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Background: We aimed to determine the population attributable risk fraction (PARF) of the risk factors for poor SRH in Iranian children and adolescents., Method: This was a nationwide cross-sectional study conducted in 2015 among 14,400 students aged 6-18 years, living in 30 provinces of Iran. Data were collected using global school health survey questionnaire. Logistic regression was employed to determine the adjusted association of modifiable risk factors with SRH. We used average PARF to determine the preventable proportion of poor reported SRH., Results: Of 14,400 recruited students, data on 13,983 subjects were analyzed in current study. The mean (SD) age of participants (n = 13,983) was 12.3 (3.16) years, and 49.3% were female. Poor SRH was reported in 19% of subjects. In total, 77% of poor reported SRH in Iranian children and adolescents could be attributed to insufficient daily sleep duration, physical injury, lack of close friend, dissatisfaction with family relationship, and the lack of a companion to share personal problems. We also found that physical pain had the largest PARF (32.4%) followed by anxiety (26.1%) and un-satisfaction with family relationship (5.2%)., Conclusion: The established physical and social support factors of poor SRH were associated with a remarkable proportion of poor SRH in the Iranian pediatric population. Changing the children's risk factor profile to the lowest physical risk factor as well as reducing the anxiety level and preventing from physical painsmay significantly improve the SRH of children and adolescents., Competing Interests: Declaration of Competing Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2023. Published by Elsevier Inc.)

Introduction: Air pollution is one of the environmental factors that influences the pathogenesis of systemic autoimmune diseases, followed by the development and spread of inflammation and increased oxidative damage. Only a few studies have been conducted on the impact of air pollution on disease activity in patients with lupus, which mostly have focused on PM 2.5 particles., Materials and Methods: We longitudinally studied 50 patients with lupus bimonthly in a 6-month period in Mashhad, one of the polluted cities of Iran. Disease activity and quality of life were examined considering SLEDAI2K, SLEQOL, and VAS criteria. The outdoor air pollutant was measured by monitoring the average concentration of nitrogen dioxide (NO 2 ), carbon monoxide (CO), some particles less than 10 and 2.5 micrometers in diameter (PM <10, PM <2.5) and the level of temperature and humidity which were taken from the Meteorological Organization of Mashhad. Confounding factors such as medications were investigated by univariate and multivariate statistical analysis, specifically by GEE method., Results: The possible relation among various factors to SLEDAI, SLEQOL and VAS by two different univariate and multivariate analyses were studied. Our analysis indicated that spring season, decreased temperature, increased air pollutants including (PM 2.5 , and NO 2 ) and increased humidity increase SLEDAI2K. Furthermore, the percent of polluted days directly correlates with Anti-dsDNA and NO 2 significantly increases SLEQOL., Conclusion: Based on our findings, air pollution (particularly NO 2 and PM 2.5 ) has affected at least some aspects of the disease and the health-related quality of life (HRQL) of lupus patients. Further research is needed to confirm these findings., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: 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., Aims: 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., Methods: 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., Results: 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., Conclusions: 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., (Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Objective: To develop and psychometrically assess spiritual health scale based on Islamic view in Iran., Methods: The cross-sectional study was conducted at Imam Ali and Quem hospitals in Mashhad and Imam Ali and Imam Reza hospitals in Bojnurd, Iran, from 2015 to 2016 In the first stage, an 81-item Likert-type scale was developed using a qualitative approach. The second stage comprised quantitative component. The scale's impact factor, content validity ratio, content validity index, face validity and exploratory factor analysis were calculated. Test-retest and internal consistency was used to examine the reliability of the instrument. Data analysis was done using SPSS 11., Results: Of 81 items in the scale, those with impact factor above 1.5, content validity ratio above 0.62, and content validity index above 0.79 were considered valid and the rest were discarded, resulting in a 61-item scale. Exploratory factor analysis reduced the list of items to 30, which were divided into seven groups with a minimum eigen value of 1 for each factor. But according to scatter plot, attributes of the concept of spiritual health included love to creator, duty-based life, religious rationality, psychological balance, and attention to afterlife. Internal reliability of the scale was calculated by alpha Cronbach coefficient as 0.91., Conclusions: There was solid evidence of the strength factor structure and reliability of the Islamic Spiritual Health Scale which provides a unique way for spiritual health assessment of Muslims.

Background: The role of nutritional factors including trace elements has been reported in the pathogenesis of many autoimmune diseases., Objective: Regarding the relatively high prevalence of pemphigus vulgaris in Iran, we investigated the serum levels of zinc and copper as two important trace elements, together with the oxidative stress status in patients with pemphigus vulgaris., Materials and Methods: This case-control study was performed on 25 patients with newly diagnosed pemphigus vulgaris and 25 age- and sex-matched healthy control subjects. Serum concentrations of zinc, copper, ceruloplasmin as well as copper/zinc ratio were determined for each subject. Oxidative stress was also measured using a novel assay of peroxidant-antioxidant balance (PAB)., Results: Mean serum concentrations of zinc and copper as well as copper/zinc ratio were significantly lower in patients (mean age: 47.2±16.2 years; male/female: 14/11) compared with the controls (mean age: 47.3±12.8 years; male/female: 14/11; P<0.001). In contrast, PAB values were significantly elevated in patients compared with controls (P<0.01). No significant difference in serum ceruloplasmin concentrations was observed between the groups (P>0.05)., Conclusion: Our findings indicate that low serum zinc and copper and increased oxidative stress may be associated with pemphigus vulgaris., (© 2011 The International Society of Dermatology.)

Aims: Iran is one of the known countries with a high incidence of esophageal cancer in Asia . We have recently shown that the incidence of Barrett's esophagus, a precancerous lesion for esophageal adenocarcinoma (AC) is very low in the northwest of the country. Therefore, we hypothesized that esophageal AC would also be lower than in the Western world. The aim of this study was to assess the clinicopathologic characteristics of esophageal cancer in comparison the data from western populations., Methods: This mixed (prospective-retrospective) study enrolled 350 consecutive patients with esophageal cancers (216 endoscopically and pathologically documented, including 134 surgically proven cases) from May 2000 to May 2006, in our referral center in Tabriz, in the northwest of Iran. We localized the tumors in esophagus and esophago-gastric junction. Type III gastric cardial cancers were excluded., Results: The mean age of the patients was 61+/-12.36 (min 16, max 83). The male to female ratio was almost equal (51.7% vs 48.3%). The lower third of the esophagus was involved in 62% of the patients and esophageal ACs accounted for 18.9% of the cases. However, distinct esophageal adenocarcinomas was only seen in two and in the remainder gastric cardia was also involved. SCC was more frequent in females, and adenocarcinoma in males (x 2=8.89, df=2, p=0.012. Among 134 operated cases, resection was feasible in 74.6%., Conclusion: In this Iranian population, the incidence of esophageal adenocarcinoma is very much lower than in Western countries.

Objective: There is consensus that the majority of colorectal carcinomas (CRCs) arise from adenomatous polyps. Therefore, for management of colorectal cancer, diagnosis and endoscopic resection of adenomas is advised. If the same etiologic factors are operating for polyps and cancers their anatomical distributions should be the same. The present study was conducted to determine whether the distribution of adenomas is consistent with that of CRCs and for comparison with other studies, especially in Western populations., Materials and Methods: We reviewed, retrospectively , endoscopically reported anatomic sites of all adenomatous polyps and CRCs which were histologically confirmed from Jan 1992 to Dec 2005 in Tabriz, the North-west of Iran. One hundred and forty-three CRC's and 180 adenomatous polyps (in 145 patients) were found. Patients with polyposis syndromes were excluded the analysis. Age and sex of patients, size and anatomic sites of polyps and cancers were studied., Results: The average ages of patients with adenomas and cancers were 46.3(SD 14.7) and 53.9(SD 13.3)years, with 55.5% and 62.2% in males, respectively. In both cancer and adenoma cases the most common presenting symptoms were rectal bleeding and bloody diarrhea ( 52.4% , 16.9% and 39.2% , 15.8% for cancers and adenomas, respectively) without any significant difference(0>05). The vast majority of adenomas (85%) and cancers (81.7%) were left sided (p>0.05). The propensity for polyps to be found in the descending colon was of borderline significance (p=0.07). The cecal segment uniquely demonstrated cancers(p=0.01) without any polyps., Conclusion: A similar anatomic distribution pattern and left shift of colorectal adenomas and cancers in this Iranian population is compatible with most other Asian countries. However, because of the occurrence of the neoplasms in the right colon total colonoscopy should still be considered for screening purposes.

Background: Heartburn is a common manifestation of gastroesophageal reflux disease. Barrett's esophagus and esophageal adenocarcinoma, known complications of this disease, appear to be less prevalent in Asia than in Western countries. We looked for endoscopic and histologic evidence of Barrett's esophagus in Iranian patients with heartburn., Methods: During September 2001 to September 2003, endoscopy was done in all patients with heartburn, either lasting longer than 3 months (n=1182) or for 1-3 months but resistant to 4 weeks of omeprazole therapy (n=66). Biopsy was taken from columnar-lined mucosa above the GE junction, at 5 cm above the Z line in normal- appearing mucosa, and from any abnormal areas., Results: Of the 1248 patients (mean age 45 [SD 15.5] years, 750 men; duration of heartburn 68 [SD 87.5] months), 960 (66.5%) had erosive esophagitis and 30 (2.4%) had Barrett's esophagus, including 10 and 20 with long- and short-segment involvement, respectively. Of 134 patients with normal-appearing mucosa, 122 had histologic evidence of esophagitis., Conclusion: Barrett's esophagus may be less common in Iran than in Western countries, despite presence of severe heartburn and erosive esophagitis.

Objective: Asian countries generally have low incidences of colorectal cancers (CRCs). One approach to prevention is based on recognition and removal of polyps. The aim of this study was to determine basic demographic features, anatomic distribution and characteristics of colorectal polyps in a local Asian population for comparison with western data., Methods: We here performed a retrospective chart review of 194 patients with colorectal polyps detected by endoscopy [total colonoscopy in 136 cases (73.1%), and flexible sigmoidoscopy in the remainder] during 1992-2005, focusing on descriptive statistics for categorical variables, including distribution pattern and histology. Cold biopsy in 14 cases, piecemeal endoscopic resection in 5 patients, and usual snare polypectomy in the remainder were performed. Patients with polyposis syndromes were excluded from the analysis., Results: The average age of patients was 43.2 yr (range 2-80) with 71% being males. Most of the polyps were presented in 5th decade (p=0.029). A total of 32 (17.2%) had synchronous proximal polyps (15% adenomas), and 154 cases had solitary polyps. The vast majority of the polyps were left sided and the most frequent type was adenoma (63%), with a villous component in 37.1%. Coexistent cancer was seen in 10.9% of cases., Conclusion: In this Iranian population, the majority of polyps are left sided. The incidence of adenomas and their histology appear comparable to data for western patients, but with a significantly lower rate for synchronous neoplastic lesions.