Papers by Abdorrahim Afkhamzadeh
Health Promotion International
Health literacy is one of the most critical determinants of health for effectively improving heal... more Health literacy is one of the most critical determinants of health for effectively improving health services and reducing health inequalities. The importance of accurate measurement cannot be overstated. The European 47-item Health Literacy Questionnaire (HLS-EU-Q47) can provide precise measurements of health literacy. Therefore, this study aimed to evaluate the psychometric properties of the European Health Literacy Instrument in Iranian society (HLS-PV-Q47) for its Persian version. This cross-sectional study was conducted using a convenient sampling of 560 people referred to comprehensive healthcare centers. The construct validity was assessed by exploratory (280 people) and confirmatory factor (with 280 people). The internal consistency was calculated using Cronbach’s alpha coefficients. Based on the exploratory factor analysis, three factors of healthcare, disease prevention, and health promotion explained 48.9% of the total variance of health literacy. Cronbach’s alpha was 0.96...
World Academy of Science, Engineering and Technology, International Journal of Psychological and Behavioral Sciences, Dec 3, 2015
ABSTRACT Background: Luck of individual health is one of the major factors health problems among ... more ABSTRACT Background: Luck of individual health is one of the major factors health problems among the pilgrims, can be followed several complications. the main aim of this study was determine factors predicting individual health among pilgrims of Kurdistan County; in the west of Iran, and health belief model (HBM) was applied as theoretical framework. Methods: A cross-sectional study was conducted among 100 pilgrims who referred in the red crescent of Kurdistan County, the west of Iran which was randomly selected for participation in this study. A structured questionnaire was applied for collecting data and data were analyzed by SPSS version 21 using bi variate correlation and linear regression statistical tests. results: The mean age of respondents was 59.45 years [SD: 11.56], ranged from 50 to 73 years.The HBM predictor variables accounted for 47% of the variation in the outcome measure of the individual health. The best predictors for individual health were perceived severity and cause to action. Conclusion:Based on our result, it seems that designing and implementation of educational programs to increase seriousness about complications of luck of individual health and increasing cause to action among the pilgrims may be usefulness of the results in order to individual health promotion among pilgrims.
PubMed, May 1, 2022
Background: There is no compelling evidence to prove an association between serum free L-carnitin... more Background: There is no compelling evidence to prove an association between serum free L-carnitine levels and changes in left ventricular (LV) geometry. The present study aimed to evaluate a possible association between these parameters. Methods: In a cross-sectional study, 504 outpatients were randomly selected among those registered at Sanandaj Pediatric Heart Clinic (Sanandaj, Iran) during 2014-2020. The patients aged one to 25 years and were presented with cardiac complaints. The serum L-carnitine levels of all patients were evaluated and associated with changes in LV geometry measured by echocardiography. The association was assessed using the Chi squared test, Fisher's exact test, and one-way ANOVA with post hoc Tukey test. Data were analyzed using SPSS software (version 22.0). P≤0.05 was considered statistically significant. Results: The mean serum L-carnitine levels in the normal, low, and high serum groups were 52.69, 14.16, and 178.67 nmol/dL, respectively. There was a significant statistical association between abnormal serum levels of free L-carnitine and changes in LV geometry (P<0.001). Conclusion: Our findings are indicative of an association between abnormal serum L-carnitine levels and changes in LV geometry in pediatric and adolescent patients.
Research Square (Research Square), May 13, 2022
Background: The aim of this study was to assess unmet needs for health care (UNHC) and its causes... more Background: The aim of this study was to assess unmet needs for health care (UNHC) and its causes during COVID-19 pandemic among pregnant women in Iran. Methods: This cross-sectional study was performed among pregnant women in Kurdistan province in 2020 with a sample size of 800 people who were selected by multi-stage sampling method. Data were collected by a questionnaire. Chi-square test was used to examine the relationship between independent variables including demographic variables with dependent variables of perceived need and bene ting from health services. Also, multiple logistic regression was used to determine the relationship between independent variables and outcome variable. Statistical tests were performed using STATA software package. Results: The highest UNHC were related to dental services with 66%, rehabilitation services with 58.6% and psychological services with 43.2% and the lowest were related to hospital services with 12%, midwifery services with 15.6% and physician visit services with 39.1%. The most important reasons for UNHC were fear of getting COVID-19 and the cost of the service. The variables of age group and spouse education for physician visit services; age group for midwifery services; age group, education and employment status for dental services; age group, supplementary insurance and economic status for rehabilitation services; and age group and economic status for psychological services were signi cantly associated with UNHC (P<0.05). Conclusion: A signi cant percentage of health care needs of pregnant women were unmet, for which the fear of getting COVID-19 and nancial barriers were the main reasons. The health care delivery system in Iran has three levels. The rst level is responsible for providing primary health care, which is funded by public sector and through an extensive health care network a liated with medical universities across the country. Health houses and rural health centers at rural level and comprehensive urban health centers at urban level provide these healthcare services. At this level, pregnant women receive routine pregnancy care in 8 visits (2 visits in the rst half and 6 visits in the second half of pregnancy). Second and third level services are also provided by public, quasi-public and private sector through hospitals, clinics, doctors' o ces and laboratories. Public sector is dominant in providing inpatient services and private sector provides mainly outpatient services. In Iran, public health services are provided by medical universities. Medical universities are a liated with the Ministry of Health and Medical Education, and there is at least one medical university in each province that is in charge of providing health services through health houses, rural health centers, comprehensive urban health centers, clinics and a liated hospitals. The Ministry of Health is in charge of the health system in Iran and the universities of medical sciences are in charge of providing healthcare services at provincial level. Kurdistan province has a population of more than 1.6 million, is economically one of the less developed provinces of Iran, and is one of the rst provinces in terms of maternal mortality index [19-21]. Methods Study participants and sampling This was a descriptive-analytical and cross-sectional study. The study population included pregnant women in Kurdistan province in 2020, who were pregnant for at least 6 months. In the rst stage, the sample size was determined 553 people using the following formula and taking into account p = 50% (bene ting from health services), d = 0.02 (accuracy rate) and α = 0.05 (type I error). Since the clustering method was used for sampling; therefore, in order to increase the sampling accuracy, the design effect was set at 1.45 and the nal sample size was 800 people. Multi-stage sampling was used for choosing the samples. First, Sanandaj and Mariwan cities were randomly selected from among the cities of the province, and then within each city, the city center and its villages were randomly selected. In the next stage, 10 centers (5 urban and 5 rural centers) were randomly selected by cluster random sampling from the comprehensive urban and rural health centers. Then, among the pregnant women covered by each center, 40 pregnant women were randomly selected and after obtaining the addresses, a questionnaire was completed for them by a trained person by going to their door.
Introduction: Polycystic ovary syndrome (PCOS) is one of the most common hormonal problems among ... more Introduction: Polycystic ovary syndrome (PCOS) is one of the most common hormonal problems among women in the age of fertility that causes infertility via stopping ovulation. Prescribing calcium with clomiphene may greatly impact induction ovulation and follicles growth. Thus, this study was conducted aimed on investigating the effect of Calcium-vitamin D in efficacy of induction ovulation in infertile women with PCOS. Methods: This randomized controlled trial was conducted on 44 infertile women with PCOS in years 2010-2011. Patients were divided into two groups (22 Intervention and 22 controls) using block randomization method. Intervention group received a daily dose of 50 mg clomiphene tablet with 400 units of vitamin D3 and 1000 mg calcium and control group received a daily dose of 50 mg clomiphene tablet with placebo. In order to measure follicles size, patients underwent sonography during three menstruation cycles, each time at 13th day of menstruation. Data were analyzed using SPSS software version 11.5 and Chi square, Fisher, Mann-Whitney and repeated measures ANOVA Tests. P less than 0.05 was considered statistically significant. Results: No significant statistical different was observed in trend of changes in follicle size in two groups (p=0.1). However, the median and mean of follicles size in intervention group was higher than control group in first, second and third months (p<0.05). There was also no significant statistical difference between the first and second months regarding the size of follicles (p=0.82); but the size of follicles in third month was significantly different from second month (p=0.01). Conclusion: Adding 400 units of vitamin D3 and 1000 mg calcium to normal clomiphene dosage may increase the size of follicles that its effect is especially more significant after the second post-treatment menstruation.
PubMed, Jul 23, 2022
Background and objective: Chronic subdural hematomas (CSDH) is frequently encountered in neurosur... more Background and objective: Chronic subdural hematomas (CSDH) is frequently encountered in neurosurgical practice. The aim of this study was to investigate the factors associated with the outcome of Burr Hole Craniotomy. Methods: This study was conducted on 116 patients with CSDH in Be'sat Hospital, an educational hospital, in Kurdistan province, Iran. We used Glasgow outcome scale (GOS) at times of discharge and 1 month after stitch removal as favorable outcome. Student t-test or corresponding nonparametric test (Mann-Whitney U test) and logistic regression were used to assess the relationship between investigated variables and favorable outcome. Results: : The results indicated that the chance of success after surgery in patients with CSDH was different based on several variables. The chance of cure after surgery among CSDH male patients (OR = 12.5), patients who have no atrophy (OR = 25.0), patients with no cardiovascular diseases (OR = 7.14), patients who had no medical complications after surgery (OR = 2.08), and patients with higher GCS score at the time of hospitalization (OR = 1.31) was higher. s: Burr hole drainage technique is a simplified, efficient and reliable method of treating patients with CSDH. Our study highlights various factors including female gender, diffuse brain atrophy, postoperative medical complications, a previous history of cardiovascular disease, and lower GCS score at the time of admission can be related to patients' worse outcome.
International journal of human rights in healthcare, May 7, 2019
Purpose The purpose of this paper is to survey the prevalence of exposure to workplace violence (... more Purpose The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS). Design/methodology/approach This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, χ2 and Fisher’s exact tests as well as univariate and adjusted logistic regression. Findings The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56–4.32) and having shift work (AOR=3.13, CI: 1.67–5.84) were the most significant risk factors for total WPV. Originality/value The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV.
Archives of Disease in Childhood, Oct 1, 2012
feasibility of fetal cardiac access using a percutaneous transhepatic approach in the mid-gestati... more feasibility of fetal cardiac access using a percutaneous transhepatic approach in the mid-gestational fetal lamb, as a model for human fetus. Method Eight fetal lambs of 95-97 days gestation (term 147 days) were studied. Under ultrasound guidance, the fetal right hepatic vein was punctured percutaneously, using a 16GA intravenous cannula (BD Angiocath). A coronary catheter (FineCross TM MG, Terumo) was inserted into the 16 GA cannula, over a 0.014inch guidewire, and advanced into the inferior vena cava and the right atrium. Contrast was injected to document position of the catheter. Three fetal lambs were to be euthanized at the end of the procedure to evaluate blood loss. The rest were to deliver vaginally at term, and euthanized for postmortem examination. Results Percutaneous fetal cardiac access was successful in 7 out of the 8 fetuses. All 4 heart chambers were catheterized in the last 3 fetuses. One fetus died during the procedure, post-mortem showed pericardial and peritoneal haemorrhage. The other two fetuses dedicated for immediate post-mortem, after having survived the procedure, had small haemoperitoneum. Averaged fetal weight was 1027±153g. All other lambs were born normally at term. Conclusion Ultrasound-guided fetal cardiac catheterization through a percutaneous transhepatic approach is feasible. Our experience provides a potentially safer route for human fetal cardiac intervention at midgestational age.
BMC Infectious Diseases, Nov 28, 2021
Background: Truck, bus, transit drivers, and men with mobile jobs are at high risk for HIV/AIDS. ... more Background: Truck, bus, transit drivers, and men with mobile jobs are at high risk for HIV/AIDS. The purpose of this study was to investigate the prevalence of HIV and risky behaviors among truck and bus drivers in Kurdistan province. Methods: This cross-sectional study was conducted on 601 bus and truck drivers in Kurdistan province during 2018-2019. Data on high-risk behaviors were collected using a standard questionnaire. ELISA test was used to detect HIV in the study participants. Data were analyzed using Chi-square, Mann-Whitney U tests, and logistic regression modeling in Stata-14 software. Results: The mean and standard deviation of the age of study participants was 44.04 ± 11.44 years. HIV rapid test was positive in two subjects; in other words, the prevalence of HIV in the study population was 0.33%. Ninety-two (15.3%) individuals reported a history of drug use, with one (1.1%) having a history of injecting drugs. One hundred and thirtyone (21.8%) of them had a history of high-risk sexual behavior outside of marriage. Conclusion: According to the results of the present study, the prevalence of high-risk behaviors in bus and truck drivers is high. It seems necessary to direct the drivers' attention to self-care while considering disciplinary intervention programs to prevent the use of drugs, cigarettes, alcohol along with high-risk sexual behaviors to maintain the health of drivers and passengers.
Journal of the Medical Sciences, Aug 10, 2020
Journal of preventive medicine, Nov 10, 2017
Journal of Epidemiology and Community Health, Aug 1, 2011
continue post pregnancy. Pregnancy outcomes vary between Pakistani and white British pregnant wom... more continue post pregnancy. Pregnancy outcomes vary between Pakistani and white British pregnant women, but differences in health behaviours during pregnancy between these two groups are under researched. Methods 4807 (1831 white British, 2222 Pakistani and 754 of Other origin) pregnant women were interviewed at 26e28 weeks of gestation using a questionnaire which collected information on alcohol, cigarette, caffeine, pregnancy vitamin and fruit and vegetable consumption and exercise levels. Latent class analyses were conducted to identify subgroups (classes) of the cohort defined according to clustering of health behaviours. The association between ethnicity, and other characteristics, with class membership was then examined. Results Five independent classes of health behaviours were identified: three generally healthy classes that differed on alcohol and cigarette consumption, two unhealthy classes; one that smoked but didn't drink and one that was generally unhealthy. Although pregnant Pakistani and Other ethnicity women rarely reported smoking or alcohol consumption compared to white British women, other unhealthy behaviours such as lower rates of exercise and fruit and vegetable consumption were evident. Membership of the comprehensively unhealthy class was more likely in younger, white British pregnant women, of lower educational attainment. Conclusions These techniques provide better understanding of negative behavioural clusters and characteristics associated with cluster membership. This could aid clinicians' ability to identify pregnant women who would benefit from interventions to modify these behaviours.
Journal of Epidemiology and Community Health, Aug 1, 2011
Accessibility to clean water was difficult. 96% individuals reported not practicing any preventiv... more Accessibility to clean water was difficult. 96% individuals reported not practicing any preventive measure for malaria. Inadequate Chloroquine was available in the medical camps, arthremeter was not available. The doctors reported, visiting of 8e10 patients daily with malaria symptoms. Conclusion Malaria is a major epidemic and public health concern particularly during flood catastrophe. Transparent policy making is required to design strategies for the preparedness of malaria in Pakistan.
Journal of Epidemiology and Community Health, Aug 1, 2011
Accessibility to clean water was difficult. 96% individuals reported not practicing any preventiv... more Accessibility to clean water was difficult. 96% individuals reported not practicing any preventive measure for malaria. Inadequate Chloroquine was available in the medical camps, arthremeter was not available. The doctors reported, visiting of 8e10 patients daily with malaria symptoms. Conclusion Malaria is a major epidemic and public health concern particularly during flood catastrophe. Transparent policy making is required to design strategies for the preparedness of malaria in Pakistan.
Neuropsychiatric Disease and Treatment, Nov 1, 2019
Background and aim: Memory impairment in the elderly has a high prevalence and can affect their p... more Background and aim: Memory impairment in the elderly has a high prevalence and can affect their performance, interactions and quality of life. A valid and reliable questionnaire is required to investigate the changes in the memory of the elderly. The aim of this study was to investigate the psychometric properties of the Persian version of the Memory Impact Questionnaire (MIQ) in the elderly. Methods: In this methodological study, 361 elderly people (181 people for exploratory factor analysis and 180 people for confirmatory factor analysis) were selected via convenience sampling. This questionnaire was translated based on the World Health Organization's (WHO) guidelines. Construct validities were assessed through exploratory and confirmatory factor analyses. Its reliability was also assessed using Cronbach's alpha coefficient. Results: In the exploratory factor analysis, three factors of lifestyle restrictions, positive coping, and negative emotion were extracted that were able to explain 54.04% of the total variance of the impact of memory change in the elderly. Confirmatory factor analysis confirmed the goodness of fit of the three-factor model of MIQ (RMSEA: 0.083; GFI: 0.97; NFI: 0.94; IFI: 0.97; PNFI: 0.86; AGFI: 0.75). The reliability of the "lifestyle restrictions", "negative emotion" and "positive coping" factors was found to be 0.89, 0.74, and 0.67, respectively, using Cronbach's alpha coefficient. Conclusion: The Persian version of the MIQ is simple and practical and has acceptable reliability and validity that can be used to measure memory changes in the Iranian elderly.
International Journal of Infectious Diseases, 2008
Journal of Epidemiology and Community Health, Aug 1, 2011
Shiraz E-Medical Journal
Background: Congenital atrioventricular heart block (CAVB) is a relatively rare condition that ca... more Background: Congenital atrioventricular heart block (CAVB) is a relatively rare condition that can lead to long-term complications. Early diagnosis and management of CAVB is currently the ideal goal, particularly in high-risk pregnancies. Methods: The Fetal Heart Center at Kurdistan University serves as the primary referral center for pregnant mothers residing in the western region of Iran. Fifteen fetuses with CAVB were admitted between November 2007 and August 2022. They were referred for one or more of the following reasons: Fetal bradycardia or arrhythmia, abnormal ultrasound findings, and previous maternal or fetal risk factors. After obtaining a complete medical history, we conducted fetal echocardiography and ordered testing for maternal Lo/Ra autoantibodies. Our therapeutic approach was based on the type of atrioventricular block (AVB), serum titer of Lo/Ra antibodies, and specific risk factors associated with each type of AVB. Consequently, we used a combination of differen...
Medical journal of the Islamic Republic of Iran, 2022
Background: According to recent evidence, there is an association between some genetic factors an... more Background: According to recent evidence, there is an association between some genetic factors and rheumatoid arthritis (RA). The aim of this study was to determine whether genetic variations in the interleukin 10 (IL10) and anti-cyclic citrullinated peptide (Anti-CCP) antibody loci were linked to RA. Methods: In this hospital-based case-control study with 224 cases and 194 healthy individuals, we investigated the association of IL-10 genotypes and anti-CCP antibodies with RA. Independent sample t, chi-square, and Fisher exact tests were used to assess the association between study variables. Results: Frequency of IL-10-1082 A/G genotype in RA patients is significantly higher than the control group (odds ratio [OR], 1.67 [95% CI, 1.11-2.51]) (p=0.009), while the frequency of IL-10-1082 A/A and G/G polymorphisms in RA patients was lower than controls and this finding for G/G polymorphism was statistically significant (p=0.01). No significant difference was observed between the 2 studied groups regarding IL-10-592 C/C, C/A, and A/A polymorphisms (p>0.05). The chance of RA occurrence among persons with positive anti-CCP was significantly (63.3 times [22.7-176.5]) higher than individuals with negative anti-CCP (p<0.001). Conclusion: According to our data, the chance of anti-CCP positivity in persons who have IL-10 genotype 1082 A/G is higher. Further studies are recommended to determine the relationship between IL-10 genotype 1082 G/A and RA. If such a relationship is proven, this finding as a diagnostic clue can help rheumatologists in the early detection of RA.
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Papers by Abdorrahim Afkhamzadeh