Journal of research in health sciences最新文献

Background: The empirical dietary inflammatory potential (EDIP) score is designed to assess the inflammatory potential of a diet based on the pro- and anti-inflammatory properties of its various components. This study examined the association of EDIP with all-cause mortality in a large, community-based, multiracial sample of the United States population.

Study design: A prospective cohort study.

Methods: This analysis included 13155 participants (44.6±18.4 years, 54.21% women, and 40.33% White) without prior history of cardiovascular disease (CVD) from the Third National Health and Nutrition Examination (NHANES III) Survey. A 24-hour dietary recall information was used to calculate EDIP. The National Death Index was employed to identify the date and cause of death. Cox proportional hazard analysis was utilized to evaluate the association between the tertiles of EDIP and all-cause mortality over a median follow-up of 26.6 years.

Results: In a model adjusted for demographics and CVD risk factors, a higher EDIP tertile, compared with the lowest tertile, was associated with an increased risk of all-cause mortality (hazard ratio [HR]=1.10; 95% CI: 1.02, 1.19). A standard-deviation increase in EDIP (0.27 units) was related to a 4% increased risk of mortality (HR=1.04; 95% CI: 1.01, 1.08). This association was stronger in older participants compared to younger ones (HR=1.09; 95% CI: 0.98, 1.21 vs. HR=0.89; 95% CI: 0.80, 1.01), respectively, interaction P=0.030)].

Conclusion: Pro-inflammatory diet is associated with an increased risk of mortality, especially in the older population. Dietary changes that reduce inflammation may have the potential to reduce the risk of poor outcomes.

Background: Pregnant women are vulnerable to oral disease due to physiological, hormonal, and dietary alterations. The aim of the present study was to evaluate the impact of the educational program according to the Health Promotion Model (HPM) on the oral health prevention behavior of pregnant women.

Study design: A randomized controlled trial.

Methods: This study was performed on 105 pregnant women visiting health centers located in Arak from February to November 2022. The subjects were randomly assigned to intervention (n=54) and control (n=51) groups. A reliable and valid questionnaire according to HPM constructs was used to collect the data. The pre-test was conducted in the groups. The intervention group received the educational program in 9 educational sessions (from 12 to 24 weeks of pregnancy). Then, the post-test was conducted in the 36th week of pregnancy in the groups. Finally, the data were analyzed by SPSS software (version 18) and using independent t-test, paired t-test, and Chi-square test.

Results: There were statistically significant differences between the intervention and control groups regarding perceived benefits (24.68±3.63 vs. 26.57±3.67, P=0.009), perceived barriers (7.31±3.14 vs. 5.81±3.59, P=0.025), positive affect (10.50±1.66 vs. 11.29±1.34, P=0.009), negative affect (1.59±0.223 vs. 1.40±1.51, P=0.006), commitment to the action plan (4.05±1.92 vs. 4.77±1.50, P=0.034), and tooth brushing time (2.29±0.72 vs. 2.74±0.48, P<0.001). However, no significant difference was observed regarding the tooth brushing frequency (2.05±0.58 vs. 2.07±0.66, P=0.901) after the intervention. The brushing time for 2-3 minutes in the intervention group increased from 51.85% to 75.92% after the intervention.

Conclusion: HPM-based education was effective in promoting the duration of tooth brushing in pregnant women. However, it had no effect on the tooth brushing frequency.

Background: The increasing trend in animal bites and rabies in recent years makes the disease a public health concern in Iran. The objectives of the current study were to investigate the epidemiologic aspects of the animal bite and determine the associated risk factors of the delay in initiation of post-exposure prophylaxis (PEP) against rabies in Iran.

Study design: National registry-based cross-sectional study.

Methods: This study included all registered cases of animal bites between March 2021 and March 2022 at the Ministry of Health and Medical Education in Iran. We retrieved epidemiologic data on person, time, place, and PEP outcome.

Results: A total of 260470 animal bite cases (approximately 334 per 100000 populations, and 11 deaths) were registered during the study period. About 77.2% of them were reported in males, 4.3% in children aged less than 5 years, 56.4% occurred in urban areas, 98% in domestic animals, and mostly in north and northeast areas of Iran. Additionally, 2.8% of cases had a delay of more than 48 hours in the initiation of PEP. Significant determinants of the increase in delay were female gender (OR=1.43, 95% CI: 1.36, 1.51, P<0.001), foreign nationality (OR=1.19, 95% CI: 1.01, 1.12, P=0.001), rural residence (OR=1.07, 95% CI: 1.01, 1.12, P=0.010), and the wild animals (OR=1.22, 95% CI: 1.12, 1.34, P<0.001).

Conclusion: The observed frequency of animal bites in a year indicates a serious public health concern and the need for targeted interventions, especially in at-risk areas and vulnerable populations.

Background: Headaches are common among children and adolescents, with more than half of adolescents reporting headache symptom worldwide. The number of migraine sufferers among adolescents has increased dramatically in the past decade. Headache has negatively influenced children and has been linked with emotional and behavioral problems.

Study design: A cross-sectional study.

Methods: This study was conducted using secondary data from the Indonesian Family Life Survey (IFLS) to evaluate the relationship between sociodemographic and psychosocial factors in Indonesian adolescents and headaches. We used data from the fifth wave of IFLS, which was conducted between September 2014 and April 2015. The figures represent roughly 83% of the Indonesian population. We investigated the possible relationship between sociodemographic and psychosocial factors in adolescents with headaches.

Results: A total of 3605 participants (1875 females and 1730 males) aged 15 to 19 years with headache symptom were included in the study. Headache was associated with sleep disturbances (OR 1.99; 95% CI: 1.72, 2.30), depression (OR 1.94; 95% CI: 1.65, 2.28), and female gender (OR 1.72; 95% CI: 1.50, 1.98). Other factors contributing to headaches include poor/moderate sleep quality (OR 1.25; 95% CI: 1.08, 1.45) and low income (OR 1.22; 95% CI: 1.01, 1.48).

Conclusion: In Indonesian adolescents aged 15 to 19 with headaches, sleep disturbances were the dominant factor associated with headache occurrence. Other factors such as depression, female gender, low socioeconomic status (SES), and poor/moderate sleep quality showed a positive association with headaches but further large population-based studies with more refined variables are needed to elucidate this association.

Background: Seasonal variation in hospitalizations for diverticulitis has a sinusoidal pattern, peaking in summer. Little is known about seasonal, regional trends, and risk factors associated with hospital admissions regarding diverticular bleeding in the United States.

Study design: Cross-sectional population database review using the healthcare cost and utilization project's national inpatient sample.

Methods: Patients that had diagnoses of diverticulitis with bleeding or diverticulosis with bleeding admitted from January 1, 2015, through December 31, 2017, were identified and stratified by month and season. Then, the potential effects of region, age, gender, race, and patient risk factors on seasonal admissions for diverticular bleeding were explored, and data were analyzed in SAS and presented in Excel using chi-square and Kruskal-Wallis for categorical and continuous variables, respectively.

Results: Of the 54191 hospitalized cases for diverticular bleeding, the peak and the lowest seasons were spring and summer (25.5% vs. 24.2%, P<0.0001). A significant seasonal pattern in comorbidities was also identified, and those with diabetes (P<0.0001), hypertension (HTN) (P<0.0001), obesity (P<0.0001), and those on anticoagulants (P=0.016) all had more bleeding events in the spring. This was noted across US regions, gender, race, and age. Eventually, the southern region had the most admissions for diverticular bleeding at 40.9% (P<0.0001).

Conclusion: A better understanding of these seasonal and regional trends may provide a mechanism to identify a potential trigger for diverticular bleeding events. This helps identify individuals at greatest risk for hospitalization, as well as prepare hospitals to allocate supplies appropriately during the seasons.

Background: In hemodialysis patients, changes in dialysis adequacy (DA) are examined longitudinally. The aim of this study was to determine factors affecting DA using the generalized estimating equation (GEE) and to compare them with the quadratic inference function (QIF).

Study design: A longitudinal study.

Methods: This longitudinal study examined the records of 153 end-stage renal disease (ESRD) patients. The longitudinal data on the DA and baseline demographic and clinical characteristics were obtained from patients' files. The GEE1, GEE2, and QIF models were fitted with different correlation structures, and then the best correlation structure was selected using the quasi-likelihood information criterion (QIC), Akaike information criterion (AIC), and Bayes information criterion (BIC) fitting criteria.

Results: The majority of patients (59.5%) had unfavorable DA (KT/V<1.2). Women and patients<60 years had more favorable DA. In the GEE model, the coefficients of female gender (β=0.079, 95% confidence interval [CI]: 0.032, 0.062), age at starting dialysis (β=-0.002, 95% CI: -0.004, -0.0001), hypertension (HTN, β=-0.055, 95% CI: -0.007, -0.103), diabetes (β=-0.088,95% CI: -0.021, -0.155), dialysis duration (β=0.132, 95% CI: 0.085, 0.178), and weight (β=-0.004, 95% CI: -0.006, -0.003) demonstrated a significant relationship with DA. The three models resulted in a similar estimate of regression coefficients. The relative efficiencies of QIF versus GEE1, QIF versus GEE2, and GEE2 versus GEE1 were 1.175, 1.056, and 1.113, respectively.

Conclusion: DA is not optimal in most hemodialysis patients, and gender, age at the start of dialysis, HTN, diabetes, dialysis duration, and weight had a significant association with DA. The three different models yielded quite similar coefficient estimates, but the QIF model resulted more efficient than GEE1 and GEE2.

Background: This study was conducted to determine the mortality rate and years of life lost (YLL) due to homicide in Fars province.

Study design: This was a cross-sectional study.

Methods: All data related to deaths due to homicide in Fars province were obtained from the Populationbased Electronic Death Registration System. Crude and age-standardized mortality rate, YLL, and YLL rate data were calculated and joinpoint regression was used to examine the trend.

Results: During 2004-2019, 2148 deaths due to homicide occurred in Fars province, and (1782 cases (83.0%) were men. The crude mortality rate in men decreased by 44.0% from 2004 to 2019, but a stable trend was observed in women. The total YLL due to homicide during these 16 years was 43230 (1.37 per 1000 people) in men and 8931 (0.29 per 1000 people) in women. According to the joinpoint regression analysis, the 16-year trend of the YLL rate due to premature mortality in men was decreasing, and the annual percent change (APC) was -4.00% (95% confidence interval [CI]: -6.60 to -1.20, P=0.008). However, women demonstrated stable trends in this respect, and APC was -0.50% (95% CI: -3.10 to 2.20, P=0.704).

Conclusion: The crude and standardized mortality rates and the number of YLL due to homicide in the study period had a significant decreasing trend in men but a stable trend in women. To control this issue, officials and policymakers should identify the areas of homicide and control its risk factors such as economic and social issues, drug addiction, and the state of violence.

Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) are major public health challenges globally, and the number of TB infections and death caused by HIV are high because of HIV/ TB co-infection. On the other hand, CD4 count plays a significant role in TB/HIV co-infections. We used a joint model of longitudinal outcomes and competing risks to identify the potential risk factors and the effect of CD4 cells on TB infection and death caused by HIV in HIV-infected patients.

Study design: This was a retrospective cohort study.

Methods: The current study was performed on 1436 HIV+patients referred to Behavioral Diseases Counseling Centers in Kermanshah Province during 1998-2019. In this study, joint modeling was used to identify the effect of potential risk factors and CD4 cells on TB and death caused by HIV.

Results: The results demonstrated that the decreasing CD4 cell count was significantly associated with an increased risk of death, while it had no significant relation with the risk of TB. In addition, patients with TB were at a higher risk of death. Based on the results, a significant relationship was found between CD4 count and sex, marital status, education level, antiretroviral therapy (ART), time, and the interaction between time and ART. Further, people infected with HIV through sexual relationships were at higher risk of TB, while those with a history of imprisonment who received ART or were infected with HIV through drug injection had a lower risk of TB.

Conclusion: The findings revealed that the decreasing CD4 count had a significant association with an increased risk of death caused by HIV. However, it was not significantly related to the risk of TB. Finally, patients with TB were at higher risk of death caused by HIV.

Background: Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level.

Study design: A parallel-group, single-blinded randomized controlled trial.

Methods: Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention.

Results: After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P<0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively.

Conclusion: Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management.

Background: Despite the increase in the age of marriage, early marriage and subsequent adolescent pregnancy remain a serious problem in many regions and societies. Due to low evidence in this regard, this study was conducted to determine the health consequences of adolescent pregnancy.

Study design: This was a case-control study.

Methods: The present study was performed on pregnant women who were referred to Ayatollah Mousavi hospital of Zanjan for delivery in 2021. Pregnant women with gestational age less than 19 years were considered as the case group and those with gestational age between 19-35 years as the control group. The pregnancy outcomes on the mother and the neonate were obtained through the researcher-made checklist. Chi-square test and student's t-test were used to compare variables between the two groups.

Results: In this study, 169 adolescent and 258 adult mothers were compared as the case and control groups, respectively. The mean age of cases and controls was 17.41±1.22 and 30.66±6.46 years, respectively. Cesarean delivery (34.5% vs. 23.67%, P=0.017) and anemia during pregnancy (16.28% vs. 10.7%, P=0.005) were significantly higher in the control group, while mood disorder after delivery was significantly higher in the case group (11.24% vs. 5.84%, P=0.04). The Apgar score 5 minutes after birth and birth weight were significantly higher in mothers of the control group (P<0.05).

Conclusion: The results demonstrated that adolescent mothers are more prone to postpartum depression, and babies born to these mothers are more prone to low birth weight and a low Apgar score. Therefore, adolescent pregnancy should be managed as a high-risk pregnancy.