Journal of research in health sciences最新文献

Background: Low birth weight (LBW) is a major public health issue associated with increased neonatal morbidity and mortality. This study aimed to examine the association between household food insecurity and LBW in Mashhad, Iran. Study Design: A population-based case-control study.

Methods: This study involved 6294 mothers (3247 cases and 3247 controls) who visited healthcare centers affiliated with Mashhad University of Medical Sciences for term births between March 2019 and March 2022. Cases included women who delivered neonates weighing<2500 g, while controls delivered babies≥2500 g. Food security was measured using the validated Household Food Insecurity Access Scale. Logistic regression models examined the associations between food insecurity and LBW. Geographic information system techniques mapped LBW distribution in Mashhad.

Results: Household food insecurity was significantly associated with higher odds of LBW (adjusted odds ratio [AOR]=1.25, 95% confidence interval [CI]: 1.03, 1.53). Other risk factors included younger maternal age (AOR=1.03, 95% CI: 1.01, 1.04), lower maternal education (AOR=0.55, 95% CI: 0.43, 0.71), cesarean delivery (AOR=1.70, 95% CI: 1.40, 2.06), and exposure to secondhand smoke (AOR=1.68, 95% CI: 1.02, 2.75). Gestational diabetes demonstrated a protective effect (AOR=0.37, 95% CI: 0.15, 0.91). Geographic mapping revealed that regions with higher food insecurity had elevated LBW prevalence.

Conclusion: These findings underscore the importance of addressing food insecurity among pregnant women to reduce the risk of LBW and improve newborn outcomes.

Background: COVID-19 is a viral disease caused by the SARS-CoV-2, leading to several variants. This study aimed to examine the effectiveness of booster doses against the Delta and Omicron variants over different follow-up times. Study Design: This was a longitudinal meta-analysis.

Methods: Searches were performed in PubMed, Cochrane Library, Scopus, and Web of Science databases, and eighty studies were selected for investigation. The analyses were separately performed on the unvaccinated control group (UNVCG) and the complete two doses of the vaccine control group (C2DCG) against Delta and Omicron variants. Three outcomes were examined, including symptomatic infection, hospitalization, and death.

Results: Vaccine effectiveness (VE) in UNVCG studies for symptomatic infection revealed a non-linear trend against Omicron with a peak of 67.3%, declining to 27.1% after 25 weeks after a booster dose. The mean of VE for hospitalization over time started to decrease after four weeks against Omicron and after eight weeks against Delta. The VE reached a peak at week eight (96.0%) and started to decline with a VE of 93.3% after 20 weeks after the booster dose against Delta. It was 90.8% at week four and decreased to 73.4% after 25 weeks after the booster dose against Omicron. VE in the C2DCG studies demonstrated more decreases in outcomes over time.

Conclusion: Our findings showed a tendency to decrease effectiveness over time based on outcomes and variants. The early protection levels were lower in Omicron. Moreover, the VE decrease over time was stronger in Omicron compared to the Delta variant.

Background: Tuberculosis (TB) remains a major public health issue in Iran, especially smear-positive pulmonary tuberculosis (SPPTB), due to its high transmission rate. Examining the effective reproduction number(R_t ) of SPPTB and patient characteristics is crucial for crafting targeted TB control measures. This study aimed to assess the R_t of SPPTB in Iran from 2011 to 2021 and profile SPPTB patient demographics, initial smear bacilli density, diagnosis delays, and spatial distribution. Study Design: This is a historical cohort study.

Methods: A time-dependent method was used to estimate R_t , and monthly data from the national TB registry were scrutinized from 2011 to 2021.

Results: A decline was observed in SPPTB incidence rates of 50909 SPPTB cases in Iran from 2011 to 2021. Approximately 29.1% of the cases were diagnosed within a month, while 44.5% experienced a one to three-month delay in diagnosis. The analysis revealed substantial heterogeneity in TB transmission dynamics across various provinces of Iran. Provinces such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi exhibited the highest effective reproduction numbers. Additionally, there was a decreasing trend in the effective reproduction numbers across all provinces from 2011 to 2020.

Conclusion: Effective reproduction numbers declined in most provinces from 2011 to 2020 but increased moderately after the COVID-19 pandemic, highlighting the need for targeted public health interventions. Although SPPTB incidence rates are declining nationally, elevated incidence rates and effective reproduction numbers in regions such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi signify the need for persistent TB management efforts in Iran.

Background: Thyroid carcinoma (TC) is a global clinical concern, and its incidence has progressively increased worldwide. Early detection of TC and subsequently decreased age at the diagnosis seem to result from extensive employment of imaging modalities, biopsy techniques, and improvements in the healthcare system. Study Design: A retrospective cohort study.

Methods: Overall, 400 patients diagnosed with TC following thyroidectomy in the Endocrinology Clinic, who were followed for fifteen years, were investigated in this study. The checklist included patients' demographic characteristics, clinical information, and response to treatment, recurrence, and death.

Results: There were 19.25% men and 80.75% women. The mean age was 41.005±15.58 years. The risk of death and recurrence was significantly higher in men, patients>65 years, smokers, patients with a family history of TC, undifferentiated cancer, multifocality, and stages III and IV (P<0.001). Each additional year of life was associated with a 21% increase in the risk of death (P<0.001). Smoking was associated with a 4.36-fold increase in the risk of death (P=0.05). For each additional year of life, the probability of recurrence increased by 3% (P=0.009). Men were 4.73 times more likely to recur (P<0.001) than women.

Conclusion: To employ the proper therapeutic intervention and perform meticulous postoperative surveillance, it is crucial to consider the predictive influence of pertinent elements. Diagnosing TC in its early stages is essential for the healthcare system because of the increased incidence, younger age at diagnosis, and overall favorable prognosis of TC.

Background: Polymorphisms within the excision repair cross-complementation group 1 (ERCC1), an essential component of DNA repair mechanisms, have been associated with various malignancies. This study aimed to evaluate the association of the single-nucleotide polymorphisms (SNPs) rs3212986 and rs11615 within the ERCC1 gene in non-small cell lung cancer (NSCLC) patients. Study Design: A case-control study.

Methods: Genomic DNA was extracted from the peripheral blood samples of 83 NSCLC patients and 119 healthy individuals. The genetic diversity of SNPs rs3212986 and rs11615 was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The RFLP results were confirmed through sequencing.

Results: The TT genotype of the rs11615 SNP was associated with a higher risk of NSCLC development (odds ratio: 3.900, 95% confidence interval: 0.603, 22.866, P=0.050). Furthermore, the AA genotype of rs3212986 was related to a higher risk of NSCLC development (OR: 2.531, 95% CI: 1.017, 6.300, P=0.046). A significant association was observed between smoking and lung cancer (OR: 3.072, 95% CI: 1.715, 5.503, P<0.001). Moreover, among non-smokers, there was an association between lung cancer risk and the AA (OR: 6.825, 95% CI: 1.722, 27.044, P=0.006) and AC (OR: 2.503, 95% CI: 0.977, 6.412, P=0.056) genotypes of rs3212986. However, no correlation was found between the genotypes of these SNPs and patients' sensitivity to cisplatin and carboplatin (P ˃ 0.05).

Conclusion: The rs11615-related TT genotype and the rs3212986-related AA genotype may be associated with a higher risk of lung cancer development.

Background: Human papillomavirus (HPV) infection is the most common sexual transmitted disease and Pap smears and HPV testing are crucial for early detection. Advancements in HPV testing improve accuracy, but optimal screening strategies are still debated. This cross-sectional study explores HPV genotypes and predictors of infection among Iranian women undergoing gynecological screening. Study Design: A retrospective cross-sectional study.

Methods: Women undergoing their initial cervical screening enrolled in this study. Cervical cytology samples for Pap smear analysis were collected from women referred to the genetic laboratory of Academic Center for Education Culture and Research (ACECR), Khorasan Razavi, during gynecological visits, adhering to standardized liquid-based cytology protocols. These samples were obtained over a one-year period since January 2023. Statistical analyses were conducted using SPSS version 21.0, with a significance level set at P<0.05.

Results: A total of 328 women enrolled in this study. The mean age of participants was 36±11 years and the overall HPV prevalence was 37.5% (n=123). Among HPV-positive women, nearly half (48.7%) had a single HPV genotype. Genotypes 6 (13%), 16 (12.3%), and 53 (6.7%) were the most prevalent types. Notably, high-risk HPV genotypes (16 and 18 among all) were identified in one-fourth of the study population. Women with endocervical/transformation zone cells had 25% higher odds of having HPV infection, and having mild, moderate, and severe inflammation increased the odds of having HPV infection by 14%, 11%, and 20%, respectively.

Conclusion: The considerably high prevalence of HPV infection highlights the significance of HPV prevention programs in this population. Neither bacterial vaginosis nor candida infection showed a direct link to HPV positivity.

Background: While the direct benefits of food assistance programs are well-documented, there is a need to explore indirect benefits like increased physical activity. This study examined whether participation in the Supplemental Nutrition Assistance Program (SNAP) was associated with improved physical activity levels in children and adolescents aged 2-17 in the United States during 2017-2018. Study Design: A cross-sectional study.

Methods: This cross-sectional study used a subset of National Health and Nutrition Examination Survey (NHANES) data (n=2620). In the NHANES 2017-2018 dataset, physical activity was measured through self-report questionnaires, which captured participants' frequency, duration, and intensity of various activities. We used weighted logistic regression and the Hosmer - Lemeshow - Sturdivant forward model - building strategy to investigate this hypothesized association using SAS version 9.4.

Results: In the adjusted model, controlling for the other variables in the model, we found that children and adolescents from households that had received SNAP/Food Stamps had 1.53 times higher odds (odds ratio [OR]=1.53, 95% CI: 1.24-1.89) of achieving the recommended guidelines of 60 minutes of daily physical activity compared to those who had not received benefits. Each additional year of age resulted in 0.82 times lower odds (OR=0.82; 95% CI: 0.79, 0.85) of meeting the recommended amounts of physical activity. Additionally, each unit increase in BMI was associated with 0.96 times lower odds (OR=0.96, 95% CI: 0.93, 0.98) of engaging in recommended physical activity.

Conclusion: These findings suggest that participation in the SNAP/Food Stamps program may indirectly benefit participants by increasing physical activity levels.

Background: In 2021, Nigeria had an estimated 1.9 million people living with the human immunodeficiency virus (PLHIV) and 1.7 million (90%) on antiretroviral therapy (ART). Study Design: A systematic review and meta-analysis.

Methods: This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. We searched PubMed, Embase, PsychINFO, CINAHL, Global Index Medicus, and Cochrane Library. Studies were included if they reported on ART retention in care among PLHIV in Nigeria. The random-effects meta-analyses were used to combine the studies that had complete retention data. The I² statistic was used to assess the heterogeneity of the studies. A sensitivity analysis was then done by conducting a leave-one-out analysis. Afterward, data were analyzed using STATA version 18.

Results: The search yielded 966 unique articles, of which 52 studies met the inclusion criteria for the meta-analysis, and four experimental studies were split into their component arms. The total number of study participants was 563,410, and the pooled retention rate was 72% (95% CI: 67%, 76%; I²=99.9%; n=57). Sub-analysis showed that the Southeast region of Nigeria had the highest retention of 86% (95% CI: 78%, 92%), and the South-South had the lowest retention (58%; 95% CI: 38%, 79%).

Conclusion: In Nigeria, the pooled ART retention rate is less than optimal to achieve the UNAIDS goal of 95%, thus developing new models for ART retention is needed.

Background: Exposure to air pollution is a major health problem worldwide. This study aimed to investigate the effect of the level of air pollutants and meteorological parameters with their related lag time on the transmission and severity of coronavirus disease 19 (COVID-19) using machine learning (ML) techniques in Shiraz, Iran. Study Design: An ecological study.

Methods: In this ecological research, three main ML techniques, including decision trees, random forest, and extreme gradient boosting (XGBoost), have been applied to correlate meteorological parameters and air pollutants with infection transmission, hospitalization, and death due to COVID-19 from 1 October 2020 to 1 March 2022. These parameters and pollutants included particulate matter (PM2), sulfur dioxide (SO₂ ), nitrogen dioxide (NO₂ ), nitric oxide (NO), ozone (O₃ ), carbon monoxide (CO), temperature (T), relative humidity (RH), dew point (DP), air pressure (AP), and wind speed (WS).

Results: Based on the three ML techniques, NO₂ (lag 5 day), CO (lag 4), and T (lag 25) were the most important environmental features affecting the spread of COVID-19 infection. In addition, the most important features contributing to hospitalization due to COVID-19 included RH (lag 28), T (lag 11), and O₃ (lag 10). After adjusting for the number of infections, the most important features affecting the number of deaths caused by COVID-19 were NO₂ (lag 20), O₃ (lag 22), and NO (lag 23).

Conclusion: Our findings suggested that epidemics caused by COVID-19 and (possibly) similarly viral transmitted infections, including flu, air pollutants, and meteorological parameters, can be used to predict their burden on the community and health system. In addition, meteorological and air quality data should be included in preventive measures.

Background: Rotavirus is the most common cause of gastroenteritis among children. Currently, four oral live-attenuated vaccines are available to prevent rotavirus infection. The World Health Organization (WHO) has recommended including rotavirus vaccination in national immunization programs; however, it has not been introduced to the Iranian national immunization program. The study aimed to assess the frequency of rotavirus gastroenteritis in the west of Iran and investigate the necessity of rotavirus vaccination. Study Design: A case series study.

Methods: In this case series study, 284 cases under six years of age who presented with acute gastroenteritis from March 2021 to 2022 to a referral hospital in the west of Iran were evaluated. Data on baseline characteristics, clinical manifestations, results of stool test, ELISA for rotavirus detection, and polymerase chain reaction (PCR) test for genotyping of rotavirus-positive samples were recorded.

Results: Results showed that the prevalence of rotavirus infection was 36.6%. The highest frequency was observed among children aged 6-12 months and during the autumn. According to the PCR results, G1P[8], G9P[8], G9P[4], and G1P [4] were the dominant genotypes, and 33.75% of samples were infected with multiple rotavirus genotypes.

Conclusion: The study highlights the considerable prevalence of rotavirus infection among cases of acute gastroenteritis in children under six years of age who were referred to a referral hospital in the west of Iran and the high diversity of rotavirus genotypes in the targeted community. Consequently, physicians and health policymakers should prioritize strategies for the prevention and control of this infection, particularly by considering the rotavirus vaccine as a priority for the Iranian national immunization program.