East Azerbaijan Research Articles

Letter to Editor: Positive predictive value of diabetes mellitus risk assessment

Diabetes mellitus (DM) is an important public health challenge [1 ].Different studies predicted that the frequency of diabetic patients will be increased to 642 million throughout the world by 2040 [2]. A notable percentage of diabetic patients are not aware of their disease (approximately 30% in Iran) [3]. Lag in the diagnosis of DM raises the expense of controlling disease and makes the prognosis poorer [4]. It is indicated the importance of diabetic risk assessment as a screening test for high risk populations. However, most of the screening methods to detect high risk people are invasive [5]. So, detecting population at high risk of developing DM by an easy way that can be applied by health care providers in the health centers may lead to preventive measures of public health magnitude [4]. Griffin et al developed a questionnaire according to the risk factors commonly collected in clinical practice and evaluated the characteristics of the questionnaire. They reported the positive predictive value of 11% for diabetes screening questionnaire in England and Wales [6].In Iran, primary health care providers in rural regions were named “Behvarz”. They were performed diabetes mellitus risk assessment as a screening program in health houses. They worked in “Health House,” which is the small health center in the rural areas of Iran. In the present study, we evaluated DM risk assessment positive predictive value (PPV) on the 30 years and older rural population. The PPV is the probability of the diabetes in a person with a positive risk assessment result ( ) [7]. A cross-sectional study was done in three villages of Bostanabad, one of East Azerbaijan ‘s cities in Iran. Three villages out of more than fifteen hundred villages in the Bostanabad were selected as considered concerns about arranging the population in the villages. In these three villages, Behvarzes performed screening activities for diabetes between March2019 to January2020. Screening for diabetes was regarded for all individuals older than 30 years of age living in chosen villages. Participants were interviewed and asked the presence of risk factors of DM. Risk factors contained family history of DM, overweight or obesity (BMI>25), already detected pre-diabetes. Among persons took part in screening test, those even with one risk factor were regarded positive and they as soon as were visited by a primary care physician for detection of individuals with unknown DM. The total population of the three villages, namely Saeid abad, Tikmedash and Kordkandy was 5137. More than half of them (57.62%) were more than 30years old in these villages. Out of 1305 people, who had at least one risk factor, 57 persons were diabetics. Accordingly, 57 was true positive .The value of1305 was the sum of true positive and false positive. Calculated positive predictive value was 4.36%. So, the positive predictive value of the risk factor assessment was low. In Conclusion, the ability of the risk factor assessment to predict individuals with DM was quite poor (96% of people with risk factors were not diabetic) and the risk assessment did not work well to identify at risk individuals

A taxonomic revision of Psephellus sect. Psephelloidei (Asteraceae, Cardueae–Centaureinae) from Iran

A taxonomic revision of Psephellus Cass. sect. Psephelloidei (Boiss.) Wagenitz (Asteraceae) in Iran is preented. Four taxa are recognized and one of them from East Azerbaijan Province, NW Iran, is described as a new species: Psephellus sennikovianus Negaresh. Psephellus gilanicus (Bornm.) Wagenitz and P. leuzeoides (Jaub. & Spach) Wagenitz are lectotypified. Images of the type specimens of all species and photos of the species in their natural habitats are provided. In addition, the geographic distribution of all the four species recognized is presented and mapped. Finally, a taxonomic key to species of the section Psephelloidei in Iran is provided.

Investigation of Ground Waters Quality Using Multivariate Statistical Techniques (Case Study: Maragheh-Bonab Plain, East Azerbaijan Province)

Investigation of Ground Waters Quality Using Multivariate Statistical Techniques (Case Study: Maragheh-Bonab Plain, East Azerbaijan Province)

Challenges of Emergency Medical Services Response to Arasbaran Twin Earthquakes; a Content Analysis

Introduction:One of the most important concerns in responding to disasters is providing Basic Life Support (BLS) services. Considering the key role of Emergency Medical Services (EMS) in providing BLS, the purpose of this study is to investigate the experience of provincial EMS during their response to the Arasbaran twin earthquakes and its challenges in Iran.Methods:This study was conducted using a qualitative approach and the conventional content analysis method. Data were collected through Focused Group Discussions (FGD) and semi-structured in-depth interviews with purposively-selected EMS paramedics and officials in East Azerbaijan Province, Iran. To form the main categories, the interviews were encoded in three stages and the similar codes were placed under the same subcategories and merged. Results:A total of 26 EMS paramedics participated in the study. The codes extracted from the interviews, after three stages of reduction, were placed in the top ten categories, including the lack of preparedness and coordination, dead bodies' management challenges, responders’ psychosocial support, deficiencies in supplies and ambulances, difficulty of access to rural areas, volunteer management, non-documentation of the experiences, communication challenges, recalling, and deploying of EMS responders. Conclusion:Timely response of the EMS and paramedics’ sense of responsibility for providing services were positive and successful points about the emergency response operations. The weaknesses of EMS should, therefore, be addressed through transferring of experiences and by planning and arranging training courses.

Investigating the Relationship between Self-awareness and Job Performance among the Librarians of Public libraries in East Azerbaijan Province

Investigating the Relationship between Self-awareness and Job Performance among the Librarians of Public libraries in East Azerbaijan Province

Demographic Characteristics and Personality Disorders in People With Gender Dysphoria in East Azerbaijan Province, Iran

Background: Gender identity is an important part of human identity. It is a personal conception of oneself as male or female. One of the major goals of treatment for individuals with Gender Dysphoria (GD) is to treat comorbid psychological and psychiatric disorders such as personality disorders. The present study aims to investigate demographic characteristics and personality disorders in people with GD seeking gender reassignment therapy in East Azerbaijan Province, Iran. Methods: In this descriptive cross-sectional study, study population consists of all patients with GD referred to the forensic medicine centers in East Azerbaijan province during 2016-2020, of whom 61 (21 males and 40 females) were selected using a convenience sampling method. Their age, gender, educational level, and marital status were recorded and their personality profile was assessed by the Millon Clinical Multiaxial Inventory–III. Results: The frequency (percentage) of Cluster A, B and C personality disorders in males were 0(0%), 9(50%) and 2(11.10%), while in females they were 1(5.56%), 4(22.40%), and 2(11.10%), respectively. The frequency (percentage) of antisocial, obsessive, borderline, avoidant, narcissistic, histrionic, and paranoid personality disorders in males were 4(22.2%), 2(11.10%), 3(16.67%), 0(0%), 0(0%), 2(11.10%), and 0(0%), while in females they were 4(22.20%), 1(5.56%), 3(16.67%), 1(5.56%), 1(5.56%), 2(11.10%), and 1(5.56%), respectively. The prevalence of different clusters (P=0.34) and types (P=0.18) of personality disorders was not significantly different between males and females. Conclusion: Personality disorders are comorbid with GD. They exist in one-third of patients with GD in East Azerbaijan Province. Personality disorders are significantly more prevalent in male patients with GD than in females.

A Competency Model for the Training and Development Administrators of Local Government Organizations of East Azerbaijan Province

A Competency Model for the Training and Development Administrators of Local Government Organizations of East Azerbaijan Province

Institutional analysis of organizations active in the restoration of Lake Urmia: the application of the social network analysis approach

ABSTRACT This study aimed to analyse, using the social network analysis approach, the institutional organizations active in the restoration of Lake Urmia regarding the issues related to credit and management in the provinces of East Azerbaijan and West Azerbaijan. Forty relevant institutional organizations were identified and their communications and interactions were analysed using expert and key information. According to the results, the density index is low in the networks of organizations involved in issues related to credit and management. Results pertaining to issues of credit in the studied network revealed that certain institutions (Urmia Lake Restoration Program, Department of Natural Resources and Watershed of West Azerbaijan Province, Keshavarzi Bank and Urmia Lake Restoration Program, West Azerbaijan Province) had a higher impact (higher betweenness centrality) on others, but different institutions (Urmia Lake Restoration Program, educational and academic centres, West Azerbaijan Province Meteorological Department, and Department of Natural Resources and Watershed of West Azerbaijan Province) had a higher impact (higher betweenness centrality) on other institutions concerning issues related to management.

Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran.

BackgroundColorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. However, CRC is considered as one of the most preventable cancers by which the mortality rates reduce about 60% through implementing the screening programmes. The present study aimed to evaluate the main barriers of CRC screening in a defined population.MethodHealthy individuals from all regions of the state were invited to participate in different healthcare centres. They were assessed by a provided online risk assessment tool, which was completed for all recruited subjects, and has been developed to assess the CRC risk based on personal and family history of adenoma, CRC, and other high-risk diseases. Research team staff assessed all individuals by this tool and then eligible people according to their lifetime risk of CRC were included in the study. There was not any age restriction in this study. Colonoscopy and three stool-based tests including faecal occult blood test, faecal immunochemical test and stool DNA tests were performed.ResultsOverall, 725 cases including 425 (58.6%) males and 300 (41.4%) females participated in the study. Lack of knowledge and attitude about screening programmes was the most common barrier, especially among women (68% for women versus 58% for men) and those from rural areas (88% in rural versus 55% in urban areas). Fear of colonoscopy and procedure complications and pain (48%), discomfort and anxiety from inserting a tube into the bowel (65% among females versus 43% among males) were reported commonly. Embarrassment and dignity were other complaints, especially in women (62% in females versus 35% in males).ConclusionIncreasing knowledge and attitude about the aims and benefits of screening programmes, acceptable and convenient communication of health systems with the general population are considered to be the key elements in the success and implementation of any screening programme.

Designing and Sensitivity Analysis of an Off-Grid Hybrid Wind-Solar Power Plant with Diesel Generator and Battery Backup for the Rural Area in Iran

Because of the lack of transmission and distribution grid of electricity in remote and inaccessible areas due to the high cost of construction of the transmission line along with the unsuitable geographical conditions and taking into account the factors affecting sustainable energy production, renewable energy seems like a sensible solution. Therefore, in this paper, considering the solar and wind potential of Turkalan village located in East Azerbaijan Province, the combined solar-wind-diesel generator system with battery bank and independent of the grid was evaluated. Sensitivity analysis and optimal measurement of the studied system were performed by HOMER software. Sensitivity analysis was performed on the parameters of solar radiation, light reflection from the environment, and wind speed. The goal was to supply 22 kWh/d of energy with a maximum load demand of 2.5 kW. The four hybrid systems proposed by the software considering the total net present cost (NPC) were solar-generator-battery, solar-wind-generator-battery, solar-battery, and solar-wind-battery, respectively. The studies were conducted to determine which of the systems is more suitable for the area.

Case fatality and mortality rates, socio-demographic profile, and clinical features of COVID-19 in the elderly population: A population-based registry study in Iran.

We aimed to investigate COVID‐19 case fatality rate (CFR), mortality, and screening in the older population of East Azerbaijan Province. We conducted a population‐based registry study from Death Registration System in the elderly population (N = 433 445) from the outbreak that emerged up to May 30, 2021 (before vaccination). We analyzed CFR and mortality rates due to COVID‐19 as well as the case findings and characteristics in the elderly population. Logistic regression analysis was carried out for the association between COVID‐19 mortality and effective factors. During the study, the province had 18 079 confirmed cases and 4390 deaths. The male to female CFR risk ratio was 3.2. The overall CFR and mortality rates were 24% and 1%, respectively. CFR and mortality ranged from 9.56% to 0.37% in the 60–64 age group to 70% and 2.6% in the age group ≥85 years, respectively. We found a significant trend in CFR and mortality of COVID‐19 with advanced age. Male sex, advanced age, marital status, and living alone were associated with an increased risk of COVID‐19 fatality. COVID‐19 mortality measures were higher in the older population of this province. Advanced treatment supports and interventions are needed to reduce mortality rates of COVID‐19 in the elderly population.

Effects of Different Mulches and Fertilizers under Two Irrigation Methods on Garlic Yield and Soil Properties

ABSTRACT Successive use of sand on the soil surface during garlic planting process facilitates clove sprouting and prevents soil crust formation. However, this process has led to the destruction and damage of the soil structure and texture in the East Azerbaijan province, northwest of Iran. In this study, the effects of different organic mulches and irrigation methods on soil properties and garlic yield were investigated. Experiments were conducted based on the split-plot design with three replications. The treatments consisted of two surface and drip irrigation methods, while seven types of mulches (straw 1.5 kg m−2, cow manure in two quantities of 2 kg m−2 and 4 kg m−2, sand in two quantities of 4 kg m−2 and 8 kg m−2, poultry manure 1.5 kg m−2, polyethylene mulch) and no mulch as a control treatment were used. The use of poultry and cow manures increased the average yield of garlic to 18.51 and 20.92 ton ha−1, respectively, as compared to the sand mulch case (11.5 ton ha−1). The results of this study showed that the use of cow manure and poultry manure can increase soil fertility and better garlic yield. Moreover, the use of drip irrigation method instead of surface irrigation method, besides maintaining soil characteristics and consuming fewer water levels, was increased the average yield of garlic from 14.19 to 16.67 ton ha−1.

Investigating barriers to accident precursor reporting in East Azerbaijan Province Gas Company from the perspective of HSE officers: a qualitative study

Objectives. Investigating the root causes of under-reporting near misses is very important. The aim of this study was investigating barriers to near-miss reporting in East Azerbaijan Province Gas Company from the perspective of health, safety and environment (HSE) officers. Methods. Semi-structured individual interviews were used and 21 interviews were conducted with HSE officers. Inductive content analysis was used for analyzing interviews. After analyzing the interviews, the codes in the interviews were categorized. Results. In general, two categories of code were created: reasons for non-reporting of accident precursors; and suggested solutions to improve the reporting system of accident precursors. However, two main categories were found for not reporting: individual reasons such as lack of commitment to the job, lack of attention to social responsibility, forgetfulness and laches in reporting, etc.; and organizational reasons such as job instability among employees, lack of sufficient training, failure of the organization to provide feedback, etc. Conclusion. This study found that the opinions of people working in the organization can be very effective in promoting reporting, so any organization can choose the appropriate strategy to increase the number and quality of reports by examining the opinions of managers, HSE officers and workers in the organization.

Evidence of High-Risk Human Papillomavirus in Esophageal Cancer in East Azerbaijan Province, Northwest of Iran.

Background Human papillomavirus (HPV) is one of the most important viral agents associated with several classes of cancers in humans. The aim of this study was to investigate HPV in esophageal cancer in the East Azerbaijan province, northwest of Iran. Methods 140 paraffin-embedded specimens of esophageal tissues were investigated using nested-polymerase chain reaction (nested-PCR) with primer designing for the L1 region of HPV genome. According to the pathological diagnosis, the samples were divided into two groups: 70 patients with esophageal cancer EADC (n = 35) and ESCC (n = 35) as the case group and those without tumour in esophagus tissue as a control (n = 70). Results HPV DNA was isolated from 20 (28.57%) of the 70 paraffin-embedded tissue specimens of esophagus cancer. Of these, 6 cases (17.14%) of EADC and 14 cases (40%) of ESCC were positive. In contrast, all cases of the control group were negative for the HPV genome. Sequence analysis revealed that HPV types 16 and 18 are the most frequent ones identified in this study. Conclusion The prevalence of HPV in esophageal cancer can vary depending on the geographical location and other factors. Based on the findings of this study, HPV infection may possibly have contributed to an increased risk of esophageal cancer in a group of patients in Tabriz.

The monitoring of Francisella tularensis in surface water of East Azerbaijan province, Iran

BackgroundFrancisella tularensis could be disseminated through arthropod bites and exposure to infected animals, water, and aerosols. Water sources that are contaminated with rodent excrement could be a source of contamination; therefore, an analysis of water samples is an appropriate method to investigate the routes of dissemination. Since an outbreak occurred in one of the villages in East Azerbaijan. The current study aimed to investigate the Francisella isolation in the different water samples from East Azerbaijan, Iran. Sampling was carried out in East Azerbaijan province. Forty-six specimens of surface water were collected. Filtration, culture, and inoculation of the water sample into NMRI (Naval Medical Research Institute) inbreed mice were performed. DNA was extracted from filtered water samples, different organs of inoculated mice, and bacterial isolates and was tested by TaqMan real-time PCR by targeting ISFtu2 and fopA genes. Despite the unsuccessfulness in isolation of F. tularensis, molecular test results indicate the presence of bacteria in surface water. The highest rate of F. tularensis (ten from 46 water samples, 21.7%) was detected from injected mice based on molecular methods. Despite the high efforts of researchers to isolate Francisella spp. in Iran, in recent years, and also the evidence that shows the presence of this bacterium in different parts of the country, the culture was not successful again in this study and the molecular method still is recommended to identify the possible sources of Francisella spp.

The analysis of breast cancer survival in East Azerbaijan province of Iran; prognostic impact of chemotherapy and hormone therapy protocols

BackgroundThe global cancer pattern indicated that there were about 2.3 million newly diagnosed breast cancer cases in 2020 worldwide, and was the most common cancer incident in the world. The aim of the study was to assess the prognostic impact of various treatment modalities and cancer-specific overall and disease-free survival rates. MethodsOne, 5-, 10-, and 15 -years survival rates were calculated; furthermore, overall survival (OS) and disease free survival (DFS) rates were obtained using Kaplan Meier method. To assess the effects of different treatment methods and all clinico-pathological variables with OS and DFS, cox-regression method was used to achieve adjusted hazard ratios of mortality and recurrence rates. ResultsDuring the study period, 504 primary breast cancer cases were evaluated, with mean age of 49.69(± 10.68) years. The one, 5-, 10-, and 15- year survival rates were 98.21%, 87.39%, 68.17% and, 60.60%, respectively. Tamoxifen + GnRh Agonist and Tamoxifen protocols decreased the hazard of relapse 46% and 84%, respectively. The best one-year OS was obtained for patients treated with Tamoxifen with an aromatase inhibitor (AI) for about 100% overall survival rate. The breast cancer mortality rate was lower than relapse rate in the first and 5thyears of disease, but 10- and 15- year mortality were higher than 10- and 15 -year relapse rates. ConclusionOur results revealed better overall survival and disease- free survival among primary breast cancer patients in East Azerbaijan; consequently, this underscores establishing and using better chemotherapy and hormone therapy protocols and sufficient follow-ups.

Analysis of the role of long-term and short-term periods of inflow in reservoirs water resources planning

Predicting of inflow discharge to reservoir dams is very important in achieving the purposes of reservoirs water planning. Due to climate change and human activities in the upstream of basins in recent years, the time series of discharge data has generally had downward trend. Therefore, estimating of the discharge in different statistical periods (long-term, medium-term and short-term) and analyzing it in the selection of project purposes has undeniable importance. In this study, the estimate of inflow discharge in 4 dams located in East Azerbaijan province (northwest of Iran) in different statistical periods was performed, and the effect of selecting each statistical period in the dams water resources planning was analyzed. The results showed that depending on the conditions of each basin, the selection of the appropriate discharge period will be different. But in general, choosing a short period of 15-20 years is appropriate and effective in achieving the goals of the project.

Incremental Healthcare Resource Utilization and Expenditures Associated with Cardiovascular Diseases in Patients with Diabetes: A Cross-Sectional Study.

Background: Cardiovascular disease (CVD) is the most prevalent comorbid condition among patients with diabetes. The objective of this study is to determine the incremental healthcare resource utilization and expenditures (HRUE) associated with CVD comorbidity in diabetic patients.Methods: In a cross-sectional study, patients receiving antidiabetic drugs were identified using the 2014 database of the Iran Health Insurance Organization of East Azerbaijan province (Iran). The frequency of HRUE was the main outcome. Outcome measures were compared between diabetic patients with and without CVD comorbidity during 2014-2016. The generalized regression model was used to adjust for cofounders because of a highly skewed distribution of data. Negative binomial regression and gamma distribution model were applied for the count and expenditure data, respectively.Results: A total of 34,716 diabetic patients were identified, of which 21,659 (63%) had CVD comorbidity. The incremental healthcare resource utilization associated with CVD compared to non-CVD diabetic patients for physician services, prescription drugs, laboratory tests, and medical imaging was 5.9±0.34 (28% increase), 46±1.9 (46%), 12.9±0.66 (27%), and 0.16±0.40 (7%), respectively (all P<0.001). Similarly, extra health care costs associated with CVD comorbidity for physician services, prescription drugs, laboratory tests, and medical imaging were 10.6±0.67 million IRR (294.4±18.6 USD) (50% increase), 1.44±0.06 million IRR (40±1.6 USD) (32%), 8.36±0.57 million IRR (232.2±15.8 USD) (58%), 0.51±0.02 million IRR (14.1±0.5 USD) (24%), and 0.29±0.02 million IRR (8±0.5 USD) (22%), respectively (all P<0.001).Conclusion: CVD comorbidity substantially increases HRUE in patients with diabetes. Our findings draw the attention of healthcare decision-makers to proactively prevent CVD comorbidity in diabetic patients.

A Case Report of Renal Hydatid Cyst in a 16-Year-Old Patient in Bonab, Iran

Introduction: Hydatidosis is a worldwide zoonotic disease caused by the larval stage of Echinococcus granulosus. Most cases of hydatid cysts have been reported from the liver and lungs. This study reported a case of a renal hydatid cyst in a 16-year-old patient. Case Report: The patient was a 16-year-old boy from Bonab, East Azerbaijan province, who presented to the physician due to pain in the right side during urination. The CT scan showed a 34×41 mm cystic mass calcified in the middle of the right kidney. The patient underwent surgery successfully, and pathological findings confirmed the existence of cysts. Conclusion: The findings demonstrated that the age of the renal hydatid cyst is decreasing and can be considered as many problems for the health of children and society, and any organ of the body can be attacked with E. granulosus. Therefore, the hydatid cyst should be suspected by observing any adhesive space in the kidney. The calcified hydatid cyst has been rarely reported in a 16-year-old boy.

Designing a Hostel in the Touristic Complex of Quri-Gol Lake near Tabriz, Iran

Quri-Gol Lake is located in East Azerbaijan province, southeast of Tabriz City, next to the main highway of Tabriz-Tehran. This beautiful region, due to its special and outstanding features, can serve for the development of the tourism sector and ecotourism of the province. The hostel is a cheap and comfortable accommodation, which provides simple and inexpensive food, accommodation, and facilities for passengers who have travelled during the holidays. There are four types of hostels: student hostels, single hostels, workers hostels, and youth hostels. This hostel is designed near Quri-Gol Lake, where all the rooms have beds, closets, toilets, bathrooms, and balconies with a beautiful view of the lake. This article aims to study the different kinds and standards of hostels and also the potential of Quri-Gol Lake as an appropriate location for designing a hostel. The methodology of this survey is qualitative and quantitative, using reliable first-hand resources and references.