Marzieh Nojomi
Tehran University of Medical Sciences, Community Medicine, Faculty Member
Background Vaccination is a key intervention to prevent COVID-19. Many vaccines are administered globally, yet there is not much evidence regarding their safety and adverse effects. Iran also faces this challenge, especially as data... more
Background Vaccination is a key intervention to prevent COVID-19. Many vaccines are administered globally, yet there is not much evidence regarding their safety and adverse effects. Iran also faces this challenge, especially as data regarding the Sputnik V vaccine is sparse. Therefore, the aim of this study is to determine the adverse effects of the most commonly used vaccines in Iran. Methods Using a retrospective cohort study design, 6600 subjects aged 18 years or older who had received two doses of any of the three COVID-19 vaccines (Sinopharm, AstraZeneca, and Sputnik V) were selected using a random sampling method between March and August 2021. Subjects were asked about any adverse effects of the vaccines by trained interviewers via telephone interview. Vaccine-related adverse effects in individuals during the first 72 h and subsequently following both doses of the vaccines were determined. The demographic variables, type of administered vaccine, adverse effects, and history of...
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Background: Sleep disturbances are common among adult populations and can have a significant effect on daytime activities. The aim of this study is to determine the prevalence of sleep problems and subjective sleep quality in the adult... more
Background: Sleep disturbances are common among adult populations and can have a significant effect on daytime activities. The aim of this study is to determine the prevalence of sleep problems and subjective sleep quality in the adult population of Tehran, Iran. Methods: From an urban community of Tehran, a random sample of 3400 adult men and women were selected by a cross-sectional design. Using the Persian version of the Pittsburgh Sleep Quality Index (PSQI), subjects were interviewed face-to-face. There were ...
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Background: Assessment of quality-of-life (QOF) as an outcome measure after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD) need a valid, reliable and responsive instrument. The aim of the current study... more
Background: Assessment of quality-of-life (QOF) as an outcome measure after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD) need a valid, reliable and responsive instrument. The aim of the current study was to determine responsiveness of validated Persian version of PD questionnaire with 39-items (PDQ-39) after DBS surgery in patients with PD. Methods: Eleven patients with PD, who were candidate for DBS operation between May 2012 and June 2013 were assessed. PDQ-39 and short-form questionnaire with 36-items (SF-36) were used. To assess responsiveness of PDQ-39 standardized response mean (SRM) was used.
Abortion is a public health concern because of its impact on maternal morbidity and mortality. Each year, about 79 million unintended pregnancies, excluding miscarriage, occur worldwide. More than half of these unintended pregnancies end... more
Abortion is a public health concern because of its impact on maternal morbidity and mortality. Each year, about 79 million unintended pregnancies, excluding miscarriage, occur worldwide. More than half of these unintended pregnancies end in abortion. The purpose of this study was to determine the ever-event incidence of abortion (spontaneous and induced) and some related factors in a population-based sample of reproductive age women. From July 2003 through January 2004, 2470 women were included in the study through multistage random sampling and were interviewed. Data were collected using a checklist with questions about demographics and specific items regarding abortion history. Information about age, literacy, gravidity, marriage age, abortion, type of abortion, family history of abortion, history of family marriage, smoking, drug use, alcohol use, coffee intake, and incidence of abortion during the previous year were recorded. Statistical analysis included Student's t-test, C...
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The burden of obesity and diet-related chronic diseases is increasing in Iran, and prevention and treatment strategies are needed to address this problem. The aim of this study was to determine the outcome, cost, safety and... more
The burden of obesity and diet-related chronic diseases is increasing in Iran, and prevention and treatment strategies are needed to address this problem. The aim of this study was to determine the outcome, cost, safety and cost-consequence of non-invasive weight loss interventions in Iran. We performed a systematic review to compare non-invasive interventions (cryolipolysis and radiofrequency/ ultrasonic cavitation) with semi-invasive (lipolysis) and invasive (liposuction). A sensitive electronic searching was done to find available interventional studies. Reduction of abdomen circumference (cm), reduction in fat layer thickness (%) and weight reduction (kg) were outcomes of efficacy. Meta-analysis with random models was used for pooling efficacy estimates among studies with the same follow-up duration. Average cost per intervention was estimated based on the capital, maintenance, staff, consumable and purchase costs. Of 3,111 studies identified in our reviews, 13 studies assessed ...
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Background: Spiritual well-being is an important issue in health sciences, hence the need for validated instruments to assess this aspect of health in the Iranian population. The aim of the current study was to determine the validity of... more
Background: Spiritual well-being is an important issue in health sciences, hence the need for validated instruments to assess this aspect of health in the Iranian population. The aim of the current study was to determine the validity of the Persian versions of 2 most common measures of spiritual health (Spiritual Well-Being Questionnaire [SWBQ] or Spiritual Health and Life-Orientation Measure [SHALOM] and Spiritual Well-Being Scale [SWBS]). Methods: This was a cross-sectional study via a convenience sampling method in Iran University of Medical Sciences with 170 participants aged above 18 years comprising students, teachers, and administrative staff and managers. The study was conducted from September 7, 2014 to September 20, 2015 in Tehran. Four questionnaires, namely the SWBQ, SWBS, General Health Questionnaire (GHQ-12), and Oxford Happiness Questionnaire (OHQ), were used. Statistical analysis was done using SPSS 18 and LISREL (version 8.2). Cronbach's alpha, intra-class corre...
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Women with chronic medical conditions require careful contraceptive management. The aim of this cross-sectional study in Tehran was to determine the pattern of contraception use by women with diabetes, hypertension or obesity. A sample of... more
Women with chronic medical conditions require careful contraceptive management. The aim of this cross-sectional study in Tehran was to determine the pattern of contraception use by women with diabetes, hypertension or obesity. A sample of 264 women aged 18-53 years old was recruited; 81 (30.7%) had diabetes type 2,100 (37.9%) were obese/overweight (BMI > 25 kg/m2) and 83 (31.5%) had hypertension. Across all 3 groups, the rate of use of contraceptive methods was significantly different before and after diagnosis. Before diagnosis of disease the most common method was hormonal contraception in all women (55.0%, 71.6% and 78.3% of diabetic, overweight and hypertensive women respectively), whereas after diagnosis coital withdrawal was the most common method in diabetic and obese/overweight women (41.2% and 28.0% respectively) and almost the most common method for hypertensive women (35.4%). Use of safe and modern methods of contraception in women with certain chronic medical conditio...
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Background: Alzheimer's disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable... more
Background: Alzheimer's disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. Methods: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. Results: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesi...
Objective: In this systematic review, we aimed to evaluate the existing strategies and interventions in domestic violence prevention to assess their effectiveness. Method : To select studies, Pubmed, ISI, CINAHL, PsycINFO, Cochrane,... more
Objective: In this systematic review, we aimed to evaluate the existing strategies and interventions in domestic violence prevention to assess their effectiveness. Method : To select studies, Pubmed, ISI, CINAHL, PsycINFO, Cochrane, Scopus, Embase, Ovid, Science Direct, ProQuest, and Elsevier databases were searched. Two authors reviewed all papers using established inclusion/ exclusion criteria. Finally, 18 articles were selected and met the inclusion criteria for assessment. Following the Cochrane quality assessment tool and AHRQ Standards, the studies were classified for quality rating based on design and performance quality. Two authors separately reviewed the studies and categorized them as good, fair, and poor quality. Results: Most of the selected papers had fair- or poor-quality rating in terms of methodology quality. Different intervention methods had been used in these studies. Four studies focused on empowering women; 3, 4, and 2 studies were internet-based interventions,...
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Background: Assessment of quality-of-life (QOF) as an outcome measure after deep brain stimulation (DBS) surgery in patients with Parkinson’s disease (PD) need a valid, reliable and responsive instrument. The aim of the current study was... more
Background: Assessment of quality-of-life (QOF) as an outcome measure after deep brain stimulation (DBS) surgery in patients with Parkinson’s disease (PD) need a valid, reliable and responsive instrument. The aim of the current study was to determine responsiveness of validated Persian version of PD questionnaire with 39-items (PDQ-39) after DBS surgery in patients with PD. Methods: Eleven patients with PD, who were candidate for DBS operation between May 2012 and June 2013 were assessed. PDQ-39 and short-form questionnaire with 36-items (SF-36) were used. To assess responsiveness of PDQ-39 standardized response mean (SRM) was used. Results: Mean age was 51.8 (8.8) and all of the patients, but just one were male (10 patients). Mean duration of the disease was 8.7 (2.1) years. Eight patients were categorized as moderate using Hoehn and Yahr (H and Y) classification. All patients had a better H and Y score compared with the baseline evaluation (3.09 vs. 0.79). The amount of SRM was ab...
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Background: Early detection through screening is the best method to reduce death due to breast cancer. It has been shown, having knowledge and generating positive attitudes, influences the decision of women to participate in the screening... more
Background: Early detection through screening is the best method to reduce death due to breast cancer. It has been shown, having knowledge and generating positive attitudes, influences the decision of women to participate in the screening programs. The aim of this study was to identify the factors associated with breast cancer screening (BCS) and with an intention to have screening among women in Tehran, Iran. Methods: A cross-sectional study was carried out from January to July 2011, among women who had attended to primary health-care centers in West Tehran using multi-stage sampling method. We invited 1,240 women sequentially to complete a self-administered survey questionnaire at the beginning of their visit; and 1,012 (82%) completed the survey. The questionnaire included, items drawn from the Preventive Health Model that assess socio-demographic background and perceptions about BCS. Multiple logistic regression analysis was performed to identify factors associated with screenin...
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Background: The risk of violence is higher in some occupations, including nursing. Also, violence is becoming more prevalent in health care settings. The first step for reducing violence is recognition of its potential risk factors. The... more
Background: The risk of violence is higher in some occupations, including nursing. Also, violence is becoming more prevalent in health care settings. The first step for reducing violence is recognition of its potential risk factors. The aim of present study was assessment of violence against nurses and related risk factors in Iran. Methods: In this descriptive-analytical and cross-sectional study Persian version of NEXT questionnaire was used. Sampling method was multistep sampling. Stratification was performed based on the hospital and then in each hospital questionnaires was given to nurses non-randomly. 1070 nurses working in 14 TUMS (Tehran University of medical sciences) hospitals were included in the study. Results: Psychological violence from patients and their relatives against nurses included in the study was 60.3%. There was no significant relationship between age, sex, professional position, work experience, patients numbers who worked with participants in a single shift ...
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BACKGROUND Responsiveness refers to non-clinical aspects of the health system and responds to this question that whether health system is responsive to rightful expectations of people. The present study was conducted to determine the... more
BACKGROUND Responsiveness refers to non-clinical aspects of the health system and responds to this question that whether health system is responsive to rightful expectations of people. The present study was conducted to determine the health system responsiveness about chronic heart failure patients in one of the main heart centers in Tehran during 2012 - 2013. METHODS In this cross-sectional study 300 patients have completed a valid questionnaire that designed by World Health Organization (WHO) for measurement of responsiveness. Analysis of data was based on analysis WHO multi-country study that was designed to evaluate responsiveness in health care systems. RESULTS In outpatient services, worst performance was related to choice and prompt attention domains (35.8% and 35.1%). Autonomy (31.5%) has the worst performance of inpatient services. Both in outpatient and inpatient services "confidentiality of information" has the best performance (87.8% and 85.6%). Responsiveness ...
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BACKGROUND Depression and anxiety are the most common mental disorders and currently, they constitute one of the main causes of disability and death. The high prevalence of psychiatric disorders and their increasing burden are noteworthy.... more
BACKGROUND Depression and anxiety are the most common mental disorders and currently, they constitute one of the main causes of disability and death. The high prevalence of psychiatric disorders and their increasing burden are noteworthy. The aim of this study is to investigate the effectiveness of community-based preventive interventions for depression and anxiety in women. METHODS We systematically searched for articles published up to the beginning of 2018, which addressed community-based preventive interventions for depression and anxiety in women. The studies were searched in PubMed, Scopus, Cochrane Library, Web of Science, PsycInfo, IranMedex, SID and EMBASE electronic databases. Articles that complied with our inclusion criteria (preventive interventions involving healthy adult women aged 18 to 65 years) were reviewed. Quality assessment of the articles was performed using standard tools. We extracted the required data and reported the results in a narrative form. RESULTS Tw...
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Objective In the last 30 years, ever since the PHC network in Iran has been established, the job duties of Behvarzes (Mental Health Workers in rural areas) have been constantly increasing. The aim of this study was to determine the... more
Objective In the last 30 years, ever since the PHC network in Iran has been established, the job duties of Behvarzes (Mental Health Workers in rural areas) have been constantly increasing. The aim of this study was to determine the burnout level, mental health status and the severity of occupational stress among Behvarzes. Methods All Behvarzes (227) working in areas covered by Iran University of Medical Sciences were considered for participation in the study. Maslach Burnout Inventory, GHQ-12, and Stainmentz questionnaires were used. Results The completed questionnaires were returned by 93% of the subjects. The mean score of job stress was in the first percentile (42.8 ± 27.16). 17.6% of the study subjects had moderate to severe level of burnout; 12.3%, 5.3% and 43% of the subjects had abnormal scores on emotional exhaustion, depersonalization and personal subscales respectively; and 28.3% of the cases were suspected to have mental disorders by GHQ. Discussion In spite of increasin...
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Background: Back pain is a common patients’ complaint, and its etiology is important because of different potential treatment approaches (based on causes). For a better diagnosis, magnetic resonance imaging (MRI) is widely used in... more
Background: Back pain is a common patients’ complaint, and its etiology is important because of different potential treatment approaches (based on causes). For a better diagnosis, magnetic resonance imaging (MRI) is widely used in clinical settings that may result in inappropriate requests. This study aims to evaluate the appropriateness of the lumbosacral MRI requests in patients with back pain in two public/referral and private imaging centers in Tehran. Methods: In this cross-sectional study, 279 patients from both centers were recruited in 2014. A checklist was developed based on the internationally recognized clinical guidelines (NICE, and AHRQ) for determining the indications. An expert panel of related specialties finalized them. Patients’ demographic and some anthropometric measures, as well as MRI reports, were collected. Results: The mean±SD age of patients was 47.9±14.78 years with a dominance of females (M/F=38.4/61.6). About 77% (n=214) of lumbosacral MRIs were requeste...
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Seyed Kazem Malakouti 1 Marzieh Nojomi Saied Mahmoudian 2 Neda Alifattahi 3 Maryam Salehi 4 1 Psychiatry Tehran University of Medical Sciences Tehran Ivory Coast (Côte d’Ivoire). sk-malakouti@tums.ac.ir 2 Ear, Nose, Throat, Head and Neck... more
Seyed Kazem Malakouti 1 Marzieh Nojomi Saied Mahmoudian 2 Neda Alifattahi 3 Maryam Salehi 4 1 Psychiatry Tehran University of Medical Sciences Tehran Ivory Coast (Côte d’Ivoire). sk-malakouti@tums.ac.ir 2 Ear, Nose, Throat, Head and Neck Research Center, Tehran University of Medical Sciences Tehran AC Brazil. saeid.mahmoudian@gmail.com 3 Mental Health Research Center Tehran University of Medical Sciences Tehran Ivory Coast (Côte d’Ivoire). nalifattahi@yahoo.com 4 Community Medicine Tehran University of Medical Sciences Tehran Ivory Coast (Côte d’Ivoire). drmaryamsalehi@yahoo.com Tehran University of Medical Sciences Correspondence: Marzieh Nojomi, MD, MPH. Professor of Community Medicine Fellow, Clinical Epidemiology (U.W, Seattle), Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences Tehran, Iran Tel : +98 21 88602225 Fax : +98 21 88602217 Email:mnojomi@tums.ac.ir Objective: Complaining of psychiatric symptoms is more common among individuals ...
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Background: Alzheimer’s disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable... more
Background: Alzheimer’s disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. Methods: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. Results: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity w...
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Background: With increasing knowledge concerning fractures of the distal radius, different classifications have been proposed. Reliability of most of these classifications has been assessed. The Fernandez classification has never been... more
Background: With increasing knowledge concerning fractures of the distal radius, different classifications have been proposed. Reliability of most of these classifications has been assessed. The Fernandez classification has never been assessed for intraobserver and interobserver reliability, although this classification is commonly used. Methods: Five observers including one attending orthopaedic hand surgeon, one hand surgery fellow, two attending orthopaedic surgeons and one senior resident of orthopaedic surgery classified 42 standard anteroposterior and lateral radiographs of prereduction distal radius fractures. Four weeks later the radiographs were renumbered differently and reviewed and classified by the same observers. Reliability of classification was assessed by Kappa value. Results: The mean intraobserver Kappa value was 0.64 (0.53-0.73), indicating good or substantial reliability, while the mean interobserver reliability was 0.45(0.300.71) representing moderate reliabili...
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Background: The Endometriosis Health Profile-30 (EHP-30) is a disease-specific questionnaire to measure the health-related quality of life in patients with endometriosis. The aim of this study was to evaluate the validity and reliability... more
Background: The Endometriosis Health Profile-30 (EHP-30) is a disease-specific questionnaire to measure the health-related quality of life in patients with endometriosis. The aim of this study was to evaluate the validity and reliability of the Persian version of Endometriosis Health Profile (EHP-30) in women with endometriosis referring to three Gynecology Clinics in Tehran, Iran. Methods: One hundred women (20 to 50 years old) with surgically confirmed endometriosis recruited from three outpatient Gynecology Clinics affiliated to the Iran University of Medical Sciences. All 100 patients were asked to complete EHP-30 questionnaire while referring to the Clinics. The findings were analyzed using descriptive statistics, internal reliability consistency, construct validity (using short form-36, which had already been validated in Iran), factor analysis (with principle component analysis method), and item total correlation to assess the validity and reliability of the questionnaire. Re...
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Background: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide... more
Background: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds. Methods: This work as a field trial study was conducted in Nahavand and Savojbolagh from April 2010 to March 2011 (12 months). A screening tool was designed. Required capacities such as treatment, referral and registration system were provided six months before the main study. The intervention phase (for one year) including the treatment process and five consultation sessions was conducted to identify depressed people and individuals with high risk of suicide. The data were analyzed by Chi square test...
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Cancer is a problem of both global and local concern. We determined the geo-epidemiological and spatial distribution of the 10 most common cancers in Iran. We used the data of the Iranian Cancer Registry for the year 2014 analysing the... more
Cancer is a problem of both global and local concern. We determined the geo-epidemiological and spatial distribution of the 10 most common cancers in Iran. We used the data of the Iranian Cancer Registry for the year 2014 analysing the prevalence of 112,131 registered cancer cases with the aim of detecting potential geographical underlying causes. The geographic distribution of cancers is reported as standardized incidence rates at the provincial level considering risk with respect to sex and age. A geographical information systems (GIS) approach based on Anselin Local Moran's index method was used to map clusters and spatial autocorrelation patterns. The mean age of the patients was 55.6 (±17.8) and 61.7 (±18.2) for females and males, respectively, in the database which showed 46.1% (n=51,665) of all cases to be female. Analysis of the spatial distribution of cancers showed significant differences among the different provinces. Stomach and breast cancers were the most prevalent...
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BACKGROUND Cardiovascular disease (CVD) is the leading cause of death globally and has enormous costs for healthcare systems. This disease has a strong association with lifestyle behaviors. Therefore, applying reliable and effective... more
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death globally and has enormous costs for healthcare systems. This disease has a strong association with lifestyle behaviors. Therefore, applying reliable and effective strategies for prevention and treatment of CVD is important. In this study, we aimed to evaluate the adherence of cardiologist physicians to the American Heart Association (AHA) guideline for prevention of CVD. METHODS Using a cross-sectional study, data were gathered for 208 patients using their medical records in the cardiology ward of a general teaching hospital. A physician systematically reviewed the medical records and completed the checklist in each domain. Adherence to the AHA guideline was evaluated in treating physician's choices and recommendations regarding these eight variables: hypertension (HTN), dietary intake, weight management, diabetes management, physical activity, blood lipid management, smoking, and aspirin prescription. RESULTS...
Background: The process of medical education is stressful and medical students are at risk of psychological problems. In addition to the normal stressors of everyday life, medical students must deal with stresses specific to medical... more
Background: The process of medical education is stressful and medical students are at risk of psychological problems. In addition to the normal stressors of everyday life, medical students must deal with stresses specific to medical school. The aim of this study was to assess mental health in senior medical students and residents. Methods: This cross-sectional study included 100 senior medical students and 100 residents of Iran University of Medical Sciences, Tehran, between October and December of 2006. The measurement method was the SCL-90-R questionnaire. Respondents rate 90 items using a 5-point scale to measure the extent to which they have experienced the listed symptoms during the last 7 days. In this study we only reported GSI and raw scores of SCL-90-R subscales. We used the cut off point of 0.7 for GSI. All statistical analyses were carried out by using SPSS for Windows 14. A significant level was considered as 5%. Results: The mean and standard deviation of GSI was 0.55. ...
Atopic dermatitis (AD) is a chronic disease affecting 10–30% of children and 2–10% of adults worldwide. It is manifested by the pruritus eczema lesions on the skin. Immune thrombocytopenic purpura (ITP) is the most common cause of acute... more
Atopic dermatitis (AD) is a chronic disease affecting 10–30% of children and 2–10% of adults worldwide. It is manifested by the pruritus eczema lesions on the skin. Immune thrombocytopenic purpura (ITP) is the most common cause of acute onset of thrombocytopenia in childhood. The aim of this study was association of primary immune thrombocytopenic purpura and atopia among children. This case control study was performed on patients with acute and chronic ITP who were confirmed by a hematologist. The control group was also selected from the siblings of the patients who were healthy and almost matched by age and sex with the patient group. Data were entered into a questionnaire under the SPSS-20 program, and demographic data were analyzed descriptively. In the present study, 120 patients were enrolled, 60 of whom were in the patient group and 60 in the control group. Mean age was 95 and 98 months for patients and control. This study showed a significant association of ITP with allergic...
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Background. High blood pressure (HBP) is a proven risk factor for cardiovascular diseases. So, determining the extent of the contribution of the factors associated with HBP seems to be necessary. Accordingly, this study aimed to... more
Background. High blood pressure (HBP) is a proven risk factor for cardiovascular diseases. So, determining the extent of the contribution of the factors associated with HBP seems to be necessary. Accordingly, this study aimed to investigate how much the prevalence of HBP attributed to obesity and high blood glucose (HBG). Methods. Data were collected from 7612 participants extracted from a screening program in 2018, in Iran, which was conducted on the subjects with the age of 30 years old and older to investigate the prevalence of HBP and their associated risk factors. To collect data, we used a standard checklist in terms of the WHO STEPS manual, and a stratified multistage sampling method was also applied. The adjusted population attributable risk of overweight, obesity, and HBG for HBP was calculated by the logistic regression model using the aflogit module. Results. Among the studied people, 7.4% of male and 10.8% of female subjects were hypertensive. The adjusted analysis showe...
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Background. The onset of breastfeeding has a high success rate in most countries, but the time for termination of breastfeeding varies between countries. Objective. This survey was aimed to determine the effective factors on the early... more
Background. The onset of breastfeeding has a high success rate in most countries, but the time for termination of breastfeeding varies between countries. Objective. This survey was aimed to determine the effective factors on the early termination of breastfeeding. Methods. This study was conducted in 2018, in Iran. About 410 mothers were enrolled in the study. All considered factors were evaluated as factors influencing the continuity of breastfeeding. Survival analysis was used to analyze data. Results. The mean age of the mothers was equal to 29.48 ± 5.8 years. The frequency of termination of breastfeeding before the first 2 years was equal to 34%. The mean of breastfeeding duration was equal to 21.49 ± 5.3 months. The percentage of infants who had been breastfed for 24 months was equal to 65.8%. An infant’s birth weight (2500–4000 gr) (hazard ratio: 0.54), neonatal birth order (hazard ratio: 0.69), neonatal pathologic jaundice (hazard ratio: 1.52), starting time of using compleme...
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Objective The primary objective of the present study was to compare the mental health status of Iranian medical vs other health sciences students and to examine how demographic factors relate to their mental health problems. Methods A... more
Objective The primary objective of the present study was to compare the mental health status of Iranian medical vs other health sciences students and to examine how demographic factors relate to their mental health problems. Methods A total of 560 medical and other health sciences students (250 (44.6%) males and 310 (55.4%) females) were recruited from Iran University of Medical Sciences. Data were obtained by self-administered questionnaire, including questions on socio-demographic characteristics. The Beck Depression Inventory, Beck Anxiety Inventory, General Health Questionnaire, and WHO well-being index were used to assess mental health status of students. Results Ten percent of students had BDI scores consistent with clinically significant depression (6.6% mild, 1.8% moderate, 1.6% severe), and 28.7% had BAI scores consistent with clinically significant anxiety (20.7% mild, 7.1% moderate, 0.9% severe). Kurdish students had an odds ratio (OR) of 2.71 (95% CL, 1.22–6.02) for mild to severe depression symptoms when compared to Persian students. The prevalence of distressed health sciences students and poor psychological well-being was 13.4% and 14.1%, respectively. Maternal education gave an OR of 0.57 (0.35–0.93) for anxiety symptoms, after adjustment for all other factors. The possibility of general psychiatric morbidity was significantly lower in students who studied medicine (OR, 0.40 (0.21–0.71)). Being born in the capital city was associated with better psychological well-being (OR, 0.48 (0.26–0.86)). Conclusions Ethnicity, birthplace, discipline, and maternal educational level were major determinants of mental health status among health sciences students. Further research should be undertaken to determine the prevalence of psychological disorders using more reliable diagnostic interview.
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OBJECTIVES To estimate the cost effectiveness of introducing the quadrivalent human papillomavirus (HPV) vaccine into the national immunization program of Iran. METHODS The CERVIVAC cost-effectiveness model was used to calculate... more
OBJECTIVES To estimate the cost effectiveness of introducing the quadrivalent human papillomavirus (HPV) vaccine into the national immunization program of Iran. METHODS The CERVIVAC cost-effectiveness model was used to calculate incremental cost per averted disability-adjusted life-year by vaccination compared with no vaccination from both governmental and societal perspectives. Calculations were based on epidemiologic parameters from the Iran National Cancer Registry and other national data sources as well as from literature review. We estimated all direct and indirect costs of cervical cancer treatment and vaccination program. All future costs and benefits were discounted at 3% per year and deterministic sensitivity analysis was used. RESULTS During a 10-year period, HPV vaccination was estimated to avert 182 cervical cancer cases and 20 deaths at a total vaccination cost of US $23,459,897; total health service cost prevented because of HPV vaccination was estimated to be US $378,646 and US $691,741 from the governmental and societal perspective, respectively. Incremental cost per disability-adjusted life-year averted within 10 years was estimated to be US $15,205 and US $14,999 from the governmental and societal perspective, respectively, and both are higher than 3 times the gross domestic product per capita of Iran (US $14,289). Sensitivity analysis showed variation in vaccine price, and the number of doses has the greatest volatility on the incremental cost-effectiveness ratio. Using a two-dose vaccination program could be cost-effective from the societal perspective (incremental cost-effectiveness ratio = US $11,849). CONCLUSIONS Introducing a three-dose HPV vaccination program is currently not cost-effective in Iran. Because vaccine supplies cost is the most important parameter in this evaluation, considering a two-dose schedule or reducing vaccine prices has an impact on final conclusions.
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Numerous studies have been conducted to evaluate the frequency of hypovitaminosis D in patients with fibromyalgia syndrome (FMS) and its association with FMS symptoms. This study aimed at assessing the effect of hypovitaminosis D on the... more
Numerous studies have been conducted to evaluate the frequency of hypovitaminosis D in patients with fibromyalgia syndrome (FMS) and its association with FMS symptoms. This study aimed at assessing the effect of hypovitaminosis D on the symptoms and quality of life of patients with fibromyalgia. A total of 74 FMS patients with hypovitaminosis D were randomly assigned into group A (Trazodone 25 mg at bedtime + vitamin D 50 000 IU weekly) and group B (Trazodone 25 mg at bedtime + placebo). Serum vitamin D level, Widespread Pain Index (WPI), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), and Short Form Health Survey (SF-36) were used at the beginning of the treatment and 4 and 8 weeks post treatment. Significant improvements were observed in WPI, FIQ, and PSQI scores in both groups. Moreover, combination of vitamin D and Trazodone resulted in significant improvement of SF-36 scores compared to Trazodone therapy. Improvement in pain-related indices inclu...
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The recent limitation in the provision of publicly-funded family planning services in Iran has concerned stakeholders in reproductive health about the incidence of unintended pregnancies. This study used data from Hamedan Survey of... more
The recent limitation in the provision of publicly-funded family planning services in Iran has concerned stakeholders in reproductive health about the incidence of unintended pregnancies. This study used data from Hamedan Survey of Fertility, conducted in April-June 2015 among a representative sample of 3,000 married women aged 15-49 years living in the city of Hamedan (Iran), to estimate levels of unintended pregnancies and examine factors related to pregnancy intentions for the most recent birth, using multinomial logistic regression analyses. Results showed that 23% of pregnant women reported their pregnancy as unintended (17% mistimed and 6% unwanted). Moreover, unintended pregnancies in the five years preceding the survey were the result of failures of withdrawal (35%) and of modern contraceptive use (33%), along with contraceptive discontinuation (23%) and nonuse (9%). Multivariate results indicated that the risk of unintended pregnancy was lower among women reporting modern c...
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Spiritual well-being is an important issue in health sciences, hence the need for validated instruments to assess this aspect of health in the Iranian population. The aim of the current study was to determine the validity of the Persian... more
Spiritual well-being is an important issue in health sciences, hence the need for validated instruments to assess this aspect of health in the Iranian population. The aim of the current study was to determine the validity of the Persian versions of 2 most common measures of spiritual health (Spiritual Well-Being Questionnaire [SWBQ] or Spiritual Health and Life-Orientation Measure [SHALOM] and Spiritual Well-Being Scale [SWBS]). This was a cross-sectional study via a convenience sampling method in Iran University of Medical Sciences with 170 participants aged above 18 years comprising students, teachers, and administrative staff and managers. The study was conducted from September 7, 2014 to September 20, 2015 in Tehran. Four questionnaires, namely the SWBQ, SWBS, General Health Questionnaire (GHQ-12), and Oxford Happiness Questionnaire (OHQ), were used. Statistical analysis was done using SPSS 18 and LISREL (version 8.2). Cronbach's alpha, intra-class correlation coefficient, P...
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Intravenously administered erythropoietin (EPO) was firstly commenced (phase 1) in patients with indirect traumatic optic neuropathy (TON) by this group in 2011. It was re-tested by another group (phase 2) in 2014. This multicenter... more
Intravenously administered erythropoietin (EPO) was firstly commenced (phase 1) in patients with indirect traumatic optic neuropathy (TON) by this group in 2011. It was re-tested by another group (phase 2) in 2014. This multicenter clinical trial was designed to compare its effect with intravenous steroid and observation. Included were TON patients ≥5 years of age and with trauma-treatment interval of ≤3 weeks. Follow-up visits were set at 1, 2, 3, 7, 14, 30, and at least 90 days after treatment. EPO and methylprednisolone were infused intravenously every day for three consecutive days. Primary outcome measure was change in the best corrected visual acuity (BCVA). Secondary outcomes included change in color vision and relative afferent pupillary defect (RAPD), side effects, and factors affecting the final visual improvement. Out of 120 patients, 100 (EPO: 69, steroid: 15, observation: 16) were finally included. All three groups showed a significant improvement of BCVA which was not ...
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Summary The enduring sub-replacement level of fertility in Iran is the result of changing timing of births. Using data from the 2015 Hamedan Survey of Fertility, conducted in a representative sample of 3000 married women aged 15–49, this... more
Summary The enduring sub-replacement level of fertility in Iran is the result of changing timing of births. Using data from the 2015 Hamedan Survey of Fertility, conducted in a representative sample of 3000 married women aged 15–49, this study examined variations in median lengths of birth intervals employing cumulative survival functions, and investigated the determinants of birth interval lengths using regression hazard models. The results showed that the median first, second and third birth intervals, estimated at 28, 74 and 136 months respectively, doubled between 1995 and 2015. The multivariate analysis results indicated the strong impact of contraceptive use and higher education on lengthening birth intervals, with greater effects on the timing of second and third births. The relative risks of second and third births were higher among rural migrants, unemployed women and those with shorter periods of breast-feeding and the death of a preceding birth. Only timing of the third b...
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The aim of current study was to determine women´s maternal asthma in pregnancy, delivery and birth outcomes. Using a retrospective cohort design, data of 580 pregnant women were gathered form a large teaching hospital in Tehran, Iran. The... more
The aim of current study was to determine women´s maternal asthma in pregnancy, delivery and birth outcomes. Using a retrospective cohort design, data of 580 pregnant women were gathered form a large teaching hospital in Tehran, Iran. The medical records of pregnant women who had attended this hospital between 2009 and 2011 were assessed. Data of delivery and birth outcomes were gathered by observation and medical records of women. Multiple logistic regression and adjusted odds ratio (OR) were used to assess the independent association of asthma and outcomes. 274 patients (47.2%) were in "asthmatic group" and 306 patients (52.8%) were in the "non-asthmatic group". Basic and demographic variables showed the same distribution across two groups. Maternal asthma showed an adjusted relationship with gestational diabetes (OR=2.64), gestational hypertension (OR=3.79), cesarean delivery (OR=2.68), small for gestational age (OR=2.86), premature rupture of membrane (OR=2.1...
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To determine the measurement properties of the Persian language version of the Graves orbitopathy quality of life questionnaire (GO-QOL). Following a systematic translation and cultural adaptation process, 141 consecutive unselected... more
To determine the measurement properties of the Persian language version of the Graves orbitopathy quality of life questionnaire (GO-QOL). Following a systematic translation and cultural adaptation process, 141 consecutive unselected thyroid eye disease (TED) patients answered the Persian GO-QOL and underwent complete ophthalmic examination. The questionnaire was again completed by 60 patients on the second visit, 2-4 weeks later. Construct validity (cross-cultural validity, structural validity and hypotheses testing), reliability (internal consistency and test-retest reliability), and floor and ceiling effects of the Persian version of the GO-QOL were evaluated. Furthermore, Rasch analysis was used to assess its psychometric properties. Cross-cultural validity was established by back-translation techniques, committee review and pretesting techniques. Bi-dimensionality of the questionnaire was confirmed by factor analysis. Construct validity was also supported through confirmation of...
Research Interests: Psychometrics, Quality of life, Medicine, Ophthalmic Epidemiology, Humans, and 12 moreFemale, Male, Clinical Sciences, Aged, Middle Aged, Optometry and Ophthalmology, Adult, Public health systems and services research, Reproducibility of Results, Severity of Illness Index, Disability Evaluation, and Surveys and Questionnaires
Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and... more
Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) wa...
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Media advertisements especially radio and TV are one of the most important and effective ways for health promotion and consumption of healthy productions worldwide. Ministry of Health and some other ministries in Iran agreed to control... more
Media advertisements especially radio and TV are one of the most important and effective ways for health promotion and consumption of healthy productions worldwide. Ministry of Health and some other ministries in Iran agreed to control and restrict the advertising of unhealthy products and services. Therefore, adequate supervision and monitoring should be done in this field. A content analysis of Health-related Advertisements was done in Islamic Republic of Iran Broadcasting (IRIB) Methods: This study was a cross-sectional research and collecting of data was carried out in 2012. Ten selected TV and radio channels were recorded from 6 a.m. to 12 p.m. for two successive months in the special weekdays. Broadcasted advertisements data were extracted by the trained observers according to a checklist and analyzed using SPSS 18 software and described with descriptive statistics. The percentage of different types of advertising were including 73.9% unrelated to health, 21.9% harmless health...