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Abstract Background Early diagnosis and control of risk factors affecting frailty syndrome (FS) in older adults may lead to changes in the health/disease process, prevention of disability and dependency in the older adults, and reduction of health care costs and mortality rates. The aim of this study was to determine the predictive role of CVD risk factors and FS in community-dwelling older adults of Amirkola city in Iran. Methods This descriptive-analytic cross-sectional study is part of the second phase of the Amirkola Health and Aging Project (AHAP) cohort study conducted since 2011 on all individuals ≥ 60 years in the city of Amirkola in northern Iran. Totally, 1000 older adults were included in the study and divided into three groups: frail (n = 299), pre-frail (n = 455), and non-frail (n = 246) older adults. In the present study, age ≥ 60 years, female sex, fasting blood sugar (FBS) ≥ 126 mg/dl, affected diabetes mellitus (DM), body mass index (BMI) ≥ 27 kg/m², waist circumference (WC) or abdominal obesity > 102 cm in men and > 88 cm in women, low-density lipoprotein (LDL) > 100 mg/dl, triglyceride > 150 mg/dl, cholesterol > 200 mg/dl, high-density lipoprotein (HDL) 90/140 mmHg, uric acid > 7 mg/dl and a positive smoking history were considered CVD risk factors. Results The results showed that with each centimeter increase in WC, the odds of frailty compared with non-frailty was 79% higher, and the odds of frailty compared with pre-frailty was 1.43 times higher in older adults. In addition, the prevalence of pre-frailty compared with non-frailty, pre-frailty, and non-frailty was 10.59 times, 6.08 times, and 73.83 times higher in older individuals > 84 years old, respectively. The results of the present study indicated that the prevalence of pre-frailty compared with non-frailty, frailty compared with pre-frailty, and frailty compared with non-frailty was 2.86 times, 3.01 times, and 14.83 times higher in older adults women, respectively. The comparison between frail and non-frail groups represented that in DM older adults, the prevalence of frailty compared with non-frailty was 1.84 times higher and that of frailty compared with pre-frailty was 98% higher. The older adults with an FBS ≥ 126 mg/dl were 53% more likely to become frail, and with each unit increase in uric acid, the odds of becoming frail increased 2.05 times compared with non-frail older adults, and pre-frail compared with non-frail increased 99%. Conclusion The results demonstrated that CVD risk factors predictive of FS included central obesity, age > 84 years, female sex, DM, FBS ≥ 126, and uric acid > 7. This problem highlights the need for preventive strategies in the older adults who are simultaneously vulnerable to CVD and frailty.

Background and purpose: Cardiovascular diseases are the most important diseases of the elderly, and recently the effect of triglyceride glucose (TYG) index as one of the indicators of insulin resistance in type 2 diabetes and coronary artery disease has attracted the attention of researchers. Previous research has shown a link between insulin resistance and coronary artery calcification. Since triglyceride glucose index (TyG) is an index that is easily available, this study aimed to investigate the relationship between triglyceride index and fasting blood sugar and coronary heart disease and diabetes in the elderly of Amirkola. Materials and methods: This cross-sectional study was conducted on the elderly participating in the second phase of the Amirkola Health and Aging Cohort Study (AHAP). The elderly were divided into two groups of 200 people, the first group was diabetics with cardiovascular disease and the second group was diabetic elderly without cardiovascular disease. Patient information including age, sex, body mass index, diabetes, coronary artery disease, history of dyslipidemia, medications, triglycerides, fasting blood sugar, smoking habits, systolic and diastolic blood pressure, cholesterol, creatinine, physical activity, and HbA1c were collected in a checklist. The TYG index was calculated based on the LN formula [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Ultimately, SPSS version 25 software was utilized to describe the data using mean, standard deviation, and percentage. The qualitative variables were compared with the coronary artery disease using the chi-square test, while the quantitative variables were compared using the independent t-test in univariate analysis. Furthermore, the process of adjusting for confounding variables was carried out by using multivariate logistic regression. Results: In this study, 400 diabetic elderly participants were examined based on the relationship between triglyceride glucose index and coronary artery disease. The average age of the elderly with coronary artery disease was 70.46±6.10 and the elderly without coronary artery disease was 70.50±6.49 years. Triglyceride glucose index in diabetic elderly with and without coronary artery disease was 9.3±0.68 and 9.30±0.65, respectively, which was not statistically significant (P=0.92). Mean creatinine (P=0.004), number of comorbidities (P

Abstract Background and Aim Psoriasis is a prevalent chronic inflammatory skin condition, and the Mediterranean diet is often recommended for its health benefits, particularly its ability to mitigate chronic inflammation. This study sought to examine the extent to which psoriasis patients adhere to the Mediterranean diet and to explore its correlation with the severity of their condition Methods Seventy‐one psoriasis patients and 71 age‐ and sex‐matched healthy controls were enrolled the study and filled a standard questionnaire of adherence to the Mediterranean diet. The relationship between disease severity and adherence to the diet was also dealt with. Results The Mediterranean diet adherence score in the psoriasis group (5.25 ± 1.64) was significantly lower than the control group (6.28 ± 2.10) (p = 0.004). In addition, the consumption of fruit and fish in psoriasis patients was significantly lower than the control group and the consumption of red meat was significantly higher in the patient group. No significant relationship was found between the severity of the disease and the score of adherence to the Mediterranean diet (p = 0.42). Conclusion A significant difference between the two groups of psoriasis and the control group following the Mediterranean diet might be indicative of the relationship between diet and psoriasis and the potential benefits of this type of diet due to its anti‐inflammatory properties.

Introduction For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults. Material and Methods This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests. Results The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis. Conclusion From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis.

Sleep disorders are more common in diabetes mellitus (DM) cases rather than normal ones. In addition, this condition could be associated with diabetic retinopathy (DR) development with more inflammatory indices in circulation. In the present study, we have evaluated the association between DR and sleep quality. This cross-sectional study is a part of the second phase of the study of the elderly cohort of Amirkola City, which was conducted in 2015-2016 on all people aged 60 and higher. Of all diabetic cases, 44 cases had retinopathy and were selected as the case group. To compare two control groups, 135 diabetic patients without retinopathy and 135 people without diabetes were randomly selected. The presence and type of retinopathy were determined based on an eye physical examination by an ophthalmologist. In addition, sleep quality was evaluated based on the Pittsburgh Questionnaire. The obtained data were analyzed by ANOVA, t-test, and linear regression tests. In the present study, there was a significant difference in the score of the Pittsburgh questionnaire between people with DR (45.5±68.2) compared to diabetic people without retinopathy (76.5±48.2) and people without diabetes (95.4±36.2) (P=0.470), but diabetic people without retinopathy had significantly worse sleep quality than people without diabetes (P=0.019). Also, sleep quality in women with DR was worse than in men (P=014). In the linear regression analysis, it was observed that age, gender, diabetes, and history of depression significantly affect the sleep quality of the evaluated cases (P

Abstract The objectives of this study were to translate and validate the Persian version of the food involvement inventory (FII) and eating restriction questionnaire (ERQ) and to determine the measurement invariance based on gender, body mass index (BMI) status, and age. This cross-sectional study included 1100 Iranian adults. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the construct validity of FII and ERQ. Convergent and discriminant validity, measurement invariance in gender, BMI and age, reliability including internal consistency, and stability were investigated for FII and ERQ. The results showed that the four-factor construct of the FII and the one-factor construct of the ERQ were 44.27% and 55.12% of the total variance, respectively. The factor loadings of all items were > .3 in both scales and none of the items were deleted. Fitting indices indicated that the four-factor construct of the FII and the one-factor construct of the ERQ had a good and acceptable fit among the Iranian adults. The Persian versions of the FII and ERQ, translated into Persian and localized according to international standards, had high construct, convergent and discriminant validity as well as high reliability.

Background: Self -rated health (SRH) is a subjective assessment of health status that results from asking a question as “How do you assess your health?”. The aim of this study was to determine the value of SRH for survival of older adults. Materials and Methods: This cohort study was conducted among a population aged 60 years and over living in the north region of Iran. The participants’ characteristics including demographic information, life-style behaviors, medical history, body mass index, depressive symptoms, cognitive function, and social support were examined. SRH was categorized into two groups (1. poor or fair and 2. good or excellent). All of the study population were followed up again after 5 years to determine the survival condition. Results: Totally, 1475 elderly people were included. Good or excellent SRH showed a significant association with male gender, to be married, higher physical activity, less co-morbid chronic disorders, no depressive symptoms, normal cognitive function, higher social support, smoking (P < 0.001), and normal body mass index (BMI) (P = 0.021); however, no significant association with age (P < 0.083) was observed. Out of 944 elderly people expressing good or excellent SRH, 85 (9%) persons died after 5-year follow-up (P < 0.001). Cox regression analysis revealed that SRH had a significant impact on mortality of older adults (adjusted hazard ratio = 1.447; 95% confidence interval: 1.008–2.076; P = 0.045). Conclusion: Considering health-related characteristics including age, gender, number of drugs the participant was taking, physical activity, BMI, and social support, SRH showed a significant effect on 5-year survival of older adults.

Background: Given the high prevalence of hypertension in older adults, this study was conducted to identify the factors affecting the 5-year survival of older people with hypertension. Materials and Methods: In this cohort study, individuals aged 60 and over living in Amirkola, north of Iran who were diagnosed with hypertension were followed up for 5 years, and the effect of various factors on their survival was analyzed. Results: Among 1439 older people, 892 individuals (61.99%) had hypertension. Age (adjusted hazard ratio [aHR] =1.052, 95% confidence interval [CI] =1.019–1.086, P = 0.002), diabetes mellitus (aHR = 2.166, 95% CI = 1.398–3.354, P = 0.001), serum creatinine (aHR = 2.163, 95% CI = 1.391–3.363, P = 0.001), female gender (aHR = 0.460, 95% CI = 0.276–0.766, P = 0.003), body mass index ≥30 kg/m2 (aHR = 0.386, 95% CI = 0.212–0.701, P = 0.002), physical activity score >150 (aHR = 0.382, 95% CI = 0.162–0.898, P = 0.027), each one unit increase of social support score (aHR = 0.914, 95% CI = 0.861–0.970, P = 0.003), and instrumental functional ability score (aHR = 0.907, 95% CI = 0.843–0.974, P = 0.009) showed a significant effect on 5-year survival of older people. Conclusion: Multiple factors (such as age, gender, social support, lifestyle behaviors, and comorbidities including diabetes mellitus and renal function) might predict the 5-year survival of the elderly with hypertension. They should be considered in health-care package of these patients.

Background and purpose: Poor sleep quality is one of the most common problems in older population. Sleep disorder has negative effects on physical, mental, and social aspects of their life and influences their quality of life. This study was carried out to assess the sleep quality and its related factors in older adults. Materials and methods: This cross-sectional study was conducted in older adults aged 60 years and over living in Amol, north of Iran who were willing to participate in the study, did not have Alzheimer's disease and major depression, and could respond to questions. They were selected via multi-stage random sampling. The Pittsburgh Sleep Quality Index, Abbreviated Mental Test Score (AMTS), Hospital Anxiety and Depression Scale (HADS), SF36 Quality Of Life Questionnaire, and Physical Activity Scale For The Elderly (PASE) were used for data collection. A trained researcher filled out the research questionnaires. Results: Among 401 participants, 191 (47.6%) were women and 276 (68.8%) people were living in urban areas. Findings showed that 192 (47.9%) people had poor sleep quality. Multivariate logistic regression analysis showed significant relationships between sleep quality and taking sleeping drugs (adjusted OR: 6.57, 95% CI: 2.95-14.60, P=0.001), female gender (aOR: 5.40, 95% CI: 2.81-10.36, P=0.001), and depression (aOR: 0.46, 95% CI: 0.21-1.00, P=0.05), and also between physical (aOR: 0.97, 95% CI: 0.95-1.01, P=0.05) and mental (aOR: 0.95, 95% CI: 0.92-0.99, P=0.05) aspects of life. Conclusion: Findings revealed a high prevalence of poor sleep quality in the elderly which was associated with female gender, taking sleeping drugs, and depression. So, appropriate interventions are suggested to improve sleep quality in older adults.

Abstract An important target in the treatment of type 2 diabetes is α-glucosidase. Inhibition of this enzyme led to delay in glucose absorption and decrease in postprandial hyperglycemia. A new series of phthalimide-phenoxy-1,2,3-triazole-N-phenyl (or benzyl) acetamides 11a–n were designed based on the reported potent α-glucosidase inhibitors. These compounds were synthesized and screened for their in vitro inhibitory activity against the latter enzyme. The majority of the evaluated compounds displayed high inhibition effects (IC50 values in the range of 45.26 ± 0.03–491.68 ± 0.11 µM) as compared to the positive control acarbose (IC50 value = 750.1 ± 0.23 µM). Among this series, compounds 11j and 11i represented the most potent α-glucosidase inhibitory activities with IC50 values of 45.26 ± 0.03 and 46.25 ± 0.89 µM. Kinetic analysis revealed that the compound 11j is a competitive inhibitor with a Ki of 50.4 µM. Furthermore, the binding interactions of the most potent compounds in α-glucosidase active site were studied through molecular docking and molecular dynamics. The latter studies confirmed the obtained results through in vitro experiments. Furthermore, in silico pharmacokinetic study of the most potent compounds was also performed.

Abstract Royal jelly, due to its unique bioactive components, has special biological activities, but a great extent of its nutritional value is lost during processing and storage. Lyophilization, an effective preservation technique, can feasibly preserve the main bioactive compounds present in royal jelly. In this study, fresh royal jelly was subjected to the freeze‐drying process at a pressure and temperature of 100 Pa and − 70°C, respectively, for 40 h. The results obtained indicated that the pH, turbidity, total phenol content, and antioxidant activity of the royal jelly powder (RJP), during 3 months of storage at ambient temperature (30°C), were constant with values of 4.30, 1.634 (%A.U.), 0.617 (g/L), and 28.7 (%), respectively. Moisture content of the prepared RJP was less than 1%, while that of the fresh royal jelly was 70%. Furthermore, for the fresh royal jelly, the mentioned parameters were significantly (p

Background & Aims: Sleep problems have become the most common complaint among the elderly. Various factors are involved in the prevalence of poor sleep quality in this age group. Due to the lack of community-based data, this study was conducted to determine the prevalence of poor sleep quality among the elderly in Amirkola, Northern Iran. Methods: This cross-sectional study is part of the second phase of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. The sleep quality and related factors were assessed through Pittsburgh Sleep Quality Index (PSQI-P) and interviews, respectively. Results: Of the 1675 older people, 914 (54.6%) were male, and 761 (45.4%) were female, of whom 714 (42.6%) had poor sleep quality. The prevalence of poor sleep quality in women and men was 56.9% and 30.7%, respectively (p

Background: Vitamin D is best known as a key regulator of bone metabolism and calcium and phosphate homeostasis. This study aimed to assess the effect of different factors on the five-year changes in serum vitamin D concentration among older adults.Methods: This cohort study was conducted on adults aged ≥60 years living in Amirkola, in the North of Iran, from 2012 to 2017. Serum 25-hydroxyvitamin D (25-OH vitamin D) concentrations of 0.05). Conclusion: Regardless of age, sex, body mass index, metabolic syndrome, or physical activity, the mean serum concentration of vitamin D decreased over a five-year follow-up.

Epilepsy, particularly in older people, is associated with significant changes in physical activities, social and occupational functions, and diet. It is associated with significant changes in physical activities, social and occupational functions, and diet. Valid and reliable instruments are needed to assess these changes. This study aimed to develop and validate a questionnaire to assess lifestyle in older people with epilepsy, named the Epilepsy Lifestyle Questionnaire (ELQ). This methodological study was conducted in 2022. The primary ELQ items were generated through reviewing the literature. Then, its face, content, construct, convergent, and discriminant validity, internal consistency, and test-retest stability were evaluated. Older patients aged ≥ 60 years were recruited from the Iranian Epilepsy Association to assess construct validity using confirmatory factor analysis (CFA). Data were analyzed using the SPSS (v. 26.0), AMOS (v. 24.0), and JASP software. The primary ELQ had 99 items with five subscales, namely health-oriented self-care, risk-averse behavior, emotional and psychosocial adaptation, epilepsy stigma, and intimacy and sexual behaviors. Sixty five items were deleted during psychometric evaluation. CFA showed the good fitting of the five-factor structure of the 34-item ELEQ (PCFI = 0.741, PNFI = 0.693, CMIN/DF = 0.073, IFI = 0.917, CFI = 0.916, AND GFI = 0.902). The values of internal consistency based on Cronbach's alpha and test-retest reliability based on intraclass correlation coefficient (ICC) of ELQ were 0.89 and 0.95, respectively. The ELQ is a valid and reliable self-report instrument. The results suggest that the ELQ is a useful clinical tool for assessing the lifestyle of patients with epilepsy.

Background and purpose: Osteoporosis and periodontitis are two diseases associated with bone loss and are common among postmenopausal women. There are many contradictory results on the effect of osteoporosis on periodontal tissue. This study aimed to determine the association between osteoporosis and periodontal status in postmenopausal women. Materials and methods: This cross-sectional study was part of the second phase of the Amir kola Health and Aging Project (AHAP), in which 210 postmenopausal women were randomly divided into three groups (n=70 per group); normal bone density group, osteopenic group, and osteoporotic group. Periodontal status was measured using Periodontal Disease Index (PDI), Plaque Index (PI), and Simplified Oral Hygiene Index (OHI-S). Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DEXA). Data were analyzed in SPSS V17 applying ANOVA, Kruskal-Wallis, and Pearson correlation coefficient. Results: The average age of the participants was 65.24±4.36 years. There were no statistically significant differences between the mean OHI (2.26±1.40), PDI (2.76±1.42), and PI (1.23±0.87) in the osteoporotic group, and the mean OHI (2.01±1.62), PDI (2.56±1.61), and PI (1.35±0.91) in the osteopenia group, and mean OHI (1.73±1.37), PDI (2.47±1.43), and PI (1.23±0.87) in the normal group (P>0.05). The OHI, PDI, and PI had a slight but insignificant negative correlation with BMD. Conclusion: According to this study, there is no link between osteoporosis and periodontal status in postmenopausal women.

Introduction: Considering that nutrition plays a prominent role in the health of the elderly, oral health and the associated quality of life are very important for a healthy diet. The aim of this study was to investigate the association between the frequency of fruit and vegetable consumption and oral health-related quality of life (OHRQoL) among the elderly in Amirkola. Materials & Methods: This study was part of the second phase of the Amirkola elderly cohort study conducted on 750 older people who underwent a special oral and dental examination in 2016-2020 using the Oral Health Questionnaire. The frequency of fruit and vegetable consumption was assessed with the Semi-Quantitative Food Frequency Questionnaire (SQFFQ), OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI), and information on age, sex, history of systemic diseases, and the number of teeth was extracted from the full data set completed by specialists for each patient. Data were analyzed with SPSS 20 using the chi-square statistical test, ANOVA, and Pearson correlation coefficient. A value of p

Background: The purpose of this study was to determine the distribution of intraocular pressure (IOP) and assess its association with age, sex, systemic blood pressure, diabetes mellitus, body mass index (BMI) and tobacco smoking in Iranian elderly population. Methods: This cohort-based, cross-sectional study assessed elderly individuals aged 60-90 years in Amirkola, northern Iran, in 2016-2017. Past medical history, blood pressure, diabetes mellitus, BMI and tobacco smoking were recorded through an interview and physical examination. IOP was assessed using non-contact tonometry. Results: Total of 1377 individuals participated in this study, out of which 1346 IOP measurements were included for the final analysis. The mean age of participants was 69.4 ± 7.1 years and mean IOP was determined to be 16.7 ± 3.2 mmHg. Majority of the participants were males (56.1% vs 43.1%), 73.8% of participants were overweight or obese, 6.1% smoked tobacco, 28.9% had diabetes mellitus and 84.9% had higher than normal blood pressure. Through multiple regression analysis, it was determined that age (β=-0.132, p

Background: One of the principles of Persian medicine (PM) is the individualized approach that is presented with the concept of Mizaj. In this viewpoint, Mizaj is determined for every person based on 10 criteria, which is a result of the Mizaj of the main organs, including the brain, liver, and heart. There is no standard diagnostic tool for Mizaj assessment in the elderly. The purpose of this study is to explain the method of Mizaj assessment and data analysis in the elderly in the second phase of the Amirkola health and aging project (AHAP) in Iran. Methods: In this study, a novel Mizaj assessment method in two phases is presented. In the first phase, 1541 elderly were assessed by a PM expert and typical diagnoses were determined. At the second phase, an expert panel including 5 PM experts evaluated the cases. The paraclinical and metric data of the elderly whose Mizaj agreed in the expert panel was used to assess its correlation with Mizaj. Conclusion: In the lack of valid and reliable questionnaires to assess the personalized viewpoint of PM, a new expert-based method has been introduced that can be used in similar studies. The result of the Mizaj assessment in this way will be used to obtain objective values for the Mizaj assessment.

Background: Hypertension is one of the most common chronic diseases in the world. The prevalence of hypertension in the elderly is increasing. Patients with high blood pressure have to take medication throughout their lives. In this study, the relationship between antihypertensive drugs and oral health-related quality of life in the elderly was evaluated. Methods: This modified cross-sectional study, which is the part of the second phase of the Amirkola Health and Ageing Project (AHAP), was performed on 900 elderly people. Participants included 300 people with hypertension under medical treatment, 300 people with hypertension without medication and 300 people with normal blood pressure. All patients’ blood pressure was recorded, and the standard xerostomia questionnaire and GOHAI questionnaire (Geriatric Oral Health Assessment Index) was completed for all participants. Then, the obtained data were analyzed by SPSS 17, whereby student’s t-test, ANOVA and chi square, Pearson correlation coefficient and logistic regression model were used. A p

Abstract 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.

Background: 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.Methods: 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. Results: 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 stability>0.8 and CR>0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; P

Background and purpose: Anthropometric measures are of great importance in evaluating older adult health. This study was carried out to examine five-year changes in anthropometric indices of older adults and its association with demographic characteristics, muscle strength, and comorbid disorders. Materials and methods: This cohort study was conducted during 2011-2016 in people aged 60 years and over participating in the Amirkola Health and Ageing Project (AHAP). The elderly whose anthropometric characteristics were complete in the data bank of AHAP were included in the research by census. Demographic characteristics, comorbidities, and anthropometric measures, including height, weight, body mass index, neck, waist and hip circumferences, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were assessed, and five-year changes were calculated. Results: Among 897 people, significant reductions were seen in height, neck, waist, and hip circumferences, WHtR (P

Background: When the first wave of COVID-19 outbreak occurred, the infrastructure for definitive detection of the disease through real-time polymerase chain reaction (RT-PCR) was not yet available in many regions, and a large proportion of suspected patients were inevitably referred to radiology centers to provide a chest CT scan. This research was conducted to describe chest CT characteristics in patients who underwent chest CT during the first weeks of COVID-19 outbreak in Babol, Iran. Methods: All non-hospitalized suspected COVID-19 patients referred to the state radiologic clinic to perform chest CT from March 8, 2020 to March 28, 2020 have been enrolled in this observational study. All CT scans were reviewed by a faculty member radiologist with approximately 20 years of experience. Results: Totally, 2,207 (52.3%) men and 2016 (47.7%) women have been examined. Imaging characteristics in 2292 (54.3%) individuals illustrated a highly suggestive sign of COVID-19 infection while 1869 (44.3%) had a normal chest CT scan. 1813 cases (77.00%) had bilateral involvement and 541 cases (23.00%) were infected unilaterally; Also, 1727 (73.36%) patients had left-sided involvement. Lung field involvement in 2036 (86.49%) patients was less than 20%. Ground glass opacity had a sensitivity, specificity, PPV, NPV, LR+ and LR- of 99%, 96%, 96%, 98%, 22 and 0.01, respectively, for categorization of a patient as a COVID-19 case. These values were 99%, 73%, 70%, 99%, 3.72% and 0.01%, respectively for consolidations. Conclusion: Although, RT-PCR is still introduced as the gold standard method for definite diagnosis, diagnostic accuracy of chest CT in COVID-19 detection is considerable.

This study aimed to evaluate the effectiveness of a Persian Medicine-based dietary protocol (PM diet) in patients infected with COVID-19. A randomized clinical trial was performed from July 2020 to January 2021 in Tehran, Iran. Eighty patients admitted due to pulmonary dysfunction caused by COVID-19 were randomly allocated into two groups: the PM diet or the common hospital (CH) diet. Eight beds in 2 rooms were considered for each group. Patients were randomly hospitalized in these rooms and received these diets up to discharge or death. The details of the PM diet were published before (Hospital diet for COVID-19, an acute respiratory infectious disease: An evidence-based Protocol of a Clinical Trial). O2 saturation level and duration of hospitalization, the rate of mortality, duration of fever, and duration of cough were considered as the primary and secondary outcomes, respectively. O2 Saturation and fever durationwere not different between groups (P-value= 0.08, 0.312, respectively). But the duration of hospitalization and the duration of cough in the PM diet group were significantly shorter than in the CH diet (P-value= 0.002, 0.009, and HR=2.02, 1.86 respectively). The mortality rate was significantly lower in the PM diet group than in the CH diet group (Odds ratio: 0.12, P-value=0.026). PM diet caused a lower mortality rate, shorter hospital stay, and better improvement in cough, but did not have a significant effect on O2 saturation and fever.

Abstract Background The aim of the present study was to assess the relationship between neck circumference and gestational diabetes. Methods This prospective study was conducted on 372 Iranian pregnant women. The criteria set by the American Diabetes Association through 2 h was used to classify subjects with regard to their gestational diabetes. At the 14–16th weeks of pregnancy, the neck circumference was measured. The maternal and fetal outcomes were measured as well. Results The adjusted logistic regression revealed that neck circumference was a predictor for gestational diabetes mellitus (OR = 1.20; 95% CI = 1.06, 1.34; P = 0.002). The ROC analysis depicted that the cut-off for neck circumference in indicating gestational diabetes was 34.3 cm, with the sensitivity of 53% and the specificity of 66%. Conclusion The findings of the present study revealed that the neck circumference of ≥34.3 cm can be deemed as a predictor of gestational diabetes in the case of Iranian pregnant women.

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.

Abstract Background and Aims Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID‐19 in pregnant women, the role of psychological self‐care is unclear. The present study aimed to investigate the role of psychological self‐care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID‐19. Methods The present cross‐sectional study was conducted during the peak of the Delta variant of COVID‐19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self‐care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination‐3 inventory. Results Pregnant women were in relatively good condition based on psychological self‐care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self‐care of pregnant women which negatively predicted the depressive symptoms (β = −0.311, p

Abstract 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

Background: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study is to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women. Methods: This cross-sectional study is a part of the second phase of the AmirKola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA and Pearson’s correlation coefficient and P value less than 0.05 was considered significant. Results: The mean age of participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass, had a greater spine, femur and whole body BMD (p

Background: A few studies compared the epidemiologic features of the first and second waves of coronavirus disease 2019 (COVID-19) outbreak. This research was carried out to compare the 1st and the 2nd waves of the epidemics in the northern Iran. Methods: In this observational research, demographic, clinical and laboratory characteristics of the patients with COVID-19, admitted to four government hospitals affiliated to Babol University of Medical Sciences during the 1st and the 2nd waves of COVID-19 epidemics have been compared. The period from May 21, 2020 to September 21, 2020 was considered as the second wave of the epidemics while from February 19, 2020 to May 20, 2020, as the first wave of the outbreak in this region. Results: Out of 6691 total hospitalized cases, 4374 (65.37%), including 1532 (49.6%) people in the first wave and 2842 (78.9%) in the second wave had RT-PCR test for disease confirmation. Among those who were examined with RT-PCR test, 2322 patients (53.1%) including 728 (31.4%) persons in the first wave and 1594 (68.6%) in the second wave were positive for SARS-CoV-2 RNA. 414 (56.9%) of the confirmed cases in the first wave and 767 (48.1%) in the second wave were males (p

Background: COVID-19 caused a global pandemic problem. No confident management is introduced for it yet. This study aimed to propose a dietary protocol for hospitalized patients with the diagnosis of acute respiratory infectious disease caused by COVID-19 based on Persian Medicine. Methods: This study was conducted in three phases. In the first phase, any diseases that could be matched with the clinical features of infection with COVID-19 were searched in selected PM references. In the second phase, medicinal herbs and foods that were available and could be used in the hospital diet were extracted and summarized. In the third phase, the new documentation of these pharmaceutical and food items was conducted. Results: The signs and symptoms of infectious respiratory disease caused by COVID-19 can be categorized in the field of Zato al-rieh that can mainly be matched with pneumonia. Based on the described criteria, some nutrients and medicinal materia medica have been introduced for acute respiratory infection including Cydonia oblonga, Honey, Citrus sinensis, Malus domestica, Citrus medica, Crocus sativus, Raisin, Rosa Damas Cena, D.Carota, Camellia Sinensis, Anethum graveolens dhi, Punica granatum, Petroselinum Crispum, Coriandrum sativum, Urtica dioica, Allium sativum, Sesamum indicum Conclusion: Most materia medica has documents in current articles including anti-cough suppressants, antiviral properties, anti-bacterial, anti-inflammatory, antioxidant, immunomodulatory etc. A protocol of hospital diet for patients with infectious respiratory syndrome caused by COVID-19 has been introduced in this manuscript.

Abstract Purpose This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high‐risk pregnancy. Design and Methods In this cross‐sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53‐items (BSI‐53), and the BSI‐18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. Results The usual cutoffs (≥13 for EPDS, T‐score of 63 for BSI‐53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI‐53, and GSI = 0.5 for BSI‐18. Practice Implications The use of psychological tools among pregnant women with high‐risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.

This study, through structural equation modeling, examines the structural relationship between social intelligence and self-differentiation with the mediational role of the teachers’ religiosity. The statistical population of the present study was all 1341 primary school teachers in Bojnourd. The participants, 299 people (135 males and 157 females), were selected through cluster random sampling method; They answered the three standard questionnaires: the Tromsø Social Intelligence Scale (2001), the Model of Religiosity of Glock and Stark (1965), and Skowron and Lander Differentiation of Self Inventory (1986). The validity and reliability of all three questionnaires were confirmed. Data analyzed by path analysis method of structural equation modeling by IBM SPSS STATISTICS 22 software, and SPSS AMOS 16 software. The findings showed that the path coefficient between the social intelligence variable and self-differentiation in the total-effect model without a mediating variable is significant. The findings also confirm the direct effect of the components of social intelligence on the components of self-differentiation, but the religiosity variable does not mediate this relationship. According to these findings, both the religiosity and self-differentiation variables can be considered as a direct consequence of social intelligence, and, so as to increase these two characteristics, it can be suggested that measures should be taken to improve the components of social intelligence in teachers.

Background and Aims: loneliness has some implications for health. The relationship between loneliness and nutritional status requires careful and principled investigation. Therefore, the aim of this study was to determine the relationship between loneliness and nutritional status of the elderly. Methods: 440 elderly 60 years and older individuals from Social Security Administration, Education Retirees Association, and Health Center were selected randomly Descriptive-Analytical study in 2018. Data collection tools included demographic information questionnaire, UCLA loneliness scale (20-80 Score in four levels; without loneliness, low, moderate and high) and mini nutritional assessment (0-30 score at three levels of malnutrition, at risk of malnutrition and normal nutritional status). Results: The Mean ± SD age for the participants was 65.32(6.22). The relationship between nutritional status and loneliness of 68 elderly people without feeling alone (< 20), 85.3% had normal nutritional status, of 317 elderly people with low loneliness (39- 21), 80.4% had normal nutritional status. Of 52 elderly people with moderate loneliness (59-40), 63.5% were at risk of malnutrition. Loneliness in the elderly was significantly associated with an increased risk of malnutrition (OR = 4.2276, P = 0.00). Conclusion: According to the felling of loneliness, more than half of the elderly and the reverse connection between the feelings of loneliness with the state of nutrition, holding free consultation classes in order to reduce the feeling of retired elderly loneliness by the politicians of the health system.

Background and purpose: Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, and a metabolic disorder affecting patientschr('39') general health in various ways. The present study aimed to evaluate the oral health-related quality of life (OHRQoL) among older adults of Amirkola, Northern Iran. Materials and Methods: A case-control study was conducted with a sample of 500 elderly people (250 with T2DM and 250 healthy controls) who answered geriatric oral health assessment index (GOHAI) questionnaire and a questionnaire evaluating xerostomia. Then, all participants underwent clinical dental examinations. The obtained data were then analyzed by t-test, chi-square test, and Pearsonchr('39')s correlation coefficient, and p < 0.05 was considered significant. Results: The prevalence of xerostomia was not statistically significant between the T2DM patients and control groups (p < 0.079). Greater number of patients suffering T2DM reported xerostomia according to the records; however, the correlation between this disorder and periodontal disease index (PDI), Plaque index (PI), oral health index-simplified (OHI-S), and geriatric oral health assessment index (GOHAI) in the subjects of the two study groups was not significant (p < 0.0001). Conclusion: In the present study, there was no significant relationship between GOHAI and periodontal indices, demonstrating no difference in the OHRQoL of elderly patients with T2DM and older healthy adults.

Abstract 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

Background: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. Methods: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. Results: The prevalence of depressive disorders was 15.4%% for Edinburg scores ≥13. The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5%. The prevalence of psychiatric symptoms was high; for 25% somatization, 258% anxiety, obsession-compulsion disorders or OCD 6.4%, 8.8% interpersonal sensitivity, 5.3% phobia, 7.6% paranoid ideation, and 1.2% psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (β=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). Conclusion: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women.

Background & Aim: Maintaining and improving the health of the elderly through effective interventions requires the recognition of their lifestyle, including exercise using a valid and appropriate culture-specific tool. The aim of this study was to design and evaluate the psychometric properties of a tool for measuring exercise self-efficacy in the elderly. Methods & Materials: A sequential exploratory mixed method study was performed in the form of a questionnaire with two qualitative and quantitative sections in 2019. The qualitative section consisted of item generation including three stages: theoretical stage (targeted search of existing literature), field work (semi-structured interviews with the elderly) and final analysis (integration of the results from the two previous stages). In the quantitative section, the psychometric properties of the questionnaire was evaluated using face, content and construct validity as well as the reliability through internal consistency and stability. Results: Out of 37 initial items, four items were removed after calculating the item impact score. Seven items were removed after assessing the content validity ratio and content validity index. Also, five items were omitted due to having a load factor less than 0.03. The result of exploratory factor analysis consisted of three factors “recognition”, “situational compatibility” and “self-control” which all together could explain 90.180% of the variance. The Cronbach’s alpha and the Intraclass correlation coefficient were found to be 0.957 and 0.949 respectively. Conclusion: The data analysis approved that the designed tool can be used for measuring exercise self-efficacy among the elderly due to having acceptable reliability and validity, simplicity and a short completion time.

Abstract 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.

The factors affecting the dynamics of lengthening of symptoms and serologic responses are not well known. In order to see how the serologic responses change in relation to the clinical features, we selected a group of 472 adults with a positive IgM/IgG antibody test result from a baseline study of the anti-SARS-CoV-2 seropositivity, assessed their COVID-19 and past medical histories, and followed them up in about 3 months. Nearly one-fourth of the subjects were asymptomatic at the baseline; 12.8% subjects became symptomatic at the follow-up (FU) when 39.8% of the subjects had some persisting symptoms. At the baseline, 6.1% showed anti-SARS-CoV-2 IgM positive, 59.3% only for IgG, and 34.5% for both. At the FU, these figures declined to 0.6, 54.0, and 4.4%, respectively, with the mean IgM and IgG levels declining about 6.3 and 2.5 folds. Blood group A was consistently linked to both sustaining and flipping of the gastrointestinal (GI) and respiratory symptoms. The baseline IgM level was associated with GI symptoms and pre-existing cirrhosis in multivariate models. Both of the baseline and FU IgG levels were strongly associated with age, male, and lung involvement seen in chest computed tomography (CT)-scan. Finally, as compared with antibody decayers, IgM sustainers were found to be more anosmic [mean difference (MD): 11.5%; P = 0.047] with lower body mass index (BMI) (MD: 1.30 kg/m2; P = 0.002), while IgG sustainers were more commonly females (MD: 19.2%; P = 0.042) with shorter diarrhea duration in the FU (MD: 2.8 days; P = 0.027). Our findings indicate how the anti-SARS-CoV-2 serologic response and COVID-19 clinical presentations change in relation to each other and basic characteristics.

Background: Several studies have developed sex-specific reference percentile curves for body fat percentage in children to be adopted in clinical surveys. Objectives: This study aimed to develop acceptable percentile curves for body fat percentage in children in Babol, North of Iran, to assess childhood obesity. Methods: Body fat percentile charts were created using bioelectrical impedance analysis of 7 to 11 years old schoolchildren from rural and urban parts of Babol. The obtained percentile charts were then smoothed. Results: The findings showed that the mean fat percentages differed between boys and girls. The 50th percentile curve was slightly higher for boys of 7-11 years, with a peak fat percentage of 22.50% at 11 years of age, whereas the mean fat percentage increased with age in 7 to 9 years old girls (16.8%-22.05%), reduced slightly from 9 years of age, and then peaked at 25.5% at 11 years. Conclusions: This study provided reference curves for body fat percentage in the North Iranian children, who were found to have significantly high body fat percentage. It may be useful to further prepare national reference values and cut-off points for body fat percentage as a predictor of childhood obesity.

Background: Considering the importance of healthy diet in the protection of cardiovascular diseases (CVD), this research aimed to assess the physiological risk factors for CVD in middle-aged adults and their association with dietary intake in the north of Iran. Methods: In this cross-sectional study conducted in the years 2016-2017 among the adults aged 40-60 years living in Amirkola, Babol, the participants´ physical activity, dietary intake, body mass index, fat mass, blood pressure, fasting blood glucose and serum lipid profile were reported. The International Physical Activity Questionnaire was used to assess physical activity and a structured 24-hour food-recall questionnaire was used to assess the participants´ dietary intake. Consumed foods and beverages on two separate days were analyzed and transcribed in 10 food groups (gram). Results: Two hundred and ninety-one persons (96.7%) had complete participation, 96.2% with at least one CVD risk factor and 75.9% had overweight or obesity; 33% with hypertension; 6.2% had high fasting blood glucose; 64.6% with hypercholesterolemia, 47.8% had hypertriglyceridemia, and 8.9% with low HDL. Mean daily intake values of carbohydrate, protein and fat were all higher than dietary reference intakes for adults. Physical activity less than 1500 MET-minutes per week was significantly associated with having three or more physiological risk factors for CVD [adjusted odds ratio: 2.04 (1.08-3.85)] (P=0.029). Conclusion: Most of the middle-aged adults in this region had at least one of the physiological risk factors for CVD and daily intakes of carbohydrate and protein were higher than dietary reference intakes (DRIs) for adults.

Background and purpose: Identifying potential risk factors for cardiovascular diseases is essential for screening and disease prevention. In this study, the association between ABO blood groups and risk of cardiovascular diseases was assessed. Materials and methods: In a cross-sectional research, 1353 consecutive elderly in Amirkola, north of Iran enrolled. Cardiovascular disease was determined according to medical history, any medications, and other medical documents. Also, the ABO blood group was determined. Finally, the frequency of cardiovascular disease was compared between ABO blood groups. Data analysis was done in SPSS 16. Results: The mean age of the population studied was 69.21±7.30 years and 754 (55.7%) and 599 (44.3%) were males and females, respectively. Blood group O (33.5%) and B (33%) phenotypes were common types in this population. Angina pectoris was significantly associated with A blood group (P=0.039). But no relationship was found between ABO blood group and cerebral stroke (P=0.624), myocardial infarction (P =0.229), heart failure (P =0.866), hypertension (P =0.623), and other risk factors. Conclusion: According to the our findings, a relationship was only detected between A blood group phenotype and angina pectoris, while no any significant association was detected between ABO blood groups and risk of other cardiovascular diseases.

Background: The study was conducted to assess reliability of modified semi-quantitative food frequency questionnaire (SQFFQ) as a part of the Amirkola Health and Aging Project (AHAP). Methods: The study was carried out in a sample of 200 men and women aged 60 years and older. A 138-item SQFFQ and two 24-hour dietary recalls were completed. The reliability of SQFFQ was evaluated by comparing eighteen food groups, energy and nutrient intakes derived from both methods using Spearman and Pearson’s correlation coefficients for food groups and nutrients, respectively. Bland-Altman plots and Pitman’s tests were applied to compare the two dietary assessment methods. Results: The mean (SD) age of subjects was 68.16 (6.56) years. The average energy intake from 24-hour dietary recalls and the SQFFQ were 1470.2 and 1535.4 kcal/day, respectively. Spearman correlation coefficients, comparing food groups intake based on two dietary assessment methods ranged from 0.25 (meat) to 0.62 (tea and coffee) in men and from 0.39 (whole grains) to 0.60 (sugars) in women. Pearson correlation coefficients for energy and macronutrients were 0.53 for energy to 0.21 for zinc in male and 0.71 for energy to 0.26 for vitamin C in females. The Pitman’s test reflected the reasonable agreement between the mean energy and macronutrients of the SQFFQ and 24-hour recalls. Conclusions: The modified SQFFQ that was designed for the AHAP was found to be reliable for assessing the intake of several food groups, energy, micro-and macronutrients.

Background: There is some evidence that shows the symptoms of anemia are fewere in overweight and obese people, so, the purpose of this research was to study the relationship between anemia and iron deficiency anemia (IDA) with lipid profile status of the elderly. Methods: This cross-sectional study came from the Amirkola Health and Ageing Project (AHAP). A demographic questionnaire was given to the older people and a blood sample was obtained to assay their lipid indexes (triglyceride, cholesterol, HDL and LDL) and the parameters related to anemia after 12 hours fasting. The data were analyzed by chi-square test, t-test and Pearson correlation using SPSS. A p

The original cohort study of AHAP started in 2011 on 1616 elderly residents of Amirkola, northern part of Iran near the Caspian Sea. The main goal of this study was to comprehensively evaluate the health of the elderly in the region with the emphasis on chronic diseases such as osteoporosis. The first cohort profile was published in the International Journal of Epidemiology in 2014. The phase 1 AHAP showed the elevated level of some diseases and conditions including osteoporosis, metabolic syndrome, obesity, vision problems and relatively low levels of oral health. Therefore, the second phase of this cohort started with more complete population coverage in 2016, not only to collect and record the information based on previous protocol, but also consider new areas such as nutritional status, complete eye and dental examinations and health assessment on the basis of Iranian Traditional Medicine. The new aspect of this project is to conduct clinical and laboratory examinations at the health center to extend more facilities to the elderly. In addition to serum and DNA, samples of saliva, hair and nails are collected and kept under standard conditions in the biobank of this cohort. Researchers can apply for access to data or suggest a collaborative study by submitting the proposal to AHAP committee.

Background and Objective: Hyperhomocysteinemia is a well-known risk factor for cardiovascular disease. Although metformin therapy can increase homocysteine (Hcy) levels, it frequently is used as an oral medicine in women with polycystic ovary syndrome (PCOS), who might be at risk of catching diabetes mellitus. The aim of this study was to investigate the effect of metformin on the levels of serum Hcy, vitamin B12 (vit B12), and folic acid in patients with PCOS. Materials and Methods: An interventional study was designed with 18 patients with PCOS at the Fatemehzahra infertility Hospital in Babol, Iran. Metformin treatment (500 mg twice daily) was initiated in all patients for a period of consecutive 6 months. The levels of serum Hcy, vit B12, and folic acid were measured in the participants before and after metformin treatment. Results: The mean vit B12 level showed a significant decrease in patients after 6 months of metformin treatment (P = 0.002). However, there was no significant difference in serum folic acid levels. The mean Hcy levels increased after treatment, but this difference not was statistically significant. When patients were stratified into four subgroups by their insulin sensitivity and body mass index (BMI), relatively similar results were obtained in the subgroups, except that Hcy levels in the overweight/obesity group (BMI > 25 kg/m2) after treatment showed a significant increase (P = 0.01). Conclusion: These findings indicate that metformin increases the serum Hcy concentration in patients with PCOS especially in the women with BMI > 25 kg/m2. The possible mechanism for this effect would be the obvious reduction in the levels of vit B12.

Background: Both vitamin D deficiency and hypertension are prevalent in the general population. Several observations indicate an association between vitamin D deficiency and high blood pressure. The present case-control study aimed to compare serum 25-hydroxyvitamin D (25-OHD) in hypertensive patients versus healthy controls. Methods: One hundred patients aged 30-60 years with hypertension (HTN) and 100 healthy controls without history of hypertention were compared regarding serum 25-OHD. Blood pressure was measured using standard method and the systolic and diastolic blood pressure more than140 mmHg and 90 mmHg respectively were considered as HTN. Patients and controls with coexistent morbidities, vitamin D supplementation were excluded. The serum levels of 25-OHD, PTH and calcium were measured after obtaining a written informed consent from the patients and taking their blood pressure under standard conditions. In statistical analysis, the two groups were compared using independent t test and chi-square test using SPSS Version 18. Results: The mean age of patients and controls was comparable (53.7±6.4 vs 52.3±7.54 years, P=0.17). Serum 25-OHD in HTN was significantly higher than controls (P=0.001). Conclusion: In the present study, serum 25-OHD level in hypertension was higher than controls. The results contradict with earlier studies indicating an association of HTN with vitamin D deficiency. This issue warrants further investigations in particular the follow-up of serum 25-OHD deficient and sufficient subjects with regard to the development of HTN.

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