Persistence of SARS-CoV-2-antibodies against N, S and RBD after natural infection

Background and Objectives

Coronavirus disease 2019 (COVID-19) pandemic has affected most countries in the world. Monitoring the humoral immune responses during the natural course of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and the duration of them provide useful information for the development of vaccination strategies against this virus and its emerging variants. The importance of the antibody response especially neutralizing antibodies in long-term immunity to SARS-CoV-2 is significant.

Materials and Methods

The present study is a cross-sectional study of sero-epidemiological type that has been proposed to compare the persistence of Immunoglobulin G (IgG) against N (nucleocapsid), S (spike) and RBD (receptor-binding domain) proteins in the community after the time of primary disease. A total of 652 serum samples were collected from hospital staff working in COVID wards, as well as a number of community members with different occupations, among those with positive antibody titers, 86 participated in the resampling test before vaccination.

Results

There was no association between antibody titer and disease severity (p>0.05). A significant decrease in Ab levels was observed in the paired second samples. The highest rate of decrease was related to anti-N, then anti-RBD and anti-S IgG levels, respectively. There is a significant relationship between the initial antibody titer and its reduction over time (p-value <0.05).

Conclusion

Our data revealed that humoral immunity following natural infection of SARS-CoV-2 is detectable for at least 4 months, regardless of disease severity. The most decrease in antibody titer over time was related to anti-N IgG levels.

The Effectiveness of Transdiagnostic Treatment Program on Clinical Symptoms and Emotion Regulation in Girls Adolescents with Premenstrual Syndrome

BACKGROUND

Premenstrual Syndrome (PMS) is the experience of some physical and psychological symptoms periodically in the last days of the menstrual cycle that interferes with academic, social and family functioning. We aimed to evaluate the effectiveness of Transdiagnostic Treatment Program (TTP) on clinical symptoms and emotion regulation in girl's adolescents with PMS.

METHODS

This experimental trial study was carried out on 32 girls adolescents with PMS referred to two medical centers located in Tehran, Iran from Mar 21, 2019, to Oct. The patients randomized in 2 groups, 1-intervention (n=16, 8 sessions, 90-minute weekly) and 2-control (n=10).The PMS Screening Tool (PSST) and Emotion Regulation Questionnaire (ERQ) before and after treatment were filled out by participant. The SPSS software and P<0.05 considered for data analysis and as significant levels respectively.

RESULTS

The study sample was 32 girls adolescents with PMS (mean age intervention and control were 16.30±2.02 and 16.40±1.6, P=0.915). The score of two questionnaires, PSST (symptom, effect) and ERQ (cognitive reappraisal, suppression) between two groups in before treatment were the same. After intervention the change of variable symptom (-1.05 vs -0.02, P<0.001), effect (-0.53 vs -0.04, P<0.001), cognitive reappraisal (0.67 vs 0.02, P<0.001) and suppression (-0.64 vs -0.07, P<0.001) were significant between two groups.

CONCLUSION

TTP is an effective technique for controlling clinical symptoms and emotion regulation in girl's adolescents with PMS.

Time to Noise-Induced Hearing Loss among Different Type of Shift Work among Steel Workers: A Survival Study

Background: There have been few reports on relationships between Shift Work (SW) and time to Noise-Induced Hearing Loss (NIHL). This research explores the relation between SW and time to NIHL among male workers. Methods: Between 1990 and 2015, this historical cohort study was conducted. Two different definitions events (Low Frequency Hearing (LFH) and High Frequency Hearing (HFH)) of NIHL An average pure-tone hearing threshold was thresholds at 1, 1.5 and 2 kHz for LFH(un-normal>20) and 4, 6 and 8 kHz for HFH (un-normal>20) for Air (AC) and Bone (BC) conduction, in both ears, respectively. In this study Kaplan–Meier and Multilevel Cox Model in addition R version 3.2.1 and MLWiN software used to analysis data. P-values less than 0.05 are considered to be statistically significant Results: There were 6632 male workers in the research survey (mean age=35(±5)). Among these subjects, 2678 (40%),278 (4%) and 3676 (56%) were Day Workers (DW), Weekly Rotating Shift workers (WRS) and Routinely Rotating Shift workers (RRS), respectively. The result of this study showed more hazard risk of ear problem in LFH (Hazard=1.55 with 95% CI= (1.06-1.39)) and HFH (Hazard=1.08 with 95% CI= (1.04-1.13)) in RRS rather than day workers. In WRS group ear problem has been seen just in LFH (Hazard=1.55 with 95% CI= (1.2-2.0)). Conclusion: The findings of the 15-year historical cohort study generally support a relationship between SW and time to NIHL. Therefore, more actions in the field of noise control, greater use of safety devices as well as increased staff training on the use of safety devices recommended for shift worker.

Mediators for Effect of Mindfulness in Promoting Marital Satisfaction: Modeling Structural Equations in an Experimental Study

Objective: The present study evaluated the model of mediating variables concerning effectiveness of mindfulness in improving women's marital satisfaction. Method: This study was quasi-experimental with pre-test, post-test and control groups. The statistical population included every married woman in Tehran in the year 1396 (2017). The research sample was composed of 60 married women with moderate marital satisfaction. They were chosen using the convenient sampling technique and were randomly assigned to control and experimental groups. The experimental group attended 8 sessions of Mindfulness-Based Stress Reduction (MBSR) and the control group was on a waiting list. Both groups answered the Five Facet Mindfulness Questionnaire (FFMQ), the Depression, Anxiety, and Stress Scale (DASS), Difficulties in Emotion Regulation Scale (DERS), Interpersonal Reactivity Inventory (IRI), Needs for Intimacy Questionnaire of Bagarozi, Positive and Negative Affect Scale (PANAS) and the Couple Satisfaction Index (CSI) before and at end of intervention. The data were analyzed by Structural Equation Modeling (SEM) using PLS-22 and SPSS-23. Results: In the initial hypothetical model, which included the direct effect of mindfulness on marital satisfaction and its indirect effects through psychological distress, emotion regulation, empathy, marital intimacy and positive emotion on marital satisfaction, coefficients of all model paths were significant at 95% level except direct path of mindfulness to marital satisfaction (t = 1.14), marital intimacy to marital satisfaction (t = 0.48) and positive affection to marital satisfaction (t = 1.75). After removing the non-significant paths, the model was tested again and the model fit index (GOF = 0.47) was a very good fit for the modified overall model. Conclusion: The results identified mindfulness-based stress reduction intervention was effective in enhancing marital satisfaction through reducing psychological distress and improving emotion regulation and empathy.

Relationship between Dissociative Experiences and Schizotypal Personality Traits: Mediating Role of Inferential Confusion

Objective: Previous research has shown a relationship between schizotypal personality traits and dissociative tendencies. The Inference-Based Approach (IBA) can explain this relationship to some extent. Purpose of this study was to investigate the mediating role of inferential confusion in relation to dissociative experiences and schizotypal personality traits.

Method: A total of 341 students from Shahed University participated in this cross-sectional study. Sampling was conducted randomly by the cluster sampling method. Data were collected using the Inferential Confusion Questionnaire (ICQ-EV), Schizotypal Personality Questionnaire-Brief (SPQ-B), and Dissociative Experiences Scale (DES-II). Data were analyzed using SPSS-22 software based on statistical methods including Pearson correlation, Baron and Kenny hierarchical regression and the Sobel test.

Results: There were significant positive relationships between dissociative experiences, schizotypal personality traits, and inferential confusion (P < 0.01). Findings showed that inferential confusion mediates the relationship between dissociative experiences and schizotypal personality traits (β = 0.29; P < 0.001).

Conclusion: According to the obtained results, the present study, considering role of inferential confusion, succeeded in explaining the relationship between dissociative experiences and schizotypal personality traits to some extent.

COVID-19 Pandemic and E-Learning Satisfaction in Medical and Non-Medical Student: A Systematic Review and Meta-Analysis

BACKGROUND

The COVID-19 pandemic has led to a rapid shift in student education style from face-to-face to electronic learning. Since the education satisfaction index is considered as a measure of the quality of educational services, therefore, this study aimed to assess E-Learning Satisfaction (ELS) in medical and non-medical students during COVID-19 pandemic.

METHODS

Articles that had been published from 22 Dec 2019 to 4 Jan 2021 were identified through searching databases including PubMed, Scopus, Elsevier, Google Scholar, Web of Science and Iranian Scientific Information Database (SID), Health.barakatkns, IranDoc, Civilica and MagIran using the following keywords: "Distance learning", "Virtual learning", "E-Learning", "Satisfaction", "COVID 19". We systematically reviewed all studies that reported ELS. In this study, meta-analysis was used to estimate the pooled ELS.

RESULTS

Overall, 184 records were identified by the electronic search, of which 24 relevant studies were included in meta-analysis. The pooled ELS in medical, non-medical and overall were 58.1% (50.5%-65.7%), 70.1% (66.8%-73.5%) and 63.8% (58.9%-68.8%) respectively.

CONCLUSION

According to our results and lower ELS in medical students in comparison with non-medical students, designing new E-Learning methods for medical students has been suggested.

The composition of lung microbiome in lung cancer: a systematic review and meta-analysis

Background

Although recent studies have indicated that imbalance in the respiratory microbiome composition is linked to several chronic respiratory diseases, the association between the lung microbiome and lung cancer has not been extensively studied. Conflicting reports of individual studies on respiratory microbiome alterations in lung cancer complicate the matter for specifying how the lung microbiome is linked to lung cancer. Consequently, as the first meta-analysis on this topic, we integrate publicly available 16S rRNA gene sequence data on lung tissue samples of lung cancer patients to identify bacterial taxa which differ consistently between case and control groups.

Results

The findings of the current study suggest that the relative abundance of several bacterial taxa including Actinobacteria phylum, Corynebacteriaceae and Halomonadaceae families, and Corynebacterium, Lachnoanaerobaculum, and Halomonas genera is significantly decreased (p < 0.05) in lung tumor tissues of lung cancer patients in comparison with tumor-adjacent normal tissues.

Conclusions

Despite the underlying need for scrutinizing the findings further, the present study lays the groundwork for future research and adds to our limited understanding of the key role of the lung microbiome and its complex interaction with lung cancer. More data on demographic factors and tumor tissue types would help establish a greater degree of accuracy in characterizing the lung microbial community which accords with subtypes and stages of the disease and fully capturing the changes of the lung microbiome in lung cancer.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12866-021-02375-z.

The risk factors and related hospitalizations for cases with positive and negative COVID-19 tests: A case-control study

BACKGROUND

The aim of this study was to evaluate the risk factors for hospitalizations of cases with positive and negative COVID-19 tests.

METHODS

In this case-control study, the case and control groups consisted of 292 COVID-19 patients and 296 non-COVID-19 patients. Patients who referred to a reference laboratory in Tehran (Iran) in March 2020 were selected and interviewed. The patients were contacted by telephone and data were recorded through a questionnaire.

RESULTS

The sample of this study consisted of 588 patients (349 [59%] females, 239 [41%] males) with a mean age of 42 ± 15. The results of this study showed that comorbidities like diabetes (OR = 7.42), hypertension (OR = 4.85), asthma and respiratory diseases (OR = 5.64) in addition to symptoms including fever (OR = 6.67), chills (OR = 11.2), anorexia (OR = 11.3), dyspnea (OR = 4.8), weakness and lethargy (OR = 5.7) were the most predictive variables for hospitalization of non-COVID-19 cases. Furthermore, demographical variables like male gender (OR = 3.71), high age (>50; OR = 3.12), BMI (>25; OR = 2.37), travel (OR = 2.79), comorbidities including diabetes (OR = 5.26), hypertension (OR = 3.7) and underlying immunosuppressant patients receiving corticosteroid therapy (OR = 3.62) in addition to symptoms like anorexia [OR = 2.55] and dyspnea (OR = 6.99) tend to increase the risk of hospital admission in COVID-19 patients, suggesting their predictive values for hospitalization of COVID-19 patients.

CONCLUSION

Our results indicated that different factors tend to increase the odds of hospital admission in patients with positive and negative COVID-19 tests, suggesting their predictive values for hospitalization.

Cross-cultural adaptation and psychometric validation of the Persian version of the central sensitization inventory

BACKGROUND

The Central Sensitization Inventory (CSI) is a patient-reported tool to assess symptoms associated with central sensitization (CS). It consists of two parts: Part A assesses 25 somatic and emotional CS-related health symptoms, and part B asks if one has previously been diagnosed with a list of 10 Central Sensitivity Syndromes and related conditions.

OBJECTIVES

The aim of this study was to translate and cross-culturally adapt the CSI into Persian and to evaluate its psychometric properties.

DESIGN

Cross-sectional study.

METHOD

After completing the Persian translation, the psychometric properties of the Persian CSI (CSI-Per) were evaluated in 256 patients with chronic pain and 46 healthy subjects.

RESULTS

A confirmatory factor analysis confirmed a 1-factor model suggested in a large recent comprehensive multicountry study. Test-retest reliability (ICC = 0.934; P < 0.001) and the internal consistency (Cronbach's α = 0.87) were both good. After dividing the patient subjects into severity level subgroups, based on CSI-Per total scores, significant associations were found with the Persian version of the pain catastrophizing scale, pain duration, current pain intensity, maximum, minimum and average pain intensity in the past week and average pain intensity in the past month. In addition, total CSI-Per scores differentiated between patients and healthy subjects.

CONCLUSION

The CSI-Per demonstrated good validity and reliability to assess symptoms associated with CS in Persian-speaking patients with chronic pain.

Real Clinical Practice and Therapeutic Management Following COVID-19 Crisis in two Hospitals in Iran: A Statistical and Conceptual View

BACKGROUND

The Coronavirus disease 2019 (COVID-19) outbreak quickly has spread and became a pandemic. However, no approved therapeutics or effective treatment is available for the treatment of these patients. The present study was done to retrospectively assess the treatment strategies (e.g., pharmaceutical care services) for COVID-19 patients in selected hospitals and highlight the importance of such services in the management of a pandemic.

MATERIALS AND METHODS

Data from a series of COVID-19 patients (978 patients; 658 males [66.9%] and 324 females [33.1%]) admitted to the selected hospitals in Tehran from 20 February to 19 March 2020 were retrieved retrospectively from the Health Information System (HIS) of the hospitals. The statistical tests were used for analyzing the effect and correlation of the variables (drugs) with the average length of stay (ALOS) in the hospital.

RESULTS

Diverse medication classes and old drugs with or without strong evidence of therapeutic effects against the novel coronavirus, some previously tried as a treatment for SARS-CoV and MERS-CoV, were mostly used for the treatment of patients in the hospitals. Many medications (broad-spectrum antibiotics and antivirals) or combination therapies are used without evidence of their therapeutic effects during pandemics.

CONCLUSION

Therefore, guidelines should be provided for the off-label use of these drugs by policymakers and stakeholders during a pandemic emergency due to high demands. Also, monitoring of the HIS data can play an important role in improving public health response to emerging diseases.

The relationship between personality traits and psychosomatic complaints in a sample of Iranian adults

BACKGROUND

It has been suggested that personality traits may be related to the psychological conditions of people. The current study aimed to explore the relationship between personality traits and psychosomatic complaints.

METHODS

This study was carried out on a sample of Iranian adults living in Isfahan province. The NEO Five- Factor Inventory questionnaire was used to assess personality traits. A 30-item comprehensive questionnaire was used to assess somatoform symptoms and factor analysis was performed to construct psychosomatic complaints profiles. Data was analyzed by Multiple Indicators Multiple Causes (MIMIC) model, using R software.

RESULTS

In total, 4763 participants were recruited 44.2% males and 55.8% females, with a mean age of 36.54 ± 8.04 years. The results of the MIMIC model showed that there is a significant association between the dimensions of personality (neuroticism, extroversion, openness, agreeableness and conscientiousness) and dimensions of psychosomatic complaints profiles (gastrointestinal, neuro-skeletal, pharyngeal-respiratory and psychological) (P < 0.05). In addition, we found that characteristics such as age, sex, marital status, education, physical activity, and body mass index are related to psychosomatic complaints (P < 0.05) and can affect the association between personality traits and psychosomatic complaints.

CONCLUSIONS

Given the relationship between personality traits and psychosomatic complaints, it is possible to provide preventive and therapeutic interventions for psychosomatic complaints based on personality traits specific to each individual.

The Signs and Symptoms Comparison of Gastrointestinal Diseases between Classic Medicine and Iranian Traditional Medicine: A Hybrid Qualitative Study

Background: Iranian traditional medicine is the oldest form of medical structure and is, in fact, an inseparable part of the life of various Iranian societies. On the other hand, gastrointestinal and liver diseases are one of the most common causes of morbidity in the world, including in Iran. Such that 10% of diseases are allocated to them and their diseases are spreading increasingly. Objective: Considering the mentioned issues and the high prevalence of gastrointestinal symptoms, the aim of this study is to investigate the compliance of the symptoms of gastrointestinal diseases in classical medicine with Iranian traditional medicine from the viewpoint of Iranian traditional medicine experts. Methods: This is a hybrid qualitative study which was conducted in three phases, including 1- theoretical, 2- field and 3- combinational phases. In the theoretical phase, two types of medical textbooks i.e. Iranian traditional and classic medicine textbooks. In the field stage, 13 academic Iranian traditional medicine experts with at least 5 years of work experiences in Iranian traditional medicine were interviewed. Then, in the combinational phase, the results of two early phases have been summarized using descriptive statistics. Results: The results of the study show that 12 of the 40 symptoms in this study had a compliance of 100%. These 12 symptoms are Increase of Salivation, Pica, Borborygmi, Hiccups, Abdominal distention, Melena, Anal Fissure, Anal Stenosis, Cryptitis, Anal pruritus, Halitosis, Rectal pain; also, the results showed that 10 of the 40 symptoms in this study had over 70% compliance. These 10 symptoms are as Dysphagia, Belching, Regurgitation, Hematemesis, Flatulence, Increased Bowel sound, Abdominal pain, Diarrhea, Jaundice and Anal prolapse. Also, the percentage of compliance with the other 18 symptoms was less than 70%. Conclusion: Considering the results of this study and the capabilities of Iranian medicine in relation to symptoms of gastrointestinal diseases with classical medicine, it is possible to design appropriate patterns to expose it. Also, an integrated approach to clinical research is recommended to improve the efficacy and safety of gastrointestinal treatments.

Lamivudine's efficacy and safety in preventing mother-to-child transmission of hepatitis B: A meta-analysis

BACKGROUND/AIMS

Mother-to-child transmission (MTCT) is a common transmission mode of hepatitis B virus (HBV). It has been shown that the infection may occur in some infants despite the use of immunoprophylaxis, and many studies have demonstrated the efficacy of antivirals such as lamivudine to reduce such events.

MATERIALS AND METHODS

A meta-analysis was conducted concerning the efficacy and safety of lamivudine during pregnancy, in the prevention of vertical transmission of HBV infection. Studies were identified by searching various databases up to January 2016 for variations of the following phrase: "lamivudine AND (pregnancy or pregnant) AND (HBV or hepatitis)." Subjects who had received lamivudine were included in the case group, and those who had not were included in the control group.

RESULTS

Our search identified a total number of 881 citations, of which 25 studies (with a total number of 2,667 pregnant women) were included in the meta-analysis. The analysis showed a significant difference between the seropositive HBsAg infants from the case and control groups (RR= 16.97, 95% confidence interval 8.36-34.45), which is the most critical factor in determining the MTCT of HBV. No significant difference was reported between the prevalence of side effects in the case and control groups.

CONCLUSION

This meta-analysis strongly suggests the use of lamivudine in the prevention of HBV vertical transmission in carrier pregnant women with the HBV DNA levels greater than 106 copies/mL. And for women with the HBV viral loads lower than 106 copies/mL, we suggest clinicians to examine the use of lamivudine on a case-to-case basis, noting that lamivudine seems to be a safe drug for the mother and the fetus.

Million Visual Analogue Scale Questionnaire: Validation of the Persian Version

Study Design

Descriptive cross-sectional study.

Purpose

To validate the Persian version of the Million Visual Analogue Scale Questionnaire (MVAS), a self-administered low back pain (LBP) questionnaire.

Overview of Literature

The majority of LBP questionnaires translated into Persian evaluate the impact of LBP on daily living. The MVAS is one of the most commonly used self-administered LBP questionnaires, and was developed to assess a different direction and effect of activities of daily living on LBP intensity.

Methods

The questionnaire was translated into Persian with the forward-backward method and was administered to 150 patients randomly sampled from an occupational medicine clinic in Tehran in 2017.

Results

Cronbach’s alpha for all subscales ranged between 0.670 and 0.799. Confirmatory factor analysis showed adequate construct validity of the Persian version of the MVAS, with root mean square error of approximation 0.046, goodness of fit index 0.902, and comparative fit index 0.969. Other indexes were satisfactory.

Conclusions

The Persian MVAS is a valid and reliable instrument that can assess the effect of various daily activities on the intensity of LBP.

Identification of candidate microRNA biomarkers in diabetic nephropathy: a meta-analysis of profiling studies

AIMS

The aim was to perform a meta-analysis on the miRNA expression profiling studies in diabetic nephropathy (DN) to identify candidate diagnostic biomarkers.

METHODS

A comprehensive literature search was done in several databases and 53 DN miRNA expression studies were selected. To identify significant DN-miR meta-signatures, two meta-analysis methods were employed: vote-counting strategy and the robust rank aggregation method. The targets of DN-miRs were obtained and a gene set enrichment analysis was carried out to identify the pathways most strongly affected by dysregulation of these miRNAs.

RESULTS

We identified a significant miRNA meta-signature common to both meta-analysis approaches of three up-regulated (miR-21-5p, miR-146a-5p, miR-10a-5p) and two down-regulated (miR-25-3p and miR-26a-5p) miRNAs. Besides that, subgroup analyses divided and compared the differentially expressed miRNAs according to species (human and animal), types of diabetes (T1DN and T2DN) and tissue types (kidney, blood and urine). Enrichment analysis confirmed that DN-miRs supportively target functionally related genes in signaling and community pathways in DN.

CONCLUSION

Five highly significant and consistently dysregulated miRNAs were identified, and future studies should focus on discovering their potential effect on DN and their clinical value as DN biomarkers and therapeutic mediators.

The Psychometric Properties of the Persian Version of the Contamination Cognition Scale (CCS)

Objective: In recent years, many researchers have been searching for effective cognitive factors in the development of obsessive-compulsive disorder (OCD). One of the scales designed to measure this characteristic is the contamination cognition scale (CCS) that evaluates 2 dimensions: overestimating the likelihood and severity of contamination. The aim of the present study was to evaluate the psychometric properties of the Persian version of CCS. Method : The study population of this descriptive psychometric study included students of Shahed University. A total of 490 students were selected via cluster sampling and completed the CCS. CCS was translated and back- translated before given to the students. The Obsessive Beliefs Questionnaire (OBQ) and the Padua Inventory (PI) were used. To assess the evidence for the validity of the scale, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed by SPSS-22 and Amos-22 software. Results: The results of the confirmatory factor analysis (CFA) showed that one-factor model did not have adequate fitness (RMSEA>.05). Therefore, to explore the factors of this scale, exploratory factor analysis (EFA) was used, and it revealed 3 factors (public equipment, food, and restroom) for each of the dimensions (likelihood and severity). CFA by AMOS-22 confirmed the three-factor model (GFI, CFI, and NFI>.95; RMSEA<.05). Furthermore, the results supported criteria validity of CCS with the PI total score (0.56- 0.47, p<0.001) and PI-contamination subscale (0.71-0.75, p<0.001). Also, the correlation between CCS and responsibility/threat subscale of the OBQ was significant (0.47- 0.49, p<0.001) The Cronbach's alpha for likelihood dimensions total was 0.93 and it was 0.94 for severity dimension total. The composite reliability was 0.95 for the likelihood dimension and 0.96 for severity dimension of CCS. Also, the test-retest reliability after a 4-week interval was confirmed (likelihood: r = 0.78; severity: r = 0.81, p<.001). Conclusion: The results indicated that one-factor model of CCS did not have adequate fitness, but three-factor model was confirmed in both dimensions (likelihood and severity). According to the results of the present study, the reliability and validity of the Persian version of CCS were acceptable.

Two Triacylglycerol Pathway Genes, CTDNEP1 and LPIN1, are Down-Regulated by hsa-miR-122-5p in Hepatocytes

BACKGROUND

Expression of miR-122 is highly specific to hepatocytes of the liver.  This miRNA is involved in lipid hemostasis of the tissue; however, there is no comprehensive understanding of its function in lipid hemostasis.

MATERIALS AND METHODS

Since hepatocytes are responsible for part of Triacylglycerol (TAG) synthesis in the body, we hypothesized that miR-122, as the most abundant miRNA in the tissue, might regulate TAG metabolism by targeting key enzymes that are involved in its production pathway. A systematic computational analysis of putative targets of miR-122 identified CTDNEP1 and LPIN1 genes in the TAG pathway. We used dual-luciferase reporter assay, quantitative RT-PCR as well as western blot to confirm the repressive effect of miR-122 on CTDNEP1 and LPIN1 in TAG pathway.

RESULTS

Real time PCR on liver needle biopsies with hepatosteatosis showed that miR-122 is up-regulated in hepatosteatosis. Surprisingly, the protein and RNA level of identified targets of miR-122 are also up-regulated in clinical samples, probably as a disproportionate feedback response to the high level of miR-122.

CONCLUSION

Our findings suggest that up-regulation of miR-122 can trigger the compensatory response of LPIN1 and CTDNEP1 in hepatosteatosis.

Predictors of Oral Health Behaviors in Female Students: An Application of the Health Belief Model

BACKGROUND

Oral and dental health diseases can affect the general health of students.

OBJECTIVES

The aim of this study was to identify the predictors of oral and dental health behavior using the health belief model (HBM) in female students in Teheran, Iran.

PATIENTS AND METHODS

This was a cross-sectional study framed by the HBM, including 400 female students living in district 5 of Tehran, Iran. The sampling technique used in this study was multi-stage stratified random sampling. The data on the HBM constructs (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy) and demographic characteristics were collected using a self-administered questionnaire. Descriptive statistics, bivariate correlations, and linear regression were performed to analyze the data, using the SPSS software, version 18.

RESULTS

The results showed that there were relationships between the knowledge, perceived barriers, cues to action, and mother's education with oral health behaviors. A multivariate hierarchical regression analysis was conducted with the barrier entered at step one, knowledge at step two, and cues to action at step three. Finally, the three variables accounted for 17% of the total variance in the oral and dental health behavior.

CONCLUSIONS

The current study provided evidence for the utility of the belief-based model in the prediction of oral health behaviors. It could be suggested that oral health behavior can be promoted by reducing the perceived barriers and enhancing the students' knowledge of oral and dental hygiene.

Expression of Folliculogenesis-Related Genes in Vitrified Human Ovarian Tissue after Two Weeks In Vitro Culture

OBJECTIVE

This study was designed to evaluate the effects of vitrification and in vitro culture of human ovarian tissue on the expression of oocytic and follicular cell-related genes.

MATERIALS AND METHODS

In this experimental study, ovarian tissue samples were obtained from eight transsexual women. Samples were cut into small fragments and were then assigned to vitrified and non-vitrified groups. In each group, some tissue fragments were divided into un-cultured and cultured (in α-MEM medium for 2 weeks) subgroups. The normality of follicles was assessed by morphological observation under a light microscope using hematoxylin and eosin (H&E) staining. Expression levels of factor in the germ line alpha (FIGLA), KIT ligand (KL), growth differentiation factor 9 (GDF-9) and follicle stimulating hormone receptor (FSHR) genes were quantified in both groups by real-time reverse transcriptase polymerase chain reaction (RT-PCR) at the beginning and the end of culture.

RESULTS

The percentage of normal follicles was similar between non-cultured vitrified and non-vitrified groups (P>0.05), however, cultured tissues had significantly fewer normal follicles than non-cultured tissues in both vitrified and non-vitrified groups (P<0.05). In both cultured groups the rate of primary and secondary follicles was significantly higher than non-cultured tissues (P<0.05). The expression of all examined genes was not significantly altered in both non-cultured groups. Whiles, in comparison with cultured tissues non-cultured tissues, the expression of FIGLA gene was significantly decreased, KL gene was not changed, GDF-9 and FSHR genes was significantly increased (P<0.05).

CONCLUSION

Human ovarian vitrification following in vitro culture has no impairing effects on follicle normality and development and expression of related-genes. However, in vitro culture condition has deleterious effects on normality of follicles.

Job Stress and Related Factors Among Iranian Male Staff Using a Path Analysis Model

BACKGROUND

In recent years, job stress has been cited as a risk factor for some diseases.

OBJECTIVES

Given the importance of this subject, we established a new model for classifying job stress among Iranian male staff using path analysis.

MATERIALS AND METHODS

This cross-sectional study was done on male staff in Tehran, Iran, 2013. The participants in the study were selected using a proportional stratum sampling method. The tools used included nine questionnaires (1- HSE questionnaire; 2- GHQ questionnaire; 3- Beck depression inventory; 4- Framingham personality type; 5- Azad-Fesharaki's physical activity questionnaire; 6- Adult attachment style questionnaire; 7- Azad socioeconomic questionnaire; 8- Job satisfaction survey; and 9- demographic questionnaire).

RESULTS

A total of 575 individuals (all male) were recruited for the study. Their mean (±SD) age was 33.49 (±8.9) and their mean job experience was 12.79 (±8.98) years. The pathway of job stress among Iranian male staff showed an adequate model fit (RMSEA=0.021, GFI=0.99, AGFI=0.97, P=0.136). In addition, the total effect of variables like personality type (β=0.283), job satisfaction (β=0.287), and age (β=0.108) showed a positive relationship with job stress, while variables like general health (β=-0.151) and depression (β=-0.242) showed the reverse effect on job stress.

CONCLUSIONS

According to the results of this study, we can conclude that our suggested model is suited to explaining the pathways of stress among Iranian male staff.

Efficacy of HBM-Based Dietary Education Intervention on Knowledge, Attitude, and Behavior in Medical Students

Background

Using various models of behavior change, a number of studies in the area of nutrition education have confirmed that nutrition habits and behaviors can be improved.

Objectives

This study sought to determine the effects of education on patterns of dietary consumption among medical students at the military university of Tehran, with a view to correcting those patterns.

Methods

In this quasi-experimental study, 242 medical students from the Military University of Tehran were chosen by convenience sampling and then divided into control (n = 107) and intervention groups (n = 135) by block randomization. The self-administered questionnaire involving six categories of item (knowledge, perceived benefits, perceived barriers, perceived threats, self-efficacy and behavior) has been validated (Cronbach alpha > 0.7 for each).

Results

Following the educational intervention, the mean score of knowledge, health belief model (HBM) structure, and behavior of students in relation to healthy patterns of food intake increased significantly (P < 0.05). The mean pre-intervention knowledge score was 6.76 (1.452), referring to threats to HBM constructs including perceived threat 2.93 (1.147), perceived benefits 7.28 (1.07), perceived barriers 5.44 (1.831), self- efficacy 4.28 (1.479), and behavior 8.84 (2.527). The post-intervention scores all improved as follows: knowledge 8.3 (1.503), perceived threats 3.29 (1.196), perceived benefits 7.71 (0.762), perceived barriers 5.9 (1.719), self- efficacy 4.6 (1.472), and behavior 9.45 (2.324). This difference in mean scores for knowledge, health belief structures and employee behavior before and after educational intervention was significant (P ≤ 0.05).

Conclusions

The significant improvement in the experimental group’s mean knowledge, HBM structures , and behavior scores indicates the positive effect of the intervention.

Hepatitis B Virus Infection in the General Population of Iran: An Updated Systematic Review and Meta-Analysis

CONTEXT

The hepatitis B virus (HBV) is a major global public health problem, affecting more than 2 billion people worldwide. Accurate and updated data on HBV prevalence is important for further planning to control the infection. The aim of this study was to update the prevalence estimate of HBV infection in the general population of Iran.

EVIDENCE ACQUISITION

A systematic review was done for data on the prevalence of HBV infection in the general Iranian population published between Jan. 1, 1990, and Jan. 1, 2016, in both international and national databases, including PubMed, Scopus, Web of Science, Scientific Information Database, IranMedex, and Magiran. All papers with clearly described time and location of the study, proper sampling strategies, and proper analysis methods were included in the present study. Data were extracted by two independent reviewers. Prevalence of HBV infection with a 95% confidence interval (CI) was calculated using Stata software, version 13.

RESULTS

The polled estimated prevalence of HBV infection in the general population of Iran was 2.2 % (95% CI: 1.9% - 2.6%). The highest prevalence of HBV infection (8.9%, 95% CI: 7.6% - 10.2%) was reported from Golestan province, and the lowest prevalence (0.7%, 95% CI: 0.4% - 1.1%) was seen in Kermanshah province. The prevalence of HBV infection was estimated at 3% (95% CI: 2.2% - 3.8%) for Iranian males and 1.7% (95% CI: 1.2% - 2.3%) for Iranian females. The prevalence of HBV infection in the general population of Iran was 2.9% (95% CI: 2.5% - 3.4%) before 2010 and 1.3% (95% CI: 0.9% - 1.7%) after 2010.

CONCLUSIONS

In total, Iran was classified within the low-intermediate HBV prevalence areas (2% - 4%), while according to recent data (after 2010), Iran was classified within the low HBV prevalence areas (< 2%), indicating that preventive measures conducted in Iran have been effective.

Identification and assessment of medical errors in the triage area of an educational hospital using the SHERPA technique in Iran

Accidents caused by human error are prominent in the medical field. The present study identified medical errors in the emergency triage area by assessing the tasks of all healthcare workers employed in the triage area of an educational hospital in Tehran, Iran in 2014. Data were collected using the systematic human error reduction and prediction approach (SHERPA). The tasks and sub-tasks were determined and analyzed using hierarchical analysis and the errors were extracted. A total of 199 human errors were identified in the different tasks. The rate of error for action was 46.8%, checking was 25.6%, retrieval was 8.5%, communication was 12.1% and selection was 7%. Rate of unacceptable and unfavorable risks were 21.1% and 38.6%, respectively. SHERPA was shown to be an appropriate technique for detecting medical errors. The establishment of control programs should be a high priority in the management and implementation of health facilities in triage areas.

Nutrition and physical activity educational intervention on CHD risk factors: a systematic review study

INTRODUCTION

Fast growing epidemic of chronic diseases causes many health challenges over the world. Regarding reported pros and cons, the aim of the current study is to review the effect of nutrition and physical educational intervention in decreasing cardiovascular risk factors.

METHODS & MATERIALS

In this review study, searching has done through the English and Persian databases. Articles with other languages, lack of important information, and score 3 or less in the JADAD standard checklist were exluded from the study.

FINDINGS

In the primary search, 194 articles have been found.Through four stages of secondary search and further evaluation, 43 articles were selected. These articles were published between 1989 to 2013.

CONCLUSION

According to these findings, the majority of articles showed a positive effect of nutrition and physical activity educational interventions on cardiovascular risk factors- blood cholesterol, systolic and diastolic blood pressure, as well as smoking cigarette in high risk patients. These results, suggest the necessity of continiuting nutrition and physical educational intervention for individuals with cardiovascular risk factors.

Factors predicting nutrition and physical activity behaviors due to cardiovascular disease in tehran university students: application of health belief model

Background:

Disease preventing methods focus mostly on lifestyle factors such as physical activity, healthy diet and not smoking. Previous studies verified using theory and models to change unhealthy behaviors, so that health belief model (HBM) is a useful framework for describing the healthy nutrition behavior.

Objectives:

This study aimed to predict factors related to unhealthy nutrition and inactive life in students of Tehran University, Tehran, Iran based on the Health Belief Model (HBM).

Patients and Methods:

In this cross sectional study, proportional quota sampling from three different educational levels was conducted from October to December 2012. A self-administered validated instrument based on the Health Belief Model (HBM) with 69 items and four sections was used to collect data. In this study through using linear and logistic regression, the effect of body mass index, age, gender, marriage, self-efficacy, cues to action, knowledge, perceived severity, susceptibility, benefits and barriers on nutrition and physical activity behavior were assessed. SPSS version 18 was used to analyze data.

Results:

Totally, 368 students including 318 female students (86.4%) and 50 male students (13.6%) with a mean age of 24.9 years (SD = 4.55) took part in the study. Among all independent variables, gender (P < 0.001), knowledge (P = 0.023) and perceived barriers (P = 0.004) predicted nutrition behavior. In case of physical activity, knowledge (P = 0.011), perceived severity (P = 0.009), perceived barriers (P = 0.019) and self-efficacy (P = 0.033) had significance association with physical activity behavior.

Conclusions:

This study indicated that health belief model contrasts could predict the risky behavior of university students due to heart disease. However, more researches are needed to verify the predictors of high risky behaviors in students.

Factor structure of the Iranian version of 12-item general health questionnaire

BACKGROUND

The 12-Item General Health (GHQ-12) questionnaire is one of the most commonly used instruments in screening studies on mental health.

OBJECTIVES

The current study aimed to examine the factor structure of the GHQ-12 questionnaire among the students in Iran.

MATERIALS AND METHODS

It was a cross-sectional study in which 428 university students were recruited and completed the GHQ-12. Reliability of the GHQ-12 was evaluated using the Cronbach's alpha and the split-half method by applying the Spearman-Brown coefficient. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was conducted to assess how well the EFA extracted model fitted the observed data.

RESULTS

The mean age of the participants was 22.83 years (SD = 3.09). Most of them were female (56.1%) and 81% were unemployed. The Cronbach's alpha coefficient for the Iranian version of GHQ-12 was 0.85. Using the split-half method, the alpha for the social dysfunction was found to be 0.77; it was 0.76 for the psychological distress. The principal component analysis revealed a two-factor structure for the questionnaire including social dysfunction and psychological distress that explained 48% of the observed variances. The confirmatory factor analysis was showed fit for the data.

CONCLUSIONS

The current study findings confirm that the Iranian version of GHQ-12 has a good factor structure and is a reliable and valid instrument to measure psychological distress and social dysfunction.

Factors affecting intensive care units nursing workload

Background:

The nursing workload has a close and strong association with the quality of services provided for the patients. Therefore, paying careful attention to the factors affecting nursing workload, especially those working in the intensive care units (ICUs), is very important.

Objectives:

This study aimed to determine the factors affecting nursing workload in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences.

Materials and Methods:

This was a cross-sectional and analytical-descriptive study that has done in Iran. All nurses (n = 400) who was working in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences in 2014 were selected and studied using census method. The required data were collected using a researcher–made questionnaire which its validity and reliability were confirmed through getting the opinions of experts and using composite reliability and internal consistency (α = 0.89). The collected data were analyzed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and using SPSS 18.0 and AMOS 18.0.

Results:

Twenty-five factors were divided into three major categories through EFA, including structure, process, and activity. The following factors among the structure, process and activity components had the greatest importance: lack of clear responsibilities and authorities and performing unnecessary tasks (by a coefficient of 0.709), mismatch between the capacity of wards and the number of patients (by a coefficient of 0.639), and helping the students and newly employed staff (by a coefficient of 0.589).

Conclusions:

The nursing workload is influenced by many factors. The clear responsibilities and authorities of nurses, patients' admission according to the capacity of wards, use of the new technologies and equipment, and providing basic training for new nurses can decrease the workload of nurses.

A Randomized Trial on the Effect of Razavi's Dietary Pattern on the Components of Metabolic Syndrome

Background

Metabolic syndrome can cause cardiovascular disease and diabetes in the affected subjects. With 20 to 30% prevalence rate among the adult population of most countries, it is considered a pandemic problem. The guidelines currently available on the management of the specific components of metabolic syndrome highlight some lifestyle changes such as enhanced physical activity and weight reduction. Adherence to Mediterranean-style diet has been shown to be associated with lower risk of metabolic syndrome in some clinical studies.

Objectives

The aim of this study was the evaluation of the effect Razavi dietary pattern, on metabolic syndrome. This is the first study performed to address this issue.

Patients and Methods

Seventy five eligible subjects with metabolic syndrome were recruited into a single-blind randomized controlled clinical trial to determine the effect of Razavi diet on metabolic syndrome. Intervention was carried out by educating the Razavi diet in the experimental group while giving no dietary recommendations to the control group. The level of physical activity was similar between the two groups. Features of the metabolic syndrome as defined by the criteria of the Iranian National Committee of Obesity were assessed after two months.

Results

The net reduction in the waist circumference (-2.85), weight (-1.44) and BMI (-0.58) in test group was significantly (P < 0.001) higher than the control. Decreases in systolic and diastolic blood pressure, fasting blood sugar and triglycerides were observed but were not statistically significant.

Conclusions

The results suggest that Razavi diet can improve some components of metabolic syndrome leading to reduced risk of cardiovascular disease and diabetes.

Interferon alpha-2b therapy in chronic hepatitis delta

BACKGROUND

Approximately 5% of hepatitis B virus (HBV) carriers are coinfected with hepatitis D virus (HDV). HBV/HDV coinfection is a major cause of cirrhosis and end stage liver disease in chronic HBsAg carriers. The only approved therapy for chronic hepatitis delta is interferon alpha (IFN α) in either pegylated or conventional forms. Although higher doses and longer durations of IFN α therapy in HBV/HDV coinfected patients are currently applied, yet treatment response is low.

OBJECTIVES

We aimed to determine the efficacy of IFN α-2b therapy in patients with HBV/HDV coinfection.

PATIENTS AND METHODS

In this cross sectional study, 20 HBsAg carriers with positive Anti-HDVAb and RT-PCR for HDV RNA were recruited and treated for three year duration with 5 million units (MU) of IFN α-2b, three times weekly or one year with 5 MU of IFN α-2b daily. Sustained virological response (SVR) was defined as a negative qualitative HDV RT-PCR, 6 months after treatment cessation.

RESULTS

Overall, 3 (15%) subjects achieved SVR, 10 cases (50%) relapsed after treatment cessation and 7 (35%) patients did not clear HDV during the treatment.

CONCLUSIONS

HDV coinfection with HBV had very low response rate to high doses and long durations of IFN α-2b therapy.

Sexual behavioral abstine HIV/AIDS questionnaire: Validation study of an Iranian questionnaire

BACKGROUND

This study was designed to assess the validity and reliability of the designed sexual, behavioral abstinence, and avoidance of high-risk situation questionnaire (SBAHAQ), with an aim to construct an appropriate development tool in the Iranian population.

MATERIALS AND METHODS

A descriptive-analytic study was conducted among female undergraduate students of Tehran University, who were selected through cluster random sampling. After reviewing the questionnaires and investigating face and content validity, internal consistency of the questionnaire was assessed by Cronbach's alpha. Explanatory and confirmatory factor analysis was conducted using SPSS and AMOS 16 Software, respectively.

RESULTS

The sample consisted of 348 female university students with a mean age of 20.69 ± 1.63 years. The content validity ratio (CVR) coefficient was 0.85 and the reliability of each section of the questionnaire was as follows: Perceived benefit (PB; 0.87), behavioral intention (BI; 0.77), and self-efficacy (SE; 0.85) (Cronbach's alpha totally was 0.83). Explanatory factor analysis showed three factors, including SE, PB, and BI, with the total variance of 61% and Kaiser-Meyer-Olkin (KMO) index of 88%. These factors were also confirmed by confirmatory factor analysis [adjusted goodness of fitness index (AGFI) = 0.939, root mean square error of approximation (RMSEA) = 0.039].

CONCLUSION

This study showed the designed questionnaire provided adequate construct validity and reliability, and could be adequately used to measure sexual abstinence and avoidance of high-risk situations among female students.

Impact of Pegylated Interferon-alfa-2a on Perforin Level in Patients With Chronic Hepatitis B; Preliminary Study

BACKGROUND

Chronic hepatitis B is one of the most common causes of cirrhosis and hepatocellular toxicity in many countries, including Iran. Cytotoxic T lymphocyte (CTL) and Natural killer (NK) cells are the two of main cell populations considered as cytotoxic cells. One of the distinct pathways CTL and NK cells exert cytotoxicity is perforin/granzyme. After the cytotoxic cell/target cell junction, perforin is released from granules by exocytosis. Once it is anchored, perforin forms cylindrical pores through which granzymes and granulysin enter and induce apoptosis.

OBJECTIVES

Large controlled trials have demonstrated the efficacy of PEG-IFN-α-2a in treatment of chronic hepatitis B. This study was aimed to examine whether the enhancement of cytotoxicity by PEG-IFN-α-2a is mainly due to the perforin pathway.

PATIENTS AND METHODS

This research work was performed on 50 patients and five healthy people. Patients with chronic hepatitis B were further subdivided into two groups: patients with inactive chronic hepatitis B (carriers, n = 30), and those with active chronic hepatitis B who were under treatment with PEG-IFN-alfa-2a (n = 20) for minimum six and maximum 12 months. Serum perforin level was measured using ELISA method (CUSABIO Company), HBV viral load was assessed using COBAS Taq-man, and we used Elecsys hepatitis B surface antigen (HBs Ag) II quantitative assay method for HBs Ag determination. HBeAg was evaluated by ELISA method, and AST and ALT were measured by routine laboratorymethods.

RESULTS

Based on the results obtained serum perforin level in healthy group was 0.64 ng/mL, the mean of serum perforin level in inactive HBs Ag carriers was 2.63ng/mL, and 4.63 ng/mL in patients with active chronic hepatitis B under treatment with PEG-IFN-α-2a. The mean of serum perforin level in patients with and without virologic response to treatment were 5.45 ng/mL,and 3.4 ng/mL respectively. Finally in patients with virologic response and seroconverted serum perforin level was 7.23 ng/mL.

CONCLUSIONS

Based on our results higher perforin level in patients under treatment with PEG-IFN-α-2a, could be an indication of elevated cytotoxicity via perforin/granzyme pathway.

Plasma zinc level in hepatitis C patients with or without Beta thalassemia major; is there any difference?

BACKGROUND

Zinc deficiency has been reported frequently in hepatitis C patients in the literature. Furthermore, a decrease in zinc level has been shown in beta thalassemia major as well. Iranians consume a large amount of phytate in their regimens which can bind with zinc and decrease its gastrointestinal absorption.

OBJECTIVES

This study was designed to determine plasma zinc level in an Iranian sample with the diagnosis of hepatitis C with or without concomitant beta thalassemia major.

PATIENTS AND METHODS

Between April 2011 and April 2012, plasma zinc level was determined via atomic absorption method, in 130 hepatitis C patients with or without beta thalassemia major in a known referral center of hepatic diseases in Tehran, Iran.

RESULTS

Mean ± standard deviation (SD) of plasma zinc levels was determined as 0.78 ± 0.22 mg/L. Also zinc level was 0.76 ± 0.19 mg/L and 0.80 ± 0.24 mg/L in thalassemic and non thalassemic patients, respectively. T-test analysis showed that there is no significant difference between these two groups regarding plasma zinc level (P = 0.235).

CONCLUSIONS

It is concluded that zinc level of studied patients is less than which is reported in normal Iranian population. Moreover, there is not a significant difference in plasma zinc levels between thalassemic and non thalassemic patients and it seems to be a common problem in both ones. Addition of zinc supplement may be recommended in both groups in order to optimize the nutritional support and probably improve the treatment response.

Historical cohort study on the factors affecting blood pressure in workers of polyacryl iran corporation using bayesian multilevel modeling with skew T distribution

BACKGROUND

Hypertension is considered as a major public health problem in most countries due to its association with ischemic heart disease which causes cerebrovascular disease and death.

OBJECTIVES

The purpose of the present study was to study factors affecting Blood Pressure (BP).

PATIENTS AND METHODS

The data were extracted from annual observation of the workers who worked in Polyacryl Iran Corporation (PIC) between 1998 and 2010. In this research, we assessed the effect of Body Mass Index (BMI), age, sex, job status, marital status, job schedule type, and education level on Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) using Bayesian multilevel modeling with skew t distribution using WinBUGS software.

RESULTS

Totally 3965 persons participated in this study, 75(1.9%) female and 3890 (98.1%) male. In this study age, sex, BMI, job status, marital status, and education level had statistical association with SBP. The result for DBP was similar to SBP except the education level which had no statistical association.

CONCLUSIONS

Treating obesity, increasing physical activity and quality of married life are proposed as practical solutions to reduce BP.

Hypertension control in industrial employees: findings from SHIMSCO study

BACKGROUND

Hypertension prevention and control are among the most important public health priorities. We evaluated the impacts of a workplace intervention project "Stop Hypertension in Mobarakeh Steel Company" (SHIMSCO) on controlling hypertension in industrial workers.

METHODS

The study was carried out in Mobarakeh Steel Company in Isfahan among 7286 male workers and employees. All individuals were evaluated for the presence of hypertension (HTN). According to examinations, 500 subjects with systolic blood pressure (SBP) ≥ 140 mmHg, and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and/or those using antihypertensive medications were confirmed to have HTN and thus included in this study. They were questioned for sociodemographic characteristics, past medical history and medication use. They received an educational program including healthy lifestyle and self-care recommendations of HTN management and control as well as training for accurate blood pressure measurement and home monitoring for two years. SBP, DBP, weight, height and routine lab tests were measured for all hypertensive subjects before and after the interventions. Paired t-test, generalized estimation equation (GEE) and ordinary linear regression (OLR) were used for statistical analysis in SPSS.

RESULTS

The comparison of SBP and DBP before and after the educational program showed significant reductions in both parameters (-7.97 ± 14.72 and -2.66 ± 9.96 mmHg, respectively). However, a greater decrease was detected in case of DBP. GEE showed SBP and DBP to decrease about -0.115 and -0.054 mmHg/month. OLR also revealed reductions of 4.88 and 2.57 mmHg respectively in SBP and DBP upon adding each antihypertensive drug.

CONCLUSION

SHIMSCO, a 3-year interventional project in workplaces, was effective in reducing SBP and DBP among hypertensive employees and workers. We conclude that implementing simple educational programs in worksites can improve the management and control of hypertension and perhaps other chronic diseases.