Particulate matter exposure in construction sites is associated with health effects in workers

Background

Exposure to suspended particulate matters (PMs) at high concentrations, mainly observed in the construction workplace, is found to be a risk factor for major health outcomes. The present study was conducted to investigate the degree of exposure to suspended PMs in different stages of construction of the buildings and the health risk associated with the exposure in Lar, Fars, Iran.

Methods

In this cross-sectional study, two construction sites were selected in Lar. Cancer and non-cancer health risks of exposure to PM_2.5 and PM₁₀ were assessed using the US Environmental Protection Agency method in three-dimensions: inhalation, digestion, and dermal absorption. The hazard quotient (HQ) and total cancer risk (TCR) were considered as parameters for risk analysis.

Results

The highest level of non-cancer risk for workers in the concentrations of PM_2.5 and PM₁₀ particles in the drilling process were determined to be 2.97 × 10^-1 and 8.52 × 10^-2, respectively. In the cancer risk analysis, PM₁₀ concentrations were estimated to be at the highest level (1.7 × 10^-7) in the drilling process and the lowest level (4.29 × 10^-8) in the facilities process. For suspended PM_2.5, it was an unacceptable risk level in all processes, except for the implementation of facilities.

Conclusion

These results show that the construction industry, especially in developing countries such as Iran, needs better management to maintain the health of construction workers.

Candida auris: outbreak fungal pathogen in COVID-19 pandemic: a systematic review and meta-analysis

Background and Objectives

Candida auris (C. auris) is the first fungal pathogen considered a global health threat. Because, C. auris is associated with multidrug resistance and associated diseases such as diabetes, sepsis, lung and kidney disease. This study investigated the prevalence and mortality of C. auris infection during Covid-19 pandemic.

Materials and Methods

Databases were searched for peer-reviewed articles published in the English language up to Jan 18, 2022. Heterogeneity across studies was evaluated using Cochrane's Q test and the I2 index. The pooled point prevalences and their corresponding 95% confidence intervals (CIs) were estimated usingthe random-effects model.

Results

In our meta-analysis, 11 eligible articles were included. The total pooled prevalence estimation of C. auris infection among COVID-19 patients was 13% (95% CI: 8%, 19%). The estimated pooled mortality rate of C. auris infection was 37% (95% CI: 15%, 61%). In terms of specific conditions, the pooled risk of mortality was higher in people with diabetes 65% (95% CI: 0.45%, 83%), in cases with >21 days admission inintensive care unit (ICU) 44% (95% CI: 21%, 0.68%), and after receiving steroids 43% (95% CI: 18%, 69%).

Conclusion

Our study highlights the high prevalence rate of C. auris infection, particularly among people with a history of metabolic disorders.

Effects of Urtica dioica on Metabolic Profiles in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Clinical Trials

BACKGROUND

Several studies have investigated the effect of Urtica dioica (UD) consumption on metabolic profiles in patients with type 2 diabetes mellitus (T2DM); however, the findings are inconsistent. This systematic review and meta-analysis of clinical trials was performed to summarize the evidence of the effects of UD consumption on metabolic profiles in patients with T2DM.

METHODS

Eligible studies were retrieved from searches of PubMed, Embase, Scopus, Web of Science, Cochrane Library and Google Scholar databases until December 2019. Cochran (Q) and I-square statistics were used to examine heterogeneity across included clinical trials. Data were pooled by using fixed-effect or random-effects model and expressed as weighted mean difference (WMD) and 95% confidence interval (CI).

RESULTS

Among 1485 citations, thirteen clinical trials were found to be eligible for the current meta-analysis. UD consumption significantly decreased levels of fasting blood glucose (FBG) (WMD= -17.17 mg/dl, 95% CI: -26.60, -7.73, I2= 93.2%), hemoglobin A1c (HbA1c) (WMD= -0.93, 95% CI: -1.66, -0.17, I2= 75.0%), C-reactive protein (CRP) (WMD= -1.09 mg/dl, 95% CI: -1.64, -0.53, I2= 0.0%), triglycerides (WMD = -26.94 mg/dl, 95 % CI = [-52.07, -1.82], P = 0.03, I2 = 90.0%), systolic blood pressure (SBP) (WMD= -5.03 mmHg, 95% CI = -8.15, -1.91, I2= 0.0%) in comparison to the control groups. UD consumption did not significantly change serum levels of insulin (WMD= 1.07 μU/ml, 95% CI: -1.59, 3.73, I2= 63.5%), total-cholesterol (WMD= -6.39 mg/dl, 95% CI: -13.84, 1.05, I2= 0.0%), LDL-cholesterol (LDL-C) (WMD= -1.30 mg/dl, 95% CI: -9.95, 7.35, I2= 66.1%), HDL-cholesterol (HDL-C) (WMD= 6.95 mg/dl, 95% CI: -0.14, 14.03, I2= 95.4%), body max index (BMI) (WMD= -0.16 kg/m2, 95% CI: -1.77, 1.44, I2= 0.0%), and diastolic blood pressure (DBP) (WMD= -1.35 mmHg, 95% CI: -2.86, 0.17, I2= 0.0%) among patients with T2DM.

CONCLUSION

UD consumption may result in an improvement in levels of FBS, HbA1c, CRP, triglycerides and SBP, but did not affect on levels of insulin, total-, LDL-, and HDL-cholesterol, BMI, and DBP in patients with T2DM.

Five Years after Implementation of Urban Family Physician Program in Fars Province of Iran: Are People's Knowledge and Practice Satisfactory?

Introduction:

Urban family physician program (UFPP) was launched in Fars province of Iran in 2012. We aimed to assess the knowledge and practice of people toward this 5-year-old program.

Methods:

In this population-based study, through a multistage random sampling from 6 cities of Fars province, 1350 people older than 18 years were interviewed. For data collection, a questionnaire consisting of sociodemographic characteristics and items about knowledge and practice toward UFPP was used.

Results:

The mean age of the interviewees was 42.4 ± 14.2 years; male (674; 49.9%)-to-female (651; 48.2%) ratio was 1.03. Mean score of knowledge was 4.2 ± 1.7 (out of 14), while 961 (71.1%) had < 50% of the desirable knowledge. Mean score of practice was 4.4 ± 1.3 (out of 9), while only 443 (32.8%) had a good performance toward this program. Knowledge and practice did not show a significant correlation (r = 0.06, P = 0.05). Among cities, the highest and the lowest mean of knowledge belonged to Pasargad (5.6 ± 2.1) and Lar (3.0 ± 1.0) (P < 0.001), respectively. Pasargad (4.8 ± 1.4) had also the highest level of practice compared to Farashband (3.8 ± 1.4) which had the lowest score (P < 0.001). Multivariable analysis showed that supplemental insurance coverage (odds ratio [OR] = 2.5, %95 confidence interval [CI]: 1.6–3.9), female gender (OR = 1.9, %95 CI: 1.2–2.9) and higher level of education (OR = 1.7, %95 CI: 1.1–2.5) were the significant determinants of knowledge, while practice in those who were not covered by supplemental insurance was better (OR = 1.6, 95% CI: 1.2-2.5).

Conclusions:

After 5 years of implementation of UFPP, knowledge and practice of people toward UFPP are not satisfactory. This finding calls for a serious revision in some aspects of UFFP.

Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran

Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was 52.3±11.0 years and of the control group was 50.1±10.9 years. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was 4.4±2.5 cm and the difference in volume displacement was 528.7±374.4 milliliters. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI: 2.6-73.3 ), invasiveness of BC (OR =13.7, 95% CI: 7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI: 2.3-7.9), BMI =>25 (OR=4.2, 95% CI: 2-8.7), radiotherapy (OR=3.9, 95% CI: 1.8-8.2 ), past history of limb damage (OR=1.7, 95% CI: 0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI: 1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in BC patients to prevent development of BCRL and improve QOL of these patients.

Denture Stomatitis and Candida Albicans in Iranian Population: A Systematic Review and Meta-Analysis

STATEMENT OF THE PROBLEM

Denture stomatitis is the common form of oral candidiasis, which is seen in the form of diffused inflammation in the areas covered by dentures. Many primary studies report the prevalence of denture stomatitis and candida albicans among patients in the Iranian population; therefore, using meta-analysis is valuable for health policy makers.

PURPOSE

The purpose of the present study is to determine the prevalence of denture stomatitis and candida albicans in Iran.

MATERIALS AND METHOD

Using relevant keywords, national and international databases were searched. After limiting the search strategy and deleting the duplicates, the remaining papers were screened by examining the title and abstract. In order to increase the sensitivity of search reference lists of papers were examined. Finally the index of heterogeneity between studies was defined using Cochran test (Q) and I-squared (I₂). According to heterogeneity, the random effects model was used to estimate the prevalence of denture stomatitis and candida albicans in Iran.

RESULT

The prevalence of denture stomatitis in 12 studies, and the prevalence of candida albicans in patients with denture stomatitis have been reported in 6 studies. The number of sample under investigated and its age range among primary studies included meta- analysis was 2271 individuals and 32.7 till 87.5 years respectively. The prevalence of denture stomatitis in preliminary studies imported to a meta-analysis varied from 1.9% to 54.6%, and its rate in Iran using the meta-analysis was estimated 28.9 % (CI 95%: 18.2-39.6). Also the overall prevalence of candida albicans in patients with denture stomatitis in Iran was estimated 60.6% (CI 95%:50.1-71.2).

CONCLUSION

This study showed that the prevalence of denture stomatitis and candida albicans among patient infected denture stomatitis is relatively significant in Iran.

The examination of relationship between socioeconomic factors and number of tuberculosis using quantile regression model for count data in Iran 2010-2011

BACKGROUND

Poverty and low socioeconomic status are the most important reasons of increasing the global burden of tuberculosis, not only in developing countries but also in developed countries for particular groups. The purpose of this study was to assess the association between socioeconomic factors and the number of tuberculosis patients using quantile regression for count data.

METHODS

This cross-sectional study was conducted on 11,320 tuberculosis patients from March 2010 to March 201 in Iran. Data was gathered from the 345 sections of Iran by Ministry of Health and Medical Education and Statistical Center of Iran. The jittering method was applied for smoothing, and then, the quantile regression for count data was fitted. The AIC was used to compare the fitness of quantile regression for count data model and Poisson log-linear model. The R (3.0.1) software and Quantreg and AER packages were used for all analysis and modeling of the data.

RESULTS

The results of fitting the quantile regression for count data showed that in all percentiles, the more increase in immigration rate, illiteracy rate, unemployment and urbanization rates, the more tuberculosis morbidity rate was increased. The maximum increase of tuberculosis due to immigration rate, urbanization rate, unemployment rate, and illiteracy rate was in 95th percentile (β^=0.315), 85'Th percentile (β^=0.162), 75'Th percentile (β^=0.114 ), and 95'Th percentile (β^=0.304), respectively. For 50th percentiles and higher percentiles, with increasing the sum of physicians to the number of population, the tuberculosis morbidity rate was decreased, and the maximum decrease was in 95'Th percentile ( β^=-0.1). For all percentiles, the AIC showed that quantile regression for count data had been a better fit to data.

CONCLUSION

With respect to the relationship between socioeconomic factors and TB rate, health care observers should pay close attention to improving these factors in Iran to reduce the TB mortality and morbidity.

Estimation of the prevalence of chronic kidney disease: The results of a model based estimation in Kerman, Iran

BACKGROUND

Chronic kidney disease is asymptomatic until its last stages and though it is increasing globally, we are faced with paucity of a population-based model to assess this disease, particularly in developing countries. Therefore, the aim of this study was to estimate the prevalence and trends of CKD according to a new estimation method.

METHODS

Using multiplier method, we estimated the numbers of different stages of CKD based on the number of patients with end stage renal failure from 2006 to 2016. The required multipliers were extracted from a simulation of the disease in Kerman following a dynamic model. The 95% uncertainty interval was computed using Monte-Carlo technique with 10,000 iterations.

RESULTS

The prevalence of CKDA (GFR<=90mL/min/1.73m2) and CKDB (GFR less than 60mL/min/1.73m2) patients were estimated to be 7.6% (95% uncertainty interval (UI), 5.7-9.1%) and 1.1% (95% UI, 0.8-1.3%), respectively in 2011. The method revealed that the prevalence may rise up to 25.7% (95% UI, 18.2-32.5%) and 3.7% (95% UI, 2.7-4.5%) for CKDA and CKDB, respectively in 2016, indicating approximately 3.3 times increase for both figures.

CONCLUSION

This study predicted an increase in the prevalence of CKD in the future. This may be due to the increasing life expectancy of the population, the increase in the prevalence of non- communicable diseases such as hypertension and diabetes, or patients' survival due to receiving better support. Therefore, the policymakers should be concerned and well informed about this increase.

Competing Risk Analyses of Patients with End-Stage Renal Disease

Introduction

Chronic kidney disease (CKD) is an important health problem that gradually leads to end-stage renal disease (ESRD). In ESRD patients, death due to other diseases or some events, such as renal transplantation (known as competing risks), would change the probability of observing the event of interest. The aim of this study was to estimate the survival of ESRD patients using competing risk analyses.

Methods

In this retrospective longitudinal study, 307 ESRD patients who were older than 20 were recruited from the dialysis and kidney transplant Centers in Kerman City, Iran, from2007 to 2011. To assess the impacts of the investigated factors on the outcome, a cause-specific hazard model and competing risk models were fitted. Also, the cumulative incidence (CI) approach and sensitivity analysis were implemented. All of the analyses were performed using Stata software, V.12.

Results

The results of competing risk models showed that age and type of dialysis were associated with death (hazard ratio (HR)=1.03, p<0.001 and HR=1.65, p=0.011, respectively). In cause specific hazard model each year increase in age was associated with a 2% increase in the risk of death. Also, the types of dialysis were associated significantly with death (HR=1.93), and the effect of the type of dialysis was estimated as HR=1.51 (p=0.04) when we assumed that all patients who had experienced transplantation survived for the longest survival time. For those for whom receiving the transplantation was considered as death, the HR for the type of dialysis as well as the corresponding p-values were 1.82 and 0.001, respectively.

Conclusion

Ignoring the competing risks of death due to ESRD, such as renal transplantation, in estimating the survival of these patients might lead to overestimation of the results.

Prediction of trauma-specific death rates of pedestrians of Fars Province, Iran

Introduction:

Pedestrians are the most vulnerable group to accidents among road users. Due to the well-known concerns and complications of accidents involving pedestrians, the aim of this study was to identify the rate of such accidents for five-year period.

Methods:

We analyzed all fatalities among pedestrians caused by traffic accidents during years of 2009–2013 in Fars Province in Iran. The study was a cross-sectional study in which logistic regression analysis was used to predict the death rate among pedestrians. Sensitivity analysis using the Monte Carlo method was used to increase the accuracy of the results. Then, we predicted the death rates for the years 2014–2018 predicted and compared the results with the actual data from the previous five-year period (2009–2013).

Results:

During 2009–2013, 1723 out of 8689 (20.3%) of the people killed in traffic accidents were pedestrians. The death rate for male pedestrians in 2011 was estimated to be 10.86 per 100,000 (with an uncertainty interval of 95% giving a range of 9.85–12.05 per 100,000). Compared to the data for 2006, this represented a decrease of 20% (with a mean decrease of 4% per year). Based on these data, the death date in 2018n was projected to be 8.08 per 100,000 (with an uncertainty interval of 95% giving a range of 7.26–8.87). Similar data and analysis for women indicated that the reduction in the rate of fatalities has been smaller than that for men in recent years, i.e., 2.2% versus 4%.

Conclusion:

Although great progress has been made in reducing traffic accidents, to date, the death rate is still high among pedestrians. It is essential to continue to find ways to reduce traffic accidents and the pedestrians’ deaths associated with them, especially among the elderly, who make up a disproportionate fraction of the deaths.

Epidemiology and clinical manifestation of fungal infection related to Mucormycosis in hematologic malignancies

Introduction: Mucormycosis is an opportunist fungus infection with acute and rapidly progressive nature in the hematologic malignancy patients. This study was done to investigate the prevalence and clinical manifestations of this infection among hematologic malignancies. Methodology:This cross-sectional study (descriptive-analytical) was performed while investigating medical records of 30 patients with hematologic malignancy affected by Mucormycosis in Imam Reza Hospital between 2001 and 2013. After collecting the data, it was entered in SPSS 19 Software with a provided checklist that included demographic characteristics, clinical manifestations, and it was analyzed by using descriptive (mean, frequency) and inferential (chi- square and independent -t-test) statistical methods (p-value < 0.05 was considered as statistically significant). Findings:Overall, the prevalence of Mucormycosis was 4.29 per 100 patient hematologic malignancies. The infection proportion among men and women was 72. 2, 27.6%, respectively. The maximum cases of Mucormycosis were observed among AML patients (62.1%). The most common place of involvement was lung (89.4%) and fever was the most popular sign of the infection (100%). The most considerable and effective factor in the prognosis of infection was using combined therapy of Amphotericin Band surgery (debridement) that has statistically significant correlation (p<0.05). Conclusion:Considerable prevalence and death related to Mucormycosis infection among patients of hematologic malignancy showed the importance of having strategies for its prevention and early diagnosis especially among acute leukemia patients.

Explaining the link among self-controlling and children parenting techniques and mental insurance of high school pupils

Introduction: One of the wellness estimation axes of various communities are the mental well-being of the communities. Health means an attempt to Self-actualization and development that exhibit in the adaptation of person's skills and experiences. No doubt mental health plays a major role in assuring efficiency in any organization and can be affected via different parameters. Accordingly, the current research conducted by the purpose of illustrating the relationship among self-managing and kid parenting techniques and mental health amongst high school pupils of Abadeh Town. Methodology: In this sectional-correlation research, 375 pupils are taken and involved in the research in stage group sampling technique of Abadeh high schools. Tangney's self-managing survey, Barry's kid parenting rate, Reef's mental survey and a framework of demographic data utilized to obtain data. Information investigated utilizing software SPSS 19 or Pearson's relationship coefficient analysis and stepwise multivariable regression investigation. Findings: Information investigation depicts self-managing parameter has a great and opposite predictability regarding mental health parameter (t =0.003, = β-0.158, P=2.99). Therefore self-managing has great and opposite predictability regarding 2 parts of mental health rate i.e. self-approval (P= 0.0001, t=4.87, β= - 0.181) and dominance on conditions (P= 0.0001, t=3.807, β= - 0.200). The decisions represent the proximity of a consequence relationship among predictability of kid parenting techniques regarding mental health (p=0.01, F=3.85, r2= 0.031, r=0.177). These sequences reveal great predictability of kid parenting styles in 2 various ways in 2 methods of grinding (P=0.035, t= 2.12, β=0.113) and standard (P=0.014, t=2.437, β= 0.434). The Severe method has a reversed important connection in maximum features of mental health. Furthermore, they note that "authoritative method" parameter just has prediction capacity 0.143 based on mental health variance parameter. Plus combining 2 other parameters i.e. self-managing and cruel way, this value rises to 0.188 and 0.225. The greatest rate for prognosticating skill refers to the standard method of kid parenting straight and after that to self-managing and severe method reversely. Conclusion: based on the significant relationship of kid parenting styles and self-managing in foretelling mental health, the need of notice to these parts is felt in describing the mental health of pupils as many as feasible. Therefore, it is suggested that education of kid parenting techniques is examined as a defensive and serving method for mental health in mental wellness plans for all teens particularly scholars therefore that parents could be satisfied in supporting their kids' emotional health and stopping their mental troubles via data and utilizing peculiar kid parenting techniques and withdrawing ineffective systems of kid parenting (as severe behavior).

Investigation of aerobic training and electrical motivation impacts on body fat decrease

Goals: Study and comparison between the effects of walking and the electrical motivation on body fat burning and weight loss. Methodology: The samples were elected among the volunteer healthy females (20-40 years) with an index rate (20 ≤ BMI ≤ 30) provided that they had no regular active exercise activity and they were classified randomly to 2 teams in this quasi-experimental research. The electrical stimulation was used for one group in 1 year each week up to eight, and the period of 40-60 min per session on intestinal muscles. The plan of the group with aerobic exercise included 40-60 min walking with an intensity of the stored heart rate (50-70%) within the similar period. The parameters of BMI, rate of body fact, and LBM were measured at the start and at terminal of study on weight. The given data are investigated via using of t- independent and correlation t-test at level (p≤ 0.05). The parameters of BMI, rate of body fact, and LBM were measured at the start and at terminal of study on weight. Findings: Weight, Body Mass Index (BMI), and body fat percentage were significantly reduced and also the LBM parameter was enhanced in 2 teams. Conclusion: Walking and electrical stimulation similarly caused to decrease in weight, BMI, body fat percentage, and enhance in lean body mass factor (LBM).

Noise pollution effect in flour factory on workers' hearing in Lamerd City

Introduction: Noise pollution is one of the most important problems in industry that has an effect on the auditory system and other physiological parameters, as well as persons in noise exposure situations. While noise-induced hearing loss is preventable, once acquired, hearing loss is permanent and irreversible. Methodology: In the current study, noise in various sections of Flour Company in Lamerd estimated via the audio recorder, which revealed that the operators' expression remained larger than the state criterion; hence, the perception experiment (audio recorder) was performed on the operators and its outcomes were examined via utilizing SPSS 16 of version. Findings: Overall, Pearson relationship r = 0.453 discovered among job reports and the performance decline between all operators by significant stage p≤0.05. Moreover, T-test applied to examine noise impact on operators included in boisterous rooms (mean more than 85 dB) also average=26. 71 and regular deviation=11.72 got (p≤0.05) that was greater than 25db (as the standard hearing threshold). Conclusion: The outcomes of audio measuring and T-test revealed that the noise corruption has an impact on the hearing of bodies operating in noisy rooms.