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Publications in this journal

• 25‑Hydroxyvitamin D Concentrations in Patients With Optic Neuritis as a Clinically Isolated Syndrome and Healthy Controls

  Authors: Abtahi SH

  International journal of preventive medicine.

• Multiple Sclerosis in Isfahan: past; present, and future.

  Authors: Abtahi SH

  International journal of preventive medicine.

• What are the next steps in designing an orthosis for paraplegic subjects?

  Authors: Mohammad Taghi Karimi

  International journal of preventive medicine. 3(3):145-59.

  Over the years, various types of orthoses have been designed to assist subjects with spinal cord injury (SCI) to stand and walk. However, the functional performance of the orthoses has not beenOver the years, various types of orthoses have been designed to assist subjects with spinal cord injury (SCI) to stand and walk. However, the functional performance of the orthoses has not been adequate, that is, patients experience stability problems, consume excessive energy during ambulation, and generally require assistance in donning and doffing the devices. This research is aimed at categorizing the available orthoses designed specifically for SCI patients and to compare the available orthoses according to the energy consumption, stability analysis, and gait parameters. An electronic search was done in PubMed, Embase, and ISI Web of Knowledge databases to extract data related to 1960 - 2010. The available orthoses were characterized based on the level of stabilization they provided and the source of power used. The orthoses were compared based on the stability, energy consumption, and gait performance parameters, according to the results of various studies collected from the literature review. Among various orthoses designed for paraplegic subjects, the mechanical orthoses seemed to have a better performance. Moreover, donning and doffing of the mechanical orthosis was easier for the subjects. Although the HGO has better functional performance than other available orthoses, the subjects are more willing to use the RGO. The new design of orthoses must allow easy donning and doffing by the users, have enough stability during walking and standing, and enable the patients to change the alignment of the orthosis to suit their needs.

• Should We Look for Celiac Disease among all Patients with Liver Function Test Abnormalities?

  Authors: Mohammad Hassan Emami, Marzieh Hashemi, Soheila Kouhestani, Hajar Taheri, Somayeh Karimi

  International journal of preventive medicine. 3(3):167-72.

  Celiac disease (CD) has been found in up to 10% of the patients presenting with unexplained abnormal liver function tests (LFT). As there is no precise data from our country in this regard, weCeliac disease (CD) has been found in up to 10% of the patients presenting with unexplained abnormal liver function tests (LFT). As there is no precise data from our country in this regard, we investigated the prevalence of CD in patients presenting with abnormal LFT. From 2003 to 2008, we measured IgA anti-tissue transglutaminase (t-TG) antibody (with ELISA technique) within the first-level screening steps for all patients presenting with abnormal LFT to three outpatient gastroenterology clinics in Isfahan, IRAN. All subjects with an IgA anti-tTG antibody value of >10 μ/ml (seropositive) were undergone upper gastrointestinal endoscopy and duodenal biopsy. Histopathological changes were assessed according to the Marsh classification. CD was defined as being seropositive with Marsh I or above in histopathology and having a good response to gluten free diet (GFD). During the study, 224 patients were evaluated, out of which, 10 patients (4.4%) were seropositive for CD. Duodenal biopsies were performed in eight patients and revealed six (2.7%) cases of Marsh I or above (four Marsh IIIA, two Marsh I), all of them had good response to GFD. The overall prevalence of CD among patients with hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis was determined as 10.7% (3/28), 3.4% (2/59), and 5.3% (1/19), respectively. Serological screening with IgA anti-tTG antibody test should be routinely performed in patients presenting with abnormal LFT and especially those with chronic liver diseases including hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis.

• Aphorisms and short phrases as pieces of knowledge in the pedagogical framework of the andalusian school of public health.

  Authors: Lorena González-García, Clarice Chemello, Filomena García-Sánchez, Delia C Serpa-Anaya, Carmen Gómez-González, Leticia Soriano-Carrascosa, Paloma Muñoz-de Rueda, Miguel Moya-Molina, Fernando Sánchez-García, Manuel Ortega-Calvo

  International journal of preventive medicine. 3(3):197-210.

  Bearing in mind the philosophical pedagogical significance of short phrases for the training of researchers in the health care ambit, we hence have studied the aphorisms and striking phrasesBearing in mind the philosophical pedagogical significance of short phrases for the training of researchers in the health care ambit, we hence have studied the aphorisms and striking phrases expressed during the epidemiology course at the Andalusian School of Public Health. Belonging to the qualitative type and applied through the establishment of a multidisciplinary focus group made up of ten post-graduated students, where one of them acted as a moderator. The collection of information lasted four months. Information was classified in two ways: Firstly, aphorisms and short phrases with a pedagogical impact; and secondly, data with statistical, epidemiological, epistemological, pragmatic, or heuristic component, and for scientific diffusion. It was decided to perform a triangulation that included a descriptive presentation and a basic categorical analysis. The two teachers with a highest interpretative load have been identified . A total of 127 elements, regarded as of interest by the focus group, were collected. Forty-four of them (34.6%) were aphorisms, and 83 were short phrases with a pedagogical load (65.3%). Most of all them were classified as statistical elements (35.4%) followed by epistemological (21.3%) and epidemiological (15.7%) elements. There was no tendency towards aphorisms or short phrases (P > 0.05) among the teachers with more informative representation. There has been a tilt in the contents towards the statistical area to the detriment of the epidemiological one. Concept maps have visualized classifications. This sort of qualitative analysis helps the researcher review contents acquired during his/her training process.

• Socioeconomic Status and Incidence of Traffic Accidents in Metropolitan Tehran: A Population-based Study.

  Authors: Mojtaba Sehat, Kourosh Holakouie Naieni, Mohsen Asadi-Lari, Abbas Rahimi Foroushani, Hossein Malek-Afzali

  International journal of preventive medicine. 3(3):181-90.

  Population-based estimates of traffic accidents (TAs) are not readily available for developing countries. This study examined the contribution of socioeconomic status (SES) to the risk of TA amongPopulation-based estimates of traffic accidents (TAs) are not readily available for developing countries. This study examined the contribution of socioeconomic status (SES) to the risk of TA among Iranian adults. A total of 64,200people aged ≥18years were identified from 2008 Urban Health Equity Assessment and Response Tool (Urban HEART) survey. 22,128 households were interviewed to estimate the overall annual incidence, severity and socioeconomic determinants of TAs for males and females in Iranian capital over the preceding year. Wealth index and house value index were constructed for economic measurement. Weighted estimates were computed adjusting for complex survey design. Logistic regression models were used to examine individual and SES measures as potential determinants of TAs in adults. The overall incidence of traffic accident was 17.3(95% CI 16.0, 18.7) per 1000 per year. TA rate in men and women was 22.6(95% CI 20.6, 24.8) and 11.8(95% CI 10.4, 13.2), respectively. The overall TA mortality rate was 26.6(95% CI 13.4, 39.8) per 100,000 person-years, which was almost three times higher in men than that for women (40.4 vs. 12.1 per 100,000person-years). Lower economic level was associated with increased incidence and mortality of TA. Association between SES and incidence, and severity and mortality of TA were identified. TAs occur more in lower socioeconomic layers of the society. This should be taken seriously into consideration by policy makers, so that preventive programs aimed at behavioral modifications in the society are promoted to decrease the health and economic burden imposed by TAs.

• Vitamin and mineral supplements: do we really need them?

  Authors: Farin Kamangar, Ashkan Emadi

  International journal of preventive medicine. 3(3):221-6.

  In the United States, 40 - 50% of the men and women 50 years of age or older regularly use multivitamin/mineral (MVM) supplements, making the annual sales of these supplements over $11 billion.In the United States, 40 - 50% of the men and women 50 years of age or older regularly use multivitamin/mineral (MVM) supplements, making the annual sales of these supplements over $11 billion. However, the question remains whether using MVM supplements is beneficial to health. This article reviews the results of randomized studies of MVM supplements and individual vitamins/mineral supplements in relation to overall mortality and incidence of chronic diseases, particularly cancer and ischemic heart disease. The results of large-scale randomized trials show that, for the majority of the population, there is no overall benefit from taking MVM supplements. Indeed, some studies have shown increased risk of cancers in relation to using certain vitamins.

• Preventing sport injuries: improving performance.

  Authors: Nader Rahnama

  International journal of preventive medicine. 3(3):143-4.

• LDL Particle Size and Reactive Oxygen Metabolites in Dyslipidemic Patients.

  Authors: Kazuhiko Kotani, Kokoro Tsuzaki, Nobuyuki Taniguchi, Naoki Sakane

  International journal of preventive medicine. 3(3):160-6.

  Small dense low-density lipoprotein (sdLDL) which has a small LDL particle size with greater susceptibility to oxidation is regarded as a risk marker for cardiovascular disease. The diacron reactiveSmall dense low-density lipoprotein (sdLDL) which has a small LDL particle size with greater susceptibility to oxidation is regarded as a risk marker for cardiovascular disease. The diacron reactive oxygen metabolites (d-ROMs) test has recently been introduced as an oxidative stress-related marker in the clinic. The aim of the present study was to investigate the correlation between the mean LDL particle size and the oxidative stress status as evaluated by the d-ROMs in dyslipidemic patients. The study included 278 dyslipidemic patients (121 male and 157 female, mean age, 60 years). Clinical data including the conventional atherosclerotic risk factors in addition to the mean LDL particle size measured with the gel electrophoresis and the d-ROMs were collected. Male patients had a significantly smaller mean LDL particle size than females (262.2 ± 7.5 [SD] vs. 264.3 ± 6.7 Å, P<0.05), while female patients had a significantly higher d-ROMs level than males (318 ± 68 vs. 350 ± 72 U. Carr., P<0.01). A multiple regression analysis revealed that there was an independent, significant, and inverse correlation between the mean LDL particle size and the d-ROMs (β=-0.19, P<0.05). These findings of the co-existence of both markers suggest that sdLDL and oxidative stress can be cooperative in atherogenesis, possibly leading to the incidence of CVD, in dyslipidemic patients.

• Establishment of Health Clinics as Mass Screening and Referral Systems for Chronic Non-communicable Diseases in Primary Health Care.

  Authors: Kamal Heidari, Sayyed Ali Sajjadi, Rezvaneh Hadian, Somayeh Hadi, Ramesh Hosseinkhani, Soudabeh Amini, Zahra Kiani, Ali Ajami, Reza Fadaei, Anahita Shahriari, Kasra Keramatian

  International journal of preventive medicine. 3(3):173-80.

  This study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases (CNCD) in the routine primary health care, and to determine the prevalence ofThis study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases (CNCD) in the routine primary health care, and to determine the prevalence of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. This survey was conducted from March 2010, and the current paper presents data obtained until November 2011. To provide health services for prevention and control of CNCDs, with priority of type2 diabetes mellitus, Health clinics were established in different parts of Isfahan city with a population of approximately 2,100,000 in Iran. The general populations aged 30 years and above were invited to the Health clinics by public announcement. A total of 198972 participants were screened. The mean age of participants was 47.8 years (48.5 men, 47.3 women), with a range of 1 to 95 years old and standard deviation of 12.3 years (12.7 men, 12.1 women). Overall, 22% of participants had impaired fasting glucose, 25% had hypercholesterolemia, 31% had hypertriglyceridemia, and 20% had metabolic syndrome. The high prevalence of dysglycemia and diabetes in our survey may serve as confirmatory evidence about the importance of mass screening and early diagnosis of CNCDs' risk factors. Our model of establishing Health clinics, as a comprehensive referral system in the routine primary health care can be adopted by Middle Eastern countries, where CNCDs notably diabetes are an emerging health problem.

• The estimation of direct medical costs of treating patients with chronic hepatitis B and C in iran.

  Authors: Hamid Kalantari, Majid Davari, Mojtaba Akbari, Seyed Mehdi Hejazi, Maryam Kalantari, Shahram Zakerin, Zahra Shahshahan

  International journal of preventive medicine. 3(3):191-6.

  The objective of this study is to estimate the average diagnosis and treatment costs of chronic hepatitis B and C, with respect to different therapeutic strategies in Iran. This is a descriptive,The objective of this study is to estimate the average diagnosis and treatment costs of chronic hepatitis B and C, with respect to different therapeutic strategies in Iran. This is a descriptive, analytical, and cross-sectional study carried out on patients with hepatitis B and C, who were referred to the Liver Disease Research Center for Prevention and Treatment of Hepatitis, Isfahan University of Medical Sciences, in 2011. We have estimated the direct medical costs including doctors' fees, cost of para-clinical tests, medical treatments, and liver biopsy, in different treatment strategies. The results of this study showed that the total cost of diagnostic services for hepatitis B virus (HBV) and hepatitis C virus (HCV) patients, with state medical tariffs, was US$ 1499.07 and US$ 2084.89, respectively. The patients' profiles showed that there were currently seven therapeutic strategies available to treat HBV patients. The total cost of treatment strategies varied significantly from US$ 73 to US$ 8256. There were also four main strategies for HCV patients, each of these could be applied in two periods of time. The total cost of these treatment strategies showed a high discrepancy from US$ 242 to US$ 8256. The results confirmed that the total direct medical cost for an HBV patient in Iran exceeded US$ 5.5 Milliard in 2011. The results implied that the market price of direct medical cost of HBV and HCV patients in Iran is much higher than the estimated state costs. These costs would likely be saved or reduced by effective disease management and early prevention.

• Body Mass Index or Microalbuminuria, Which One is More Important for the Prediction and Prevention of Diastolic Dysfunction in Non-diabetic Hypertensive Patients?

  Authors: Hasan Shemirani, Alireza Khosravi, Rohola Hemmati, Mojgan Gharipour

  International journal of preventive medicine. 3(3):211-20.

  Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients withNumerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained - 'Which is more important for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients?' The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two-dimensional, doppler, and tissue-doppler echocardiography was performed and the recording of the diastolic function parameters was carried out. High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter. According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients.

• Preoperative Topical Diclofenac and Ketorolac in Prevention of Pain and Discomfort Following Photorefractive Keratectomy: A Randomized Double-Masked Placebo-Controlled Clinical Trial

  Authors: Abtahi SH

  International journal of preventive medicine.

• Evaluation of Tuberculosis Situation in Economic Cooperation Countries in 2009; Achievement and Gaps toward Millennium Development Goals.

  Authors: Ghobad Moradi, Kourosh Holakouie Naieni, Arash Rashidian, Parviz Vazirian, Ali Mirzazadeh, Mohammad Reza Pour Vaziri, Hossein Malek Afzali

  International journal of preventive medicine. 3(2):77-83.

  Evaluating the tuberculosis (TB) status of the Economic Cooperation Organization (ECO) member countries relation to goal 6-c of the third millennium, which includes that TB incidence, prevalence, andEvaluating the tuberculosis (TB) status of the Economic Cooperation Organization (ECO) member countries relation to goal 6-c of the third millennium, which includes that TB incidence, prevalence, and death rates should be halved by 2015, compared with their level in 1990. In 2009, we have critically reviewed the countries' Millennium Development Goals (MDGs) reports and extracted the data from the surveillance system and published and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process. The TB incidence is very heterogeneous among ECO countries, which differ from 21.7 in Iran to 230.7 per 100,000 in Tajikistan. TB incidence (per 100,000) is more than 100 in six countries and is from 50 to 100 in two countries and is less than 30 in two countries. Only in two countries the crude death rate (CDR) is higher than 70%. In seven countries the death rate is higher than 10 per 100,000. Two countries are among the 20 top world countries with the highest tuberculosis burden. THERE ARE SOME SIGNS AND SIGNALS INDICATING THE BAD CONDITION OF AN ECO MEMBER INCLUDING: incidence of more than 50 per 100000, CDR of less than 70%, death rate more than 10 per 100,000, and rating two member countries among 20 top countries with the highest burden in the world. Iran and Turkey could achieve MDGs by 2015, but if other countries do not prepare urgent intervention programs, they will not be able to fulfill the goals.

• Comparing dental and pharmacy students' perceptions on public health and preventive health care course.

  Authors: Aliye Mandiracioglu, Fethi Dogan

  International journal of preventive medicine. 3(2):91-4.

  A Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views ofA Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views of pharmacy and dentistry students on a public health course and preventive health care. 173 students enrolled at Ege University, Faculties of Pharmacy and Dentistry completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and replied to 18 Likert type question to determine their perceptions on a public health course and preventive health care. The comments of the students were reviewed and categorized into key themes. SWOT analysis and the results of quantitative Likert type questions supported each other. According to the quantitative results, there was no significant difference between the scores of students from both schools in terms of their statements about the public health course and preventive care. Both groups of students mentioned the contribution of the public health course to their professions in the future. They also appreciated the importance of preventive care in the health services.

• Preventing worry and rumination by induced positive emotion.

  Authors: Fatemeh Bahrami, Rahim Kasaei, Ahmadreza Zamani

  International journal of preventive medicine. 3(2):102-9.

  Thus study aimed to test the hypothesis that positive emotion can quell or undo the lingering worry and rumination following induced negative emotion. 32 female students in grade 1 of high schoolThus study aimed to test the hypothesis that positive emotion can quell or undo the lingering worry and rumination following induced negative emotion. 32 female students in grade 1 of high school were randomly recruited and assigned in two experimental and control groups. They completed questionnaires in a pretest that are listed herewith: (1) Rumination questionnaire; (2) Two scales of the big five factorial questionnaire (extraversion - introversion; (3) MMPI(2); (4) Penn-state worry questionnaire. Then for the first group a sad movie, for the second group a cheerful movie, and for the third group a neutral movie was played, and the fourth group remained without intervention. Next day, all the group members completed the worry and rumination questionnaire again. Research findings were analyzed using covariance analysis and multivariate analysis of variance (MANOVA). Those participants whose attention was turned toward the cheerful movie recovered from negative emotions (rumination and worry) more than those who saw either a neutral or sad movie or remained without intervention. Positive emotion is effective on negative emotion like worry and rumination. This effect is called the undoing effect of positive emotions.

• Inequality in maternal mortality in iran: an ecologic study.

  Authors: Parvin Tajik, Saharnaz Nedjat, Nozhat Emami Afshar, Nasrin Changizi, Bahareh Yazdizadeh, Arash Azemikhah, Sima Aamrolalaei, Reza Majdzadeh

  International journal of preventive medicine. 3(2):116-21.

  Maternal mortality (MM) is an avoidable death and there is national, international and political commitment to reduce it. The objective of this study is to examine the relation of MM to socioeconomicMaternal mortality (MM) is an avoidable death and there is national, international and political commitment to reduce it. The objective of this study is to examine the relation of MM to socioeconomic factors and its inequality in Iran's provinces at an ecologic level. The overall MM from each province was considered for 3 years from 2004 to 2006. The five independent variables whose relations were studied included the literacy rate among men and women in each province, mean annual household income per capita, Gini coefficients in each province, and Human Development Index (HDI). The correlation of Maternal Mortality Ratio (MMR) to the above five variables was evaluated through Pearson's correlation coefficient (simple and weighted for each province's population) and linear regression - by considering MMR as the dependent variable and the Gini coefficient, HDI, and difference in literacy rate among men and women as the independent variables. The mean MMR in the years 2004-2006 was 24.7 in 100,000 live births. The correlation coefficients between MMR and literacy rate among women, literacy rate among men, the mean annual household income per capita, Gini coefficient and HDI were 0.82, 0.90, -0.61, 0.52 and -0.77, respectively. Based on multivariate regression, MMR was significantly associated with HDI (standardized B=-0.93) and difference in literacy rate among men and women (standardized B=-0.47). However, MMR was not significantly associated with the Gini coefficient. This study shows the association between socioeconomic variables and their inequalities with MMR in Iran's provinces at an ecologic level. In addition to the other direct interventions performed to reduce MM, it seems essential to especially focus on more distal factors influencing MMR.

• The role of maternal thyroid stimulating hormone receptor blocking antibodies in the etiology of congenital hypothyroidism in isfahan, iran.

  Authors: Mahin Hashemipour, Shima Salehi Abari, Neda Mostofizadeh, Shaghayegh Haghjooy-Javanmard, Nafiseh Esmail, Silva Hovsepian, Amini Masoud, Roya Kelishadi, Akbar Hasanzadeh, Mehrdad Mirouliaei

  International journal of preventive medicine. 3(2):128-33.

  Considering the role of maternal thyroid stimulating hormone (TSH) receptor blocking antibody (TRAb) in the etiology of congenital hypothyroidism (CH), this study aimed to determine TRAb amongConsidering the role of maternal thyroid stimulating hormone (TSH) receptor blocking antibody (TRAb) in the etiology of congenital hypothyroidism (CH), this study aimed to determine TRAb among patients with CH in Isfahan, Iran. In this case-control study, patients with CH and their mothers were compared with a group of healthy neonates and their mothers. Venous blood samples were obtained for measurement of TRAb using enzyme-linked immunosorbent assay (ELISA) method among mothers and their neonates. TSH of mothers was also determined. The case group consisted of 65 patients with CH and their mothers; controls were 148 healthy neonates and their mothers. The prevalence of positive TRAb in patients with CH and their mothers was higher than in the control group (81.5% vs. 1.3% in mothers and 80% vs. 0% in neonates, respectively, P<0.05). The relationship between the TRAb and occurrence of CH was significant (P<0.05), whereas the corresponding figure was not significant for TRAb and the level of maternal and neonatal TSH in case and control groups (P>0.05). It seems that autoimmunity has an important role in the etiology of CH. Further studies are necessary to determine other autoantibodies in CH patients.

• Smoking paradox at cardiac rehabilitation.

  Authors: Golabchi Allahyar

  International journal of preventive medicine. 3(2):139-40.

• Complexity of the socioeconomic status and its disparity as a determinant of health.

  Authors: Ali Akbar Haghdoost

  International journal of preventive medicine. 3(2):75-6.

• Psychometric Properties of the Iranian Version of Resources and Support for Chronic Illness Self-management Scale in Patients with Type 2 Diabetes.

  Authors: Elham Shakibazadeh, Arash Rashidian, Bagher Larijani, Davood Shojaeezadeh

  International journal of preventive medicine. 3(2):84-90.

  This article is a report of psychometric testing of the Farsi version of Resources and Support for Chronic Illness Self-management (RSSM) scale. In this cross-sectional study, a convenience sample ofThis article is a report of psychometric testing of the Farsi version of Resources and Support for Chronic Illness Self-management (RSSM) scale. In this cross-sectional study, a convenience sample of 160 patients with type 2 diabetes, registered with the Charity Foundation for Special Diseases' team-focused diabetes clinic, were recruited (response rate=83.7%; n=134). Participants older than 18 years who had active medical files in the system completed the questionnaire. Content validity was established using translation and back-translation procedures, pilot testing of the instrument, and getting views of the expert panel. Construct validity was determined using explanatory factor analysis. Internal consistency was ascertained using Cronbach's alpha. The stability was confirmed using intra-class correlation coefficients. Using exploratory factor analysis, a five-factor model emerged, which explained 75.24% of the total variance. Internal consistency reliability was sufficient (α=0.70; range=0.66 - 0.87). The intra-class correlation coefficient was 0.74 - 0.81 for individual items. The RSSM-Farsi seems to be a valid and reliable instrument to measure outcomes of diabetes self-management education programs in Farsi. The RSSM-Farsi version scale could be a useful, comprehensive, and culturally sensitive scale for assessing resources and support for self-management between type 2 diabetic patients.

• Sleep Apnea Symptoms in Diabetics and their First Degree Relatives.

  Authors: Babak Amra, Farideh Sheikh Bahaee, Masoud Amini, Mohammad Golshan, Ingo Fietze, Thomas Penzel

  International journal of preventive medicine. 3(2):95-101.

  Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of ourSleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family. As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were invited to take part in the survey. Two thousand, four hundred and sixty-two individuals (82% of invited) agreed to fill out the Berlin and Epworth sleep questionnaire. Participants consisted of 2462 subjects of 15-70 years of age, both males and females with diabetes and family history of type 2 diabetes mellitus. A total of 1234 participants had diabetes and 11,231 were relatives of diabetic patients. High risk for sleep apnea regarding Berlin questionnaire and Epworth sleepiness scale, diabetic and relative were analyzed. Prevalences of high risk for sleep apnea were higher among diabetics than relatives (P-value<0.001). In a multiple regression analysis, "age, body mass index, education, high blood pressure" were risk factor for sleep apnea symptoms while isolated blood glucose level was not by Berlin questionnaire. By Epworth sleep scale only education level was a risk factor for sleep apnea symptoms while isolated blood glucose level was not risk factor. Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family.

• Vitamin e reduces superficial bladder cancer recurrence: a randomized controlled trial.

  Authors: Hamid Mazdak, Hamidreza Zia

  International journal of preventive medicine. 3(2):110-5.

  Most patients with superficial bladder cancer who undergo transurethral resection of bladder tumor show recurrence of the disease. So far, there have been numerous studies on ways to decrease bladderMost patients with superficial bladder cancer who undergo transurethral resection of bladder tumor show recurrence of the disease. So far, there have been numerous studies on ways to decrease bladder cancer recurrence, including the intake of vitamins and antioxidants. The goal of this study was to investigate the effect of vitamin E on the recurrence of non-invasive bladder cancer. In this randomized controlled trial, 46 patients with a single, low-grade, superficial bladder cancer, less than 3 cm in diameter, were randomly divided into two groups of vitamin E intake (400 IU daily) and no intake of vitamin E. Ultrasound and urinalysis were performed every three months to detect bladder cancer recurrence. There was no significant difference between the groups in age, tumor size, mean time to recurrence, and follow-up time. There recurrence rate was 28.3% throughout the follow-up period (19% in the study group and 36% in the controls) (CI=0.19 - 0.92, RR=0.53, CI=0.11 - 0.94, OR=0.42, P=0.04). In both groups, most (69.2%) of the recurrences occurred during the first year.The rate of recurrence decreased in smokers from 50% in the study group to 25% in the control group (P=0.06) and from 26.7% to 15.4% in the non-smokers in the control and study groups, respectively (P=0.15). Intake of vitamin E significantly decreased bladder cancer recurrence, especially among smokers, possibly due to higher levels of oxidants, which vitamin E may target in smokers.The trial registry code: IRCT201105235527N2.

• Impact of addiction to internet on a number of psychiatric symptoms in students of isfahan universities, iran, 2010.

  Authors: Seyyed Salman Alavi, Hamed Alaghemandan, Mohammadreza Reza Maracy, Fereshte Jannatifard, Mehdi Eslami, Masoud Ferdosi

  International journal of preventive medicine. 3(2):122-7.

  This study aimed to investigate the impact of internet addiction on some psychiatric symptoms among university students. This cross-sectional study was conducted among 250 students selected via quotaThis study aimed to investigate the impact of internet addiction on some psychiatric symptoms among university students. This cross-sectional study was conducted among 250 students selected via quota sampling from universities in Isfahan, Iran. Participants completed demographic questionnaire, Young Diagnostic Questionnaire, Internet Addiction Test and Symptom Checklist-90-Revision (SCL-90-R). Finally, the means of psychiatric symptoms of internet addicted and non-addicted subjects were compared. Also, t-test and multivariate analysis of covariance were used through SPSS(16) software for data analysis. The mean±standard deviation (SD) of psychiatric symptoms such as somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, aggression (hostility), phobic anxiety, paranoid ideation and psychoticism in the addicted group were 11.27 ± 6.66, 14.05 ± 7.91, 10.5 ± 6.20, 15.61 ± 8.88, 10.77 ± 5.52, 6.77 ± 4.88, 6.05 ± 4.47, 7.61 ± 4.28, and 9.66 ± 6.87, respectively, and in the non-addicted group were 6.99 ± 6.42, 7.49 ± 5.23, 5.46 ± 4.95, 9.27 ± 7.92, 6.35 ± 6.69, 3.57 ± 3.35, 2.41 ± 2.79, 5.47 ± 4.1, and 5.29 ± 4.95, respectively. There were significant differences between the means of psychiatric symptoms in all SCL-90-R subscales and Global Severity Index, Positive Symptom Distress Index, Positive Symptom Total in the addicted and non-addicted individuals (P<0.05). Also, internet addiction (with controlling sex variable) seemed to affect psychiatric symptoms. Psychiatrists and psychologists involved in the field of mental health need to be well informed about mental problems due to internet addiction, such as anxiety, depression, aggression, and job and educational dissatisfaction.

• Attenuation of brain white matter lesions after lacunar stroke.

  Authors: Julia Durand-Birchenall, Claire Leclercq, Joël Daouk, Pauline Monet, Olivier Godefroy, Jean-Marc Bugnicourt

  International journal of preventive medicine. 3(2):134-8.

  White matter lesions (WMLs) are commonly observed in stroke patients with small vessel disease (SVD) and are thought to result from a progressive, irreversible disease process followingWhite matter lesions (WMLs) are commonly observed in stroke patients with small vessel disease (SVD) and are thought to result from a progressive, irreversible disease process following arteriolosclerosis. In this study, we report a case of partial disappearance of WMLs 1 year after a lacunar stroke in a 69-year-old man with evidence of SVD. We also discuss possible mechanisms associated with this observation.

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