined the number of cataract surgeries in a random week of each season. Results. Of the 237 eligible surgical centers, 124 were selected and 106 were enrolled in the study; 80 were major centers and 26 were minor centers. The number of surgeries has increased from 335,948 in 2006 to 475,526 in 2010. Cataract surgical rate has increased from 4723 (95 confidence interval, 4707 to 4739) per million population in 2006 to 6328 (95 confidence interval, 6309 to 6346) per million population in 2010. In the 50 and older population, CSR was 38,450 per million population in 2010. Average annual number of cataract surgeries per surgeon was 263 in 2006 and 339 in 2010. Conclusions. Compared with previous studies, the 2006 to 2010 CSR in Iran is on an ascending trend. Also, our numbers are higher than the minimum recommended by the World Health Organization, although lower than that in Western countries. Considering the aging population of the country, the observed rate is not sufficient for all cases of cataract in the future, and there is a need to increase CSR throughout the nation. © 2014 American Academy of Optometry.

OBJECTIVE Despite the high prevalence of vitamin D deficiency in adults worldwide, not many studies have evaluated the condition in adolescents. The present study was therefore conducted to assess the prevalence of vitamin D deficiency in a group of students from Shahroud, Iran. METHODS The cross-sectional descriptive analytical study was conducted on junior high and high school students of both genders from urban and rural areas of Shahroud, the largest city of Semnan Province in Iran, in winter 2011. The combination of stratified and cluster random sampling methods was applied in the study. A questionnaire on the demographic data, socioeconomic status, lifestyle habits (sun exposure, physical activity, dairy consumption), and drug and personal history was completed for each student. Blood samples were taken to assess vitamin D levels. RESULTS One thousand forty-seven students from four junior high and six high schools were recruited. From among them, 42.2% were boys and 57.8% were girls. Mean and standard deviation of vitamin D levels in the studied population were 14.7 ± 9.4 ng/mL. Only 7.2% of the boys and 3.8% of the girls had sensible sun exposure. The median of milk consumption was 3 glasses per week, ranging from 0 to 7. CONCLUSION It could be concluded that vitamin D deficiency is quite prevalent among the Iranian adolescents, and this is mainly because this group follows an unhealthy lifestyle due to osteoporosis.