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Abstract Background Hypertension (HTN) is well-known as a major risk factor for various noncommunicable diseases. Evidence indicates a link between socioeconomic status and the likelihood of developing HTN. A thorough comprehension of the inequalities in HTN is crucial for implementing evidence-based interventions. This study aimed to assess the socioeconomic disparities in HTN among people aged 60 and older in Fasa County, located in southern Iran. Methods A total of 1,632 seniors, aged 60 and above, were included in the analysis, with data obtained from the Fasa Adults Cohort Study (FACS). Initially, we utilized both simple and multiple logistic regression models to investigate the associations between HTN and the determinant variables. The Blinder‒Oaxaca decomposition method was used to decompose the disparity between the impoverished and the wealthy. Results The research indicated that elderly individuals with a higher risk of developing HTN were notably linked to factors such as socioeconomic status, education level, a history of coronary artery disease, employment status, smoking habits, body mass index (BMI), waist‒hip ratio (WHR), and physical activity (p

Abstract The first step to reducing the growing burden of cardiovascular disease (CVD) is to find modifiable risk factors with the highest burden in each population. Urban and rural citizens may have different priorities in this regard. This study aimed to compare the 10-year incidence probability of CVD events and its associated risk factors between rural and urban areas in Iran. Data was extracted from two big cohorts, Fasa Adults Cohort Study (FACS) and Shiraz Heart Study (SHS), with participation of over 12,000 general population. Linear regression models were used to test the difference in CVD risk between two populations. Totally, 6,258 FACS and 6,101 SHS participants entered the study. Urban participants had a significantly higher mean ASCVD score (4.43% vs. 5.51%, p-value

Background: In order to design better management for anti-diabetic medication, pharmacoepidemiological studies are required to have an update on the drug utilization. Therefore, the present study was performed with the aim of pharmacoepidemiological analysis on utilization of antidiabetic drugs based on PERSIAN cohort data.Methods: In this study, 10138 participants were included by baseline data. Use of anti-diabetic medications based on Anatomical Therapeutic Chemical (ATC) code A10 was provided. Quantitative and qualitative variables were illustrated using mean±standard deviation (SD) and frequency (percent). Logistic regression was employed to define associated factors with categorical outcomes.Results: The descriptive analysis showed that 12.3% (n=1249) of the participants had diabetes, while only 5.3% (n=540) of them had utilized anti-diabetic medications. Totally, 94.7% of the participants did not take any anti-diabetic drug, 3% received monotherapy and 2% reported a combination of anti-diabetic medication therapies. Also, the higher ages showed a more chance for use of anti-diabetic medications (40-59 years: OR=3.72, 95% CI: 2.38-5.81; ≥60, OR=5.61, 95% CI: 3.41-9.22).In addition, married and employed participants were more likely to take anti-diabetic medications. Also, having cardiovascular diseases (CVDs), fatty liver and pregnancy were associated with a higher significant chance of using anti-diabetic medications.Conclusion: Less than half of the patients diagnosed with diabetes received anti-diabetic drugs indicating the importance of medication adherence training programs in this group of patients.

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease in human history and it is expected to surpass other causes of liver disease mortality by 2030. Therefore, finding an alternative way to diagnose steatosis in the early stage when imaging modalities are not available is crucial. This study decided to validate the optimal cut-off points and the sensitivity and specificity of the Fatty Liver Index (FLI) based on the Iranian population compared to ultrasonography. Methods The data of 367 individuals, 108 males and 259 females over 35, were analyzed. Hepatic steatosis was identified by ultrasound. FLI was determined from waist circumference, gamma-glutamyl transferase, triglyceride, and body mass index data. The receiver operating characteristic curve (ROC) was used to determine the best FLI index cut point for diagnosing nonalcoholic fatty liver. The sensitivity and specificity indices were calculated for the determined cut point. Results The AUC of the FLI index in diagnosing NAFLD in the total population was 0.733 (95% CI: 0.68–0.77, specificity = 0.6705, sensitivity = 0.7320) with the optimal COP of 40.6. There was a statistically significant association between non-alcoholic liver disease and FLI-based ultrasound (p

Abstract Background Chronic kidney disease (CKD) is associated with increased cardiovascular disease (CVD) risk factors and morbidity in the elderly population. This study aimed to examine the association between CKD and CVD risk factors in the elderly population of Fasa and Yazd (Shahdieh), Iran, using the data from the enrolment phase of Fasa and Shahedieh cohort studies. Methods We conducted a cross-sectional analytical study using data from Fasa and Shahedieh cohort studies, which enrolled 1487 and 1507 participants aged over 60 years, respectively. We collected data on demographic and clinical variables, kidney problems, and CVD from the two studies. We estimated the glomerular filtration rate (eGFR) using the modification of diet in renal disease (MDRD) formula and considered values less than 60 ml/min/1.73 m2 as CKD. We used independent t-tests, Spearman’s correlation coefficient, chi-square, one-way analysis of variance, and logistic regression to analyze the data. We performed the analyses using SPSS V. 22.0 software and set the significance level at 0.05. Results The overall prevalence of CKD was 41.9%; 25.7% in women and 16.2% in men. The prevalence of CKD based on reported kidney problems was 1.7%, of which 54.7% were in stage 3 of CKD. Compared to participants in the early stages of CKD, participants in advanced stages had a higher prevalence of diabetes (p

Abstract Background Globorisk is one of the prediction tools for 10-year risk assessment of cardiovascular disease, featuring an office-based (non-laboratory-based) version. This version does not require laboratory tests for determining the CVD risk. The present study aims to determine the 10-year CVD risk using the office-based Globorisk model and factors associated with the 10-year CVD risk. Methods In this study, baseline data from 6810 individuals participating in the Fasa cohort study, with no history of CVD or stroke, were utilized. The risk equation of the office-based Globorisk model incorporates age, sex, systolic blood pressure (SBP), body mass index (BMI), and smoking status. The Globorisk model categorizes the risk into three groups: low risk (

Background: Heart failure represents the most severe and prevalent form of chronic cardiac disease, significantly impacting patients’ quality of life. Scientific evidence has established palliative care as a crucial component in the treatment of heart failure patients. However, limited research has examined how spirituality-based palliative care education affects these patients’ quality of life, death anxiety, and resilience. Objectives: This study investigated the effects of spirituality-based palliative care education on quality of life, death anxiety, and resilience among heart failure patients in southern Iran. Methods: This investigation employed a randomized controlled clinical trial design without blinding, incorporating both experimental and control groups. 80 patients who were randomly assigned to intervention and control groups (40 patients per group). Participants were recruited from patients receiving treatment at a teaching hospital in southern Iran between June and October 2022. Participants in the intervention group received spirituality-based palliative care education through six one-hour sessions. Data were collected using three validated instruments; the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Templer Death Anxiety Scale, and the Connor-Davidson Resilience Scale. Both groups completed these assessments at baseline, immediately post-intervention, and at a three-month follow-up. Data analysis was performed using SPSS version 20, employing descriptive statistics, Chi-square tests, Indipendent sample t test, and Repeated measures ANOVA. Statistical significance was set at P

Abstract Background The worldwide prevalence of type 2 diabetes mellitus in adults is experiencing a rapid increase. This study aimed to identify the factors affecting the survival of prediabetic patients using a comparison of the Cox proportional hazards model (CPH) and the Random survival forest (RSF). Method This prospective cohort study was performed on 746 prediabetics in southwest Iran. The demographic, lifestyle, and clinical data of the participants were recorded. The CPH and RSF models were used to determine the patients’ survival. Furthermore, the concordance index (C-index) and time-dependent receiver operating characteristic (ROC) curve were employed to compare the performance of the Cox proportional hazards (CPH) model and the random survival forest (RSF) model. Results The 5-year cumulative T2DM incidence was 12.73%. Based on the results of the CPH model, NAFLD (HR = 1.74, 95% CI: 1.06, 2.85), FBS (HR = 1.008, 95% CI: 1.005, 1.012) and increased abdominal fat (HR = 1.02, 95% CI: 1.01, 1.04) were directly associated with diabetes occurrence in prediabetic patients. The RSF model suggests that factors including FBS, waist circumference, depression, NAFLD, afternoon sleep, and female gender are the most important variables that predict diabetes. The C-index indicated that the RSF model has a higher percentage of agreement than the CPH model, and in the weighted Brier Score index, the RSF model had less error than the Kaplan-Meier and CPH model. Conclusion Our findings show that the incidence of diabetes was alarmingly high in Iran. The results suggested that several demographic and clinical factors are associated with diabetes occurrence in prediabetic patients. The high-risk population needs special measures for screening and care programs.

Abstract Background Type 2 diabetes being a chronic condition that requires long-term care. This study examined the impact of an educational program using King’s goal attainment model on health behaviors and life satisfaction in type 2 diabetes patients. Methods This is a randomized controlled clinical trial with no blinding in which we tested two groups of intervention control. 70 patients with type 2 diabetes were allocated to an intervention (N = 35) and a control group randomly (N = 35). The nursing process stages included examination, diagnosis, goal determination, transaction based on patient preferences, and evaluation based on King’s theory. Data was gathered using the Walker Health-Promoting Lifestyle Profile (HPLP) and Satisfaction with Life Scale (SWLS, before, after, and 3 months, post-intervention. Data were analyzed in SPSS25 through descriptive statistics, Chi-square Test, Independent and paired sample T-test, two-way ANOVA, and multivariate repeated measures ANCOVA. P-values

Abstract Background Imbalanced datasets pose significant challenges in predictive modeling, leading to biased outcomes and reduced model reliability. This study addresses data imbalance in diabetes prediction using machine learning techniques. Utilizing data from the Fasa Adult Cohort Study (FACS) with a 5-year follow-up of 10,000 participants, we developed predictive models for Type 2 diabetes. Methods We employed various data-level and algorithm-level interventions, including SMOTE, ADASYN, SMOTEENN, Random Over Sampling and KMeansSMOTE, paired with Random Forest, Gradient Boosting, Decision Tree and Multi-Layer Perceptron (MLP) classifier. We evaluated model performance using F1 score, AUC, and G-means—metrics chosen to provide a comprehensive assessment of model accuracy, discrimination ability, and overall balance in performance, particularly in the context of imbalanced datasets. Results our study uncovered key factors influencing diabetes risk and evaluated the performance of various machine learning models. Feature importance analysis revealed that the most influential predictors of diabetes differ between males and females. For females, the most important factors are triglyceride (TG), basal metabolic rate (BMR), and total cholesterol (CHOL), whereas for males, the key predictors are body Mass Index (BMI), serum glutamate Oxaloacetate Transaminase (SGOT), and Gamma-Glutamyl (GGT). Across the entire dataset, BMI remains the most important variable, followed by SGOT, BMR, and energy intake. These insights suggest that gender-specific risk profiles should be considered in diabetes prevention and management strategies. In terms of model performance, our results show that ADASYN with MLP classifier achieved an F1 score of 82.17 ± 3.38, AUC of 89.61 ± 2.09, and G-means of 89.15 ± 2.31. SMOTE with MLP followed closely with an F1 score of 79.85 ± 3.91, AUC of 89.7 ± 2.54, and G-means of 89.31 ± 2.78. The SMOTEENN with Random Forest combination achieved an F1 score of 78.27 ± 1.54, AUC of 87.18 ± 1.12, and G-means of 86.47 ± 1.28. Conclusion These combinations effectively address class imbalance, improving the accuracy and reliability of diabetes predictions. The findings highlight the importance of using appropriate data-balancing techniques in medical data analysis.

Abstract Background Regarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness. Methods This randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23. Results A statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P

Abstract Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6–14.3), female gender (OR, 95% CI: 1.8, 1.2–2.5), Fars (AOR, 95% CI: 1.6, 1.1–2.4) and Turk (AOR, 95% CI: 1.6, 1.1–2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38–2.38) and obesity (AOR, 95% CI: 2.7, 2.0–3.8) vs. BMI

Abstract Background Metabolic syndrome (MetS) is a cluster of risk factors and the Framingham risk score (FRS) is a useful metric for measuring the 10-year cardiovascular disease (CVD) risk of the population. The present study aimed to determine the 10-year risk of cardiovascular disease using the Framingham risk score in people with and without MetS in a large Iranian cohort study. Methods This cross-sectional study was done using the Fasa cohort. Participants aged ≥ 35 years old were recruited to the study from 2015 to 2016. The FRS was calculated using age, sex, current smoking, diabetes, systolic blood pressure (SBP), total cholesterol, and high-density lipoprotein (HDL) cholesterol. MetS was defined as the presence of three or more of the MetS risk factors including triglyceride (TG) level ≥ 150 mg dl− 1, HDL level

Background: This study aimed to determine the relationships between opium use and metabolic syndrome in Fasa PERSIAN cohort data. Methods: This was an analytical cross-sectional study conducted among participants of the first phase of the Fasa PERSIAN cohort study. A total of 10,074 participants (aged 35–70 years) were studied. The MetS was defined as per the National Cholesterol Education Program ATP III (NCEP-ATP III) criteria. Independent sample t-test and Chi-square test were used for univariate analysis, and multivariate logistic regression was used to control for potential confounders and calculate odds ratios (ORs). Results: The MetS prevalence was 24.6% in the whole population (28.42% in women vs. 19.94% in men, P < 0.001). The prevalence of opium use was 23.2%. The odds of metabolic syndrome in smokers was lower than in non-smokers (OR = 1.17%, 95% CI 1.001–1.37). Conclusions: The results of this study showed that opium consumption has an inverse relationship with metabolic syndrome. However, this study was cross-sectional, and longitudinal studies are needed for more accurate conclusions. Opium is also a carcinogen. Therefore, its use is not recommended.

BackgroundMetabolic syndrome (MetS) is a collection of medical conditions that elevate the chance of cardiovascular disease. An unhealthy diet is a major risk factors for MetS through different mechanisms, especially systemic chronic inflammation.ObjectiveThis study aimed to investigate the effect of dietary inflammatory potential on MetS incidence and the role of MetS in the association between Energy-adjusted dietary inflammatory index (E-DII) and cardiometabolic diseases.MethodsIn this prospective cohort study, 10,138 participants were recruited. All participants were divided into MetS or non-MetS groups based on the Adult Treatment Panel III criteria. The E-DII was used to assess the inflammatory potential of diet. After excluding the participants with MetS at baseline, 2252 individuals were followed for 5 years (longitudinal phase), and the effect of E-DII on MetS incidence was investigated using logistic regression models (p-value

BackgroundAndrogenic alopecia (AGA), the most prevalent hair loss type, causes major psychological distress and reduced quality of life. A definite and safe cure/prevention for this condition is still lacking. The role of oxidative stress and inflammation in AGA pathogenesis prompted us to investigate the association between dietary antioxidant index (DAI) and energy-adjusted dietary inflammatory index (E-DII) with AGA.MethodsThe investigation was designed based on data from 10,138 participants from the Fasa Adult Cohort Study (FACS). DAI and energy-adjusted DII (E-DII) were calculated utilizing a validated 125-item food frequency questionnaire (FFQ). A physician diagnosed AGA. Logistic regression models were utilized to evaluate the association of DAI and E-DII with AGA.ResultsAfter exclusion, 9,647 participants (44.0% men, mean age: 48.6 ± 9.5 years) consisting of 7,348 participants with AGA entered the analyses. Higher DAI was associated with 10% lower AGA odds, while higher E-DII showed 4% higher AGA odds after adjusting for various confounding variables. However, significant associations were found only among women, and adjusting for metabolic syndrome (MetS) made the E-DII-AGA association insignificant.ConclusionAntioxidant-rich diets protect against AGA, while pro-inflammatory diets increase the risk, likely through developing MetS. Patient nutrition is frequently overlooked in clinical practice, yet it plays a crucial role, especially for women genetically predisposed to androgenetic alopecia. Dietary changes, such as reducing pro-inflammatory foods (like trans and saturated fats) and increasing anti-inflammatory options (fruits and vegetables), can help prevent hair loss and mitigate its psychological impacts, ultimately lowering future treatment costs.

Introduction: Complementary and alternative medicine (CAM) has gained popularity as a therapeutic approach outside conventional medicine for various medical conditions. This study aimed to assess the prevalence, patterns, and disclosure of CAM use among patients with thyroid diseases in Iran. Methods: This descriptive-analytic cross-sectional study involved patients with thyroid diseases who were visiting Internal Medicine Clinics in Shiraz. The use of CAM was assessed by employing the Persian edition of the I-CAM-Q (I-CAM-IR) questionnaire. Results: A total of 343 individuals took part in the study, and 85.4 % of them reported using CAM within the previous 12 months. Medicinal herbs were the most commonly used CAM modality (63 %). CAM use was primarily for enhancing overall well-being. Among self-care CAM practices, praying was the most frequently employed (70 %). Women exhibited a significantly higher CAM utilization rate (four times greater) compared to men (p

Abstract Background Acute myocardial infarction is still a leading cause of death worldwide, accounting for roughly three million deaths yearly. This study aimed to investigate the prevalence and factors associated with ST-Segment Elevation Myocardial Infarction and Non-ST Segment Elevation Myocardial Infarction in Iran. Methods This cross-sectional study was conducted using the databases of the Fasa Registry on Acute Myocardial Infarction (FaRMI) and the Fasa Adult Cohort Study (FACS). chi-squared and one-way ANOVA tests were utilized to calculate the unadjusted associations between the study variables. A multivariate multinomial logistic regression model was also employed to determine the adjusted association of each independent variable with the risk of ST-elevation myocardial infarction (STEMI). Results The prevalence of STEMI and non-STEMI was 31.60% and 11.80%, respectively. Multinomial logistic regression showed that older age, anemia, high WBC, and high creatinine levels were associated with higher odds of STEMI and non-STEMI compared to healthy individuals. In addition, based on the analysis being a woman(OR = 0.63,95%CI:0.51–0.78), anemia(OR = 0.67,95%CI:0.54–0.63)and hypertension (OR = 0.80,95%CI:0.65–0.97)decreased the likelihood of STEMI occurrence compared to non-STEMI, while high WBC(OR = 1.19,95%CI:1.15–1.23)increased the odds. Conclusion In this study, significant predictors of MI risk included age, gender, anemia, lipid profile, inflammation, and renal function. Subsequent investigations ought to prioritize the comprehensive understanding of the underlying mechanisms that drive these connections and assess the effectiveness of specific interventions aimed at diminishing the occurrence of MI and improving patient outcomes.

Abstract Background One of the modifiable risk factors for cardiovascular diseases is the inter-arm blood pressure difference (IAD), which can be easily measured. This study aimed to determine the prevalence and factors related to the Iranian population’s inter-arm differences in systolic and diastolic blood pressure. Method This cross-sectional study was conducted on the baseline data of participants who had Iranian nationality, were at least 1 year of residence in the area, aged within the age range of 35–70 years, and willed to participate from the Fasa Persian Adult Cohort Study (FACS). IAD for systolic and diastolic blood pressure was measured and categorized into two groups of difference

Abstract Background Medication safety competence is very important as one of the clinical skills among nursing students to provide safe nursing care. The lack of medication safety competence in nursing students leads to occurrence of medication errors subsequently jeopardizing patient safety. Thus, the present study was conducted to investigate safe nursing care and medication safety competence among nursing students in the south of Iran. Methods A descriptive cross-sectional multicenter study was conducted from September to December 2022. The research population included nursing students of three universities of medical sciences in Fars Province, Southern Iran. A total of 310 nursing students who were selected through convenience sampling participated in the study. The data collection instruments consisted of a demographics survey, Medication Safety Competence Scale (MSCS), and a Safe Nursing Care Scale (SNCS). The collected data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and inferential statistics (Independent t-test, Analysis of variance and Pearson correlation coefficient). The data were analyzed in SPSS 23 and the level of significance was considered 0.05. Results The mean age of the participants was 22.53 ± 1.69 years. The total mean scores for medication safety competence and safe nursing care were found to be 111.97 ± 11.85 and 105.12 ± 11.64, respectively. There was a statistically significant positive correlation between safe nursing care and medication safety competence (r = 0.084, P

Background: Osteoporosis, as the most common bone-related disease, causes massive irrecoverable consequences for the health level and life quality of people, especially at advanced ages. The present research aimed to evaluate the prevalence and risk factors of osteoporosis and the correlation between drug consumption and osteoporosis. The present study is a cross-sectional study and is the first stage in the longitudinal Fasa branch of the PERSIAN cohort study. Materials and Methods: The subjects of the present cross-sectional-descriptive study consisted of all cohort populations of Fasa University of Medical Sciences (n=10123) who were chosen through census sampling. The data were collected through a demographic data form and medication checklist, and SPSS-22 was used to analyze the data. Results: Among a total population of 10133, 994 had osteoporosis, of which 880 were women and 114 were men, which was statistically significant (P

Abstract Objective Brucellosis is a highly contagious disease which is transmitted from animals to humans. One of the populations at high risk of infection is those living in rural areas. The present study was conducted to investigate rural populations’ knowledge, attitude, and practice about brucellosis in Iran. The study used a descriptive, cross-sectional design to assess 300 individuals who were living in rural areas. The subjects were selected using convenience sampling from six villages located in the south of Iran. The data gathered were analyzed using Analysis of variance (ANOVA), and Pearson correlation coefficient in SPSS version 23. Results From the 300 individuals who were enrolled in this study, 189 were male and 111 were female. The mean age of the participants was 48.27 ± 4.28 years. The mean scores of the study population’s knowledge, attitude, and practice about brucellosis were found to be low. A significant direct correlation was found between the subjects’ knowledge, attitude, and practice regarding brucellosis.

Abstract Background With increasing life expectancy and a growing population of older adults, the prevalence of osteoporosis has risen, resulting in a higher incidence of bone fractures, which necessitate extended treatment and specialized medical care. This study investigates the relationship between smoking, alcohol consumption, drug abuse, and osteoporosis among older adults in southern Iran, utilizing cohort data. Methods This cross–sectional study is derived from the Fasa Adult Cohort Study (FACS), which included 10,133 individuals. From this cohort, we selected 1,631 older adults using census sampling methods. Our study aimed to explore the correlation between smoking, alcohol consumption, and drug abuse among older adults and the incidence of osteoporosis. We collected demographic information, nutritional indexes, medical history, glucocorticoid usage, and self-reported data on smoking, alcohol consumption, drug abuse, and osteoporosis through questionnaires. To investigate the relationship between smoking, alcohol, and drug use with osteoporosis while accounting for confounding factors, we employed logistic regression analysis. Results The average age of the study participants was 64.09 ± 3.8 years, with a majority (898 (55.1%)) being female. Osteoporosis prevalence among the subjects was 25.20%. The results did not reveal a significant correlation between smoking, alcohol consumption, drug abuse, and osteoporosis (p > 0.05). Regression analysis identified gender, recent history of fractures within the past five years, history of using glucocorticoids, and physical activity as significant predictive risk factors for osteoporosis within the study population (p

Background & Objectives: Dyslipidemia is a major public health issue worldwide characterized by changes in lipid index such as cholesterol, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and triglycerides (TG).This manuscript aimed to investigate the associated factors of dyslipidemia in Fasa Persian cohort study. Materials & Methods: This cross-sectional study was conducted on the baseline data of Fasa Persian cohort with an initial sample size of 10129 subjects (35-70 years old) in 2021 in Iran. Univariate and multivariate logistic regression models were used to assess the relationship between covariates and dyslipidemia. Results: The number of males in this study was 4572 and the number of females was 5557. The prevalence of dyslipidemia in them was 40.8% and 27.7%, respectively (p-value < 0.001), and the prevalence of dyslipidemia in the whole study population was 3407 (33.6%). Dyslipidemia was also more common in alcoholics, opium users, smokers, high glycemic index and higher body mass index (BMI). Men were 1.68 times more likely to have dyslipidemia than women. Opium and cigarette smokers were 1.15 and 1.36 times more likely to have dyslipidemia than non-smokers, respectively. Also, as BMI increases, the likelihood of dyslipidemia becomes higher than the reference group (below 18.5), and people with a BMI greater than 30 have the highest obesity range. Conclusions: This study showed that the prevalence of dyslipidemia in the studied population was higher in men than in women and several risk factors such as gender differences, body mass index, smoking and opium use are effective in the prevalence of dyslipidemia.

Abstract Background Addiction increases the risk of different lifelong disorders. However, there are limited studies evaluating the effects of opioid use disorder (OUD) on thyroid function. The present study aimed to compare the thyroid function of individuals with and without OUD. Methods This cross-sectional study was conducted on 700 eligible participants of the Persian Cohort of Fasa, Iran. Pregnant women and participants with false or missing data were excluded from the study. Remained participants were divided into case and control groups based on the recorded history of OUD. Frozen plasma samples of the cohort bank were used to determine the levels of T3, T4, and thyroid-stimulating hormone (TSH). The thyroid function was compared between the two groups using the Mann-Whitney test (P

Abstract Background Two versions of Framingham’s 10-year risk score are defined for cardiovascular diseases, namely laboratory-based and office-based models. The former is mainly employed in high-income countries, but unfortunately, it is not cost-effective or practical to utilize it in countries with poor facilities. Therefore, the present study aims to identify the agreement and correlation between laboratory-based and office-based Framingham models. Methods Using laboratory-based and office-based Framingham models, this cross-sectional study used data from 8944 participants without a history of CVDs and stroke at baseline in the Fasa cohort study to predict the 10-year risk of CVDs. The laboratory-based model included age, sex, diabetes, smoking status, systolic blood pressure (SBP), treatment of hypertension, total cholesterol, and high-density lipoprotein (HDL); and the office-based model included age, sex, diabetes, smoking status, SBP, treatment of hypertension, and body mass index (BMI). The agreement between risk categories of laboratory-based and office-based Framingham models (low [

Background: Framingham risk score (FRS) and Atherosclerotic Cardiovascular Disease risk score (ASCVDrs) are widely used tools developed based on the American population. This study aimed to compare the ASCVDrs and FRS in an Iranian population. Method: The participants of the Fasa Adult Cohort Study and the patients of the cardiovascular database of Vali-Asr Hospital of Fasa, aged 40–80 years, were involved in the present cross-sectional study. After excluding non-eligible participants, the individuals with a history of myocardial infarction or admission to the cardiology ward due to heart failure were considered high-risk, and the others were considered low-risk. The discriminative ability of FRS and ASCVDrs was evaluated and compared using receiver operating characteristic curve analysis. The correlation and agreement of ASCVDrs and FRS were tested using Cohen Kappa and Spearman. Results: Finally, 8983 individuals (mean age:53.9 ± 9.5 y, 49.2 % male), including 1827 high-risk participants, entered the study. ASCVDrs detected a greater portion of participants as high-risk in comparison with FRS (28.7 % vs. 15.7 %). ASVD (AUC:0.794) had a higher discriminative ability than FRS (AUC:0.746), and both showed better discrimination in women. Optimal cut-off points for both ASCVDrs (4.36 %) and FRS (9.05 %) were lower than the original ones and in men. Compared to FRS, ASCVDrs had a higher sensitivity (79.3 % vs. 71.6 %) and lower specificity (64.5 % vs. 65.1 %). FRS and ASCVDrs had a moderate agreement (kappa:0.593,p-value

Abstract The Globorisk and WHO cardiovascular risk prediction models are country-specific and region-specific, respectively. The goal of this study was to assess the agreement and correlation between the WHO and Globorisk 10-year cardiovascular disease risk prediction models. The baseline data of 6796 individuals aged 40–74 years who participated in the Fasa cohort study without a history of cardiovascular disease or stroke at baseline were included. In the WHO and Globorisk models scores were calculated using age, sex, systolic blood pressure (SBP), current smoking, diabetes, and total cholesterol for laboratory-based risk and age, sex, SBP, current smoking, and body mass index (BMI) for non-laboratory-based risk (office-based or BMI-based). In Globorisk and WHO risk agreement across risk categories (low, moderate, and high) was examined using the kappa statistic. Also, Pearson correlation coefficients and scatter plots were used to assess the correlation between Globorisk and WHO models. Bland–Altman plots were presented for determination agreement between Globorisk and WHO risk scores in individual’s level. In laboratory-based models, agreement across categories was substantial in the overall population (kappa values: 0.75) and also for females (kappa values: 0.74) and males (kappa values: 0.76), when evaluated separately. In non-laboratory-based models, agreement across categories was substantial for the whole population (kappa values: 0.78), and almost perfect for among males (kappa values: 0.82) and substantial for females (kappa values: 0.73). The results showed a very strong positive correlation (r ≥ 0.95) between WHO and Globorisk laboratory-based scores for the whole population, males, and females and also a very strong positive correlation (r > 0.95) between WHO and Globorisk non-laboratory-based scores for the whole population, males, and females. In the laboratory-based models, the limit of agreements was better in males (95%CI 2.1 to − 4.2%) than females (95%CI 4.3 to − 7.3%). Also, in the non-laboratory-based models, the limit of agreements was better in males (95%CI 2.9 to − 4.0%) than females (95%CI 3.2 to − 6.1%). There was a good agreement between both the laboratory-based and the non-laboratory-based WHO models and the Globorisk models. The correlation between two models was very strongly positive. However, in the Globorisk models, more people were in high-risk group than in the WHO models. The scatter plots and Bland–Altman plots showed systematic differences between the two scores that vary according to the level of risk. So, for these models may be necessary to modify the cut points of risk groups. The validity of these models must be determined for this population.

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disease predisposing patients to life-threatening conditions, including cirrhosis. There is evidence that the incidence of NAFLD is related to the individuals’ dietary patterns; however, it is still remaining unknown whether the inflammatory potential of various foods/dietary patterns can directly predict a higher incidence of NAFLD. Methods In this cross-sectional cohort study, we investigated the relationship between the inflammatory potential of various food items and the incidence/odds of NAFLD. We used data from Fasa PERSIAN Cohort Study comprising 10,035 individuals. To measure the inflammatory potential of diet, we used the dietary inflammatory index (DII®). Fatty liver index (FLI) was also calculated for each individual to identify the presence of NAFLD (cut-off = 60). Results Our findings showed that higher DII is significantly associated with increased incidence/odds of NAFLD (OR = 1.254, 95% CI: 1.178—1.334). Additionally, we found out that higher age, female gender, diabetes mellitus, hypertriglyceridemia, hypercholesterolemia, and hypertension are other predictors of developing NAFLD. Conclusions It can be concluded that consuming foods with a higher inflammatory potential is associated with a greater risk of developing NAFLD. Additionally, metabolic diseases, including dyslipidemia, diabetes mellitus, and hypertension, can also predict the incidence of NAFLD.

Abstract Background Oral mucositis (OM), an acute inflammation of the oral cavity, is a common complication in patients undergoing invasive myeloblastic chemotherapy or radiation therapy. 5-fluorouracil (5-FU) is one of the most effective therapeutic drugs, but one of the common side effects of 5-FU administration is OM. Unfortunately, no suitable treatment has been found, so far to control its side effects. Studies showed that herbal medicine like Punica granatum var pleniflora (PGP) has medicinal properties such as anti-inflammatory and antibacterial and can be an alternative for the treatment of fungal infection. Accordingly, we decided to investigate the therapeutic effect of PGP in the treatment of OM caused by 5-FU in golden hamsters. Methods Sixty male golden hamsters were divided into six main group. Chemotherapy with 5-FU at dose of 60 mg/kg was performed at a ten-day duration. Then, cheek pouches of the hamsters were scratched with an 18-gauge sterile needle to induce oral mucositis in animals. On the twelfth day, as a day of intensification of OM, treatment with PGP including topical gel with concentrations of 5% and 10% and oral administration of hydro-alcoholic extract with doses of 125 mg/kg and 250 mg/kg for three- and five-day therapeutic duration were separately started. Finally, samples of cheek pouches in hamsters were collected on 14th and 17th days and histopathologic score (HPS), malondialdehyde (MDA), and myeloperoxidase (MPO) levels were assayed. Results A significant (p

Burn injuries are considered an important public health problem in the world. Burns are considered the fourth most common kind of trauma in the world, after traffic accidents, falls, and interpersonal violence. Various biochemical agents are involved in the burn healing process such as cytokines (such as IL-6 and TNF-α), antioxidants, and liver and kidney damage biomarkers. Cichorium intybus L. and milk thistle extracts showed a wide range of pharmacological activities such as significant antimicrobial effect and antioxidant activity, as well as anti-inflammatory, antidiabetic, antiproliferative, antiprotozoal, and hepatoprotective effect. Also, these two herbs possess blood-cleansing, detoxifying, laxative, and invigorating activities. Some research confirmed that the preparations of the extract are very suitable for the treatment of nonalcoholic fatty liver disease. This is a double-blind randomized controlled clinical trial. Patients with 2nd and 3rd degree burns have been selected to participate in the study according to the inclusion criteria. A total of 60 patients were selected and divided into intervention and control groups (30 patients in each group). Patients in the intervention group received chicory seed syrup 10 cc three times a day and 1 placebo capsule, and those in the control group received placebo syrup (10 cc three times a day) and one Livergol (140 mg of silymarin in each capsule) capsule. Lab data such as liver function tests, albumin, creatinine, BUN, and hemoglobin were checked every 3 days and 1 week after discharge. The treatment lasted for 4 weeks. According to the results of the study, although the average of liver enzymes at the end of the study does not show a significant difference between the two groups, the level of liver enzymes in each group decreased on the 15th day of the study compared to the first day. This trial is registered with IRCT20180609040016N1.

Background: The musculoskeletal complaints of the shoulder are prevalent in people who work with computers for a long time. Objective: This study aimed to investigate the glenohumeral joint contact forces and kinematics in different keyboards and monitor setups using OpenSim. Material and Methods: Twelve randomly selected healthy males participated in an experimental study. A 3×3 factorial design was used in which three angles were considered for the monitor and three horizontal distances for the keyboard while performing standard tasks. The workstation was adjusted based on ANSI/HFES-100-2007 standard to maintain a comfortable ergonomic posture for controlling confounding variables. Qualisys motion capture system and OpenSim were used. Results: The maximum mean range of motion (ROM) of both shoulders’ flexion and adduction was observed when the keyboard was 15 cm from the edge of the desk, and the monitor angle was 30°. The maximum mean ROM of both shoulders’ internal rotation was recorded for the keyboard at the edge of the desk. Peak forces for most right shoulder complex muscles were obtained in two setups. 3D shoulder joint moments were significantly different among nine setups (P-value

Abstract The inter-arm blood pressure difference has been advocated to be associated with cardiovascular mortality and morbidity. Our study aimed to investigate the association between Inter-arm systolic and diastolic blood pressure differences and Cardio Vascular Disease (CVD). A total of 10,126 participants aged 35–70 years old were enrolled in a prospective Fasa Persian Adult Cohort. In this cross-sectional study, the cutoff values for inter-arm blood pressure difference were less than 5, greater than 5, greater than 10, and greater than 15 mm Hg. Descriptive statistics and logistic regression were used to analyze the data. Based on the results the prevalence of ≥ 15 mmHg inter-arm systolic and diastole blood pressure difference (inter-arm SBPD and inter-arm DBPD) were 8.08% and 2.61%. The results of logistic regression analysis showed that inter-arm SBPD ≥ 15 and (OR

Abstract Background The WHO model has laboratory-based and non-laboratory-based versions for 10-year risk prediction of cardiovascular diseases. Due to the fact that in some settings, there may not be the necessary facilities for risk assessment with a laboratory-based model, the present study aimed to determine the agreement between laboratory-based and non-laboratory-based WHO cardiovascular risk equations. Methods In this cross-sectional study, we used the baseline data of 6796 individuals without a history of cardiovascular disease and stroke who participated in the Fasa cohort study. The risk factors of the laboratory-based model included age, sex, systolic blood pressure (SBP), diabetes, smoking and total cholesterol, while the non-laboratory-based model included age, sex, SBP, smoking and BMI. Kappa coefficients was used to determine the agreement between the grouped risk and Bland–Altman plots were used to determine the agreement between the scores of the two models. Sensitivity and specificity of non-laboratory-based model were measured at the high-risk threshold. Results In the whole population, the agreement between the grouped risk of the two models was substantial (percent agreement = 79.0%, kappa = 0.68). The agreement was better in males than in females. A substantial agreement was observed in all males (percent agreement = 79.8%, kappa = 0.70) and males

Background: Acupressure as one of the complementary and alternative medicine (CAM) has become very popular in the management of various diseases such as diabetes. Although the increasing use of acupuncture, there are limited systematic reviews and meta-analyses in this field.Aim: The present study was performed with aim to investigate the effectiveness of acupressure on the blood sugar parameters of patients with type 2 diabetes.Method: In this rapid systematic review and meta-analysis, the studies published globally between 2010 and 2022 were searched in the PubMed, Google Scholar, and Science Direct databases with the keywords of acupressure, diabetes, complementary medicine, blood sugar and glycosylated hemoglobin as separately and in combination. To analyze data, STATA software version 11 was used to analyze data, and the random effect model method was applied for meta-analysis of the studies.Results: Among the 411 articles found in the initial search, finally 8 articles were selected for this study. The results of the meta-analysis of studies showed that acupressure had a positive effect on blood sugar (95% CI = 0.816-1.553, P < 0.001, OR = 1.18) and fasting blood sugar (95% CI = 0.260 - 0.857, P˂0.001, OR = 0.559) in diabetic patients, while it had no effect on the level of glycosylated hemoglobin (95% CI = -0.139 - 0.389, P = 0.355, OR = 0.559).Implications for Practice: This study showed the positive effect of acupressure in reducing blood sugar and fasting blood sugar in patients with diabetes, however more studies are required to confirm the effect of acupressure on glycosylated hemoglobin.

Abstract We used machine learning methods to investigate if body composition indices predict hypertension. Data from a cohort study was used, and 4663 records were included (2156 were male, 1099 with hypertension, with the age range of 35–70 years old). Body composition analysis was done using bioelectrical impedance analysis (BIA); weight, basal metabolic rate, total and regional fat percentage (FATP), and total and regional fat-free mass (FFM) were measured. We used machine learning methods such as Support Vector Classifier, Decision Tree, Stochastic Gradient Descend Classifier, Logistic Regression, Gaussian Naïve Bayes, K-Nearest Neighbor, Multi-Layer Perceptron, Random Forest, Gradient Boosting, Histogram-based Gradient Boosting, Bagging, Extra Tree, Ada Boost, Voting, and Stacking to classify the investigated cases and find the most relevant features to hypertension. FATP, AFFM, BMR, FFM, TRFFM, AFATP, LFATP, and older age were the top features in hypertension prediction. Arm FFM, basal metabolic rate, total FFM, Trunk FFM, leg FFM, and male gender were inversely associated with hypertension, but total FATP, arm FATP, leg FATP, older age, trunk FATP, and female gender were directly associated with hypertension. AutoMLP, stacking and voting methods had the best performance for hypertension prediction achieving an accuracy rate of 90%, 84% and 83%, respectively. By using machine learning methods, we found that BIA-derived body composition indices predict hypertension with acceptable accuracy.

Abstract Background Patients with cancer are at higher risk of contracting COVID-19 with poor prognosis. Therefore, the present study was conducted to investigate anxiety, spiritual well-being, and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic in the south of Fars Province, Iran. Methods This is a descriptive study with a cross-sectional design conducted on the patients undergoing chemotherapy at Dr. Ali Shariati Hospital in Fasa from November 2021 to February 2022. Cancer patients undergoing chemotherapy were included in the study by census method. Out of 210 patients, 155 participated in the study. Data were collected electronically using the standard instruments of Ellison’s Spiritual Well-being Scale, COVID-19 anxiety questionnaire, and Connor-Davidson resilience scale. The collected data were analyzed in SPSS 22 using descriptive statistics, Pearson correlation tests, T-test, ANOVA and multivariate linear regression at a level of significance of P

Background & Objective: Prediction of preterm delivery can reduce a large number of its complications. The present study aimed to compare vaginal and plasma fibronectin concentrations in the diagnosis of preterm delivery. Materials & Methods: Serum samples were obtained from 105 women at 24-36 weeks of gestation. However, only 40 women gave permission to collect vaginal samples. Fibronectin concentration was measured using the ELISA technique. Then, plasma and vaginal fibronectin levels were compared in term and preterm deliveries. Results: The mean plasma fibronectin level was 6226.43±7174.97 ng/ml among the mothers with term infants and 7724.01±1143.82 ng/ml among those with preterm infants (p=0.667). The mean fetal fibronectin level was 156.61±126.42 ng/ml among the mothers with term infants and 127.71±43.14 ng/ml among those with preterm infants (p=0.241). The cut-off point of plasma fibronectin level was 1750 ng/ml with a sensitivity of 80.25% and specificity of 85.17%. Additionally, the cut-off point of vaginal fibronectin level was 158.98 ng/ml with a sensitivity of 94.62% and specificity of 22.08%. Conclusion: Plasma fibronectin analysis had lower sensitivity and higher specificity compared to vaginal fibronectin analysis. This implies that plasma testing has lower false-positive cases and can identify a more significant number of true positive cases of preterm delivery.

Background: Childhood hypertension can have serious consequences for children, especially during their adulthood. This study aimed to determine the prevalence of hypertension and its related factors in children aged 7 to 12 years in Larestan (Iran). Methods: In this cross-sectional study, 1110 students from 7 to 12 years old in Larestan were enrolled in the study using cluster sampling. In order to collect educational data, 10 girls' primary schools and 10 boys' primary schools were randomly selected from all the girls' and boys' primary schools. Then, considering that each school has different number of students, 55 students of each school were randomly selected. Students' blood pressure was measured as standard. Their personal information was also recorded in a checklist. A checklist containing demographic information, factors and variables that affect the prevalence of hypertension in children aged 7 to 12 years was used. To collect information, a checklist was used that included demographic information such as age, gender, and place of residence. Also, in order to identify factors and variables effective in the prevalence of high blood pressure (HBP), tools such as sphygmomanometer and other risk factors including obesity, type of diet, physical activities, and body mass index (BMI) were used. Results: The mean age of girls was 9.11 ± 1.53 and boys were 9.19 ± 1.52, which did not differ significantly from the statistical point of view. The prevalence of pre hypertension was 6.03% (95% CI: 4.71-7.60) and the prevalence of hypertension was 4.14% (95% CI: 3.05-5.49). Systolic and diastolic blood pressure has direct relation with height and weight of children. Diastolic blood pressure also had a higher prevalence in girls (P < 0.001). Conclusion: Overweight and obesity as a moderate aggressive factor were significantly associated with blood pressure. Also, the prevalence of HBP in children was significant, and it is necessary to pay attention to it in childhood. Moreover, hypertension cases should be identified and treatment should start faster for the affected person to prevent the adverse consequences in the future.

Background: The present study aimed to compare the effect face-to -face and distance learning on knowledge, attitude and practice of females about breastfeeding in Shiraz, Iran.Methods: This randomized controlled trial was conducted in Shiraz, Iran in 2019 on 313 women who were referred to health centers (93 face-to face group, 105 distance learning group, and 115 control group). The study outcomes included knowledge, attitude, and practice of the women about breastfeeding which were measured at the onset and one-month post-intervention. The data were analyzed using SPSS 21 software.Results: Mean changes of knowledge and attitude were significantly higher in the face-to-face and distance learning intervention groups compared to the control group (P

Abstract Background Globorisk is a novel risk prediction model for predicting cardiovascular disease (CVD). Globorisk is a country-specific risk prediction model that determines CVD risk for all countries. This model has two versions; laboratory-based and office-based. This study aimed to determine the agreement between laboratory-based and office-based models in a large sample of the general population. Methods Baseline data from the Fasa cohort study was used for the current study. In total, 6810 participants ≥ 40 years without any history of cardiovascular disease or stroke were included in the study. To determine the laboratory-based risk model, factors include age, sex, current smoking status, history of diabetes, systolic blood pressure (SBP), and total cholesterol. To estimate the office-based risk model, factors were age, sex, current smoking status, SBP, and body mass index (BMI). Kappa statistics was used to distinguish the agreement between grouped scores in these two models. Additionally, correlation coefficients and scatter plots were used to determine the linear correlation between the two models. Results In this study 46.53% of the participants were men. The mean age (SD) of participants was 51.08 (7.88) years. Agreements between the two models were moderate and substantial in all women and all men, respectively. The agreement between the two CVD risk groups was 90.15% (kappa = 0.717) in all men, 92.94% (kappa = 0.571) among men aged 60 years (r = 0.94). Among all women, there was a very strong positive correlation (r = 0.87), and the strong positive correlation remained among 60 years old (r = 0.76). Conclusion The Globorisk office-based model which is easier to use as it does not require blood testing can determine the risk groups in this population. The Globorisk office-based model may be used for CVD risk screening in low-middle income countries where resources are limited.

Abstract Background As a chronic, disabling disease, multiple sclerosis (MS) has challenged healthcare systems in many ways. MS adversely affects patients’ quality of life and self-efficacy and results in psychological stress. The present study was conducted to investigate the effect of peer education based on Pender’s health promotion model on the quality of life, stress management, and self-efficacy of patients with MS in the south of Iran. Methods The present study was a randomized controlled clinical trial. A total of 90 patients were divided into group A intervention group 45 patients) and group B (control group 45 patients). The intervention was peer education based on Pender’s health promotion model. Data were collected using the MS Quality of Life Scale, the Self-efficacy Scale, and the Stress Management Scale. Data analyses were conducted using SPSS version 22. To analyze the data, we used descriptive statistics. Thus, inferential statistics applied included Chi-square, independent-samples t-test, and Repeated measures (ANOVA). The significance level was considered p

Type 2 diabetes (T2DM) and its complications can cause severe morbidity and mortality. The researchers and clinicians’ attention has been toward finding the efficient treatment for T2DM to decrease its heavy burden on the people and countries. Whey protein (WP) is a known glucose-lowering treatment of traditional Persian medicine. This randomized controlled clinical trial aimed to evaluate the efficacy of the WP on the improvement of the glycemic index of the patients with T2DM in Fars, Fasa, Iran. A total of 58 people with T2DM met the inclusion criteria and were randomly assigned to one of two groups: intervention or placebo. For 12 weeks, they were given 1 sachet of WP or 1 sachet of placebo. Before and after the trial, fasting blood sugar, lipid profile, and liver enzymes were tested. Finally, 35 patients completed the study (18 in the whey group and 17 in the placebo group). The mean ± standard deviation of age, BMI, and the disease duration in placebo group were: 52.1±9.2 years, 26.8±3.9 kg/m2 and 102.9±67.7 months and in WP group were 51.2±8.2 years, 25.7±3.7 kg/m2 and 74.2±51.1 months. There were no significant differences among the study groups at the beginning (P>0.05). Meanwhile, the WP and placebo groups were the same by means of the amount of anti-diabetic drugs that participants consumed (P=0.242). After 12 weeks: the fasting blood sugar (FBS) and hemoglobin A1C amounts showed important decreases in the WP group compared to its starting point (P=0.011 and P=0.001 respectively), while in the placebo group, there was no significant difference in this matter (P>0.05). No severe complications were reported in both groups. In conclusion, we found that whey protein would be a promising complementary therapy to control hyperglycemia in the patients with T2DM.

Abstract Background In the medical management of acute myocardial infarction, the transport of patients and primary care provided by emergency medical technicians (EMTs) and paramedics are effective in reducing the mortality and disabilities. Therefore, the present study aimed to compare the outcomes of emergency medical services (EMS) vs. non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in southern Iran. Methods This is an analytical, cross-sectional study. The study population consisted of the individuals registered in Fasa Registry on Acute Myocardial Infarction (FaRMI) in the south of Iran. 2244 patients with STEMI were included in the study. Statistical analyses were performed using Chi-Square test and independent t-test at a significance level of P

Abstract Objectives Opium use, cigarette smoking, and alcohol consumption are serious health problems in many countries including Iran. The present study aimed to examine the association between the opium use, cigarette smoking and alcohol consumption with liver enzyme levels in Southern Iran. This analytical cross-sectional study was conducted in 2020. The entire population of the Fasa Persian cohort study in the southern region of Iran was selected as the sample. Accordingly, 10,145 people participated in the study. Results Results indicated that there was a significant relationship between cigarette smoking and alcohol consumption with liver enzymes (AST, ALT, and ALP). There was also a significant relationship between inhaled opium and liver enzymes, but oral opium revealed no significant relationship with the activity of liver enzymes. Accordingly, policymakers of the health care system are recommended to hold educational programs to improve the health literacy level of the society and take effective preventative strategies in reducing the use of these substances.

BackgroundKidney dysfunction is a risk factor for cardiovascular disease and chronic kidney disease. Herein, we aimed to describe the attributable burden of kidney dysfunction at the national and sub-national levels in Iran.MethodsThe Global Burden of Disease (GBD) 2019 data were extracted on the deaths, disability-adjusted life years (DALYs), years of life lost, and years lived with disability attributed to the risk factor of kidney dysfunction by age and sex at the national and provincial levels from 1990-2019. Also, risk exposure was reported by summary exposure value (SEV) with a range of 0 to 100. The estimated values were based on a comparative risk assessment framework.ResultsIn 2019, the age-standardized death rate and age-standardized DALYs rate attributable to kidney dysfunction were 58.2 (95% uncertainty interval of 48.8-68.1) and 1127.2 (981.1-1282.7) per 100,000 population in Iran, respectively. Also, the Sistan and Baluchistan province (1729.3 [1478.3-2006.4]) and the province of Tehran (681.9 [571.4-809.8]) had the greatest and lowest age-standardized DALYs rates, respectively. Nationally, SEVs increased from 22.8 to 26.2. The age-standardized burden attributable to kidney dysfunction had a positive association with age advancement. The attributable age-standardized deaths and DALYs rates in all socio-demographic index regions decreased from 1990-2019. Also, the highest and lowest attributable age-standardized DALYs rates of kidney dysfunction came from ischemic heart disease and peripheral artery disease in 2019, respectively.ConclusionAlthough the attributed age-standardized DALYs and death rates decreased from 1990-2019, risk exposure increased and remains a crucial risk factor in Iran. Therefore, policymakers should consider preparing a preventive program that takes into account different levels of prevention of kidney dysfunction.

Abstract Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep duration, physical activity, and ECG parameters in the Fasa Persian cohort study. Methods In this cross-sectional study, the basic information of 10,000 participants aged 35–70 years in the Fasa cohort study was used. The data used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep duration, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model. Results Based on multivariate linear regression analysis results, increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference, hip circumference and waist circumference significantly increased the mean values of the ECG parameters. However, sleep duration was not significantly associated with the ECG parameters. In addition, hypertension was major comorbidity, which was shown to increase the mean values of the ECG parameters. Conclusion Several factors affected the ECG parameters. Thus, to interpret ECGs, in addition to age and gender, anthropometric indices, physical activity, and previous history of comorbidities, such as hypertension and ischemic heart disease, should be taken into consideration.

Abstract Background Oral mucositis is one of the serious complications of chemotherapy and/or radiotherapy that significantly affects the quality of patients’ life. The Oropharyngeal Mucositis-Specific Quality-of-Life questionnaire (OMQoL) is an acceptable instrument for measuring the quality of life in these patients. The aim of this study was to evaluate the validity and reliability of the Persian version of OMQoL questionnaire. Methods This study was a cross-sectional and multi-centric research. After translation from English to Persian, back translation, and cultural adaptation, the Persian version of the questionnaire was prepared. One hundred forty-four patients suffering from oral mucositis referred to three different university affiliated hospitals related to Zahedan, Kerman and Tehran Universities of Medical Sciences, were participated in this study. Then the questionnaire was completed by trained interviewers. The reliability was assessed by Cronbach’s alpha coefficient, and validity was measured through factor analysis, and construct validity (including discriminant validity, and convergent validity) methods. Results Cronbach's alpha in all dimensions was higher than 0.9 that indicated a perfect internal consistency. The results of factor analysis indicated that the dimensions specified in the Persian version were the same as the original version (Factor loading of all items > 0.4). The correlation coefficient for all items was more than 0.75, and the convergence validity was 100% in all dimensions. Conclusion The results of this study showed that the reliability, and validity of Persian version of OMQoL were acceptable, which can be used to measure the quality of life in patients with oral mucositis.

Abstract Background Education can contribute to promotion of the quality of life and reduction of heart anxiety in patients with heart failure, so it is important to find a suitable educational method for these patients. Therefore, the present study was an attempt to determine the effect of multimedia education using teach-back method on the life quality and cardiac anxiety in patients with heart failure. Methods The present study was a randomized clinical trial. 120 patients with heart failure class I to III and aged less than 60 years old were selected using sequential sampling; then, they were assigned randomly into two intervention groups and one control group. Group A (multimedia education), group B (education using multimedia together with teach-back method), and group C (control). The quality of life and cardiac anxiety were evaluated in the participants of the three groups before, after, 1 month, and 3 months after the intervention. Data were analyzed using descriptive tests, Pearson correlation, Kolmogorov–Smirnov, chi square and ANOVA test in SPSS 22. The significance level was set at P