ایاد بهادری منفرد

Celiac disease is an autoimmune enteropathy caused by gluten consumption in genetically predisposed individuals. Gluten is a protein that is soluble in alcohol and is present in grains such as wheat, barley, and rye. This abnormal response to gluten causes atrophy of the intestinal mucosa, resulting in reduced absorption capacity of the intestine and inadequate uptake of essential nutrients, accompanied by both digestive and non-digestive symptoms. Due to the increasing prevalence of celiac disease, athletes must have a comprehensive understanding of the disease, associated risks, and the management options of this disease in areas such as diet management and exercise prescription. This review paper discusses the etiology of the disease, nutritional assessment, and exercise management for athletes with celiac disease.

Diabetes is one of the most common metabolic diseases that causes debilitating complications. Obesity control could be considered to prevent its complications. The aim ofthis study was to evaluate the factors related to body mass index of diabetic patients referred to the HAFT-E-Tir martyrs center in Firoozkooh.

All diabetic patients cared for in the mentioned center during 2016-2016 and wereregistered in the health system were included in the presentdescriptive-analytical study. Data were analyzedusing SPSS version 23 by chi-square test.Confidentiality of information and ethical issues were all considered in the implementation stages of study as well as in the publication of results.

Out of 242 diabetic patients studied, 63.6% were female and 36.4% were male.The mean age of patients was 58.2 years. About 50% (121 people) were obese and 33.9% (82 subject) were overweight. The rateof obesity was higher in women than men (53.9% vs. 43.2%). Only 21.9% (53 patients) had a history of diabetestheir families. There was no statistically significant relationship between body mass index variables andparticipants’ gender, age, family history,and duration of diabetes (p> 0.05).

Increasing body mass index is a predictor of diabetes in age groups and controlling obesity.Furthermore,overweight has a great role in controlling diabetes, so healthy diet training should be included in the care programs of these patients

Global health reports are valuable sources in all health areas for policymakers. The aim of our study was to review the global reports published within ten years, focusing on the situation and functions of Iran health system.

The study reviewed global health reports. In our study and with a systematic approach, we attempted to find and review all the main published reports from 2008 to 2018, using appropriate search strategies. At first, we assessed how these reports are published and who are the main participants. Then, the importance of the area and approach of the report was assessed. The indicators at international and national levels from the aspect of both the process and outcomes were the fundamental part of our analysis. Finally, special experiences from Iran were extracted from each global report.

Sixteen global reports in the areas of non-communicable disease, communicable diseases, mental health, and injuries were selected and indicators related to the world and Iran was extracted.

Assessment of the global reports demonstrated that the situation of Iran's health system in the areas of controlling the non-communicable diseases, maternal health, and water safety was favorable. However, the situation in the areas of unintentional injuries and happiness was unfavorable. The situation in the field of mental health and violence prevention was intermediate

Recently, the demand for functional foods consumption is growing rapidly due to the increased awareness of the consumers from the impact of these foods on health. The aim of this study was to assess microbiological, biochemical and sensory aspects of probiotic Doogh.
In this research, the effects of type (skim milk power and whey protein) and percents of dry matters and final pH of fermentation (4 and 4.4) on biochemical viability of probiotics and sensory properties of probiotic Doogh during fermentation and 21 days in refrigerated storage were studied. In this way, pH and redox potential values were measured by pH-meter. Titrable acidity value was determined by titration with 0.1 N NaOH. Probiotic bacteria were enumerated using MRS-bile agar medium.
Treatment with 4% skim milk power and 1% whey protein at pH of 4.4 (6 WP-1) -4.4) showed the highest viability of both probiotic bacteria after fermentation and during refrigerated storage. Treatments 4% skim milk power at pH of 4.0 (4 SMP-4.0), 3% skim milk power with 1% whey protein concentrate at pH of 4.4 (4 WPC-1) -4.4), 6% skim milk power at pH of 4.4 (6-SMP-4.4), 6% skim milk power at pH of 4.0 (6 SMP-4.0) and 5% skim milk power with 1% whey protein (6 WP-1) in both final pH 4.4 and 4.0 had the highest level of organoleptic acceptance. However, they have more economic considerations than 6% of dry matter.
Overall, whey protein can be used as part of the dry matter Doogh without changes of organoleptic properties and viability of probiotic Doogh.

Doogh is a traditional Iranian fermented milk drink, which is produced by lactic fermentation of pasteurized milk. In order to isolate and identify the microorganisms present in Iran industrial Doogh samples, polymerase chain reaction (PCR) was applied. Doogh samples were 17 name brands. After conducting the preliminary identification by microscopic observations and biochemical tests, in order to verify the obtained results the samples were pure-cultured which was followed by PCR and sequencing. According to the results obtained through sequencing of 16S rRNA, the identified bacteria belonged to lactic acid bacteria (Lactobacillus brevis, L. fermentum, L. paracaseiand L. gallinarum); gram-posetive spore-forming bacteria (Bacilluslicheniformis, B. anthracis and B. subtilis) and acetic acid bacteria (Acetobacter tropicalis and A. indonesiensis). Moreover, based on the results obtained by sequencing of D1/D2 26S rDNA the identified yeasts were including Pichia fermentans, Saccaromyces unisporous and Cryptococcus magnus. The obtaining of present study illustrated that in addition to identified non-starter lactic acid bacteria, other types of bacteria and yeasts were found in Iran industrial Doogh samples.

Obesity is one of the most common nutritional problems. Understanding the prevalence of overweight and obesity in women is essential to planning and prioritizing of health problems. The current study aimed to broaden our understanding of the prevalence and related factors of overweight and obesity in the women at ages of pregnancy in Rasht, Iran, in 2015.
The present cross-sectional study was designed to investigate the prevalence of overweight and obesity in women aged 20 to 50 years living in Rasht. The multiple-stage sampling method was used to recruit the participants. All participants provided informed consent before entering the study. Body mass indexes of >30 kg/m2 and >25 kg/m2 were considered obese and overweight, respectively. The collected data were analyzed by descriptive statistics, chi-square test and correlation coefficients.
The mean age of participants in the study was 19.28 (SD= 6.99). About 2.9% and 24.8% of study participants were obese and overweight, respectively. Also, the relationship between prevalence of overweight, mobility status, age and income was statistically significant.
Our study found that overweight and obesity is a major public health problem among women living in the region and, thus, more attention should be given to reproductive-aged women with increased obesity-related measures.

Improving quality and safety of hospital services is a challenge for managers. Utilizing an appropriate nosocomial infection management model can improve the quality of safety procedures; quality of care and reduce the nosocomial infections. This study aimed to survey the effect of nosocomial infection management model on reduction of nosocomial infections at Hospital of Jahrom 2014: performing an action research study. The undergone action research study through necessary intervention was performed in 6 months. Two valid & reliable checklists including “Hand Hygiene Checklist “and “Sterilization of Surfaces and Patient Care Units Checklist” were completed and scored before and after the intervention. Data were analyzed using SPSS/22. With the implementation of “Nosocomial Infection Management Model” due to structural problems, infections was increased three times during the last 6 months of this survey compared to similar months in past year. However, implementation of the model decreased the nosocomial infections’ rate by 39% compared to the first three months of the same year. Utilizing “Nosocomial Infection Management Model”, plays a significant role in reducing the nosocomial infections. Hence applying this model in hospitals is recommended.

Functional prebiotic products have many additional health effects on the gastro-intestinal system. Due to the high consumption of pasta products in Iran during the last decade, pasta fortification with non-digestible oligosaccharides seems to be integral. Resistant starch can tolerate enzyme hydrolyzation and high moisture and temperature of pasta production line. The aim of the present study was to formulate a macaroni product with resistant starch type 2 and compare its physical, rheological, cooking and sensory properties with the control sample. Semolina flour and industrialized water were used to produce macaroni. Resistant starch type two (Hi-maize260TM)-based macaroni was incorporated in four proportions (w/w): 2.5, 5.0, 7.5, and 10.0 g/100 g. After dough was produced in the extruder under 60cmHg, it was dried in appropriate conditions. Physical, rheological, cooking and sensory properties were analyzed and compared with control sample. Replacement of resistant starch type two (RS2) with semolina resulted in a significant reduction in moisture. The color of final macaroni was brighter in 10%RS2 (p<0.05). Cooking loss and absorption of water were significantly reduced (p<0.01). Textural analysis of the cooked samples declared that RS2 caused a significant increase in hardness and cohesiveness; while it reduced adhesiveness and chewiness of the final product (p<0.01). The results of sensory evaluation showed no negative effects on the RS samples; while it reduced adhesiveness (p<0.05). We observed that the macaroni fortified with 7.5 g/100g RS2 was the best product from both the technological and sensory points of view.

Nutrition is one of the effective factors in the protection of health and the prevention of disease. Therefore، determination of the relationship between nutrition choices and health of people is emphasized. The aim of this study is to determine the effectiveness of education and nutrition consultation on changing the unhealthy nutritional habits، and improving healthy nutrition behavior among the clients of Sardar-Jangal health center in 2012. This interventional study was performed with the participation clients of Sardar Jangal health center in 2012. The sample size was 1500 and the sampling method was census. Data was gathered through a questionnaire and interview. The questionnaire included information regarding age، sex، education، employment and nutritional status. The scores between 9-11، 5-8 and less than 5، respectively، were considered as favorable، relatively favorable and unfavorable nutritional status. The participants with relatively favorable and unfavorable status were referred to nutrition education and consultation classes. At the end of the consultation classes، their nutritional status were assessed again. The data was analyzed through SPSS 21، using T-Test. In the study، 1500 clients of Sardar Jangal health center participated. The sample included 383 (25. 6%) male and 1117 (74. 4%) female. The mean age of male and female was 38. 3±21. 1 and 36. 9±17. 4 respectively. Before participating in the nutrition education and consultation classes، the nutrition status of 343 (30. 7%) of females was favorable whilst for 775 (69. 3%)، the nutritional status was unfavorable. Among 114 (29. 8%) of males it was favorable and amongst 268 (70. 2%) it was unfavorable. Between the mentioned clients، the nutrition status of 144 (20. 1%) females and 28 (12. 7%) males improved after nutritional consultation (P < 0. 001). The results showed nutritional education and consultation are effective in improving the nutritional behavior and modifying the incorrect nutritional behavior.

This study compares the effects of modified diets containing legumes on fasting blood glucose and lipid profiles in patients with type II diabetes. In this randomized crossover trial, 24 subjects with type 2 diabetes, age range of 50 to 80 years, were selected and randomly assigned to two groups, one receiving diets of therapeutic lifestyle change (controls) or the other, with therapeutic lifestyle change with legumes (replacing meat with 2 servings of legumes in their therapeutic lifestyle change diet, three days a week). Period of each diet was 8 weeks with a 4 week wash out period. Fasting blood samples were taken to measure the fasting plasma glucose and blood lipid profiles (LDL-C, triglycerides, HDL-C, total cholesterol). Compared to the therapeutic lifestyle change diet, in the group with the therapeutic lifestyle change diet with legumes, diet were fasting insulin, total cholesterol and triglycerides were significantly decreased (P<0.05). After 8 weeks intervention fasting plasma glucose and LDL cholesterol in both diets significantly reduced compared with baseline values (P<0.05), while, no significant change was observed in HDL cholesterol. Replacement of 2 servings of legumes instead of meat 3 days a week in the TLC diet resulted in improved total cholesterol and triglyceride levels.

Backgrounds and The purpose of this study is to investigate injuries resulting from accidents and incidents referred to medical centers and hospitals of Shahid Beheshti University of Medical Sciences. This study is a cross-sectional study. All cases admitted to hospitals'' of Deputy of Health of Shahid Beheshti University of Medical Sciences، due to accidents and injuries from March 2012 to March 2013 were reviewed. Categorization of accidents and injuries data was performed according to tenth version of international classification of diseases. SPSS V. 18 was used for analysis of data. The main variables in this study، the type of incident، type of accident، accident location and background variables that were studied included: gender، age. Data collected by means of forms and software injury register by Hospital emergency department staff to interview and hospital records، were completed. In total، 248438 cases were reviewed. 67. 7% were male and 32. 3% were female. Traumas، traffic accidents and falls were major causes of accidents and injuries. Accidents and injuries were more prevalent in 15-25 years age group. Individuals living in urban areas sustained more injuries compared to individuals from rural areas. A total of 722 deaths were reported due to accidents and injuries. Research results indicate that traffic accidents constitute a large proportion of accident and injuries. Also، men، young people were the most victims of accidents and injuries. Training of different groups، including before and during recruitment، training mothers and elderly it seems to be useful. Further studies on the improvement of accidents and injuries software is suggested for access to complete and reliable data. Promoting Knowledge and training، especially in the younger age group، intervention to resolve the accident prone spots and technical defects is recommended to reduce traffic accidents

Human serum albumin with its singular structure acts as a carrier mo-lecule that can attach to a variety of sub-stances. Any structural or functional chan-ges in albumin are accompanied with unde-sirable outcomes. In the present research، attachment of some ligands such as det-ergents (DTAB) and sugars (glucose) to albumin were evaluated at temperatures 27°C and 42°C. Tris-buffer solusion for albumin with a pH close to the pH of body was prepared. To denature albumin، hydrochloric acid was used. UV spectero-photometric technique was applied to eval-uate denaturation process. With increment of DTAB conc-entration the maximum optical absorption of albumin decreased. Glucose concent-ration at 400mg/dl level caused a profound change in the optical absorption of albumin that might affect the structure of the mo-lecule. Discussion & Glucose elevate-on has deleterious effects and deteriorates the function of many molecules in blood. The effects may exert on hormones، drug transportation، necessary ions and elements

It is obvious due to lack of resources،resources; we should devote our limited resources to priorities in order to reach an acceptable level of health. The objective of this study is research priority setting for Pediatric Surgery Research Center with the participation of all stakeholders. This is a Health System Research (HSR) project. In order to apply governance and leadership issues with the participation of 41 people including faculty members in Pediatric Surgery Research Center of Shahid Beheshti University of Medical Sciences، other pediatric specialists and health system stakeholders and the people associated with the health system inside and outside of the university. This study was performed with little change in 2010 using the Council on Health Research for Development (COHRED) model. Based on the model، at first the stakeholders were identified and the field situation of pediatric surgery was analyzed. Then، research areas and titles were specified and research priorities were setup by giving scores according to the criteria. The seven obtained research areas in order of priority are pediatric trauma، pediatric cancers، pediatric urology diseases، undescended testicles in children، developmental genetics and congenital defects، emergency in children and application of laparoscopic surgery in children. SinceBecause each of the research areas are composed of multiple subareas. Finally we specified 43 research subareas as research priorities. These subareas include epidemiology، risk factors، prevention، screening، diagnosis، treatment، follow-up، complications، knowledge and attitudes of parents، quality of life، economy aspects and data bank for further research. ‍ In this project، research priorities were setup for Pediatric Surgery Research Center of Shahid Beheshti University of Medical Sciences with the participation of all the stakeholders based on the recommended model of WHO (COHRED). It seems that reliability of the priorities is in moderate level، but there is a certaincertain validity in obtaining the best content in terms of the study conditions.

Microbial transglutaminase (MTG) catalyzes the formation of ε – (δ glutamyl -)- lysine cross links in proteins via an acyl transfer reaction. The effect of adding of MTG and two incubation time (30 and 60 minutes) in 38°C on textural and sensory properties of UF cheese was investigated at 1, 15, 30 and 45 days after production.

MTG was used in three concentrations of 15, 30 and 45 unites per liter of milk. To study textural characteristics, stress at breaking point and Young module were measured by texture analyzer (Testometric M350-10 CT, UK). MTG in first day increased protein level, stress in breaking point and Young module of cheese.

Ratio of moisture to protein in different samples decreased in comparison to control sample. During the storage time the level of moisture was increased, level of protein was decreased, moisture to protein ratio increased, and stress in breaking point and Young module decreased and as a result the reduction of firmness in treated samples were observed.

Increasing the incubation time from 30 minutes to 60 minutes lead to increase the effect of MTG on physical, chemical, textural and sensory properties of UF cheese. Increasing of MTG (15 unites) per liter of milk in 30 and 60 minutes caused to have a stable texture and high total acceptability of UF cheese. High concentration of MTG in two incubation time increases hardness and decreases total acceptability of cheese. MTG in concentration of 15 per liter of milk and incubation in 30 minutes causes to increase texture strength and improve sensory properties of UF chesse.

During cheese ripening, some of water insoluble casein change to water soluble nitrogen which are include intermediate hydrohysate protein and free amino acids.

These enzymes save their activities in pasteurization temperature and also UHT processing. In this study effect of number of Pscyrotroph bacteria on physical and chemical properties on UF and white cheese was investigated.

In this work, ripening and efficiency of traditional white and UF cheese as affected by psychotroph bacteria was investigated. The result of this research showed that amount of psycrotroph bacteria on the white and UF cheese was significant.

Also, there was a good correlation between psycrotroph bacteria and ratio of soluble nitrogen to total nitrogen during ripening period. In fact, as the psycrotroph bacteria increase, the ratio of soluble nitrogen to total nitrogen will be increased during ripening period. The percent of N recovery (efficiency index) for UF and traditional white cheese was 88. 01-90. 45 and 77. 23-80. 52, respectively. The effect of changing above parameter on UF cheese is more than white cheese.

There is no reliable prediction model on the rate of mortality due to road traffic accidents in Iran. The present study aimed to predict deaths from road traffic crashes in Iran.

All death records from traffic accidents in Iran between March 2004 and March 2011 were analyzed. The Box-Jenkins time series model was used for obtaining trends. Death from traffic accidents were predicted from March 2011 to March 2013 and then compared with the actual frequencies.

Overall, 21548 deaths (95% CI: 15426-27669) due to road traffic accidents were predicted for 2011 compared to 2010, with a negative growth of 7.32%. Actual frequency was 20404 deaths (95% CI: 9914-30893) for 2013 compared to 2011 with a negative growth of 5.31%. An accuracy rate of 93% was found for prediction of fatal traffic accidents compared to the formal reports by the government.

With respect to the frequency of real crashes leading to death by the end of 2011 and its comparison with the time series prediction model, an acceptable accuracy rate of 93% was found. Keywords: Accidents, Death, Iran, Traffic, Prediction

Health system research improves health system processes. This study was designed to define health system research priority setting for sub-secretaries of Shahid Beheshti University of Medical Sciences. These could be lead to purposeful researches and better resource allocation. Through a health system research, stakeholders of each sub-secretary were defined and analyzed. Those who had the base score were selected to be asked. Research fields were listed through brain storming and finalized by Delphi technique. Research fields were prioritized through a questionnaire in which weighted criteria used for scoring. Final score calculated by multiplication of mean of each criterion’s weigh by research field mean score. Totally 89 sub-secretary were selected in 15 research fields. The top priority for sub-secretary of research was providing the University research map and priority setting, for sub-secretary of students was psychological problems in students, for sub-secretary of resources was criteria for workforce planning, for sub-secretary of food and drug was automation of services, for sub-secretary of treatment was hospital infections and for sub-secretary of health was needs assessment and situational analysis in the field of Shahid Beheshti University of Medical Sciences. Health system research committees in Shahid Beheshti University of Medical Sciences should be considered as an opportunity. Announcing the health system research priorities shows the way to promote community health based on its need. It also provides a tool for better resource allocation when there is resource shortage.