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Background : Tobacco consumption is the second major cause of death and the fourth most common risk factor for diseases, worldwide. Epidemiologic studies have traced the use of alcohol, tobacco, and illicit substances among medical students and physicians. Objectives : The current study aimed to investigate the prevalence of cigarette smoking and the related factors among the students of medical sciences in Mashhad University of Medical Sciences, Mashhad, Iran. Patients and Methods : This cross-sectional study was conducted on 946 health professional students in Mashhad University of Medical Sciences (MUMS, Iran) in autumn 2008. A standard self-administered questionnaire consisting of socio-demographic data, participant smoking status, family and peer smoking, attitudes and beliefs about smoking, awareness of cigarette negative effects and reasons for smoking cessation was used in the current study. Results : Among the students, 18.3 % reported having ever tried or experienced with cigarette smoking. The overall prevalence of cigarette smoking was 9.8 % with significant differences in prevalence rates by gender, 17.6 % among males and 4.2 % among females. Starting and continuing smoking was significantly correlated with the family cigarette consumption habits. The most common reason to start smoking was friends (24.9 %) and the most important reason to continue smoking was personal life distress (17.6 %). The majority of participants (92.3 %) reported that they were aware of the hazards of smoking. A significant difference regarding awareness of smoking hazards was observed between smokers and non-smokers. The most important preventive factor for cigarette smoking was religious beliefs (69.1 %). Conclusions : Although the prevalence of regular smokers among health professions students of MUMS was lower than general populations, but this level is still alarming and points at the rapid growth of cigarette use, especially among female students. Medical schools should work harder to tackle this phenomenon and address it more efficiently in their curricula.

Although not mandatory for patients, many Muslims fast in Ramadan. We aimed to investigate the effects of long hours (17.5) fasting on renal functions in patients with chronic kidney disease (CKD). Stage 3–5 CKD patients with stable renal function were recruited to this prospective observational study three months ahead of Ramadan in 2015. All patients were instructed regarding possible deleterious effects of dehydration caused by fasting. Forty-five patients (mean age 66.8 ± 10.3 years, 68.8% male) chose to fast and 49 (mean, age: 64.1 ± 12.6 years, 51% male) chose not to fast. Clinical and laboratory data were recorded before and after Ramadan. Baseline clinical and laboratory parameters were similar in the two groups, except for higher serum creatinine and lower estimated glomerular filtration rate (eGFR) in the nonfasting group (2.22 ± 0.99 vs. 1.64 ± 0.41 mg/dL, P <0.001 and 3 1.9 ± 12.4 vs. 42.6 ± 9.8 mL/min, P <0.001, respectively). More than 30% elevation in serum creatinine after Ramadan occurred in 8.8% and 8.1% of fasting and nonfasting patients, respectively (P = 0.9). More than 25% drop eGFR after Ramadan was noted in seven (15.5%) and six (12.2%) fasting and nonfasting patients, respectively (P = 0.642). Patients with ≥25% drop in eGFR (13 vs. 81) were older (72.3 ± 8.3 years vs. 64.3 ± 11.7 years, P = 0.020) and more frequently using diuretics (69.2% vs. 35.8%, P = 0.023). In multiple linear regression analysis, only advanced age was found to be associated with ≥25% drop in eGFR after Ramadan in the fasting group. Fasting during Ramadan was not associated with increased risk of declining in renal functions in patients with Stage 3–5 CKD. However, elderly patients may still be under a higher risk.

Disease preventing methods focus mostly on lifestyle factors such as physical activity, healthy diet and not smoking. Previous studies verified using theory and models to change unhealthy behaviors, so that health belief model (HBM) is a useful framework for describing the healthy nutrition behavior. Objectives : This study aimed to predict factors related to unhealthy nutrition and inactive life in students of Tehran University, Tehran, Iran based on the Health Belief Model (HBM). Patients and Methods: In this cross sectional study, proportional quota sampling from three different educational levels was conducted from October to December 2012. A self-administered validated instrument based on the Health Belief Model (HBM) with 69 items and four sections was used to collect data. In this study through using linear and logistic regression, the effect of body mass index, age, gender, marriage, self-efficacy, cues to action, knowledge, perceived severity, susceptibility, benefits and barriers on nutrition and physical activity behavior were assessed. SPSS version 18 was used to analyze data. Results : Totally, 368 students including 318 female students (86.4%) and 50 male students (13.6%) with a mean age of 24.9 years (SD = 4.55) took part in the study. Among all independent variables, gender (P < 0.001), knowledge (P = 0.023) and perceived barriers (P = 0.004) predicted nutrition behavior. In case of physical activity, knowledge (P = 0.011), perceived severity (P = 0.009), perceived barriers (P = 0.019) and self-efficacy (P = 0.033) had significance association with physical activity behavior. Conclusions : This study indicated that health belief model contrasts could predict the risky behavior of university students due to heart disease. However, more researches are needed to verify the predictors of high risky behaviors in students.

Background : Adolescent smoking problem has still remained as a public health concern, but factors that attributing to the initiation of adolescent smoking are not well known in Iran. Objectives : The aim of this study is to estimate the prevalence of smoking, and its associations among high school male adolescents in Iran, in the context of the theory of planned behavior (TPB). Patients and Methods: This was a cross-sectional study involving male adolescent students (high school) in the city of Zarandieh, Iran. A multiple-stage sampling protocol was used. The participants completed an anonymous, voluntary, and self-report questionnaire. Prevalence was estimated, and demographic variables, psychological factors, and the theory of planned behavior components were used to indicate factors contributing to adolescents’ cigarette smoking. Results : In all, 365 students were entered the study. The mean age of respondents was 16.49 ± 1.11 years. The prevalence of current smoking was 15.1 %. The result obtained from logistic regression analysis revealed that all theory of planned behavior (TPB) components [knowledge (OR = 0.75 ; 95 % CI : (0.59-0.97), attitude (OR = 0.75 ; 95 % CI : (0.65-0.86), self-efficacy (OR = 0.82 ; 95 % CI : (0.71-0.95), subjective norms (OR = 0.84 ; 95 % CI : (0.72-0.98)] were significant predating factors for adolescents smoking habits. In addition, having parents who smoke (OR = 4.75 ; 95 % CI : (1.38- 12.35), smoking friends (OR = 3.76 ; 95 % CI : (1.20-11.76), and smoking siblings (OR = 4.21 ; 95 % CI : (1.17-11.16) were significant contributing factors to adolescents’ cigarette smoking behavior. Conclusions : The results showed that the prevalence of cigarette smoking in adolescents was high, and the theory of planned behavior (TPB) components were significant predictors of cigarette smoking. It seems that interventions targeting adolescents’ smoking habits might benefit using the TPB model.

Background: Socioeconomic status (SES) is one of the main determinants of health-related quality of life (HRQoL), where people with lower SES experience more health problems, have a lower quality of life, and are exposed to have a greater number of health-related risk factors. Objectives: This study aimed to examine the relationships between HRQoL, SES, and several demographic factors among the residents of the city of Ilam (located at the West of Iran). Methods: This cross sectional study was conducted on 400 households from 3 districts of the city of Ilam in 2015. The participants were selected on the basis of the multistage sampling method. The second version of the 12-item Short-Form Health Survey (SF-12v2) questionnaire and the Wealth Index were used to measure HRQoL and SES, respectively. Results: The mean scores of the physical component summary (PCS) and the mental component summary (MCS) were 46.32 ± 9.69 and 42.12 ± 9.11, respectively. The findings indicated that PCS (P = 0.01) and MCS (P = 0.01) were significantly related to SES (wealth index). The demographic variables of age, gender, education level, marital status, job status, and home ownership (P < 0.05) were also significantly related to both PCS and MCS. Conclusions: HRQoL is directly related to SES, in that HRQoL is higher in families with higher SES. Similarly, HRQL is higher in younger people, men, and those with a university degree. A decrease in socio-economic inequalities and the gap between the rich and the poor can enhance the individuals’ health status and HRQoL within a community.

Background: Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life. Objectives: This study aimed to understand the experiences of return to normal life in RTA victims. Patients and Methods: This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis. Results: By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life. Conclusions: The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.

Background : Working outside daylight hours (7 am to 7 pm) is called shift work. Shift work is a common practice in many industries and factories such as steel industries, petroleum industries, power plants, and in some services such as medicine and nursing and police forces, in which professionals provide services during day and night. Objectives : Considering the contradictory reports of different studies, we decided to evaluate the effect of shift work on cholesterol and triglyceride (TG) levels through a historical cohort on steel industry workers. Patients and Methods : This retrospective cohort study was performed on all the staff of Isfahan’s Mobarakeh Steel Company between years 2002 and 2011. There were 5773 participants in this study. Data were collected from the medical records of the staff using the census method. For analysis of data, generalized estimating equation (GEE) regression was used. Results : The results showed a significant difference in cholesterol levels between shift workers and day workers on the first observation (P < 0.001), yet no such difference was observed for TG (P = 0.853). Moreover, the results showed that the variables of age, work experience and BMI were not similar between shift workers and day workers. Therefore, to remove the effect of such variables, we used GEE regression. Despite the borderline difference of cholesterol between regular shift workers and day workers, this correlation was not statistically significant (P = 0.051). The results for TG also showed no correlation with shift work. Conclusions : According to the findings of this study, there is no relationship between shift work and changes in serum TG and cholesterol. The lack of relationship can be due to shift plans for shift workers, nutrition, or the “Healthy Heart project” at Isfahan Mobarakeh Steel Company.