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BackgroundAdherence to unhealthy dietary patterns is a major cause of overweight and obesity in adults. Therefore, it is recommended that assessment and modification of unhealthy lifestyle should be included in prevention programs. To achieve this goal, it is necessary to evaluate the status of dietary patterns in adults with valid and reliable tools. Thus, the aims of the present study were to translate the KomPAN questionnaire, evaluate its psychometric properties in Iranian adults and measure 4 dietary indices including high-saturated-fats-Diet-Index-8 (hSFDI-8), high-Sugar- Diet-Index-4 (hSDI-4), low-Glycaemic-Diet-Index-4 (LGIDI-4) and high- Glycaemic-Diet-Index-7 (hGIDI-7) based on 3 groups of body mass index (BMI) (BMI = 18.5–24.9, BMI = 25–29.9 and BMI ≥ 30), gender, educational level, income status, and age.MethodsThe KomPAN questionnaire included 4 scales nutrition beliefs (NB), lifestyle, food frequency consumption (FFC), dietary habits (DH) and after its translation from English into Persian, the psychometric properties of all 4 scales (face and content validity) were evaluated. For both FFC and NB scales, the construct validity was assessed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and convergent and discriminant validity, the internal consistency was evaluated using the Cronbach's alpha coefficient, McDonald's omega (Ω) and Theta coefficient (θ), as well as the stability was assessed via intraclass correlation coefficient (ICC). Cross-classification and Kappa statistics were evaluated for both DH and lifestyle scales. Then, 4 dietary indices were measured in terms of demographic variables.ResultsThe cross-classification of DH (93.96%) and lifestyle (95.87%) scales indicated the percentage of correct classification in the test-retest scales. The Kappa statistic was >0.4 and its value was acceptable. The mean Kappa statistics were 0.734 and 0.865 for the DH and lifestyle scales, respectively. The fit indices showed that the two-factor construct of the FFC scale and the one-factor construct of the NB scale had a good and acceptable fit among the Iranian adults. The FFC and NB scales had acceptable internal consistency and stability.ConclusionIt is recommended that other researchers use the KomPAN questionnaire to identify DH, FFC, NB and lifestyle as well as measure diet quality scores in the adult community.

Background The first large serosurvey in Iran found a SARS-CoV-2 antibody seroprevalence of 17.1% among the general population in the first wave of the epidemic by April, 2020. The purpose of the current study was to assess the seroprevalence of COVID-19 infection among Iranian general population after the third wave of the disease. Methods This population-based cross-sectional study was conducted on 7411 individuals aged ≥10 years old in 16 cities across 15 provinces in Iran between January and March, 2021. We randomly sampled individuals registered in the Iranian electronic health record system based on their national identification numbers and invited them by telephone to a healthcare center for data collection. Presence of SARS-CoV-2-specific IgG and IgM antibodies was assessed using the SARS-CoV-2 ELISA kits. The participants were also asked about their recent COVID-19-related symptoms, including cough, fever, chills, sore throat, headache, dyspnea, diarrhea, anosmia, conjunctivitis, weakness, myalgia, arthralgia, altered level of consciousness, and chest pain. The seroprevalence was estimated after adjustment for population weighting and test performance. Results The overall population-weighted seroprevalence adjusted for test performance was 34.2% (95% CI 31.0-37.3), with an estimated 7,667,874 (95% CI 6,950,412-8,362,915) infected individuals from the 16 cities. The seroprevalence varied between the cities, from the highest estimate in Tabriz (39.2% [95% CI 33.0-45.5]) to the lowest estimate in Kerman (16.0% [95% CI 10.7-21.4]). In the 16 cities studied, 50.9% of the seropositive individuals did not report a history of symptoms suggestive of COVID-19, implying an estimation of 3,902,948 (95% CI 3,537,760-4,256,724) asymptomatic infected individuals. Conclusions Nearly one in three individuals were exposed to SARS-CoV-2 in the studied cities by March 2021. The seroprevalence increased about two-fold between April, 2020, and March, 2021.

There is very little knowledge about the immune responses, particularly cellular immunity to coronavirus disease 2019 (COVID‐19). The main objective of this study was to evaluate the frequency of T helper (Th) cell subtypes, including Th1, Th17, and Treg cells, in moderate‐to‐severe and critical COVID‐19 patients compared to healthy controls. Twenty‐nine moderate‐to‐severe and 13 critical patients confirmed for COVID‐19, and 15 healthy subjects were included in this study. Interferon‐γ (IFN‐γ)‐producing Th1 and interleukin‐17A‐producing Th17 and Treg cells in peripheral blood were measured with flow cytometry. The frequency of Th1 and Th17 was significantly decreased in critical patients compared to healthy subjects (aMD: −2.76 and − 2.34) and moderate‐to‐severe patients (aMD: −1.89 and − 1.89), respectively (p

Background. The prevalence of obesity and metabolic syndrome (MetS) is increasing, worldwide. Using a simple, efficient and reliable tool for predicting MetS is an essential approach in preventive health programs. The aim of this study was to compare the different anthropometric indices in predicting metabolic syndrome in older adults. Methods. This cross-sectional study is a part of the Amirkola Health and Ageing cohort Project (2011–2016). Of total, 1,488 older people aged 60–92 years were entered to the study. Medical and personal information of participants were collected by a questionnaire. After measuring the height, weight, waist circumference, hip circumference and neck circumference, body mass index, waist to hip ratio, waist to height ratio, abdominal volume index and conicity index were calculated. Independent t-test, chi-square and ROC curve were used to analyze the data. Results. Based on ATPIII-2005 diagnostic criteria, the prevalence of metabolic syndrome was 71.57%.The prevalence in female was higher than male. All of examined anthropometric indices, except neck circumference (p = 0.10), showed a significant difference in people with MetS compared to the individuals without metabolic syndrome (p Conclusion. Waist to height ratio was the best predictor of MetS in older adults.

Background Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy. Methods This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P Conclusion E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.

BACKGROUND: This study was aimed to investigate the risk factors for mortality in patients with COVID-19. METHODS: For this retrospective cohort study, we included 121 deceased and 436 discharged cases with COVID-19 in Babol, Northern Iran. The cases were between March 1 to April 1, 2020. RESULTS: Multivariate Poisson regression analysis revealed that older age (aRR: 1.03, 95% CI: 1.01, 1.05, p < 0.001), hospital length of stay (aRR: 0.94, 95% CI: 0.90, 0.97, p = 0.003), ICU admission (aRR: 4.34, 95% CI: 2.95, 6.37, p < 0.001), cerebrovascular disease (aRR: 1.96, 95% CI: 1.20, 3.19, p = 0.007), ventilator-associated pneumonia (VAP) (aRR: 2.09, 95% CI: 1.22, 3.55, p = 0.006), septic shock (aRR: 2.98, 95% CI: 1.44, 6.19, p = 0.003), acute respiratory distress syndrome (ARDS) (aRR: 3.80, 95% CI: 2.28, 6.31, p < 0.001), acute kidney failure (AKF) (aRR: 1.45, 95% CI: 1.12, 3.76, p = 0.021), acute heart failure (AHF) (aRR: 1.63, 95% CI: 1.01, 2.62, p = 0.043) and lymphocyte count (aRR: 3.01, 95% CI: 1.99, 4.57, p < 0.001) were associated with mortality. CONCLUSION: Findings showed that elderly with comorbidities such as cerebrovascular diseases had an increased risk of death. Some complications such as: pneumonia, septic shock, ARDS, AHF, and AKF played crucial roles as well death (Tab. 2, Ref. 25).

Adult eating behavior questionnaire (AEBQ) is an age upward extension tool that measures appetite traits in individuals. This instrument was developed by Hunot in 2016. The present study aimed to determine the psychometric properties of the Persian version of AEBQ in adults with epilepsy.The current research is a cross-sectional study conducted in 2019 in Iran. 700 adults with epilepsy completed the 35-item AEBQ. Qualitative face validity, qualitative content and structure validity (exploratory factor analysis [EFA], N=400, and confirmatory factor analysis [CFA], N=300) appetitive traits were evaluated. Reliability was also measured using Cronbach's alpha, Construct reliability (CR), and Intra-Class Correlation (ICC). The SPSS 26-AMOS24 software was employed to analyze the data with a significance level of 0.05.The EFA and CFA results comprised eight factors, namely enjoyment of food, emotional over-eating, food responsiveness, hunger, satiety responsiveness, emotional under-eating, food fussiness, and eating slowly. Indices of root mean square error of approximation=0.068, parsimonious normed fit index=0.644, parsimonious comparative fit index=0.671, adjusted goodness of fit index=0.618, goodness of fit index=0.911, and Chi square degree-of-freedom ratio (normalized Chi square CMIN/DF=2.842) confirmed the fitness of the final model. Convergent and divergent validity was acceptable for all the factors. The results revealed that the internal stability0.8 and CR0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; P0.001). The results also showed that AEBQ has acceptable convergent and divergent validity.The eight-factor structure of AEBQ can measure eating behavior traits and is of good validity and reliability for assessing the eating behavior of Iranian adults with epilepsy.

The aim of the Randomized Clinical Trial (RCT) study was to determine the effect of Group Walking Program (GWP) on social physique anxiety (SPA) and the risk of Eating Disorders (EDs) in aged women.70 young-old women with medical records in Sari-Iran health centers were selected by a multi-stage sampling. They obtained score of 15 or more from SPA Scale (SPAS), a score of 20 or more from Eating Attitude Test (EAT-26). The group walking lasted eight weeks. 70 young-old women with medical records in Sari-Iran health centers were selected by a multi-stage sampling. They obtained score of 15 or more from SPA Scale (SPAS), a score of 20 or more from Eating Attitude Test (EAT-26). The group walking lasted eight weeks. To compare differences in EDs and SPA at post-test, analysis of Covariance was used.The results showed significant differences in the mean score of SPA (P = 0.01), EDs (P 0.001), and EDs subscales between the groups.The GWP can be used as an easy and affordable solution to reduce SPA and EDs in the aged women.

Background Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines. Methods This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH). Results Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them (p p = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L (P = 0.016). Conclusions Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients. Trial registration The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2.

Background Awareness of nutrition self-efficacy dimensions can enable healthcare providers to guide their use in screening and providing a context for positive changes such as in promoting a healthy lifestyle and quality care among elderly people. Objectives Developing an instrument for assessing nutrition self-efficacy among Iranian elderly population. Methods A sequential mixed exploratory design was applied to clarify and determine dimensions of nutrition self-efficacy in a community-dwelling elderly population in two phases. The first phase included a related literature review and a qualitative study. The validity and reliability of the tool were investigated in the second phase. The instrument’s content validity was assessed by experts in nutrition self-efficacy’s field and reliability was determined by internal consistency and construct reliability. Results Three factors (adherence efficacy, preventive behaviors, and information effectiveness) and 29 items were obtained after assessing the face, content, and construct validity. The reliability of the nutrition self-efficacy questionnaire (NSEQ) exceeded α > 0.7. Concerning the cumulative percent of the variance, the three factors determined 64.05% of the total variance. Conclusions The NSEQ designed in this study, using the background experiences of the elderly living in the community and a review of related texts, and has acceptable reliability and validity. However, the diet self-efficacy questionnaire cannot yet be used as a gold standard, but it can be recommended for use as a measurement of individual diet self-efficacy in a community-dwelling elderly population.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations., A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.

Background: We conducted a meta-analysis to investigate the possible effects of vitamin D deficiency on clinical outcomes of critically-ill children.Methods: We searched Scopus-Embase and PubMed-Medline databases to find eligible observational articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations.Results: Seventeen articles (eighteen studies) involving 2987 critically ill patients met our inclusion criteria. Vitamin D deficiency was not associated with increased mortality. A significant association was only observed in very high developed countries between vitamin D deficiency and risk of sepsis [OR (95%CIs): 2.65 (1.30, 5.41)] and ventilation support requirement [OR (95%CIs): 1.35 (1.03, 1.77)].Conclusion: Our findings suggest that vitamin D deficiency is not associated with higher mortality among critically ill children but increases susceptibility to sepsis and the need for ventilator support in critical care settings.

Disease-related fear is one of the important diagnoses of healthcare providers in caring for people with epilepsy whose conceptual dimensions should be discovered and investigated. To this end, it is necessary to provide healthcare providers with appropriate tools to assess fears related to the disease in accordance with the sociocultural milieu of each community.The purpose of this study was to design and psychometrically evaluate the disease-related fear scale (D-RFS) in adults with epilepsy.This study was of a sequential exploratory mixed methods design conducted in Iran in 2019. In the item generation phase, inductive (face-to-face, semi-structured interviews with 14 adult patients with epilepsy) and deductive (literature review) were used. In the item reduction, integration of qualitative and literature reviews and scale evaluation were performed. For the scale evaluation, face validity, content validity, construct validity [exploratory factor analysis (EFA) (n = 367) and confirmatory factor analysis (CFA) (n = 250)], and convergent and divergent validity and reliability (internal consistency and stability) were investigated.After the qualitative phase and literature review, 40 items were codified. After investigation of the qualitative and quantitative face validity, 7 items were deleted. Two items were deleted due to content validity ratio (CVR) of less than 0.56 and one item due to content validity index (CVI) of less than 0.78. Finally, a 30-item scale was obtained, and its construct validity was assessed. Kaiser-Meyer-Olkin (KMO) index was 0.85, and Bartlett's test of sphericity was 7237.504, P 0. 001. The results of CFA showed that the bivariate model of the D-RFS (fear of seizure consequences and fear of the disease's long-term consequences) had the most appropriate fitness to the data. Convergent and divergent validity results showed that the values of composite reliability (CR) and average variance extracted (AVE) for the two factors were greater than 0.7 and 0.5, respectively, and the AVE for each factor was greater than CR. Internal consistency of the first and second factors were obtained 0.891 and 0.910, respectively. Cronbach's alpha coefficient for the total scale was obtained 0.921. The results of test-retest reliability showed that there was a significant agreement between the scores of the test and retest (P .001).The D-RFS has an acceptable factorial structure, and its internal consistency was confirmed by different approaches. This scale is a valid and reliable tool for assessing disease-related fear in patients with epilepsy. The simplicity of the items and the appropriate time to complete the scale can be considered as its strengths.

Background. The purpose of this study was to determine the current situation of lifestyle behaviors and related outcomes, as the first step to make proper local health policies for improvement of health lifestyle behaviors.Materials and Methods. This analytic research has been conducted as a cross-sectional study on the middle-aged (40–60 years old) population of Amirkola, Northern Iran. The Persian translation of the Health-Promoting Lifestyle Profile II questionnaire and the International Physical Activity Questionnaire were used for data collection. Also, anthropometric variables, blood pressure, fasting blood sugar, and serum lipids profile were examined.Results. Three hundred one individuals have been enrolled in the study. Results showed that 10.6% of the participants had unhealthy lifestyle behaviors in the subdomain of spiritual growth; 46.8% in the subdomain of health responsibility; and 48.2% in the subdomains of stress management, physical activity, and nutrition; men had more physical activity than women (p<0.001). Totally, 189 persons (63.9%) had serum cholesterol greater than or equal to 200 mg/dL; seventy-five individuals (25%) had high blood pressure. One hundred twenty-six persons (81.8%) of women and 103 (70.1%) of men were overweight or obese.Conclusions. Health lifestyle behaviors in 40- to 60-year-old population need a proper intervention to improve the current situation.

Various indices have been used to estimate overweight and obesity; all have limitations and strengths. The prevalence of overweight and obesity may differ by ethnicity.This study evaluated waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR) and neck circumference (NC) as reliable alternatives to body mass index for screening for overweight and obesity, and determined their optimum cut-off values in different ethnic groups.The study was conducted from November 2015 to February 2016 among adolescents aged 12-14 years from five ethnicities in the Islamic Republic of Iran: Arab, Kurdish, Sistani and Baluchi, Turkish and Turkman. Stratified multistage sampling was used to select 2444 students. Receiver operating characteristic curves were constructed to evaluate WC, WHpR, WHtR and NC as screening indices for overweight and obesity as categorized by body mass index centiles.The prevalence of overweight and obesity in the total sample were 15.3% and 9.2% respectively, with higher rates in students of Arab, Kurdish and Turkish ethnicity. The areas under curve ranged from 0.8 to 0.9 for WC, WHtR and NC. The mean optimum values with the highest sensitivity and specificity to identify overweight were: 72.3 cm (sensitivity 0.80, specificity 0.75) for WC, 0.46 (0.85, 0.70) for WHtR and 31 cm (0.76, 0.76) for NC. For obesity mean optimum values were: 77 cm (0.84, 0.81) for WC, 0.50 (0.84, 0.84) for WHtR and 31.5 cm (0.88, 0.71) for NC.WC, WHtR and NC may be useful tools to screen for adiposity using their optimum values for sex and ethnicity.تقييم لزيادة الوزن والسمنة لدى المراهقين الإيرانيين: القيم المثلى لقطع مؤشرات الأنثروبومترية.محمد مطلق، السيد شيرواني، زهراء حسن زاده رستمي، مجذوبة طاهري، رضا قديمي.استخدمت مختلف المناسب لتقدير زيادة الوزن والسمنة؛ وكان لجميعها مواطن قوة وضعف. ويختلف معدل انتشار زيادة الوزن والسمنة باختلاف العرق.قيمت هذه الدراسة استخدام محيط الخصر ونسبة الخصر إلى الورك ونسبة الخصر إلى الطول ومحيط الرقبة كبدائل موثوقة لمِنْسَب كتلة الجسم لتحرِّي زيادة الوزن والسمنة، كما تم التعرف على قِيَم الفَصْل المُثلَ في المجموعات العرقية المختلفة.وقد أجريت الدراسة من نوفمبر/تشرين الثاني عام 2015 إلى فبراير/شباط 2016 وتناولت المراهقين الذين تتراوح أعمارهم بين 12 - 14 سنة وينتمون إلى 5 مجموعات عرقية (إثنية) في جمهورية إيران الإسلامية: فهم من العرب والكرد والسيستانيين والبلوشيين والترك والتركمان. واستخدمت الدراسة أخذ العينات الطبقية المتعددة المراحل لاختيار 2444 طالبًا. وتم رسم منحنيات للخصائص العاملة في المتلقين لتقييم محيط الخصر ونسبة الخصر إلى الورك ونسبة الخصر إلى الطول ومحيط الرقبة باعتبارها مناسِب لزيادة الوزن والسمنة بتقسيمها إلى فئات حسب الشرائح المئوية لمَنْسَب كتلة الجسم.بلغ معدل انتشار زيادة الوزن 15.3 % والسمنة 9.2 % في العينة الكلية مع معدلات عالية بين الطلاب من الأعراق العربية والكردية والتركية. وتراوحت المساحة التي تقع تحت المنحنى بين 0.8 و 0.9 لمحيط الخصر ونسبة الخصر إلى الورك ونسبة الخصر إلى الطول ومحيط الرقبة وكان متوسط القِيَم المثلى ذات الحساسية والنوعية الأعلى لتعريف زيادة الوزن: 72.3 سم (الحساسية 0.80 ، والنوعية 0.75) لمحيط الخصر، و 0.46 سم (الحساسية 0.85 ، والنوعية 0.70) لنسبة الخصر إلى الطول، و 31 سم (الحساسية 0.76 ، والنوعية 0.76) لمحيط الرقبة. وكانت متوسط القيم المثلى للسمنة: 77 سم (الحساسية 0.84 ، والنوعية 0.81) لمحيط الخصر، و 0.50 سم (الحساسية 0.84 ، والنوعية 0.84) لنسبة الخصر إلى الطول، و 31.5 سم (الحساسية 0.88 ، والنوعية 0.71) لمحيط الرقبة.محيط الخصر، ونسبة الخصر إلى الطول، ومحيط الرقبة قد تكون أدوات مفيدة لتحري السمنة واستخدام قيمها المثلى للجنس وللعرق.Évaluation de la surcharge pondérale et de l’obésité chez les adolescents iraniens : valeurs seuils optimales pour les indices anthropométriques.Divers indices sont utilisés pour estimer la surcharge pondérale et l’obésité ; ils présentent tous des avantages et des inconvénients. La prévalence de la surcharge pondérale et de l’obésité peut varier en fonction de l’origine ethnique.La présente étude a évalué le tour de taille, le rapport tour de taille/tour de hanches, le rapport tour de taille/ taille et la circonférence du cou en les considérant comme des alternatives fiables à l’indice de masse corporelle pour dépister la surcharge pondérale et l’obésité. Elle a ensuite déterminé leurs valeurs seuils optimales pour différents groupes ethniques.L’étude a été réalisée en République islamique d’Iran entre novembre 2015 et février 2016 auprès d’adolescents âgés de 12 à 14 ans et issus de 5 groupes ethniques différents : arabe ; kurde ; sistani et baloutche ; turc et turkmène. Une méthode d’échantillonnage stratifié à plusieurs degrés a été utilisée pour sélectionner 2444 étudiants. Des courbes ROC (fonction d’efficacité du récepteur) ont été tracées pour évaluer le tour de taille, le rapport tour de taille/tour de hanches, le rapport tour de taille/taille et la circonférence du cou en tant qu’indices de dépistage de la surcharge pondérale et de l’obésité telles que catégorisées par les percentiles d’indice de masse corporelle.La prévalence de la surcharge pondérale et de l’obésité dans l’échantillon total était, respectivement, de 15,3 % et 9,2 %. Des taux plus élevés ont été observés chez les étudiants d’origine arabe, kurde et turque. Les aires sous la courbe oscillaient entre 0,8 et 0,9 pour le tour de taille, le rapport tour de taille/taille et la circonférence du cou. Les valeurs optimales moyennes ayant la sensibilité et la spécificité la plus élevée pour dépister la surcharge pondérale étaient : 72,3 cm (sensibilité 0,80 ; spécificité 0,75) pour le tour de taille, 0,46 (0,85 ; 0,70) pour le rapport tour de taille/taille et 31 cm (0,76 ; 0,76) pour la circonférence du cou. Pour l’obésité, les valeurs optimales moyennes étaient : 77 cm (0,84 ; 0,81) pour le tour de taille, 0,50 (0,84 ; 0,84) pour le rapport tour de taille/taille et 31,5 cm (0,88 ; 0,71) pour la circonférence du cou.Les valeurs optimales du tour de taille, du rapport tour de taille/taille et de la circonférence du cou selon le sexe et le groupe ethnique peuvent s’avérer utiles pour dépister l’adiposité.

To evaluate the relevance of body mass index (BMI), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH ratio with clinical symptoms in polycystic ovary syndrome (PCOS) women. Methods: We reviewed the medical records of all women visited in the PCOS Clinic of Babol (Iran) from 2008 to 2012. A retrospective cross-sectional study was conducted on 175 PCOS women; aged 18–38 years diagnosed based on the Rotterdam criteria. Among the PCOs women, the prevalence of oligomenorrhea, acne, and hirsutism were found to be 92.0%, 31.4%, and 78.9%, respectively. Positive finding of polycystic ovaries was observed in 89.1% of PCOS women with by using sonography. A total of 69.2% overweight/obesity patients had polycystic ovary morphology on ultrasound image. Compared with non- overweight/obesity, the adjusted OR of PCOS women for sonographic view of polycystic ovaries was 4.33 (95% CI, 1.42-13.15, p=0.001), Nevertheless, the adjusted odds ratio (OR) showed no significant associations between LH, FSH, and LH/FSH ratio with clinical symptoms in these women. The findings of this study indicated that the overweight/obese women with PCOS are at an increased risk for sonographic view of polycystic ovaries. Therefore, it is suggested that successful weight loss is the most effective method of restoring ovulation, menstruation that should be used as major advice in obese PCOS patients.

Child body mass index (BMI) is an internationally accepted indicator to assess child health status. International BMI reference curves are available but their suitability for Iranian children in not known.This study aimed to produce BMI-for-age growth curves for northern Iranian schoolchildren aged 7-11 years and compare them with the World Health Organization (WHO 2006) and Centers for Disease Control and Prevention (CDC 2000) reference curves.Stratified multistage cluster sampling was used to select schoolchildren from urban and rural areas of Babol. Height and weight were measured and BMI calculated. Smoothed BMI-for-age growth curves were constructed for both sexes and compared with the WHO and CDC reference curves.A total of 4 083 children aged 7-11 years were included; 48.8% were boys and 56.7% were urban residents The major significant differences between the Iranian curves in this study and the CDC2000 and WHO 2006 growth charts were in the upper centiles. The 5th centile is close to the 5th centiles of the reference curves.BMI centiles for 7-11 years schoolchildren in Babol differed significantly from the international growth reference curves. Therefore, local and population-specific BMI curves should be developed to assess physical growth of children.مخططات النمو للأطفال الذين تتراوح أعمارهم ما بين 7 - 11 سنة بشمال إيران: مقارنة مع المنحنيات المرجعية الدولية.هالة إسماعيل، محمود حاجي احمدي، مريم فتحي، رضا قديمي.إن مَنْسَب كتلة الجسم مؤشر مقبول دوليًا لتقييم الحالة الصحية للطفل. تتوافر المنحنيات المرجعية الدولية لمَنْسَب كتلة الجسم، إلا أن ملاءمتها للأطفال الإيرانيين غير معروفة.هدفت هذه الدراسة إلى إنتاج منحنيات النمو لمَنْسَب كتلة الجسم نسبة إلى العمر لتلاميذ المدارس في شمال إيران الذين تتراوح أعمارهم ما بين 7 - 11 سنة ومقارنتها مع المنحنيات المرجعية لمنظمة الصحة العالمية (2006) ومراكز مكافحة الأمراض والوقاية منها (2000).تم أخذ العينات الطبقية العنقودية المتعددة المراحل لاختيار تلاميذ المدارس من المناطق الحضرية والريفية في بابول. تم قياس الطول والوزن وحساب مَنْسب كتلة الجسم. أعدت منحنيات النمو المُمَهَّدة لمَنْسَب كتلة الجسم بالنسبة للعمر لكلا الجنسين ومقارنتها مع منحيات مرجعية لمنظمة الصحة العالمية ولمراكز مكافحة الأمراض والوقاية منها.شملت الدراسة 4083 طفلً تتراوح أعمارهم بين 7 - 11 سنة منهم 48.8 % فتيان و 56.7 % من سكان الحضر، وكانت الاختلافات الكبيرة بين منحنيات الأطفال الإيرانيين في هذه الدراسة وبين مخططات النمو لمركز مكافحة الأمراض لعام 2000 ولمنظمة الصحة العالمية لعام 2006 في الشرائح المئوية العليا. فالشريحة المئوية الخامسة تقرب من الشريحة المئوية الخامسة للمنحنيات المرجعية.الشرائح المئوية لمَنْسَب كتلة الجسم لتلاميذ المدارس في الأعمار 7 - 11 سنة في بابول تختلف اختلافًا كبيرًا عن المنحنيات المرجعية الدولية للنمو. ولذلك، ينبغي وضع منحنيات محلية خاصة بالسكان لمَنْسَب كتلة الجسم لتقييم النمو الجسمي للأطفال.Comparaison des courbes de croissance d’enfants de 7 à 11 ans du nord de la République islamique d’Iran avec les courbes de référence internationales.L’indice de masse corporelle (IMC) des enfants est un indicateur reconnu internationalement pour évaluer l’état de santé des enfants. Des courbes d’IMC de référence internationales sont disponibles, mais leur adéquation à la réalité des enfants iraniens est encore méconnue.La présente étude visait à produire des courbes de croissance représentant l’IMC-pour-l’âge d’écoliers de 7 à 11 ans du nord de la République islamique d’Iran et à les comparer avec les courbes de référence de l’OMS (2006) et des Centers for Disease Control and Prevention (2000).Un échantillonnage stratifié en grappe à plusieurs niveaux a été utilisé pour sélectionner des écoliers dans des zones rurales et urbaines de Babol. La taille et le poids ont été mesurés et l’IMC a été calculé. Des courbes de croissance lisses de croissance montrant l’IMC-pour-l’âge ont été créées pour les deux sexes et comparées avec les courbes de référence de l’OMS et des CDC.Au total, 4083 enfants de 7 à 11 ans ont été inclus dans l’étude : 48,8 % étaient des garçons et 56,7 % résidaient en zones urbaines. Les différences majeures observées entre les courbes iraniennes produites dans le cadre de cette étude et les courbes de croissance des CDC (2000) et de l’OMS (2006) concernaient les centiles supérieurs. Le cinquième centile des courbes iraniennes était proche du cinquième centile des courbes de référence.Les courbes des centiles d’IMC des écoliers de 7 à 11 ans de Babol différaient significativement des courbes de croissance de référence internationales. Des courbes d’IMC propres à la population et au lieu devraient donc être créées pour évaluer la croissance physique des enfants.

The purpose of this research was to develop an infrared spectroscopic technique (Fourier transform infrared spectroscopy with attenuated total reflectance system; FTIR-ATR) for non-invasive measurement of saturated and unsaturated fatty acid compositions in human oral mucosa obtained from three nationalities; Iranian, Vietnamese, and Indonesian. The histogram patterns of fatty acid compositions for three nationalities suggest that the pattern of unsaturated fatty acids were quite different, although the distribution profiles of fatty acid to lipid ratios in FTIR-ATR has a similar normal pattern with small difference in skewness and mode. The second derivative infrared spectra of the mucosal tissues in the wavenumber regions from 1,600 to 1,760 cm(-1) and 2,800 to 3,050 cm(-1) were analyzed with partial least squares (PLS) multivariate regression analysis method. With this analysis method we compared predicted values with the measured values of ten categorized fatty acid compositions, i.e., a(saturated C17 or lower), b(C16:1 + C17:1), c(C18:0), d(C18:1), e(C18:2), f(saturated C20 or longer), g(C20:3 + C20:4), h(C22:1 + C24:1), i(C22:6), j(gammaC18:3). Almost all fatty acid compositions of oral mucosa were well predicted with differences between predicted and measured values within +/-5% of total, however, errors were relatively larger in minor components such as C22:6 than major components.

Oesophageal cancer is one of the most common causes of cancer mortality in developing countries, including Iran. This study aimed to assess factors affecting survival of patients with oesophageal cancer using parametric analysis with frailty models.Data on 359 patients with oesophageal cancer was collected from the Babol Cancer Registry for the period 1990-1991. By 2006, the patients had been followed up for a period of 15 years. Hazard ratio was used to interpret the risk of death. To explore factors affecting the survival of patients, log-normal and log-logistic models with frailty were examined. The Akaike Information Criterion (AIC) was used for selecting the best model(s). Cox regression was not suitable for this patient group, as the proportionality assumption of the Cox model was not satisfied by our data (p = 0.007).Multivariate analysis according to parametric models showed that family history of cancer might increase the risk of death from cancer significantly. Based on AIC scores, the log-logistic model with inverse Gaussian frailty seemed more appropriate for our data set, and we propose that the model might prove to be a useful statistical model for the survival analysis of patients with oesophageal cancer. The results suggested that gender and family history of cancer were significant predictors of death from cancer.Early preventative care for patients with a family history of cancer may be important to decrease the risk of death in patients with oesophageal cancer. Male gender may be associated with a lower risk of death.

Esophageal cancer is a major cause of mortality and morbidity in the Caspian littoral north-eastern part of Iran. The aim of this study was to calculate cure function as well as to identify the factors that are related to this function among patients with esophageal cancer in this geographical area.Three hundred fifty nine cases of esophageal cancer registered in the Babol cancer registry during the period of 1990 to 1991 (inclusive) were followed up for 15 years up to 2006. Parametric cure model was used to calculate cure fraction and investigate the factors responsible for probability of cure among patients.Sample of subjects encompassed 62.7% men and 37.3% women, with mean ages of diagnosis was 60.0 and 55.3 years, respectively. The median survival time reached about 9 months and estimated survival rates in 1, 3, and 5 years following diagnosis were 23%, 15% and 13%, respectively. Results show the family history affects the cured fraction independently of its effect on early outcome and has a significant effect on the probability of uncured. The average cure fraction was estimated to be 0.10.As the proportionality assumption of Cox model does not meet in certain circumstances, a parametric cure model can provide a better fit and a better description of survival related outcome.

Accelerated intimal and medial calcification and sclerosis accompany the increased cardiovascular mortality of dialysis patients, but the pathomechanisms initiating microcalcifications of the media are largely unknown. In this study, we systematically investigated the ultrastructural properties of medial calcifications from patients with uremia. We collected iliac artery segments from 30 dialysis patients before kidney transplantation and studied them by radiography, microcomputed tomography, light microscopy, and transmission electron microscopy including electron energy loss spectrometry, energy dispersive spectroscopy, and electron diffraction. In addition, we performed synchrotron x-ray analyses and immunogold labeling to detect inhibitors of calcification. Von Kossa staining revealed calcification of 53% of the arteries. The diameter of these microcalcifications ranged from 20 to 500 nm, with a core-shell structure consisting of up to three layers (subshells). Many of the calcifications consisted of 2- to 10-nm nanocrystals and showed a hydroxyapatite and whitlockite crystalline structure and mineral phase. Immunogold labeling of calcification foci revealed the calcification inhibitors fetuin-A, osteopontin, and matrix gla protein. These observations suggest that uremic microcalcifications originate from nanocrystals, are chemically diverse, and intimately associate with proteinaceous inhibitors of calcification. Furthermore, considering the core-shell structure of the calcifications, apoptotic bodies or matrix vesicles may serve as a calcification nidus.

The aim of this study is to evaluate hepatitis B vaccine protection in those adults who have taken one or two does of vaccine before. It was a retrospective cross sectional study was conducted on fifty-six military personnel in Tehran, Iran in the spring 2007. Demographic data such as age, marital status, education level, number of vaccine doses injected and, type of vaccine and date of last vaccination was collected. Their serum was tested for HBs Ab, HBc Ab and HBs Ag and finally the results were analyzed by SPSS software. All individuals were male with the mean age of 33.9+/-8.9 years. Twelve individuals who had only received one dose of injected vaccine had no antibody against HBsAg and no protection against hepatitis B virus. Of forty-four individuals that had received two doses of injected vaccine, 27 persons (61.4%) were protected and had serum HBsAb more than 10 MIU mL(-1). In conclusion one dose of HBV vaccine cannot produce immunity for five years but two doses of HBV vaccine can produce immunity for five years. However, HBsAb should be tested to make sure of immunity.

Epidemiologic studies of n-3 fatty acids (FAs) and risk of colorectal cancer have generated inconsistent results, and relations with precursor colorectal adenomas (CRA) have not been evaluated in detail. We here focused on possible associations of serum FAs with CRA in the Japanese population.We conducted a case-control study of 203 asymptomatic CRA cases (148 men, 55 women) and 179 healthy controls (67 men, 112 women) during 1997-2003 in Nagoya, Japan. Baseline information was obtained using a lifestyle questionnaire and serum FA levels were measured by gas chromatography.A non-significant inverse association with CRA was observed for eicosapentaenoic acid (EPA) among women. Moreover, the concentrations of docosahexaenoeic acid (DHA), a major component of n-3 highly-unsaturated FAs (HUFAs), were significantly lower in cases in both sexes. In addition, serum concentrations of total FAs, saturated FAs (SFAs) and mono-unsaturated FAs (MUFAs) had strong positive links with CRA risk. In contrast, arachidonic acid (AA) and DHA were inversely related, with 66% and 59% risk reduction, respectively. Ratios of SFAs/n-3 PUFAs and SFAs/n-3 HUFAs exhibited significant positive relations with CRA risk but there was no clear link with n-6 PUFAs/n-3 PUFAs.Our findings suggest a promoting influence of SFAs and MUFAs along with a protective effect of DHA on CRA risk. However, further research is needed to investigate the observed discrepancy with the generally accepted roles of the AA cascade in carcinogenesis.

We investigated the possible influence of an exhaustive physical exercise on mental stress biomarkers (serotonin, tryptophan, and beta-endorphin) along with dopamine, noradrenaline and free fatty acids in an ultramarathon race in which 45 km was run on the first day and 90 km on the second. We obtained serum samples at 6 different time points during and after the race from 18 Japanese male runners who completed the marathon. Overall changes of serum serotonin and tryptophan concentrations were statistically significant according to ANOVA for repeated measurements (p < 0.05). Serum serotonin levels elevated rapidly on the first day with the post hoc Tukey's test. Tryptophan concentrations inversely decreased during the race, possibly because of utilization for synthesis of serotonin. Levels of beta-endorphin appeared to increase on the first and second days, but were not statistically significant. In conclusion, serum serotonin, tryptophan and beta-endorphin appeared to be used for mental stress markers in physical exercise.

The great variability in gastric cancer rates across Asia, with very high incidences in Japan and Korea, and exceedingly low incidences in ethnic Malays, whether in Malaysia or Indonesia, appears largely due to variation in Helicobacter pylori infection rates. While between 2% and 10.6% of gastric cancers in a recent Japanese survey were considered to be negative for bacterial infection on the basis of seropositivity and H. pylori-dependent mucosal atrophy, it is notoriously difficult to preclude past infection. The situation is greatly complicated by reported differences in the etiology of gastric cardia and non-cardia cancers. In the Western world there do appear to be tumours arising close to the esophageal-gastric junction which are not related to H. pylori and associated inflammation, but in most Asian populations these appear to be very rare. Therefore preventive efforts, and particularly screening, should be focused on markers of bacterial infection, with avoidance of unnecessary exposure to X-ray radiation.

To clarify host and environmental factors for gastric carcinogenesis, we obtained information about gastric cancer mortality in Babol, in the North of Iran, and recruited 130 participants aged 30-80 years from the general population of Babol in 2004. A urea breath test, assessment of IgG antibodies to Helicobacter pylori, a pepsinogen test, a marker of chronic atrophic gastritis, and determination of urinary excretions of sodium and potassium were performed. Diet and lifestyle information was also obtained using a questionnaire. The stomach cancer mortality rate for men in Babol (38.2/10 5 ) was found to be somewhat lower than that for Japanese men (45.1 /10 5 ), while the mortality for women (26.9/10 5 ) was higher than for Japanese women (20.9/10 5 ). Positive rates for the urea breath test were 77.5 and 81.8% for Iranian men and women, respectively. Helicobacter pylori IgG antibodies were present in 68.7 and 73.7% of Iranian men and women, respectively, both values being marginally higher than for Japanese. We also found 51.0 and 52.8% to be positive for a pepsinogen test, significantly higher than the Japanese values. Urinary excretions of salt and potassium in this population appeared approximately the same as the consumption in Japanese. The elevated gastric cancer mortality in both men and women in Babol seems, by and large, to be related to higher H. pylori infection rates and prevalence of chronic atrophic gastritis. Certain factors, including H. pylori DNA diversity, host factors and their interactions, together with the level of medical practice, prevalence of and access to secondary prevention of stomach cancer, may also be associated with the relatively high mortality.

The gastric cancer incidence in Semarang, Indonesia, is exceedingly low: only approximately 1/100th of the level in Japan. To elucidate the reason, we carried out an ecological study recruiting 69 male and 102 female participants from the general populace in January 2005. Positive urea breath tests were 0% for both men and women, and Helicobacter pylori (H. pylori) IgG antibodies were found in 2% (0–5, 95% confidence interval) of men and 2% (0–4) of women, significantly lower than the 62% (58–65) and 57% (53–60), respectively, in Japan. Furthermore, there were no positive findings with the pepsinogen tests in Semarang, again significant in comparison with the 23% (22–25) and 22% (20–23) in Japan. Variation in smoking levels and consumption of NaCl, vegetables and fruit were found, but not to an extent that would allow explanation of the major differences in gastric cancer incidence. We may conclude that the very low prevalence of H. pylori infection and thus chronic atrophic gastritis account for the rarity of stomach cancer in Semarang, Indonesia. (Cancer Sci 2005; 96: 873–875)

Aim The level of mutans streptococci (MS) is reduced by regularly consumption of probiotic Kefir drink. The present study aiming at answer to this question ‘may the Kefir drink be considered an alternative to fluoride rinse?’ Materials and Methods Twenty-two healthy volunteers aged 22-32 years with good oral hygiene participated in this study. None of participants had received any antibiotic or antimicrobial agent or professional fluoride therapy within the last month. None of them exhibited active caries lesions. Smokers and subjects who have chewing gums xylitol habit or who were undergoing orthodontic treatment were excluded. In a cross over design with 2 parallel groups, people in group A for 2 weeks received 100 ml of Kefir drink per day, then avoided brushing, eating and drinking for an hour. Simultaneously, people in group B were administered 0.05% sodium fluoride rinse in the same manner. After washout period, people in groups A and B respectively used 0.05% sodium fluoride rinse and Kefir drink. Saliva sampling was performed before and after interventions. The acidity and the count of MS were assessed and data were analyzed statistically. Result There was no significant difference between base line pH values of saliva in study groups (p > 0.05). Although, a significant difference was shown between MS counts before and after interventions (p . 0.0001 and p . 0.0001 for NaF and Kefir respectively), but the equal inhibitory effect was found between study groups (p > 0.05). Conclusion Kefir drink can inhibit salivary MS as well the sodium fluoride rinse. This beverage may be considered an alternative for fluoride rinse. Clinical significance Probiotics containing dairy products was known with anticariogenic properties. These agents may be used in caries control strategies adjunctively. How to cite this article Ghasempour M, Sefidgar SAA, Moghadamnia AA, Ghadimi R, Gharekhani S, Shirkhani L. Comparative Study of Kefir Yogurt-Drink and Sodium Fluoride Mouth Rinse on Salivary Mutans Streptococci. J Contemp Dent Pract 2014;15(2):214-217.