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1.  Methodology of Isfahan Tobacco Use Prevention Program: First Phase 
Background. Tobacco use continues to be the leading global cause of preventable death. The majority of smokers begin using tobacco products at teen ages. The aims of this study were providing a methodology of Isfahan Tobacco Use Prevention Program and investigating the prevalence of tobacco use and its related factors. Method. It was a cross-sectional study among guidance and high school students in Isfahan province. Initiation, social, psychological (depression and self-efficacy), family, and attitudinal and belief factors and school policy toward smoking (cigarettes and water-pipe) were investigated. Saliva qutinin was given from 5% of participants for determination of accuracy of responses. A self-administered anonymous questionnaire was used for gathering all data. Results. Of all 5500 questionnaires distributed, about 5408 completed questionnaires were returned (with response rate of 98.3%). Of all participants, 2702 (50.0%) were girls and 2706 (50.0%) were boys. Respectively, 4811 (89.0%) and 597 (11.0%) were from urban and rural. Of all participants, 2445 (45.2%) were guidance school and 2962 (54.8%) were high school students. Conclusion. This study will provide a unique opportunity to study prevalence of smoking cigarettes and water-pipe (ghelyan) among guidance and high school students in Isfahan province and determine the role of initiation, social, psychological, family, and attitudinal and belief factors and school policy toward smoking.
PMCID: PMC3870653  PMID: 24383007
2.  Is thromboprophylaxis effective in reducing the pulmonary thromboembolism? 
ARYA Atherosclerosis  2012;8(1):16-20.
Deep vein thrombosis (DVT) is a relatively prevalent disease which causes high costs due to the required diagnostic tests, specialized treatments, and hospital admission. In recent decades, implementation of thromboprophylaxis protocols has significantly reduced the incidence of thromboembolism in hospitals. The present study aimed to compare the incidence of venous thromboembolism before and after implementation of the mentioned protocol in hospital with identified risk factors and underlying diseases.
In this case-control group, 385 patients at the risk of DVT, some before and some after implementation of the protocol were studied. Therefore, the level of thromboprophylaxis and the incidence of venous thromboembolism were compared before and after the protocol. Data was entered into SPSS15 and analyzed by chi-square and t tests
Out of 385 patients, 34 patients (8.8%) had venous thromboembolism while 351 (91.2%) were not affected. The incidence of venous thromboembolism was significantly different before and after the implementation of the protocol (17.7% vs. 5.9%; P < 0.001). The incidence of venous thromboembolism in patients not receiving thromboprophylaxis was almost 5 times higher than those who received it (20.7% vs. 5.1%). The frequency distribution of thromboembolism had a significant difference in the two above mentioned groups (P < 0.001).
Thromboprophylaxis protocol reduced venous thromboembolism incidence in patients with underlying diseases which increase the risk of the complication.
PMCID: PMC3448396  PMID: 23056095
Deep vein thrombosis; Thromboprophylaxis
3.  Relationship between depression and apolipoproteins A and B: a case–control study 
Clinics  2011;66(1):113-117.
To investigate the relation between major depressive disorder and metabolic risk factors of coronary heart disease.
Little evidence is available indicating a relationship between major depressive disorder and metabolic risk factors of coronary heart disease such as lipoprotein and apolipoprotein.
This case–control study included 153 patients with major depressive disorder who fulfilled the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV), and 147 healthy individuals. All participants completed a demographic questionnaire and Hamilton rating scale for depression. Anthropometric characteristics were recorded. Blood samples were taken and total cholesterol, high‐ and low‐density lipoproteins and apolipoproteins A and B were measured. To analyze the data, t‐test, χ2 test, Pearson correlation test and linear regression were applied.
Depression was a negative predictor of apolipoprotein A (β = −0.328, p<0.01) and positive predictor of apolipoprotein B (β = 0.290, p<0.05). Apolipoprotein A was inversely predicted by total cholesterol (β = −0.269, p<0.05) and positively predicted by high‐density lipoprotein (β = 0.401, p<0.01). Also, low‐density lipoprotein was a predictor of apolipoprotein B (β = 0.340, p<0.01). The severity of depression was correlated with the increment in serum apolipoprotein B levels and the decrement in serum apolipoprotein A level.
In view of the relationship between apolipoproteins A and B and depression, it would seem that screening of these metabolic risk factors besides psychological interventions is necessary in depressed patients.
PMCID: PMC3044579  PMID: 21437446
Coronary risk factors; Coronary heart disease; Major depression
4.  Non-alcoholic Steatohepatitis in a Sample of Iranian Adult Population: Age is a Risk Factor 
Non-alcoholic Steatohepatitis (NASH) is a cause of cirrhosis. Detecting its preventable causes could be useful in decreasing the disease and its complications. This study aimed to assess the prevalence of NASH in adult population living in Isfahan city as a sample of Iranian population.
Blood samples of 2030 individuals referring to Dr. Shariati Hospital for routine health checkup were collected. All individuals with high liver enzymes [aspartate aminotransferase (AST) and/or Alanine aminotransferease (ALT)] were included in the study. Known causes of altered liver enzymes were excluded. Second blood samples were obtained 6 months later and those cases with persistent enzyme elevation were surveyed with ultrasonography.
In the first survey, 234 individuals (11.5 %) had ALT levels of more than 40 U/L. By rechecking samples after 6 months, 50% of all high serum ALT individuals remained at high level. After conducting complementary biochemical tests, 3.3% of the population was considered to have NASH; 20% of NASH cases did not have any abnormal findings in ultrasonography. Hypercholesterolemia was the most coexisting risk factor in NASH cases. We found a reverse correlation between ALT level and age (P = 0.02).
The prevalence of NASH was comparable with other countries. According to the significantl correlation between ALT level and age, preventive interactions in younger individuals would decrease the incidence of NASH.
PMCID: PMC3063465  PMID: 21448401
Non-alcoholic steatohepatitis; Population-based study; Liver enzyme; Iran

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