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Background: Recent studies show that Iranians, especially women, do not have enough physical activity and if serious measures are not taken to resolve this problem, the consequences will be harmful to the society. The purpose of this advocacy paper was to determine and explain the responsibilities of all organizations and institutions responsible for promoting physical activity to root out the problem. Methods: After a thorough library search we conducted nine in-depth interviews with the relevant policymakers and government officials, managers, and practitioners in promoting physical activity. All interviews were recorded. To analyze, all of voice files were typed, saved as Word files, and exported to MAXQDA10 software by the research team. To find the main themes, all the files were read carefully several times. Then they were coded, categorized, and organized based on the main objectives of the study. In this way, themes and subthemes were emerged. Results: According to the participants in the study current state of physical activity in the country, especially among women, is not promising. The participants explained about the main obstacles for promotion of physical activity in the country and recommended practical strategies for its promotion. The strategies were suggested in three areas: Promoting culture, social protection, and adjusting current policies to overcome the existing barriers. Conclusion: Regarding the unfavorable state of physical activity in the country presentation of this advocacy document can be an effective step in promoting physical activity, thus reducing chronic diseases and improving general health in the country. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata is a chronic and relapsing condition that affects individuals of all age groups. Dermoscopy is a popular and non‐invasive method for diagnosing alopecia areata. This study aimed to analyze dermoscopic findings and their relationship with age, gender, appearance, and clinical signs in children and adults. Methods: This retrospective cross‐sectional study was conducted on 124 children and adults diagnosed with alopecia areata who were referred to a Hospital in Iran between 2021 and 2022. After reaching the calculated sample size, trichoscopic findings were examined and the results were recorded. Data analysis was performed by a statistician and presented in relevant tables. Results: The participants in the study comprised 53.2% female children, 46.8% male children, 27.42% adult males, and 72.58% adult females. The median age in the pediatric group was 10 years, while it was 27 years in the adult group. Yellow dots were significantly less observed in children than in adults (29% vs. 48.4%), while exclamation mark hairs were significantly more common in children than adults (38.7% vs. 21%). No significant differences were found in the frequency of other trichoscopic features between children and adults. Specifically, black dots, broken hairs, short vellus hairs, pigtail hairs, and empty follicular openings were observed in 38.7%, 40.3%, 32.3%, 11.3%, and 75.8% of children, respectively, and in 35.5%, 32.3%, 21%, 46.8%, and 12.9% of adults, respectively. Conclusion: The most common trichoscopic findings in alopecia areata in children are empty follicular openings and broken hairs, while exclamation mark hairs are more common in children than adults. In contrast, yellow dots are less frequently observed in children compared to adults. This distinct difference between children's and adults' dermoscopic findings highlights the critical need for age‐specific considerations in AA evaluations. [ABSTRACT FROM AUTHOR]

Aim: This study was aimed to investigate the presence of H. pylori and its virulence genotypes in dental plaques of Iranian patients with chronic periodontitis. Background: Helicobacter pylori is a Gram-negative bacterium that is associated with atrophic gastritis, peptic ulcer, and gastric cancer. Several studies have detected this bacterium in the oral cavity, suggesting it as a potential reservoir. Methods: A hundred individuals were divided in 2 groups: 50 patients with chronic periodontitis (case group), and 50 subjects in non-periodontitis (control group). Supragingival and subgingival plaque samples were collected from the individuals using wood wedges and sterile paper points respectively, and prepared for PCR analysis. Results: Totally, H. pylori DNA was detected in 5 out of 100 (5%) dental plaques. Of 5 dental plaques positive for H. pylori, cagA gene was detected in 4 specimen, 3 in periodontitis group and one in non-periodontitis group. The H. pylori vacA s1m1 genotype was predominantly detected in 2/5 samples. The babA2 gene was detected in all (5/5) H. pylori-positive dental plaques. There was no significant correlation between the presence of H. pylori genotypes from dental plaques and chronic periodontitis (P > 0.05). Conclusion: Our results revealed that the rate of H. pylori is very low in the dental plaques of Iranian patients with chronic periodontitis. Majority of H. pylori strains from oral cavity were highly virulent based on the main clinically virulence factors they carried. [ABSTRACT FROM AUTHOR]

Background: This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive O Elderly Study (ICES). Materials and Methods: In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. Results: The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). Conclusion: The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population. [ABSTRACT FROM AUTHOR]

Background: Dietary patterns, encompassing an overall view of individuals' dietary intake, are suggested as a suitable means of assessing nutrition's role in chronic disease development. The aim of this study was to evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) designed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN), by comparing major dietary patterns assessed by the FFQ with a reference method. Methods: Study participants included men and women who enrolled in the PERSIAN Cohort Study at seven of the eighteen centers. These centers were chosen to include dietary variations observed among the different Iranian ethnic populations. Two FFQ were completed for each participant over a one-year study period (FFQ1 upon enrollment and FFQ2 at the end of the study), with 24 interviewer-administered 24-hour dietary recalls (24 h) being completed monthly in between. Spearman correlation coefficients (SCC) were used comparing FFQs 1 and 2 to the 24 h to assess validity, while FFQ1 was compared to FFQ2 to assess reproducibility of the questionnaire. Results: Three major dietary patterns—Healthy, Low Protein/High Carb and Unhealthy—were identified, accounting for 70% of variance in the study population. Corrected SCC ranged from 0.31 to 0.61 in the validity and from 0.34 to 0.57 in reproducibility analyses, with the first two patterns, which accounted for over 50% of population variance, correlated at above 0.5 in both parameters, showing acceptable findings. Conclusions: The PERSIAN Cohort FFQ is suitable for identification of major dietary patterns in the populations it is used for, in order to assess diet-disease relationships. [ABSTRACT FROM AUTHOR]

Obesity is one of the main public health problems which underlie many chronic illnesses and socioeconomic difficulties. According to the literature review, there are limited data on the prevalence of obesity in different parts of Iran as well as its trend and prevalence among different age and gender groups. The aim of this study was to estimate the obesity prevalence in Iran using meta-analysis. All the corresponding articles published in the external and internal journals, final reports of research projects, articles of related congresses and the reference index of the correlated papers published between 1995 and 2010 were collected via the electronic research engines (PubMed, Scopus, SID, Magiran, IranMedex). Data were analyzed using meta-analysis (random effects model) and meta-regression). A total of 144 articles with the sample size of 377858 people (134588 males and 164858 females) were enrolled in the study. The prevalence of obesity in populations above the age of 18 was estimated as 21.7% (CI 95%: 18.5% - 25%) and in populations below 18 as 6.1% (CI 95%: 6.8%-5.4%). Meta-regression analysis showed an ascending trend in the prevalence of obesity in Iran. The prevalence rates of obesity according to the BMI index, NCHC and percentile above 95 were 17.4%, 7.6% and7.4%, respectively. The BMI mean was 19.3 in populations below the age of 18 (CI 95%: 17-21.6) and 25.2 in those above the age of 18 (CI 95%: 27.1-23.3). Considering the increasing rate of obesity in Iran and its effects on the public health, corresponding health authorities should revise the obesity preventive programs and, using public health interventions, reduce the rate of obesity in the country. [ABSTRACT FROM AUTHOR]

Background: Earlier forms of food frequency questionnaire (FFQ) used in Iran have extensive lists of foods, traditional categories and food-based design, mostly with the interviewer-administered approach. The aim of the current paper is to describe the development of a dish-based, machine-readable, semi-quantitative food frequency questionnaire (DFQ). Methods: Within the framework of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project, we created a novel FFQ using Harvard FFQ as a model. Results: The following steps were taken to develop the questionnaire: Construction of a list of commonly consumed Iranian foods, definition of portion sizes, design of response options for consumption frequency of each food item and finally a pilot test of the preliminary DFQ. From a comprehensive list of foods and mixed dishes, we included those that were nutrient-rich, consumed reasonably often or contributed to between-person variations. We focused on mixed dishes, rather than their ingredients, along with foods. To shorten the list, the related food items or mixed dishes were categorized together in one food group. These exclusions resulted in a list of 106 foods or dishes in the questionnaire. The portion sizes used in the FFQ were obtained from our earlier studies that used dietary recalls and food records. The frequency response options for the food list varied from 6-9 choices from "never or less than once a month" to "12 or more times per day". Conclusions: The DFQ could be a reasonable dietary assessment tool for future epidemiological studies in the country. Validation studies are required to assess the validity and reliability of this newly developed questionnaire. [ABSTRACT FROM AUTHOR]

Background: A school-based surveillance system entitled the childhood and adolescence surveillance and prevention of Adult Noncommunicable disease (CASPIAN) Study is implemented at national level in Iran. This paper presents the methods and primary findings of the third survey of this surveillance system. Methods: This national survey was performed in 2009-2010 in 27 provinces of Iran among 5570 students and one of their parents. In addition to physical examination, fasting serum was obtained. Body mass index was categorized based on the World Health Organization growth charts. Findings: Data of 5528 students (2726 girls, 69.37% urban, mean age 14.7 ± 2.4 years) were complete and are reported. Overall, 17.3% (17.3% of girls and 17.5% of boys) were underweight, and 17.7% (15.5% of girls and 19.9% of boys) were overweight or obese. Abdominal obesity was documented in 16.3% of students (17.8% of girls and 15% of boys). 57.6% of families consumed breads, the staple food for Iranians, prepared with white flour. Most families (43.8% in urban areas and 58.6% in rural areas) used solid hydrogenated fats. 22.7% of students did not add salt to the table food. 14.2% of students reported to have a regular daily physical activity for at least 30 min a day. Overall, 10.4% of students (11.7% in urban areas and 7.3% in rural areas) reported that they used tobacco products, often waterpipe. 32.8% of students experienced at least three times of bullying in the previous 3 months. During the year prior to the survey, 14.46% of students had an injury needing the interference by school health providers. Conclusion: This survey is confirmatory evidence on the importance of establishing surveillance systems for risk behaviors to implement action-oriented interventions. [ABSTRACT FROM AUTHOR]

Background: Knowledge, attitudes, and practices (KAP) studies are widely used in public health. This study aimed to investigate and compare KAP among patients with coronary artery disease (CAD) and premature coronary artery disease (PCAD) regarding cardiovascular disease (CVD). Methods: This cross-sectional study was conducted on 100 PCAD patients and 100 CAD patients in a general hospital in Tehran, Iran, between April and October 2022. A valid questionnaire was utilized to gather information, and descriptive analysis and logistic regression were employed for analysis using SPSS, version 23. Results: This study involved 100 CAD and 100 PCAD patients with average ages of 68.09±7.20 and 50.20±7.65 years, respectively. Men accounted for 58% of the PCAD group and 73% of the CAD group. The PCAD group had a higher level of knowledge and exhibited a more positive attitude toward CVD than the CAD group (P=0.007 and P<0.001, respectively). The PCAD patients and those with a family history of chronic diseases had a higher level of knowledge (P=0.045 and P=0.27, respectively) and showed a more positive attitude (P=0.030 and P<0.001, respectively). However, participants with a self-reported history of chronic diseases and those who were employed exhibited a less positive attitude. Occupation was associated with nutritional and smoking status (P=0.037). Conclusion: Higher levels of knowledge and more positive attitudes regarding CVD were observed; still, the study population's behaviors were unsatisfactory. Educational interventions are needed to promote positive health behaviors, emphasizing the link between knowledge and risk reduction and decreased CVD and mortality rates. [ABSTRACT FROM AUTHOR]

Background and Objectives: Anxiety manifests as feelings of worry, stress, and physical changes, such as rapid heart rate and high blood pressure. According to the coronavirus prevention protocols, home quarantine is necessary to control the disease in society, but doing it causes a feeling of social isolation and, ultimately, different psychological effects, such as mood disorders, depression, anxiety, and mental disorders. This study aims to investigate the relationship between religious attitudes and anxiety caused by COVID-19 in the population of South Khorasan Province, Iran. Methods: Using a web-based descriptive-analytical study, data from 507 people were voluntarily collected using a demographic information questionnaire, religious attitudes of Sirajzadeh (26 questions), and anxiety caused by COVID-19 disease (18 questions). Multivariate linear regression was used to identify the effect of factors affecting anxiety related to the disease. Results: The results of this study showed no significant relationship between religious attitudes and anxiety in two-variable analysis (P>0.05), but in the presence of other variables in multivariate linear regression analysis, a significant relationship is observed between the dimension of the consequence of religious attitudes and physical anxiety (P=0.006). Also, the level of anxiety among women (P<0.001) in the age group 31-40 (P=0.003), married people (P<0.001), the unemployed (P<0.001), and people with a history of chronic diseases (P=0.003) was higher. Conclusion: This study showed a significant relationship between the consequences of religious attitude and physical anxiety, as well as high levels of anxiety among different population groups. Our study revealed high levels of anxiety among different populations among these groups. In this regard, the health care system should reduce the level of anxiety among high-risk groups by using psychological interventions and strengthening the religious basis of the society using religious leaders. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are of the major health challenges and the leading cause of death in Iran and at the global level. Moreover, Iran is a disaster-prone country and considering the exacerbation of diabetes and chronic respiratory diseases in natural disasters, its healthcare system is facing challenges. This study was designed to explore challenges in providing healthcare services to patients with diabetes and chronic respiratory diseases during disasters in Iran. Materials and Methods: The conventional content analysis is used in this qualitative study. Participants included 46 patients with diabetes and chronic respiratory diseases, and 36 of stakeholders were experienced and had theoretical knowledge. Participants' selection started by means of purposive sampling and continued to the point of data saturation. Data collection was carried out employing semi-structured interviews. Data analysis was performed using Graneheim and Lundman method. Results: Based on participants' experiences, four major challenges in providing care to patients with diabetes and chronic respiratory diseases during natural disasters include integrated management (with three subcategories: control and supervision, patient data management, volunteer management), physical, psychosocial health (with three subcategories: psychological impacts, exacerbation of signs and symptoms, special patient characteristics), health literacy and the behavior (with three subcategories: risk perception, values and beliefs, education and awareness) and barriers to healthcare delivery (with three subcategories: facilities and human resources, financial and living problems and insurances, accessibilities and geographic access). Conclusion: Developing countermeasures against medical monitoring system shutdown in order to detect medical needs and problems faced by chronic disease patients including those with diabetes and chronic obstructive pulmonary disease (COPD), is essential in preparedness for future disasters. Developing effective solutions may result in improved preparedness and better planning of diabetic and COPD patients for disasters, and potentially promote health outcomes during and after disasters. [ABSTRACT FROM AUTHOR]

Chronic illness in children causes more mental health risks for parents than for other family members. Therefore, exploring the experiences of parents who have a daughter with multiple sclerosis (MS) and presenting them to health care planners and managers can have a positive impact on community health. This phenomenological study involving 12 participants in Iran aimed to explore the experiences of parents of young women (aged 17 to 40) with MS. The data collected from semi-structured interviews were analyzed using Colaizzi's method. Open coding resulted in 450 codes, and after several stages of analysis and integration of similar codes, five main themes containing 21 subthemes were produced. The main themes were mental distress, feeling trapped, adaptation issues, reaction to the disease, and coming to terms with the disease. This study showed that having a daughter with MS affects all dimensions of the parents' life, and can lead to experiences that are new to them and may confuse them. These findings provide a path towards improving effective parental care for their daughters with MS, and ultimately reducing the burden of disease on the family, the health system, and the community. [ABSTRACT FROM AUTHOR]

Objectives: Characterizing the psychometric attributes of the Persian variant of partners in health (PIH) in multiple sclerosis (MS), Diabetes, and Low Back Pain (LBP) patients. Methods: In this cross-sectional study, 183 MS, diabetes, and LBP patients (70 male, 113 female) were treated with PIH post-forward-backward translation. Confirmatory factor analysis was used for studying the factor structure. Cronbach's a and McDonald's O coefficients were used to analyze PIH internal consistency. We used an interclass correlation coefficient to evaluate test-retest reliability. Criterion validity was determined by studying the correlation of PIH and Short Form (36) Health Survey (SF-36), Diabetes Self-Management Scale (DSMS), and Self-Efficacy in Chronic Disease Self-Management (SES6G). Results: The median age of the participants was 49.73±15.16 years, 113 (61.75%) of them were female, 64 (35.0%) had MS, 66 (36.1%) had diabetes, and 53 (29.0%) had LBP. Content validity was determined across all areas (clarity, relevancy, simplicity) by a content validity index =0.82. Additionally, all items were confirmed via a content validity ratio =0.78. The outcome of CFA depicts that the statistics presented as model fit were as follows: CFI= 0.938, NFI= 0.899, and RMSEA= 0.085. All PIH items exhibited valid internal consistency (0.886-0.893). The PIH showed sufficient test-retest reliability regarding its corresponding subscales (0.554-0.679). The construct validity was confirmed by the total scores of PIH correlated with the total score of SF-36, SES6G, and DSMS. Discussion: The Persian variant of the PIH showed sufficient validity and reliability as a measure to assess self-management in patients suffering from chronic disease (MS, diabetes, and LBP). [ABSTRACT FROM AUTHOR]

Background: Hormonal changes in women throughout life might affect the oral health. The aim of this study is to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and reproductive history. Methods: The present cross-sectional study was performed using data of Azar Cohort Study conducted in 2014, in Shabestar city, East Azerbaijan Province, Iran. In the present study, the data of all 8294 women from the enrollment phase of the Azar cohort were included. All available data related on the variables of reproductive history (including age at the onset of menstruation, age of onset of menopause, age of first pregnancy, and frequency of pregnancy), age at interview, educational level, socioeconomic status, frequency of tooth brushing, chronic diseases, body mass index and DMFT were extracted. Negative binomial regression with loglink was used to analyze the relationship between variables. Three regression models have been applied to adjust the effect of confounding variables. Model 1 adjusted for education, socio-economic status, age, chronic diseases, body mass index and frequency of tooth brushing. Model 2 adjusted for education, socioeconomic status, age, chronic diseases and body mass index. Model 3 adjusted for education, socio-economic status and age. Results: The mean DMFT of 8294 women was 20.99 ± 8.95. In model 1, there was no significant relationship between DMFT and frequency of pregnancy. However, model 2 and 3 showed that in women who had four or more pregnancies, the DMFT rate was significantly higher than those who did not have a history of pregnancy (P = 0.02, P = 0.04). Age at the onset of menopause, age at the onset of menstruation and age of first pregnancy had no significant relationship with DMFT in the models. Brushing less than once a day and increasing age at interview had significant relationship with DMFT in the models (P < 0.001). Conclusion: Despite hormonal changes through the life, the history of reproductive showed no significant relationship with women's DMFT. Oral health education for women is an important step in promoting oral health and it is necessary to pay special attention to preventive programs in oral health policy for women specially with increasing the age. [ABSTRACT FROM AUTHOR]

Background and Aim: Women are the central pillar of social development and the main axis of family health. Success, survival, and promotion of society depend on the health of women in society. Since Health Promotion lifestyle and psychological well-being are important determinants of health, this study was conducted to determine the Health Promotion lifestyle and psychological well-being in women attending the health centers of Arak City in 2019. Methods & Materials: In this cross-sectional study, among women who attended health centers in Arak City, 221 women who met the inclusion criteria were included in the study by continuous sampling and the form of demographic information, health promoting lifestyle profile-Ii (HPLP-II), and Ryff Psychological well-being Questionnaire was completed. Data were described using descriptive statistics of frequency, frequency percentage, mean, standard deviation, and data analysis by analysis of variance, independent t-test, and regression using SPSS software v. 19. Ethical Considerations: This study was approved by the Ethics Committee of Research Deputy of Iran University of Medical Sciences (Code: IR.IUMS.REC.1398.609). Results: The mean health-promoting lifestyle in the study units was 135.96; the mean physical activity components were 16.31; The mean nutrition was 26.41, with the lowest and highest scores, respectively. The mean psychological well-being in the study units was 72.29. The mean components of purpose in life were 10.76, and the mean personal growth was 13.19, with the lowest and highest scores, respectively. Age, chronic diseases, employment, number of children, and alcohol consumption had a significant negative relationship with a health-promoting lifestyle, and a woman’s and her husband’s education had a significant positive relationship with a health-promoting lifestyle (P<0.05). Overall demographic variables predict as much as 13% of health-promoting lifestyles. Age, number of children, and chronic physical and psychological diseases had a significant negative relationship with psychological well-being and economic status. A woman’s and her husband’s education had a significant positive relationship with psychological well-being. Overall, demographic variables predict as much as 10% of psychological well-being. Conclusion: Considering that health-promoting lifestyle and psychological well-being are two critical determinants of health, studying these two indicators and the factors affecting them can help Intervention planning to promote women’s physical and mental health. [ABSTRACT FROM AUTHOR]

Background: Mothers may experience a great deal of fear and anxiety during their child's hospitalization during a pandemic, which can affect their decision to proceed with the child's treatment. This study was conducted with the aim of determining the relationship between mental status and fear of COVID-19 in mothers of children with chronic diseases, hospitalized during the pandemic in 2021. Methods: This is a descriptive correlational study. The research sample was 196 mothers of children with chronic diseases hospitalized in hospitals affiliated with the Iran University of Medical Sciences in Tehran, Iran who were selected by convenience sampling. Data were collected using the Fear of COVID-19 Scale and the Hospital Depression and Anxiety Scale (HADS) and analyzed by SPSS software, version 22, using analysis of variance, independent two-sample t-test, Pearson correlation test, and regression analysis. The significance level was set at 0.05. Results: The Mean±SD of hospital anxiety, depression, and fear of COVID-19 were 9.6±3.2, 10.86±2.2, and 10.8±2.2, respectively. Most mothers suffered from borderline anxiety (63.3%) and depression (86.7%). There was a significant association between hospital anxiety (P<0.001) and depression (P<0.001) with fear of COVID-19. The mothers' hospital anxiety was significantly associated with the child's type of disease (P<0.001) and the frequency of hospitalizations (P=0.1). Besides, there was a direct relationship between hospital depression with the child's age (P=0.3) and length of hospitalization (P=0.002). Furthermore, their fear of COVID-19 had a significant relationship with the child's age (P=0.008), type of disease (P<0.000), and length and frequency of hospitalizations (P<0.000). Conclusion: Providing the possibility of receiving mental health counseling during the hospitalization of children seems necessary considering the conditions of mothers during the epidemic. [ABSTRACT FROM AUTHOR]

Objectives: The social support of caregivers is fundamental, and their quality of life, mental health, and the burden of caring are related to the social support they receive during their interaction with people. Because the coronavirus pandemic and related quarantine have affected people's participation and social support, the caregivers' lifestyle has changed, and they have become more isolated and lonely. This study aims to investigate the mediating role of the burden of care in the relationship between social support and mental health of family caregivers of elderly Iranians with chronic diseases of the nervous system during the coronavirus pandemic. Methods: We recruited a sample of 249 family caregivers of the elderly with Alzheimer, Parkinson, and stroke. The study data were collected by electronic questionnaires of perceived social support of Zimet, Novak care burden, and Goldberg mental health questionnaire. The obtained data were analyzed using the Pearson correlation and structural equation modeling. Results: This study showed that family caregivers experience high social support, a moderate care load, and their mental health is on the verge of illness during the coronavirus epidemic. The results of the Pearson correlation and structural equation modeling showed a positive and significant relationship between social support perceived by caregivers and their mental health, and the burden of care has a mediating role in this relationship. Discussion: Finally, because social support is effective in reducing the distress experienced by caregivers and improving their performance and mental health, future plans and interventions are expected to consider strengthening social support as primary prevention to protect caregivers from mental health symptoms. [ABSTRACT FROM AUTHOR]

Background: Drawing on the results of the country-level Global Burden of Diseases, Injuries, and Risk Factors 2010 Study, we attempted to investigate the drivers of change in the healthcare system in terms of mortality and morbidity due to diseases, injuries, and risk factors for the two decades from 1990 to 2010. Methods: We decomposed trends in mortality, cause of death, years of life lost due to disability, disability-adjusted life years (DALYs), life expectancy, health-adjusted life expectancy, and risk factors into the contribution of total increase in population size, aging of the population, and changes in age-specific and sex-specific rates. Results: We observed a decrease in age-specific mortality rate for both sexes, with a higher rate for women. The ranking of causes of death and their corresponding number of years of life lost remained unchanged between 1990 and 2010. However, the percentages of change indicate patterns of reduction for most causes, such as ischemic and hemorrhagic stroke, hypertensive heart disease, stomach cancer, lower respiratory infections, and congenital anomalies. The number of years lost due to disability caused by diabetes and drug use disorders has significantly increased in the last two decades. Major causes of DALYs, such as injuries, interpersonal violence, and suicide, showed increasing trends, while rates of communicable diseases, neonatal disorders, and nutritional deficiencies have declined significantly. Life expectancy and health-adjusted life expectancy increased for both sexes by approximately 7 years, with the highest rate of increase pertaining to females over the age 30. Conclusions: Time trend information presented in this paper can be used to evaluate problems and policies specific to medical conditions or risk factors. Despite recent improvements, implementing policies to reduce the number of deaths and years of life lost due to road traffic injury remains the highest priority for Iranian policymakers. Immediate action by Iranian researchers is required to match Iran's decreasing mortality rate due to liver and stomach cancers to a rate comparable to the global level. Prevention and treatment plans for mental disorders, such as major depressive disorder, anxiety disorder, and particularly drug use disorders, should be considered in reforms of the health, education, and judiciary systems in Iran. [ABSTRACT FROM AUTHOR]

Objective Social isolation is one of the important concerns in the elderly population which can negatively affect their quality of life and health. The present study aims to determine the prevalence of social isolation among older adults aged 60 years and older in Tehran, Iran and find its associated factors. Materials & Methods This is a secondary analysis study on data obtained from a large cross-sectional study conducted on older adults in Tehran in 2020. The Persian version of lubben social network scale (LSNS-6) was used to measure social isolation. The demographic characteristics (age, gender, marital status, living arrangements, and number of children), socio-economic status (educational level, employment status, and household income) and health-related information (history of chronic diseases and use of assistive devices) were collected using a checklist. Data were analyzed in SPSS v. 23 software using multivariate logistic regression analysis. The significance level was set at. Results The data were related to 1280 older adults aged 60 years and older (Mean±SD age=70.97±8.07 years). The prevalence of social isolation was 30.8%. The results of chi-square test revealed that living arrangement (P<0.001, X²=46.93), marital status (P<0.001, X²=26.91), household income (P<0.001, X²=67.44), level of education (P<0.05, X²=20.26), employment status (P <0.001, X²=29.21), musculoskeletal problems (P<0.001, X²=15.47), respiratory problems (P<0.05, X²=10.43), vision problems (P<0.05, X²=4.4), hyperlipidemia (P<0.001, X²=13.53), and wearing glasses (P<0.05, X²=3.92) had significant association with social isolation. The regression analysis model could significantly predict social isolation (X²=188.35, P<0.001). The model revealed that being male (P<0.05, OR=1.7), living with spouse (P<0.05, OR=0.4), musculoskeletal disease (P<0.05, OR=1.42), diabetes (P<0.05, OR=1.41), household income (P<0.001, OR=5.82), being unemployed (P<0.001, OR=2.13), having hyperlipidemia (P<0.001, OR=0.58), and living in developed areas (P<0.001, OR=2.02) significantly predicted the social isolation. Conclusion There is a strong association between social isolation and some socio-economic, demographic-health related factors in older adults. Health policymakers and healthcare experts can develop the screening and prevention programs related to the mental and social health of older adults in Tehran, Iran in order to moderate and control these factors. [ABSTRACT FROM AUTHOR]

Background: 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 of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection is an important health problem worldwide with critical outcomes. The nucleoside analog lamivudine (LMV) is a potent inhibitor of HBV polymer­ase and impedes HBV replication in patients with chronic hepatitis B. Treatment with LMV for long periods causes the appearance and reproduction of drug-resistant strains, rising to more than 40% after 2 years and to over 50% and 70% after 3 and 4 years, respectively.Objectives: Artificial neural networks (ANNs) were used to make predictions with regard to re­sistance phenotypes using biochemical and biophysical features of the YMDD sequence.Patients and Methods: The study population comprised patients who were intended for surgery in various hospitals in Tehran-Iran. An ACRS-PCR method was performed to distinguish muta­tions in the YMDD motif of HBV polymerase. In the training and testing stages, these parameters were used to identify the most promising optimal network. The ideal values of RMSE and MAE are zero, and a value near zero indicates better performance. The selection was performed using statistical accuracy measures, such as root mean square error (RMSE), coefficient of determina­tion (R2), and mean absolute error (MAE). The main purpose of this paper was to develop a new method based on ANNs to simulate HBV drug resistance using the physiochemical properties of the YMDD motif and compare its results with multiple regression models. Results: The results of the MLP in the training stage were 0.8834, 0.07, and 0.09 and 0.8465, 0.160.04 in the testing stage; for the total data, the values were 0.8549, 0.115, and 0.065, respec­tively. The MLP model predicts lamivudine resistance in HBV better than the MLR model. Conclusions: The ANN model can be used as an alternative method of predicting the outcome of HBV therapy. In a case study, the proposed model showed vigorous clusterization of predicted and observed drug responses. The current study was designed to develop an algorithm for pre­dicting drug resistance using chemiophysical data with artificially created neural networks. To this end, an intelligent and multidisciplinary program should be developed on the basis of the information to be gained on the essentials of different applications by similar investigations. This program will help design expert neural network architectures for each application auto­matically. [ABSTRACT FROM AUTHOR]

Objectives Despite the growing population of the elderly in Iran, there is no clear picture of the prevalence of chronic diseases among them. Accordingly, the present study tries to specify the prevalence of the most important chronic diseases and multimorbidity among the elderly. In addition, the homogeneity of these diseases has been considered among different socio-economic groups. Methods & Materials Research data were obtained through a checklist of chronic disease status among the elderly. The sample was selected from the elderly over 60 years old in Tehran in 2019 through multistage sampling. The sample size of the study is 1280 persons and the prevalence rate and chi-square tests were used to describe and analyze the data. Results The results showed that hypertension (40.2%), musculoskeletal disorders (40.2%) and hyperlipidemia (32.4%) had the highest prevalence rate among the elderly in Tehran. The prevalence rate of chronic disease multimorbidity was 79.8, which was lower among men, never married, college-educated, and working-age seniors. Cardiovascular disease, diabetes, hyperlipidemia, and ear diseases have also been found to have different prevalence rates among socioeconomic classes. Conclusion The prevalence of chronic diseases has varied widely among socioeconomic groups; so the importance of the socio-economic status must be accentuated. Therefore, the pattern of prevalence of some chronic diseases can be influenced by lifestyle. As a result, research and policy-making in this field should be based on the inequalities in socio-economic status. [ABSTRACT FROM AUTHOR]

Background: Developing a chronic disease, like heart failure in older adults disrupts the foundations of the family and imposes a heavy burden on family members. The aim of this study was to determine the effect of the Family-Centered Empowerment Model (FCEM) on the care burden of family caregivers of older adults with heart failure. Methods: It was a quasi-experimental study with a controlled before and after design, which was conducted on 80 primary caregivers of older adults with heart failure referring to health centers affiliated with Kashan University of Medical Sciences, Kashan, Iran. The subjects were nonrandomly assigned to either the control (n=40) or intervention (n=40) groups. The program was implemented based on the concepts of the model (perceived threat, self-efficacy, self-esteem, and evaluation) in eight 2-hour sessions, twice a week for four consecutive weeks. Both groups answered the Zarit Burden Interview (ZBI) in the beginning, in the end, and one month after the study. The data were analyzed by Chi-square, t-test, and the repeated measures ANOVA using SPSS v. 16 software. Results: There was no significant difference between the two groups regarding the pretest mean score of care burden (P>0.05). However, the groups' mean score of care burden was significantly different immediately after the intervention (P<0.05) and one month after the study (P<0.05). The repeated measures ANOVA illustrated a significant difference between the mean scores of care burden in the three measurement time points (P<0.0001). Conclusion: Implementation of the FCEM model reduces the burden of care in caregivers of older adults with heart failure. It is suggested that this model be used in training programs for older adults with heart failure and their caregivers. [ABSTRACT FROM AUTHOR]

Background: Morbidity and mortality due to Coronavirus Disease 2019 (COVID-19) are mainly related to age and comorbidity diseases (hypertension, diabetes, cardiovascular disease, malignancies, etc.). These conditions are associated with poorer clinical outcomes and sometimes lead to long-term hospitalization. The current study aimed to investigate the relationship between COVID-19-induced mortality and various chronic diseases in patients admitted to Ali Ibn Abitaleb Hospital in Rafsanjan City, Iran, in 2020. Methods: In this retrospective, descriptive, and cross-sectional study, patients with COVID-19 referring to Ali Ibn Abitaleb Hospital in Rafsanjan City, Iran, from March 2020 to September 2020 were assessed. The required data were collected using patients' records and telephone calls by a researcher-made checklist and analyzed by Independent Samples t-test, Chi-squared test, Fisher's Exact test, Kaplan-Meier plots, and multivariate regression analysis in SPSS v. 20. Results: This study assessed 238 hospitalized patients with COVID-19. The risk of death was significantly higher in patients aged over 75 years; they were 5.5 times more prone to expire, compared to the youngest age group (P<0.001). Chronic diseases, such as hypertension, heart disease, lung disease, and various cancers were more prevalent in patients who expired, compared to those who survived (P=0.05). Of the patients who died, 73.8% were transferred to the Intensive U (ICU), while only 7.5% of surviving patients were transferred to the ICU (P<0.001). Longer hospitalization was associated with an increased risk of death among patients with underlying diseases and hypertension (P<0.05). Conclusion: This study identified the role of chronic diseases and other important indicators in the survival of patients with COVID-19 who were admitted to a hospital in Rafsanjan. It is recommended that nurses and healthcare staff consider these findings in the care of patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: A majority of parents of children with chronic illness encounter physical conditions, as well as some degrees of burnout, anxiety, and depression. This study examined the prevalence of burnout in the primary caregivers of children with chronic conditions and its related factors. Methods: A descriptive cross-sectional study was conducted on 385 family caregivers of children with chronic conditions who were selected by convenience sampling method from 4 healthcare centers in Kashan and Isfahan Provinces, Iran. A demographics questionnaire and the Maslach Burnout Inventory (MBI) were used to gather the required data. The MBI assesses caregiver burnout in 3 domains of emotional exhaustion, depersonalization, and reduced personal accomplishment. The obtained data were analyzed in SPSS using Mann-Whitney U test, Kruskal-Wallis test, Chi-Squared test, Fisher's Exact test, Analysis of Variance (ANOVA), and linear regression analysis. P<0.05 was considered significant. Results: The Mean±SD age of the examined caregivers and children were 38.2±8.04 and 8.9±4.9 years, respectively. Fifty percent of the research participants were fathers, and 74.3% had a family size of >4 members. The ill children were mostly boys (60%) and afflicted with renal (45.2%) or neurological (18.2%) disorders. The mean scores of the caregivers in the 3 subscales of emotional exhaustion, depersonalization, and personal accomplishment, were 22.21, 6.40, and 13.24, respectively. However, 62.3% and 47.9% of the caregivers experienced high or moderate levels of emotional exhaustion and depersonalization; nearly all of them (99.2%) experienced reduced personal accomplishment. The age of the child, the type of chronic condition, the frequency of medical visits, as well as the caregiver's age, job, income, and family size, could predict caregiver burnout (r2=0.17). Conclusion: The family caregivers of children with chronic conditions experience moderate burnout. Nurses and other healthcare providers should be aware of the signs of caregiver burnout and its contributing factors; accordingly; appropriate plans should be made for the periodic evaluation of family caregivers. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking is one of the most preventable causes of mortality related to noncommunicable diseases (NCDs). This study aimed to estimate the direct economic burden and years of life lost (YLL) attributable to smoking in NCDs in Mashhad, 2015-2016. Methods: Hospital-based data were utilized to calculate the economic burden of four selected diseases related to smoking. An epidemiological population-attributable risk method was used to determine the smoking-attributable fraction (SAF). Moreover, the study was conducted by data related to disease-specific expenditures and patients' information on cost and the number of mortality for estimating the YLL for each disease, population and life expectancy data, the prevalence of smoking, and the relative risk of smoking. Data analysis was performed with STATA software, version 12. Results: The total costs attributable to smoking for stroke, myocardial infarction, chronic obstructive pulmonary disease (COPD), and lung cancer were 94148, 151272, 1191396, and 574784 US Dollars, respectively (per 100000). In 2015, the YLL per deaths due to COPD were 4217 and 3522 among males and females, respectively. Furthermore, in 2016, the YLL per deaths due to the stroke in males and females were 8317 and 7563, respectively. In the same year, the highest proportion of years of potential life lost per 100000 smoking-attributable deaths belonged to COPD. Conclusions: The results of this study can be used to inform policy-makers about smoking-attributable diseases in Iran. To decrease the smoking-attributable costs, which have resulted in the spread of NCDs, policy-makers should adopt and implement effective policies regarding smoking prevention and control. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is rising in low- and middle-income countries (LMICs). However, the evidence on its epidemiology from LMICs settings is limited and the available literature has not been synthesized as yet. Objectives: To review the available evidence on the epidemiology of multimorbidity in LMICs. Methods: PubMed, Scopus, PsycINFO and Grey literature databases were searched. We followed the PRISMA-ScR reporting guideline. Results: Of 33, 110 articles retrieved, 76 studies were eligible for the epidemiology of multimorbidity. Of these 76 studies, 66 (86.8%) were individual country studies. Fifty-two (78.8%) of which were confined to only six middle-income countries: Brazil, China, South Africa, India, Mexico and Iran. The majority (n = 68, 89.5%) of the studies were crosssectional in nature. The sample size varied from 103 to 242, 952. The largest proportion (n = 33, 43.4%) of the studies enrolled adults. Marked variations existed in defining and measuring multimorbidity. The prevalence of multimorbidity in LMICs ranged from 3.2% to 90.5%. Conclusion and Recommendations: Studies on the epidemiology of multimorbidity in LMICs are limited and the available ones are concentrated in few countries. Despite variations in measurement and definition, studies consistently reported high prevalence of multimorbidity. Further research is urgently required to better understand the epidemiology of multimorbidity and define the best possible interventions to improve outcomes of patients with multimorbidity in LMICs. [ABSTRACT FROM AUTHOR]

Introduction: Pleural effusion may develop during various acute or chronic medical conditions. Despite different diagnostic workups, some cases of pleural effusion may remain undiagnosed. Pleuroscopy and closed biopsy are common diagnostic approaches used for the diagnosis of undiagnosed cases. The present research aimed to evaluate the diagnostic yield of medical pleuroscopy and closed biopsy in Iran. Materials and Methods: The present cross-sectional study was performed within 2016-2018, in the North-East of Iran. Patients who had undiagnosed lymphocytic predominance exudative pleural effusion were included in the present research. Every patient underwent medical pleuroscopy or closed pleural biopsy by an Abrams needle. The collected data were analyzed in SPSS software (version 12).Apvaluelessthan0.05 was considered statistically signi7icant. Results: A total of 108 patients with the mean age of 58.73±18.13 years enrolled in the present study. Around 50 patients underwent needle biopsy, while the other 58 patients went through medical pleuroscopy. Chronic pleuritis, malignant pleural effusion, negative results, and tuberculosis were the common results. When pleuritis is regarded as negative results and malignant and tuberculosis pleural effusion as positive results, medical thoracoscopy provides more significant positive results and fewer negative results (P=0.024). No patient developed complications after the procedures. Conclusion: In contrast to other studies, both of these techniques had low diagnostic yield for the diagnosis of undiagnosed pleural effusion. Therefore, performing other diagnostic workups (e.g., imaging techniques) may decrease the rate of undiagnosed pleural effusion. [ABSTRACT FROM AUTHOR]

There is a relationship between mental and physical health. Depression and anxiety are linked with the development of several chronic diseases. The purpose of the present study was to determine the prevalence and factors associated with anxiety and depression among adult hypertensive outpatients in Afghanistan. Methods. Two hundred thirty-four consecutive hypertensive patients from December 2015 to August 2016 were recruited to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire, which has scores for classifying the participants having anxiety and depression symptoms. Results. Of the total 234 patients, 81 (34.6%) were males and 153 (65.4%) were females. The mean age was 54.6±12.7 for the hypertensive patients with anxiety and 63.8±15.0 for the hypertensive patients with depression while this figure was 49.5±10.2 for the adult participants in general population in Kabul city (Saeed, 2013). The prevalence of anxiety and depression (42.3% vs. 58.1%) among hypertensive persons is compared with the same mental disorders among Afghan refugees (39.3% vs. 22.1%) in Dalakee Refugee Camp (in Iran) (Hosseini Divkolaye and Burkle, 2017). Of the total participants, 99 had anxiety (42.3%), 136 had depression (58.1%), and 66 had (28.2%) comorbid anxiety-depression. Multivariate analysis was used. For anxiety age, female gender, smoking, diabetes mellitus, and 2 or more chronic diseases had a significant association. For depression, age and diabetes mellitus had a significant association, and for comorbid anxiety, depression, age, diabetes mellitus, and 2 or more chronic diseases had a significant association. Conclusion. This study shows that anxiety and depression are highly prevalent among hypertensive patients in an outpatient clinic in Afghanistan. There was an association between some sociodemographic and clinical characteristics and anxiety and depression. More studies are needed on a national level to inform the development of strategies for the prevention and control of psychological distress among patients with chronic diseases in Afghanistan. [ABSTRACT FROM AUTHOR]

Aim: Chronic Hepatitis C infection is a critical health problem worldwide, which caused by hepatitis C virus (HCV). Interleukin 28B (IL28B) is a determinant factor in disease progression and also susceptibility to chronic HCV infection. Background: The most significant aim of this study is to analyze the association between IL28Bgene polymorphisms with susceptibility to chronic HCV infection in Iranian population. Methods: This study follows a case- control study design, in which, 288 patients with chronic hepatitis C and 250 healthy individuals were genotyped for IL28B polymorphisms (rs12979860 C/T and rs8099917 G/T). Studied population collected from Taleghani Haospital, Tehran. Genotyping of IL28B gene polymorphisms were performed using PCR-Restriction Fragment Length Polymorphism (PCR-RFLP) method. 10 percent of the studied population was sequenced to validate the results. Results: rs8099917 G/T and rs12979860 C/T were differently distributed in hepatitis C patients and healthy controls in the female gender. TT, TG and GG genotypes distribution in the female gender were 56.7%, 39.8% and 4.5% in cases and 67%, 31.6% and 1.4% in controls (p=0.54). Also CC, CT and TT genotypes distribution were 31.8%, 61.4% and 6.8% in cases and 51.7%, 44.9% and 3.4% in controls (p=0.2). However, there was no significant difference in the allelic frequency and genotype distribution of rs12979860 C/T and rs8099917 T/G in both HCV patients with genotype 1a and 3a. Conclusion: It seems that rs8099917 G/T polymorphism plays a significant role in susceptibility to chronic HCV infection in Iranian population. On the other hand, no association was found between rs12979860 C/T polymorphisms and chronic hepatitis C. [ABSTRACT FROM AUTHOR]

Background: Obesity is a major risk factor for chronic diseases and has a role on high blood pressure, diabetes type II, etc., This review assesses the prevalence of Iranian children obesity and overweight for different age categories and compares the three standard definitions of obesity. Materials and Methods: To retrieve desirable studies concerning childhood anthropometric data from different area of Iran, the MEDLINE, Scopus, and different local databases such as Scientific Information database were used. The studies reported the prevalence of obesity or overweight of children < 6, 6-12, and 12-20 years old, despite differences between definitions of childhood obesity, were included in the study. We combined the reported prevalence of the overweight and obesity with regard to age and gender, and also by the different standard references which are the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) definition, and the International Obesity Task Force (IOTF) references. The analysis was carried out using STATA software. Results: Our review covered 75 articles reported the prevalence of overweight or obesity among children and adolescents for different age groups in Iran. Our meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly in gender and age categories, but different definitions provide different prevalence of overweight and obesity. Conclusion: The effective factors on obesity and overweight included administration policy and organizational, interpersonal, intrapersonal, and social factors. CDC and WHO references intended in monitoring children's growth and the IOTF cutoffs would rather provide a common set of definitions that researchers and policymakers could use for descriptive and comparative purposes. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the prediction of depression on a group of Iranian older adults based on components of health locus of control. Method: Sixty-six men and 42 women over the age of 55 were recruited from the retirement clubs in Shiraz, using convenience sampling. The participants completed the research questionnaires including the Geriatric Depression Scale (GDS) and the Multidimensional Health Locus of Control Scale (MHLC). Results: The findings on health locus of control revealed that the highest score was on internal locus of control followed by God, powerful others and chance. The mean score on depression was on a normal range. Multiple regression analysis showed that two l ndependent variables including internal control (β = -.32, p < 0.01) and God control (β = -.20, = p < 0.03) significantly predicted depression. The other components of health locus of control such as chance and powerful others as well as age did not predict depression. Findings also revealed that the independents variables explained 26% of the total variance of depression (R2 = .26, p <0.001). Conclusion: This study provides more support for the application of theory of health locus of control on depression. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to test the hypothesis that the addition of buspirone, a partial agonist of 5HT1A receptor, to ongoing treatment with typical antipsychotics would improve the positive and negative symptoms in patients with chronic schizophrenia. Materials and Methods: In this study, 50 patients including 40 male and 10 female were recruited with chronic schizophrenia who were inpatients at psychiatric teaching hospital or asylums, aged between 18 and 65 years (mean age = 47 ± 10.02). All patients were on the stable dose of typical antipsychotics for at least 1-month, and their acute symptoms were controlled. Patients were allocated in a random fashion: 25 patients to buspirone at 30 mg/day plus typical antipsychotic and 25 patients to placebo plus typical antipsychotic. The positive and negative syndrome scale (PANSS), Simpson-Angus extrapyramidal rating scale (SAS) and mini mental state examination (MMSE), were administered at baseline, and 2, 4, and 6 weeks after the addition of buspirone. Results: The 30 mg/day buspirone was well-tolerated, and no clinically important adverse effects were seen. There was no statistically significant difference between the two groups in MMSE and SAS scales. There was a significant reduction in subscales of negative, general, positive, and total of PANSS over the 6-week trial in buspirone group. There was a statistically significant difference between the two groups negative subscale (mean ± standard deviation [SD] = 14.08 ± 1.4 in buspirone group) P = 0.0219, general subscale (mean ± SD = 27.42 ± 2.1 in buspirone group) P = 0.0004, and total subscale (mean ± SD = 55.63 ± 3.9 in buspirone group) P = 0.0298, of PANSS in the 6-week of trial. Conclusion: The results suggest that adjunctive treatment with 5HT1A agonist such as buspirone may improve the negative symptoms of schizophrenia. Further studies are indicated to determine the efficacy of 5HT1A agonist treatment in chronic schizophrenia. [ABSTRACT FROM AUTHOR]

BACKGROUND Gastroesophageal reflux disease is a common, chronic disease worldwide. The weekly prevalence of reflux in developed countries is 10% to 48%. It has previously been reported as 5% in Asian countries, but new reports show a higher level in both Asian and Arab countries. In Iran, reflux has increased over the last two decades. There are few studies concerning the prevalence of reflux in Iran. This study aims to review reports about the prevalence of reflux in Iran, as it may be different in various parts of the country. By evaluation of the existing articles, this study will reach a general conclusion about the reflux prevalence in Iran. METHODS This was a qualitative, systematic review that estimated the prevalence rate of reflux in Iran. In August 2010, we reviewed all electronic database published studies that concerned the epidemiology of reflux prevalence in Iran by searching PubMed, Scientific Information Database (SID), Iran Medex, and Magiran. RESULTS In our search, using specified key words and selection criteria, 15 articles fulfilled the inclusion criteria and were included in the study. CONCLUSION According to the results, the data related to the estimated prevalence in Iran have a wide range. The weekly prevalence rate of 21.2% in the Tehran study is the best estimate for reflux in Iran. It seems that reflux is more common in Iran when compared to other Asian countries, and similar to reflux in Western countries. Due to the absence of comprehensive studies in Iran, we recommend that researchers conduct accurate, comprehensive, multi-dimensional studies in order to estimate reflux prevalence and its burden in Iran. [ABSTRACT FROM AUTHOR]

Background: Patients' beliefs about the necessity of medicines and their concerns about adverse effects might influence the adherence and treatment outcomes. This study was carried out to investigate the impact of patient's beliefs on their adherence to prescribed medicines in three different chronic diseases and the role of demographic factors in this relationship. Methods: This cross-sectional descriptive study was done during 2008-2009. Data was gathered through interview with 213 patients referring to educational pharmacies of Isfahan University of Medical Sciences, Iran, and suffering from one of the chronic diseases including asthma, cancer and kidney transplantation. Three questionnaires, including demographic factors, beliefs about medicines (BMQ) and Morisky's medication adherence assessment, were used. Descriptive data and correlation analysis tests were made by using SPSS17. Findings: Age, but not gender, had a significant role in patients' adherence to medication. Education level was positively correlated with adherence to medicines in patients with asthma and whom with kidney transplantation but not in patients with cancer. The patients' belief about their medicines had a significant impact on their adherence to their prescription in all three subgroups of patients; however this relationship was stronger for patients with cancer and kidney transplantation than asthmatic patients. Conclusion: Patients' beliefs about their medicines could influence their adherence with medication, especially for more serious diseases. It is also concluded that younger and higher educated patients are more adherent. It seems that educational interventions, especially for older patients and in chronic disease states, are beneficial to improve their adherence with medication. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of end-stage renal disease is increasing worldwide. Earlier studies reported high prevalence rates of obesity and hypertension, two major risk factors of chronic kidney disease (CKD), in Golestan Province, Iran. We aimed to investigate prevalence of moderate to severe CKD and its risk factors in the region. Methods: Questionnaire data and blood samples were collected from 3591 participants (≥18 years old) from the general population. Based on serum creatinine levels, glomerular filtration rate (GFR) was estimated. Results: High body mass index (BMI) was common: 35.0% of participants were overweight (BMI 25-29.9) and 24.5% were obese (BMI ≥30). Prevalence of CKD stages 3 to 5 (CKD-S3-5), i.e., GFR <60 mL/min/1.73 m², was 4.6%. The odds ratio (OR) and 95% confidence interval (95% CI) for the risk of CKD-S3-5 associated with every year increase in age was 1.13 (1.11- 1.15). Men were at lower risk of CKD-S3-5 than women (OR = 0.28; 95% CI 0.18-0.45). Obesity (OR = 1.78; 95% CI 1.04-3.05) and self-reported diabetes (OR = 1.70; 95% CI 1.00-2.86), hypertension (OR = 3.16; 95% CI 2.02-4.95), ischemic heart disease (OR = 2.73; 95% CI 1.55-4.81), and myocardial infarction (OR = 2.69; 95% CI 1.14-6.32) were associated with increased risk of CKD-S3-5 in the models adjusted for age and sex. The association persisted for self-reported hypertension even after adjustments for BMI and history of diabetes (OR = 2.85; 95% CI 1.77-4.59). Conclusion: A considerable proportion of inhabitants in Golestan have CKD-S3-5. Screening of individuals with major risk factors of CKD, in order to early detection and treatment of impaired renal function, may be plausible. Further studies on optimal risk prediction of future end-stage renal disease and effectiveness of any screening program are warranted. [ABSTRACT FROM AUTHOR]

There is a substantial number of Iranian war veterans, exposed to sulfur mustard, who suffer from serious long term progressive health problems involving their respiratory organs, eyes, and skin. Little is known, however, about these casualties’ experiences of living with the consequences of sulfur mustard poisoning. This qualitative study aims to provide greater insight into how war veterans live with the consequences of the poisoning and involved 17 Iranian war veterans who had been poisoned by sulfur mustard during the Iran–Iraq conflict. Each participant was interviewed using a semi-structured interview schedule and the data generated through this process was analyzed using constant comparative data analysis technique. Data analysis resulted in “religious beliefs and practices” as a main category, which included two sub-categories: religious value centered life and religious support. Findings suggest that religious belief assists veterans to accept the impact of poisoning on their lives and adapt their lifestyles accordingly, to participate in religious social activities and feel socially supported, and to be hopeful about the future and live their lives as fully as possible. [ABSTRACT FROM AUTHOR]

Background: There is substantial evidence that low consumption of fruit and vegetables (FV) is a major risk factor for many chronic diseases. The aim of this study was to assess FV consumption and the variables that influence it among elderly individuals in Iran aged 60 and over. Methods: This was a cross-sectional study to investigate FV intake by a randomly-selected sample of members of elderly centers in Tehran, Iran. A multidimensional questionnaire was used to collect data on demographic characteristics, daily consumption of FV, knowledge, self-efficacy, social support, perceived benefits, and barriers against FV. Data were analyzed using t-tests, one way analysis of variance, Pearson correlation, and logistic regression. Results: In total, 400 elderly individuals took part in the study. The mean age of the participants was 64.07 (SD = 4.49) years, and most were female (74.5%). The mean number of FV servings per day was 1.76 (SD = 1.15). Ninetyseven percent of participants (n = 388) did not know the recommended intake was at least five servings of FV per day. Similarly, 88.3% (n = 353) did not know the size of a single serving. The most frequent perceived benefits of and barriers against FV consumption were availability and expense, respectively. Knowledge (OR = 0.59, 95% CI = 0.39-0.88), perceived benefits (OR = 0.92, 95% CI = 0.88-0.96) and barriers (OR = 1.08, 95% CI = 1.04-1.14), selfefficacy (OR = 0.89, 95% CI = 0.83-0.95) and family support (OR = 0.91, 95% CI = 0.83-0.99) were significantly associated with fruit and vegetable consumption. Conclusion: The findings of this study indicate that FV intake among elderly individuals in Iran was lower than the recommended minimum of five daily servings and varied greatly with age, marital status, educational attainment, and income level. The results also indicated that low perceived benefits, low self-efficacy, and perceived barriers could lead to lower consumption of FV. It seems that in order to improve FV consumption among elderly individuals in Iran, raising awareness, improving perception of benefits and enhancing self-efficacy regarding FV consumption should receive more attention. Indeed, it is essential to plan health education programs and nutritional interventions for this group of the population. [ABSTRACT FROM AUTHOR]