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High blood pressure is becoming a universal epidemic for both developed and developing countries; it is one of the main public health problems all over the world. This research was conducted to assess blood pressure self-care among hypertensive patients in Iran. This cross-sectional analytic study was conducted on 527 patients with hypertension recruited from Zarandieh, Iran in 2018. Data were gathered using questionnaires assessing socio-demographic information, social support, health belief model (HBM) constructs (perceived benefits to healthy behavior, barriers to healthy behavior, perceived disease threat, self-efficacy to engage in healthy behavior, and cues to action), and self-care activities to address blood pressure. A stepwise multiple linear regression analysis was used to determine factors associated with self-care behaviors. Overall, 512 patients (215 men and 297 women) participated in this study. Participants who were married, and more educated engaged in more self-care behaviors. At least one-half of the patients (47.6%) demonstrated a moderate level of self-care behaviors with a mean score of self-care equal to 9.32 ± 3.6 (out of 18). All the elements of HBM and social support were significant predictors of self-care behaviors and self-efficacy was the strongest predictor, followed (in descending order) by perceived barriers, social support, perceived disease threat, and perceived benefits. Health education based on HBM, enhanced with attention to social support, may help patient enact healthier behaviors to reduce blood pressure.

Background: Several studies in the recent decade have supported a relationship between different types of infections and CHD (Coronary Heart Disease); however, such a relationship is not definitely proven. Helicobacter pylori is one of the most common infections in human. The role of inflammation in the pathogens of CAD (Coronary Artery Disease) has been widely discussed; although, the mechanism is not clearly known yet. Methods: In this systematic review and meta-analysis all case-control articles on the relationship between Helicobacter pylori and CHD published from 31st June 2000 to 31st June 2016 indexed in Scopus, PubMed, Google Scholar, Science Direct, and Iranian databases Magiran, Iran Medex, Irandoc, and SID were included. The articles were searched using the following keywords in Farsi and English. The extracted data was imported into Microsoft Excel and analyzed in Stata 12. Results: Thirty case-control studies conducted in different regions of Iran (15 provinces) have been published from 2001 to 2015 included in this study. A general estimate of OR (Odds Ratio) for the association of Helicobacter pylori and heart diseases in Iran was 2.351 (95 CI: (1.715, 3.221)). Conclusion: According to the observed association between Helicobacter pylori and heart diseases in the resent study, most of the hosts of the bacterium are afflicted with the infection in their childhood. Therefore, personal hygiene promotion and preventive programs for Iranian children may have a considerable role in reducing the risk of the infection and cardiovascular diseases, consequently.

Context: The present study aimed to determine the prevalence of HBsAg in pregnant women using available data in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries from 2000 to 2016. Evidence Acquisition: Pubmed, ISI Web of Science, ScienceDirect, Ovid, Scopus, Google Scholar, and Persian databases were searched for related articles on the prevalence of HBsAg in pregnant women in EMRO and Middle Eastern countries. Heterogeneity was assessed based on Cochran’s Q-test results. However, since this test may fail to exactly identify true heterogeneity, it was complemented with Higgins and Thompson’s I2. Results: In general the numbers of 49 articles (89 452 people) were included. Based on available data, the HBsAg prevalence in countries with at least one study conducted in them were 3.2% in Egypt, 1.3 % in Iran, 4.3% in Jordan, 1.5% in Libya, 7.1% in Oman, 2% in Pakistan, 1% in Qatar, 2.6% in Saudi Arabia, 5.6% in Sudan, 4% in Tunisia, 2.8% in Turkey, 1.5% in United Arab Emirates, and 10.8% Yemen. Conclusions: The available data on the prevalence of HBsAg in pregnant women of EMRO and Middle East countries showed that there was a different pattern of HBsAg prevalence in studied countries. Although there were countries with low prevalence of HBsAg, the lowest frequency in our study was higher than the reported prevalence in developed countries.

BACKGROUND: There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD). METHODS: In a quasi-experimental clinical trial study (before and after), 51 patients with CAD scheduled for elective PCI were investigated provided that their Ejection Fraction (EF) was > 30%. Before and three months after PCI, echocardiography was carried out to evaluate left ventricular diastolic indices including the E/Ea as the most important criteria for diagnosis of diastolic heart failure (DHF). RESULTS: Based on the E/Ea indices and after PCI, the number of patients with DHF decreased significantly: 40 patients (78.4%) before PCI versus 28 patients (54.9%) after PCI (p CONCLUSION: The E/Ea ratio as an important criterion for diagnosis of DHF was improved after PCI. Improvement of several other diastolic indices was observed after the PCI procedure. It can be concluded that PCI can be an effective treatment modality in patients with left ventricular diastolic indices.

Background: Several studies in the recent decade have supported a relationship between different types of infections and CHD (Coronary Heart Disease); however, such a relationship is not definitely proven. Helicobacter pylori is one of the most common infections in human. The role of inflammation in the pathogens of CAD (Coronary Artery Disease) has been widely discussed; although, the mechanism is not clearly known yet. Methods: In this systematic review and meta-analysis all case-control articles on the relationship between Helicobacter pylori and CHD published from 31st June 2000 to 31st June 2016 indexed in Scopus, PubMed, Google Scholar, Science Direct, and Iranian databases Magiran, Iran Medex, Irandoc, and SID were included. The articles were searched using the following keywords in Farsi and English. The extracted data was imported into Microsoft Excel and analyzed in Stata 12. Results: Thirty case-control studies conducted in different regions of Iran (15 provinces) have been published from 2001 to 2015 included in this study. A general estimate of OR (Odds Ratio) for the association of Helicobacter pylori and heart diseases in Iran was 2.351 (95 CI: (1.715, 3.221)). Conclusion: According to the observed association between Helicobacter pylori and heart diseases in the resent study, most of the hosts of the bacterium are afflicted with the infection in their childhood. Therefore, personal hygiene promotion and preventive programs for Iranian children may have a considerable role in reducing the risk of the infection and cardiovascular diseases, consequently.

There is a relationship between self-awareness and emotion regulation with anxiety. Since identifying of factors affecting anxiety in particular in students is necessary; therefore, the present study aimed to determine the relationships between self-awareness and emotion regulation with controlling anxiety in students of Ferdowsi University of Mashhad. Through a cross-sectional study using randomized allocation sampling, 358 students in Ferdowsi University of Mashhad were recruited in 2012. A standard questionnaire including demographic variables and variables of self-awareness, emotion regulation and controlling of anxiety was applied. Collected data were analyzed using ANOVA and linear regression in SPSS software. Mean and standard deviation of age was 21.63 ± 1.7 years, respectively that 64.5% were female. There were significant relationships between self-awareness and emotion regulation with students’ controlling anxiety so that predicts by increasing the score of self-awareness and emotion regulation, the score of students’ controlling anxiety to be increased. Self-awareness showed that has a more predicting role. With regard to results, life skills education in advanced levels considering emotion regulation and in particular promotion of self-awareness can have an important role in the decrease of students’ anxiety.

Background: The prevalence of Hypertension (HTN) in developing countries might have a different pattern in different countries. Objectives: This study aimed at investigating the current pattern of HTN and evaluating its relationship with health complaints in elderly Iranian individuals in 2012. Methods: This cross sectional study used multistage sampling to investigate 1 350 Iranian elderly subjects (≥ 60 years) living in the community. Those elderly, who had a systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg and/or those who used antihypertensive drugs during the previous two weeks, were considered as HTN. A face-to-face interview was performed using a structured questionnaire, including demographic factors, awareness, treatment and control of HTN, and health complaints for each individual. Chi-square test and multiple logistic regression analyses were applied to detect the most important variables related to HTN. Results: Hypertension was seen in 48.5% of individuals. Awareness, treatment, and control of HTNwere seen in 40.7%, 82.5%, and 30% of individuals, respectively. Elderly individuals with HTN had significantly more experienced visual disturbances (P = 0.03), fecal or urinary incontinence (P = 0.006), nocturia (P = 0.002), attacks of shortness of breath (P = 0.004), and hyperlipidaemia (P < 0.001). After adjusting for potential confounders such as ethnicity, nocturia (OR, 1.34; CI 95%, 1.02 - 1.75) and hyperlipidemia (OR, 1.94; 95% CI, 1.5 - 2.51) remained significantly relevant to HTN. Conclusions: The prevalence of HTN was lower in elderly community-living Iranians than developed countries, yet, was still considerable. Nocturia and hyperlipidemia were the most common health complaints in Iranian elderly with HTN.

Background: The relationships that age and gender share with risk factors (RFs) of noncommunicable diseases (NCDs) were assessed among a large-scale employ in Western Iran. Methods: In this epidemiologic cross-sectional study, 7129 employees from Kermanshah Province were assessed using a census method in 2012. Data on RFs of NCD were collected using a standard questionnaire. Demographic information, diet, physical activity, tobacco use, and history of hypertension, history of diabetes, cardiovascular diseases, osteoporosis, and cancer were studied. Results: The proportion of ≥5 servings of fruits and vegetables consumption per day was lower in higher ages (P = 0.001), and this proportion was greater in females than males (72.1% vs. 47.8%; P < 0.0001). Tobacco use was more in higher ages and was higher among males than females (13.3% vs. 0.6%; P < 0.0001). Overweight and obesity prevalence increased in higher ages and was more prominent among males than females (67.8% vs. 55.3%; P < 0.0001). Overall, the prevalence of having 3–5 RFs was greater among those with ≥55 years and among males than females (20.4% vs. 6.6%; P < 0.0001). Conclusions: The prevalence of major RFs of NCDs was greater among older persons and male participants. More preventive programs such as health education on employees of Kermanshah are recommended.

Context The world health organization (WHO) recommends that all blood donations should be screened for evidence of infections, such as hepatitis B. The present study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) in blood donors at the eastern Mediterranean region office (EMRO) of the WHO and middle eastern countries. Evidence Acquisition A meta-analysis was carried out based on the results of an electronic literature search of PubMed, Ovid, Scopus, and Google Scholar for articles published from January 1, 2000, to August 31, 2015. In accordance with a significant homogeneity test and a large value of I2, the random effects model was used to aggregate data from the studies and produce the pooled estimates using the “Metan” command. Results We included 66 eligible studies. The pooled prevalence of HBsAg in blood donors of both EMRO and middle eastern (E and M) countries was 2.03% (95% confidence interval [CI]: 1.79 – 2.26). In addition, the prevalence rates in the EMRO countries was 1.99% (95% CI: 1.84 – 2.14) and 1.62% in the Middle Eastern countries (95% CI: 1.36 – 1.88). The prevalence among blood donors with more than one study was 1.58% in Egypt, 0.58% in Iran, 0.67% in Iraq, 2.84% in Pakistan, 3.02% in Saudi Arabia, 1.68% in Turkey, and 5.05% in Yemen. Conclusions Based on the WHO classification of hepatitis B virus (HBV) prevalence, the prevalence of HBsAg in blood donors from E and M countries reached an intermediate level. However, there were low prevalence levels in some E and M countries.

Background: Identifying the pattern of tobacco use and its related factors in employees is crucial. This study aimed to investigate the pattern of tobacco use and its related factors in employees of Kermanshah Province, Iran. Methods: In 2012, 7129 employees were investigated in a cross-sectional study using the census method. Data on tobacco use and on several chronic diseases obtained using a standardized questionnaire on noncommunicable diseases risk factors of the World Health Organization through face-to-face interviews. Statistical analysis was performed based on the Chi-square test and multivariate logistic regression. Results: In general, the prevalence of tobacco use, smoking cigarettes, and smoking waterpipe was 9.9%, 8.9%, and 1.2% among the employees, respectively. Tobacco use was significantly higher in the age group over 40 (14.0%), in male gender (13.3%), in married individuals (10.8%) and in those with diploma and lower degree (16.4%), (P < 0.001). At the individual level, the odds ratio of tobacco use was 1.5 (95% confidence interval [CI]: 1.2-1.8) in hypertensive, 1.8 (95% CI: 1.2-2.6) in diabetic employees and 1.7 (95% CI: 1.3-2.3) in those with heart diseases, compared to healthy individuals. After adjusting for age, gender, marital status and educational level, there was not any significant relationship between tobacco use and health complaints and only the demographic variables remained significant. Conclusions: Preventive public health policies are mandatory especially in younger ages and male employees to promote their knowledge on disadvantages of tobacco use.

BACKGROUND : Over the past decade, cardiovascular diseases have been recognized as the leading cause of mortality worldwide. Myocardial infarction (MI) is one of the most prevalent types of cardiovascular diseases that is caused by the closure of coronary arteries and ischemic heart muscle. Numerous studies have analyzed the role of H. pylori as a possible risk factor for coronary artery diseases, in most of which the role of infection in coronary artery disease is not statistically significant. METHODS : These contradictory findings made us conduct a systematic review to analyze all relevant studies in Iran through a meta-analysis and report a comprehensive and integrated result. All published studies from September 2000 until September 2016were considered. Using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, Science Direct and Persian databases like SID, Irandoc, Iran Mede and Magiran. After quality control, these studies were entered into a meta-analysis by using the random effects model. After evaluating the studies, 11 papers were finally selected and assessed. RESULTS : A total of 2517 participants had been evaluated in these studies, including 1253 cases and 1264 controls. Based on the results of meta-analysis and using random effects model, an overall estimate of OR Helicobacter Pylori with Presence of Myocardial Infarction in Iran was OR=2.53 (CI=1.37-4.67). CONCLUSIONS : The results of this review study show that H. pylori are associated with the incidence of MI so that the odds ratio of MI in the patients with helicobacter pylori is twice greater than that of the people without H. pylori. Future studies are recommended to evaluate the mechanisms associated with relation of H. pylori with MI as well as its association with time. KEYWORDS : Myocardial infarction, H. pylori, Meta-analysis, Iran

The present study aimed to determine attribution of mental disorders in suicide occurrence. By a cross-sectional study, all suicide records ( n = 5188), between 1993 and 2009 in Ilam province, were investigated. Multiple logistic regression analysis was adopted. Totally, 27.5% of the suicides occurred due to mental disorders. This was significantly higher in males (29.3%), individuals born in 1996 (44%) and 1990s (30.3%), those aged 30 years and above (33.2%) and suicide attempters (28.3%), respectively and separately. The risk of suicide due to mental disorders was observed for females (OR = 0.85, CI = 0.74–0.97), those born in 1994 (OR = 2.82, CI = 1.27–6.24), completed suicides (OR = 0.81, CI = 0.68–0.97) and the age group 25 to 29 years old (OR = 0.82, CI = 0.66–1.01). Suicide due to mental disorders was higher among males compared to females, the rate of which was directly proportional to attempted suicide and age. It is therefore recommended that health educations be seriously carried on targeted groups.

To investigate the association between lifestyle risk factors and impaired fasting glucose level.The large-scale, community-based, cross-sectional study was conducted in 2012 in Ilam province, Iran, and comprised 150 impaired fasting glucose cases and 450 controls. Face-to-face interviews were conducted using a standard lifestyle questionnaire, and subjects were checked for fasting plasma glucose. Chi-square test and multivariate logistic regression were used for statistical analysis.Of the 600 participants, 172 (28.7%) were males and 428 (71.3%) were females. Their ages ranged from 20 to 83 years with a mean of 48.9 +/- 14.2 years for the cases and 45.5 +/- 13.4 years for the controls (p0.008). There was no statistically significant difference in terms of age, gender, marital status, location, family history of diabetes and body mass index in the two groups (p0.05). Using multivariate logistic regression, ghee consumption increased the risk of impaired fasting glucose up to 2.2 folds (Odds Ratio = 1.28, 95% Confidence Interval: 0.75-2.2); inactivity up to 2.33 folds (Odds Ratio = 1.33, 95% Confidence Interval: 0.75-2.33) and smoking up to 3.13 folds (Odds Ratio = 1.46, 95% Confidence Interval: 0.68-3.13). The differences were not statistically significant.Risk of impaired fasting glucose increases with lifestyle risk factors that need to be considered seriously by policy makers.

Background The relationship between socioeconomic status and influenza vaccine uptake has a different pattern in different societies. The objective of this study was to assess the socioeconomic factors influencing influenza vaccination uptake in the older adult Iranian population. Methods In this cross-sectional study, 1,350 Iranian adults aged ≥60 years were selected using a multistage sampling method. Self-report questionnaires were administered to collect information on the status of influenza vaccine uptake within the last year. Results Overall, 10.4% of the older adult Iranian population had received influenza vaccinations within the last year. Several determinants were associated with influenza vaccination uptake, such as current occupation, education level, ethnicity, source of income, financial support from relatives, satisfaction with income, type of health insurance, and having complementary health insurance for outpatient services. Other factors, such as age, sex, marital status, residential area, and having health insurance, had no influence on the probability of vaccine uptake. After adjusting for desired variables, we found that having an occupation (odds ratio [OR] = 2.08; 95% confidence interval [CI], 1.08-4.02) and having complementary health insurance for outpatient services (OR = 1.65; 95% CI, 1.06-2.56) remained associated with higher influenza vaccine uptake. Conclusions The influenza vaccination rate in older adult Iranians was found to be low. Occupation and having complementary health insurance were associated with influenza vaccination uptake among Iranian older adults. Considering the mentioned variables in future studies is advised.

Contexts: Association of lipid markers and occurrence of impaired fasting glucose (IFG) have a different pattern in different populations. Aims: The present study aimed to investigate the associations of some lipid markers with impaired fasting glucose in Kermanshah city, 2013. Settings and Designs: By a case-control study, 120 IFG subjects and 240 controls were recruited. Materials and Methods: Each subject was interviewed using a sociodemographic questionnaire and lipid markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and fasting plasma glucose (FPG) were checked. Statistical Analysis Used: Chi-square test (χ 2 ), independent samples t-test, Pearson correlation coefficient, and a multiple logistic regression were used for statistical analyses. Results: IFG subjects had significantly higher TC, TG, and LDL-c than controls (P 0.05). FPG was positively and significantly correlated with TG and TC ranges but not with BMI, LDL-c, and HDL-c. The highest correlation coefficients (r) with FPG was for TG rather than TC (r = 0.14, P < 0.01). In multivariable regression, the odds ratios (ORs) estimated for lipid markers were not associated with IFG but ORs in those females reported to have a history of oral contraceptive pill (OCP) usage was 2.4-fold compared to the controls [OR = 2.4, confidence interval (CI): 1.16-4.95]. Conclusions: TC, LDL-c, and TG had significantly higher values in IFG subjects and should be taken into consideration for the prevention of IFG.