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The negative impact of hopelessness on mental health makes multiple sclerosis (MS) disease unmanageable. This study aimed to determine the effect of spiritual care on hope in MS patients. In the present randomized controlled trial study, 70 MS patients were selected from the MS Association of Hamadan, Iran, and randomly allocated to intervention and control groups (35 patients per group). A demographic characteristic form and Snyder's Adult Hope Scale were completed before and after the intervention. Spiritual care was provided in weekly group sessions held for four weeks (45-60 min each). The data were analyzed using SPSS-16. Before the intervention, there were no significant between-group difference (P = 0.323). After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.38), confirming the effectiveness of spiritual care in improving hope. Given the impact of spiritual care on increasing patients' hope and improving their psychological state, nurses are advised to devote adequate time to their patients' spiritual needs.

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The COVID-19 pandemic has challenged the capacity of health systems in various countries. This study was designed to evaluate the response rates of hospitals in the prevention and control of COVID-19 in Hamadan province, Iran. In this cross-sectional study, all 20 hospitals in Hamadan province were monitored in February 2020. The instrument used in this study was the WHO checklist, entitled "Infection prevention and control health-care facility response for COVID-19." In each hospital, the hospital infection control officials completed the checklists under the supervision of the hospital managers and were then provided to the project manager. Data analyzed by SPSS 22 software. There were 3482 hospital beds (the average beds of each hospital was 174) in the studied hospitals. Of 15 055 patients admitted to all hospitals, 2196 (14.6%) individuals were COVID-19 patients. The total average score obtained from the checklist was 62.25. Among 7 domains studied, the lowest scores belonged to 2 domains of "infrastructure and equipment" and "patient screening and triage." The scores of domains "IPC programs" and "visitors" were significantly higher in hospitals with ICU beds than other hospitals (P-value = .03 in both domains). A comparison between university-teaching hospitals with other hospitals and those in Hamadan city with other cities revealed no significant differences in any of the domains. The mean response rate (62.25) of hospitals in terms of COVID-19 in Hamadan province indicates their relative readiness to prevent and control the COVID19 pandemic. The shortage of infrastructure and equipment and screening and triage problems of patients were the main challenges of hospitals in managing the COVID-19 pandemic in Hamadan province, Iran.

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Side by side air sampling was conducted using a PTFE filter membrane as dry sampler and an impinger containing a suitable culture medium as a wet sampler. Most of the samples were collected from two hospitals and few air samples were collected from private houses of non-hospitalized confirmed COVID-19 patients. The collected air samples were analyzed using RT-PCR. The results indicated that all air samples collected from the hospitals were PCR negative for SARS-CoV-2. While two of four air samples collected from the house of non-hospitalized patients were PCR positive. In this study, most of the hospitalized patients had oxygen mask and face mask, and hence this may be a reason for our negative results regarding the presence of SARS-CoV-2 in indoor air of the hospitals, while non-hospitalized patients did not wear oxygen and protective face masks in their houses. Moreover, a very high concentration of particles in the size range of droplet nuclei (< 5 µm) was identified compared to particles in the size range of respiratory droplets (> 5-10 µm) in the areas where patients were hospitalized. It can be concluded that using face mask by patients can prevent the release of viruses into the indoor air, even in hospitals with a high density of patients.

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Contaminación del Aire Interior , COVID-19 , Hospitales , Humanos , Oxígeno , SARS-CoV-2

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In the current study, the concentration of heavy metals (Ba, Mn, Pb, and Cd) in drinking water resources of 328 villages in Hamadan Province were measured using ICP-OES apparatus during two dry (September 2018) and wet (April 2019) seasons. The assessment of the non-carcinogenic risk of selected heavy metals was conducted based on the recommendations of the USEPA. Also, sensitivity analysis and uncertainty of the effective variables were performed using Monte-Carlo simulations. Based on the results, Mn level in drinking water samples ranged 0.08-25.63 µg/L and 0.08-20.03 µg/L in dry and wet seasons, respectively. Similarly, Ba levels in water samples ranged 0.15-70.13 µg/L and 0.84-65 µg/L. Also, Cd and Pb concentrations in all sampling sites were below the limits of detection (LOD) of the ICP-OES apparatus. The hazard index (HI) values for adult and children were 2.17 × 10-3 and 3.29 × 10-3, respectively, which show a lack of non-carcinogenic risk for the examined heavy metals (Mn and Ba) to the local inhabitants. The results of the sensitivity analyses for adults and children revealed that two variables including metal concentration and ingestion rate of drinking water (IR) had the highest positive effects on the non-carcinogenic risk estimates. It was also found that there was no significant non-carcinogenic risk for the local residents in the studied area due to drinking water consumption.

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The aim of this study was to evaluate the potential pathogenic bacterial aerosols produced from the municipal solid waste landfill site and its health risk assessment in the Hamadan city at west of Iran. In this study, air samples were collected every month during spring and summer at six locations including the active zone, leachate collection pond, infectious waste landfill, upwind, closure landfill, and downwind using the Andersen impactor. Spatial and seasonal variations of the potential pathogenic bacterial aerosols were detected. Also, Health risk associated were estimated based on the average daily dose rates (ADD) of exposure by inhalation. The mean concentration of potentially pathogenic bacterial aerosols were 468.7 ± 140 CFU m- 3 1108.5 ± 136.9 CFU m- 3 detected in the active zone in spring and summer, respectively. Also, there was a significant relationship between meteorological parameters and bacterial concentration (p < 0.05). The predominant potential pathogenic bacterial identified in the spring were Proteus mirabilis, Streptococcus sp., and Pseudomonas sp., while in summer were Pseudomonas sp., Staphylococcus aureus, and Escherichia coli. The hazard quotient (HQ) in both seasons were less of 1. Bacteria were spread throughout the landfill space, but their maximum density was observed around the active zone and leachate collection pond. This study highlights the importance of exposure to potential pathogenic bacterial aerosols in the summer and its adverse effects, especially in the MSW landfill site active zone. Finally, controlled exposure can reduce the health hazard caused by the potential pathogenic bacterial aerosols.

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In the present study, both gaseous and particulate (PM with dae <2.5 µm) phases of polycyclic aromatic hydrocarbons (PAHs) were measured in the ambient air of Hamadan city, Iran. For this reason, two low-volume samplers equipped with glass fiber filters were used for sampling of particulate phase (N = 30) and XAD-2 sorbent tubes were applied for sampling gaseous phase of PAHs (N = 30). The sampling was conducted during warm and cold seasons in 2019. The average of cold/warm season ratios for Σ16PAH and PM concentrations were 1.14 and 0.62, respectively. Summed PAHs concentration were determined to be in the range 0.008-59.46 (mean: 11.61) ng/m3 and 0.05-40.83 (mean: 10.22) ng/m3 for the cold and warm seasons, respectively. A negative Pearson correlation coefficient was obtained for wind speed and relative humidity. The average Benzo (a) Pyrene equivalent carcinogenic (BaPeq) levels in the cold season were lower than the maximum permissible risk level of 1 ng/m3 for BaP. The BaP toxicity equivalency (ΣBaPTEQ) and BaP mutagenicity equivalency (ΣBaPMEQ) appeared to be significantly higher in the cold season (averaging 0.35 and 1.65 ng/m3, respectively) than those in warm season. Health risk assessment was performed for children and adults based on BaPeq, inhalation cancer risk. The diagnostic ratios of individual PAHs concentration showed that the significant sources of PAH emissions may be related to light duty vehicles (LDVs) in Hamadan. Although, some other sources such as pyrogenic source and petrol combustion were also suggested.

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Contaminantes Atmosféricos/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Hidrocarburos Policíclicos Aromáticos/análisis , Adulto , Benzo(a)pireno/análisis , Carcinógenos , Niño , Ciudades , Carbón Mineral , Monitoreo del Ambiente , Gases , Humanos , Irán , Mutágenos , Material Particulado/análisis , Medición de Riesgo , Estaciones del Año , Viento

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BACKGROUND: New advancements have increased the capabilities of computed tomography as a sectional medical imaging modality. An important note is assessing absorbed dose to patients and minimizing it when performing computed tomography examinations. One approach to control dose is to establish diagnostic reference levels. OBJECTIVE: This study aimed to investigate diagnostic reference levels of computed tomography in Hamadan. MATERIAL AND METHODS: This work was conducted as an experimental study. Computed tomography dose index (CTDI) was measured using a Piranha quality control kit, head and body CTDI phantoms for brain, lung, abdomen-pelvic and coronary CT angiography examinations. Volume Computed Tomography Dose Index (CTDIvol) was calculated from obtained data and 3rd quartile of that was determined as diagnostic reference levels. RESULTS: Diagnostic reference levels (DRLs) in terms of CTDIvol for brain, lung, abdomen-pelvic and coronary CT angiography were 50/25, 6/73, 22/01 and 32/06 mGy respectively in Hamadan. Difference between displayed CTDIvol and measured CTDIvol is not significance for all examinations (p>0.05). CONCLUSION: DRLs depend on to many dose affecting parameters in CT. DRL for brain CT is greater than other scan regions. Application of DRLs which resulted from this study can help to optimize radiation dose to the patients while maintaining acceptable diagnostic images quality.

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OBJECTIVE: Farshchian Heart Center is the fifth health-promoting hospital and the first center of its type in Western Iran that officially joined the International Network of Health Promoting Hospitals and Health Services (HPH) in 2016. The purpose of the present study is to evaluate the health promotion standards at this center in 2018. METHODS: We conducted this cross-sectional study at Farshchian Heart Center of Hamadan. The main data collection instruments included questionnaires obtained from indicators of five different main standards of health-promoting hospitals developed by the World Health Organization (WHO) which were evaluated from three different perspectives: Management staff, hospital employees, and patients. The data were analyzed by SPSS version 21 software. RESULTS: We evaluated 111 hospital employees, 109 patients, and 6 management staff. Nurses (46.8%) comprised the majority of the hospital staff respondents. Less than half (42.3%) of the hospital staff expressed awareness of hospital health promotion policies; however, only 13.5% had attended various health promotion programs. Only 51.4% of patients knew about the hospital health promotion policies and 17.4% of them participated in relevant programs. The mean score for patient satisfaction with the hospital health promotion programs according to the visual analogue scale (VAS, range: 0-10) was 7.16 ± 2.45, which was significantly higher in outpatients (8.16 ± 1.85) compared to inpatients (6.44 ± 2.59, p = 0.001). Two thirds (66.7%) of the management staff expressed awareness of implementation of these programs. CONCLUSION: The results of this study demonstrated that health promotion policies based on WHO standards were not well-recognized among patients, hospital employees, and management staff in Farshchian Heart Center of Hamadan, Iran.

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Guías como Asunto , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Promoción de la Salud/normas , Cardiopatías/prevención & control , Administración Hospitalaria/estadística & datos numéricos , Administración Hospitalaria/normas , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Irán , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios

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INTRODUCTION AND PURPOSE: Tularemia is a zoonotic disease, the most important hosts of which are rodents. Endemic regions and reservoirs of F. tularensis are not well-researched areas in Iran. The present study aimed to study F. tularensis infection in the rodent populations of western Iran. MATERIALS AND METHODS: Samples were collected in different areas of Kabudar Ahang County in Hamadan province (west of Iran) from 2014 to 2017. Tularemia serological and molecular tests were conducted using the tube agglutination test and Real-time PCR method tracking the ISFtu2 gene. Positive serum samples were evaluated for cross-reactivity with brucellosis. RESULTS: A total of 433 rodents, collected from 33 localities, were included in the study. The most abundant species belonged to the Persian jird (Meriones persicus; 75.5%), and Libyan jird (Meriones libycus; 10.1%). Among the studied samples, three (0.74 %) were seropositive and five (1.15%) were PCR positive. Seropositive samples were two M. persicus and one M. libycus, and PCR positive rodents were four M. persicus and one M. vinogradovi. Tularemia seropositive samples showed no cross-reactivity with brucellosis. CONCLUSION: Given the presence of infection in rodents with tularemia agent in the studied area, it is crucial to elucidate the risks of rodent exposure to tularemia for physicians, health personnel and the general population.

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Anticuerpos Antibacterianos/sangre , Reservorios de Enfermedades/microbiología , Roedores/microbiología , Tularemia/veterinaria , Pruebas de Aglutinación , Animales , Brucelosis/inmunología , Reacciones Cruzadas , ADN Bacteriano/genética , Francisella tularensis , Irán , Roedores/inmunología , Tularemia/inmunología

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BACKGROUND: Tuberculosis (TB) despite being preventive and treatable still imposes a huge burden of morbidity and mortality in developing and developed countries. We aimed to investigate the spatial and geographical distribution of TB in Hamadan province during 1992-2013. MATERIALS AND METHODS: This cross-sectional study was performed in Hamadan province, West of Iran using the surveillance database. We examined the trend for incidence rates of all TB forms including Smear Positive Pulmonary TB (SPPT), Smear Negative Pulmonary TB (SNPT) and Extra pulmonary TB (EPT) per 100,000 populations. Poisson regression model was used to estimate the standardized rates for incidence rate of all types of TB per each county. RESULTS: In this study 3,602 TB patients including 1,359 SPPT, 987 SNPT, and 1,256 EPT were included during 1992-2013. Trend of all types of TB decreased from 1992 to 2013. The Average Annual Percent change (AAPC) for all types of TB was significantly (P<0.05) decreased, AAPC= -6.4 (95% CIs: -10.7, -1.9). Among SPPT, SNPT, and EPT incidence rates, the maximum change was related to SNPT (-11.6; 95% CIs: -24.2, 3), while it was -1.4 (-8.7, 6.4) for SPPT and -5.8 (-11.4, 0.1) for EPT. CONCLUSION: Our results showed that the incidence of TB in Hamadan province during a 22-year period has decreased 6.4% on average, somehow higher than the national average. Furthermore, our study showed that the risk of extra-pulmonary occurrence in western parts of the province is higher than others parts.

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Background: Cutaneous leishmaniasis is one of the most important infectious diseases in eastern Mediterranean countries. The aim of this study was to determine the epidemiological pattern of cutaneous leishmaniasis across a 10-year period in the Hamadan province. This study was considered necessary due to the lack of new information in recent years on the epidemiology of the disease. Methods: This is a descriptive study. The data of patients who were diagnosed with cutaneous leishmaniasis in Hamadan health centers were collected during 10 years (2007-2016) and were analyzed using SPSS software. Results: Of the 908 registered patients, 94% were male and 6% were female. The mean age was 32.7 ± 11.8. About 87.1% of patients had a history of travel to endemic areas. The highest incidence rate was observed in the year 2015 with a rate of 12.6, and the lowest was in 2008 at 1.5 per 100,000 people. Conclusion: Due to an increasing trend in the number of cutaneous leishmaniasis in Hamadan and the effect of occupation, high-risk groups such as lorry drivers should be informed of preventive measures such as using insect repellents. Also, considering the possibility of shaping a new hotspot in the province, thorough reviews and more comprehensive entomological studies are recommended.

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OBJECTIVE: Dermatophytosis is one of the most common mycotic infections, which considered as a public health problem in the major of countries. This study evaluated the molecular epidemiology of dermatophytosis in patients referred to Farshchian hospital in Hamadan city with PCR-RFLP method. MATERIALS AND METHODS: Four hundred and five specimens from clinically suspected patients of dermatophytosis were collected and analyzed by direct microscopic and culture. The isolates were identified by PCR-RFLP method using the MvaI restriction enzyme. RESULTS: Of the 405 specimens, 88 specimens were positive in direct examination and culture. Among the patients, 64.8% were males and35.2% females. Tinea pedis (31.8%) was the most common type of dermatophytosis followed by tinea corporis (22.7%), tinea cruris (20.5%), tinea capitis (10.2%), tinea manuum (5.7%), tinea faciei (4.6%) and tinea unguium (4.6%). Trichophyton interdigitale (36.4%) was the most common isolate followed by Trichophyton rubrum (27.3%), Epidermophyton floccosum (17%), Trichophyton tonsurans (11.4%), Microsporum canis (4.5%), Microsporum gypseum (2.3%) and Trichophyton benhamiae (1.1%). CONCLUSION: Our finding showed that the anthropophilic dermatophyte species causing dermatophytosis are increasing, and molecular methods are reliable assays for accurse identification of dermatophyte species in epidemiological studies.

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Arthrodermataceae/genética , Arthrodermataceae/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Polimorfismo de Longitud del Fragmento de Restricción , Tiña/epidemiología , Adolescente , Adulto , Niño , ADN de Hongos/genética , ADN Espaciador Ribosómico , Dermatomicosis/epidemiología , Epidermophyton/genética , Epidermophyton/aislamiento & purificación , Femenino , Humanos , Irán/epidemiología , Masculino , Microsporum/genética , Microsporum/aislamiento & purificación , Persona de Mediana Edad , Onicomicosis/epidemiología , Tiña/microbiología , Tiña del Cuero Cabelludo/epidemiología , Tiña del Pie/epidemiología , Trichophyton/genética , Trichophyton/aislamiento & purificación , Urbanización , Adulto Joven

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Background: Osteoporosis is the most common metabolic bone disease and is a public health issue, particularly among the elderly, across the world. Given the significance of the disease in causing disability and, in particular, its dangers in old age, we aimed to examine osteoporosis and its determinant factors among the elderly. Methods: We conducted a cross sectional study in the province of Hamadan from September 2015 to March 2016 on all the elderly men and women covered by 'Integrated and Comprehensive Elderly Care Program'. The data required for this study was collected through an aging health care checklist. To estimate the adjusted association of potential risk factors and other confounding variables of osteoporosis, multiple logistic regression was used at a significance level of 5%. Results: In this cross sectional study, 1779 elderly men and women aged 6o years and over were studied. The prevalence of osteoporosis was 7.99% (95%CI:7.79-8.18), which was higher among women than in men (8.08% vs. 7.83%). The factors that raised the probability of osteoporosis were as follow: aging (OR= 1.05, 95% CI: 1.02-1.07, p<0.001), low education (OR=1.96, 95% CI:1.02-3.84, p=0.04), living in urban areas (OR=2.82, 95% CI:1.93-4.11, p<0.001), smoking (OR=2.39, 95% CI:1.42-4.04, p<0.001), and family history of osteoporosis (OR=1.95, 95% CI:1.07-3.54, p=0.03). Conclusion: Based on our results, aging, low education level, living in urban areas, being a cigarette smoker, and having a family history of osteoporosis were all predicting factors for osteoporosis among the elderly.

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AIM: This study was conducted to provide a clear epidemiological picture of HCV spatial pattern. BACKGROUND: Hepatitis C virus (HCV) is one of the major problems of public health, that its spatial and spatiotemporal pattern remain unclear in Hamadan province. METHODS: We used the scan statistic to identify the spatial and spatiotemporal clusters of HCV in Hamadan province with an emphasis on considering the role of carrier's and injecting drug users (IDUs) cases. We repeated the same analysis to estimate the effect of some influencing factors on the formation of clusters. All HCV cases that had been recorded by deputy health of Hamadan University of Medical Sciences during 2008-2016 were included in this study. RESULTS: The location of the purely spatial cluster for carriers, IDUs and total of cases were similar to each other, a cluster consisting of Toyserkan, Nahavand, Asadabad, Malayer and Bahar cities. However, after adjustment, the location of the identified cluster for both carries and IDUs cases changed to a cluster consisting of Asadabad, Bahar, Toyserkan and Nahavand cities. This cluster also observed for spatiotemporal clusters carriers, IDUs and total of cases even after adjustment. CONCLUSION: Although further studies in individual level are needed, our results revealed that spatial distribution of HCV in Hamadan province (especially in clusters areas) can strongly dependent on the distribution of IDUs cases. Consequently, the effectiveness of HCV combating programs is subjected to properly controlling these case through various counseling, behavioral and therapeutic programs.

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Iranian western cities, including Hamadan, have been experiencing Middle East Dust Storms (MEDS) phenomenon problems in recent years, so the air quality is getting worse every year in these cities. The aim of this study was to evaluate the human health impacts of criteria air pollutants including PM10, PM2.5, NO2, SO2, CO and O3 on the citizens of Hamadan using AirQ model software 2.2.3. Considering the determined baseline incidence (BI) and relative risk (RR) rate, the attributable proportion (AP) of deaths due to cardiovascular and respiratory mortality attributed to PM2.5, PM10, O3, NO2, and CO pollutants was estimated to be 4.42%, 3.37%, 1.75%, 1.74% and 0.92% (95% CI) of the total mortality and the excess death cases were respectively estimated to be 131.9, 100.4, 52.1, 51.9 and 27.3 persons. In addition, cardiovascular mortality brings more contribution than respiratory mortality in total death number. The results of our study also showed that PM2.5 poses the greatest health effects on the citizens. Analyzing the average seasonal concentrations of studied pollutants (PM10, PM2.5, and NO2) and the mean seasonal temperature values revealed a positive linear correlation. Significant negative correlations were observed between the studied pollutants (PM10, PM2.5 and NO2) and relative humidity, and between PM and wind speed. This study, therefore, provides additional data in decision-makings for the development of strategies for reduction of ambient air pollution which will result in improvements of air quality.

Asunto(s)

Contaminantes Atmosféricos , Contaminación del Aire , Exposición a Riesgos Ambientales , Estado de Salud , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Ciudades , Humanos , Irán , Medio Oriente , Material Particulado

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BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune disease that disables central nervous system (CNS) system. Cytomegalovirus (CMV) probably has an important role in the MS pathology. The infection with helicobacter pylori also is recognized as a protective agent against MS in female. METHODS: Serum samples were isolated and frozen at -70∘C. The earlier mentioned anti-virus antibodies and antibacterial antibodies were quantified by Elisa kit. RESULTS: The results showed that IgG antibody average value against cytomegalovirus in the blood of multiple sclerosis patients not only decreased but also was significant statistically (p< 0.05). IgM and IgG antibodies average value in the blood of multiple sclerosis patients against helicobacter pylori shown a statistically significant decrease (p< 0.05). CONCLUSION: Therefore it may be considered that probably helicobacter pylori presence in the individuals especially in female can alleviate MS signs. CMV infection can intensify the symptoms in multiple sclerosis patients.

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Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Infecciones por Citomegalovirus/inmunología , Infecciones por Helicobacter/inmunología , Esclerosis Múltiple/inmunología , Adulto , Estudios de Casos y Controles , Citomegalovirus/inmunología , Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/virología , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/inmunología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Irán , Masculino , Esclerosis Múltiple/microbiología , Esclerosis Múltiple/patología , Esclerosis Múltiple/virología , Factores Sexuales

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ß-Thalassemia (ß-thal) caused by mutations on the HBB gene is the most common single-gene disorder in the world. In this study, the HBB gene mutation was investigated in Hamadan province, Iran. Forty-one patients referred to a referral hospital were admitted to the study. DNA samples were extracted from peripheral blood. The HBB gene was sequenced in all recruited patients. Eleven mutations and eight polymorphisms were found in the studied patients. IVS-II-1 (G>A) (HBB: c.315+1 G>A) was the most common mutation, accounting for 25.61% of mutant alleles. Other mutations included codon 8 (-AA) (HBB: c.25-26delAA); IVS-I-110 (G>A) (HBB: c.93-21 G>A); codons 8/9 (+G) (HBB: c.27-28insG); IVS-I-1 (G>A) (HBB: c.92 G>A); codon 44 (-C) (HBB: c.135delC); codons 25/26 (+T) (HBB: c.78-79insT); IVS-I-130 (G>C) (HBB: c.93-1 G>C); -28 (A>C) (HBB: c.-78 A>C); codons 36/37 (-T) (HBB: c.112delT) and IVS-I-6 (T>C) (HBB: c.92+6 T>C). According to our findings, the IVS-II-1 mutation has the highest prevalence in Hamadan Province. It was found that the total frequency of the IVS-II-1, codons 25/26 (+T), codons 8/9 (+G), IVS-I-110 and IVS-I-1 mutations was 82.92%. Therefore, given these findings, it is recommended that these five mutations are screened for as a first step in laboratories without sequencing instruments, and that the rest of the gene is subsequently examined.

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Frecuencia de los Genes , Mutación , Globinas beta/genética , Talasemia beta/epidemiología , Talasemia beta/genética , Alelos , Sustitución de Aminoácidos , Codón , Estudios Transversales , Genotipo , Humanos , Intrones , Irán/epidemiología , Irán/etnología , Fenotipo , Polimorfismo de Nucleótido Simple

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Background: Gastric cancer is the fifth most common cancer and the third top cause of cancer related death with about 1 million new cases and 700,000 deaths in 2012. The aim of this investigation was to identify important factors for outcome using a random survival forest (RSF) approach. Materials and Methods: Data were collected from 128 gastric cancer patients through a historical cohort study in Hamedan-Iran from 2007 to 2013. The event under consideration was death due to gastric cancer. The random survival forest model in R software was applied to determine the key factors affecting survival. Four split criteria were used to determine importance of the variables in the model including log-rank, conversation?? of events, log-rank score, and randomization. Efficiency of the model was confirmed in terms of Harrell's concordance index. Results: The mean age of diagnosis was 63 ±12.57 and mean and median survival times were 15.2 (95%CI: 13.3, 17.0) and 12.3 (95%CI: 11.0, 13.4) months, respectively. The one-year, two-year, and three-year rates for survival were 51%, 13%, and 5%, respectively. Each RSF approach showed a slightly different ranking order. Very important covariates in nearly all the 4 RSF approaches were metastatic status, age at diagnosis and tumor size. The performance of each RSF approach was in the range of 0.29-0.32 and the best error rate was obtained by the log-rank splitting rule; second, third, and fourth ranks were log-rank score, conservation of events, and the random splitting rule, respectively. Conclusion: Low survival rate of gastric cancer patients is an indication of absence of a screening program for early diagnosis of the disease. Timely diagnosis in early phases increases survival and decreases mortality.

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INTRODUCTION: This research aims to determine the mental health status of population aged 15 and over in the province of Hamadan in 2015. METHODS: This cross-sectional survey was performed among 1,200 individuals aged 15 years and older, living in urban and rural areas of the three cities of Hamedan, Asadabad, and Malayer. Individuals were enrolled in the study by clustered and systematic randomization. The General Health Questionnaire-28 (GHQ-28), was used for screening for common mental disorders. Those scoring above the cut-off point of the GHQ-28 were considered to be suffering from at least one mental disorder. Data was analyzed using the SPSS-18 software. RESULTS: This study showed that using the traditional scoring method, 30.7% of the subjects (31.4% of females and 29.9% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (32.8%) was higher than the prevalence of these disorders in rural areas (25.3%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders among women, the age group of 65 and older, people living in urban areas, divorced and widowed, primary and secondary, and unemployed people was higher than other groups. CONCLUSION: The results of this study show that about one third of the sample are suspected of mental disorders, and the prevalence of these disorders has decreased from 34.7% in 1999 to 30.7% in 2015. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

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Predicción , Estado de Salud , Trastornos Mentales/epidemiología , Salud Mental , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Irán/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Muestreo , Distribución por Sexo , Población Urbana/estadística & datos numéricos , Adulto Joven

RESUMEN

OBJECTIVE: To investigate Phlebotomus sand fly fauna and their vectorial capacity in Hamadan, Iran. METHODS: During the three consecutive years (2010-2012), from May to October, sandflies were sampled monthly from residential areas of Hamadan and selected villages using sticky traps. RESULTS: A total of 3 089 sandflies comprising 12 species from 2 genera were collected, of which 6 species are known vectors of leishmaniasis in Iran and/or other parts of the world. About 75% of the collected sandflies were of two dominant species, Phlebotomus kandelaki (38%) and Phlebotomus papatasi (36.6%). These species in combination with Phlebotomus major (6.8%), Phlebotomus sergenti (6.3%), Phlebotomus caucasicus (5.3%), Phlebotomus wenyoni (1.3%), Sergentomyia sintoni (2.9%) and Sergentomyia dentate (2%) collectively comprised the majority of the sandflies. Other species including Phlebotomus halpensis, Phlebotomus longiductus, Phlebotomus comatus and Phlebotomus alexandri each comprised only less than 1% of collected samples. CONCLUSIONS: Although none of the 158 dissected female Phlebotomus kandelaki and Phlebotomus papatasi were infected with leishmania promastigote, it is probable that in the future, factors such as environmental changes, migration and urbanization can ease the transmission of leishmaniases in this area.