خیرالله اسدالهی

Behavioral and personality traits of family members, especially the parents can affect a child's behavior. According to high prevalence of mental disorders in Iran, this study was conducted to determine the relationship between personality disorders in parents and psychiatric disorders in children and adolescents.

A cross-sectional-analytical survey was performed in children and adolescents aged 6-18 years in Ilam and its suburbs, west of Iran, 2018-2019. A total of 1022 children and adolescents were selected using multi-stage cluster sampling. Semi-structured interviews were carried out and data were collected using Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) and Millon Clinical Multiaxial Inventory. Data analysis was done applying descriptive statistics and calculation of odds ratio with 95% confidence interval.

The prevalence of psychiatric disorders was 10.80% in boys and 8.15% in girls. The most prevalent disorders in boys were depression (0.81%), enuresis (3.67 %), hyperactivity (1.84 %), and specific fear (1.22 %) and in girls separation anxiety (4.17%) was more common. Findings showed significant direct relationships between depressive personality disorder in mothers and depression in children (OR= 1.07, 95% CI: 1-1.14, P=0.02) and between depressive personality disorder in fathers and nocturnal enuresis in children (OR= 1.07, 95% CI: 1.01-1.14, P=0.02), and also between avoidant personality disorder in fathers and specific fear disorder in children (OR=1.09, 95% CI: 1-1.20, P=0.04).

In this study, we observed high prevalence of psychiatric disorders in children and adolescents that are significantly linked to the personality traits of parents and should be taken into account in making diagnosis and designing interventions.

Short children face many problems throughout their lives. Consumption of growth hormone and the drugs such as Letrozole, Oxandrolone, and Anastrozole can increase the growth of children and adolescents. There is not an overall estimate of the effects of Letrozole, Oxandrolone, and Anastrozole on the growth of children and adolescents with Idiopathic Short Stature (ISS). There are different estimates of the effect of growth hormone and the drugs Letrozole, Oxandrolone, and Anastrozole on growth in children and adolescents with Idiopathic Short Stature. Therefore, the aim of this study was to compare the efficacy of growth hormone, Letrozole, Oxandrolone, Anastrozole, and a combination of growth hormone and aromatase inhibitors on height gain in children and adolescents with idiopathic short stature using meta-analysis method.

Search was done in databases such as; Scopus, Web of Science(ISI), and PubMed using keywords: Idiopathic, Short Stature, Body Height, Aromatase Inhibitors, Growth hormone, Letrozole, Oxandrolone, Anastrozole. Randomized clinical trial studies ,that have investigated the efficacy of growth hormone and aromatase inhibitors on height gain in children and adolescents with short stature, were selected. Height standard deviation score (HSDS) before intervention and after treatment has been used to measure the rate of height increase in various studies. This study was written based on the PRISMA checklist and the heterogeneity of this study was evaluated using the Q statistic and I2 index.

Height increase index (HSDS) was obtained with the use of growth hormone combined with one of the aromatase inhibitors (0.38-3.58=95%CI) (SMD=0.98), with the use of growth hormone (0.62-1.14=95%CI) (SMD=0.88), with the use of Letrozole (0.51-16.51=95%CI) (SMD=0.83), with the use of Oxandrolone (0.99-0.99=95%CI) (SMD=0.56), and with the use of Anastrozole (0.00-0.63=95%CI) (SMD=0.31), which shows that all these drugs have a significant effect on height increase. (P<0.05)

Although the effect of growth hormone on height increase was greater than that of aromatase inhibitors, but according to our results, adding an aromatase inhibitor to growth hormone can increase the effectiveness of it.

The financial consequences of the increasing prevalence of diabetes show that diabetes is one of the main challenges of healthcare systems. This study aimed to investigate the direct costs imposed on insurance companies and patients by the delivery of first-level services to patients with type 2 diabetes, who were covered by health insurance and social security insurance plans in Ilam, Iran, in 2019.

In this descriptive analytical study, the population included all patients with type 2 diabetes, who had available electronic records in comprehensive health centers and were covered by the insurance companies of Ilam. The data collection tool was a checklist, and data analysis was performed in SPSS version 20. Inferential statistics, including independent t-test and one-way analysis of variance, were measured, and descriptive statistics, including mean and standard deviation, were calculated.

A total of 800 patients entered this study, 71.4% of whom were female. The mean age of male and female patients was 59.42 and 54.97 years, respectively. The average annual direct cost was estimated at 62,742,383 Rials per person; the highest cost was related to hospitalization (49,794,297 Rials) (79.3%), and the lowest cost was related to imaging (673,148 Rials) (1%). There was no significant relationship between the direct costs and gender, age, marital status, education, occupation, duration of disease, body mass index (BMI), type of insurance, or blood pressure (P<0.05).

According to the findings of this study, diabetes imposes a significant financial burden on the healthcare system, including significant hospitalization and medication costs. The majority of patients were covered by health insurance, and the financial burden was significant for individuals and governments. Therefore, elimination of predisposing factors for the disease and optimal management can reduce the imposed costs on healthcare systems.

Osteoporosis is one of the most common bone diseases that is caused by an imbalance between the activity of osteoblasts and osteoclasts. Osteoprotegerin (OPG) plays an active role in inhibiting osteoclasts by binding to the receptor activator of nuclear factor kappa-B ligand (RANKL). The balance in the OPG/RANKL ratio is important in bone remodeling. The current study investigated and compared the effects of mumie extract and chemical drugs on cell proliferation, expression of OPG and RANKL in MG63 cells.

The effects of 100, 200 and 300 μg/ml of mumie extract on cell proliferation, expression of OPG and RANKL in MG63 cells were investigated in experimental groups, positive and negative control groups. Data were analyzed by ANOVA test.

Significant increases were observed in the proliferation of MG63 cells after exposure to 100 and 200 μg/ml concentrations of mumie extract. 200 μg/ml concentration of the extract significantly decreased the expression of RANKL and increased the expression of OPG. It also increased OPG/RANKL ratio significantly in the experimental groups, compared to those in the negative control groups. Although the effects of 100 μg/ml and 200 μg/ml concentrations were similar to each other, they showed no significant effects on the variables. 300 μg/ml concentration of the extract showed a reverse and insignificant effect.

200 μg/ml concentration of mumie extract had a significant effect on the expression of two important factors in bone remodeling. Therefore, individuals susceptible to osteoporosis can use mumie extract as an alternative to chemical drugs.

Spinal cord injury (SCI) is a serious clinical disorder, which involves the patient’s family as well as the community. After sever SCI, astrocytes of the central nervous system become reactive astrocytes, and produce glial scar which is a major obstacle to axons regeneration in the spinal cord. However, some studies have confirmed a spontaneous partial locomotor recovery in injured animals in the course of time and without any therapeutic interventions. Thus, in this study, locomotor function of animals with SCI was assessed to determine the exact scope of such a recovery through BBB (Basso, Bresnahan and Beattie) locomotor test during 20 weeks.
In this research, 18 adult male Wistar rats were used and randomly divided into 3equale groups: the normal control, the sham, the injured. Animals in the normal control group did not received any intervention, but for the sham and injured groups, laminectomy and contusion model in segment T10 of spinal cord were accomplished, respectively. Locomotor improvement of animals in all the groups was evaluated for 20 weeks.
Findings: According to our investigation, comparison of the results of locomotor assessment of the second week against that of the 20th week of the spinal cord injured group without treatment demonstrated a partial locomotor recovery, since the BBB score of lesion in these animals was 1.4 in the second week and reached up to 16 in the Twentieth week.
Discussion & Our Results showed that spontaneous locomotor recovery in animals with spinal cord defects increases after 20 weeks (from 16 21 score) in the course of time and without any therapeutic interventions

Spinal cord injury (SCI) causes constant irreversible functional deficits. Poor prognosis of such a disease prompts scientists to work on an effective way of treatment. Stem cell transplantation provides a promising strategy for such researchers. Using olfactory ensheathed cells (OECs) has, so far, indicated very good results. Hensce, the purpose of this study was to evaluate the effectiveness of transplanted OECs on functional recovery of delayed phase of SCI in rats.
In this survey, eighteen adult male wistar rats were divided into sham, control, vehicle, and treatment groups. Sham group received only laminectomy in the T9 segment of spinal cord, while in other groups, contusion model was induced following laminectomy.7 days after injury, DMEM medium alone or with OECs was injected to the vehicle and treatment groups, respectively. For cell culture, the olfactory mucosa of 7-day-old male wistar rats was used. Locomotor behavior of animals in all the groups was evaluated by BBB, (Basso, Bresnahan and Beattie) test.
Findings: Comparison of the results by the second week to the end of the study illustrated significant changing differences between the OECs receivers and the control group, (pDiscussion & Our investigation demonstrated a positive impact of the OECs on functional recovery in the delayed phase of SCI.

The deficiency of enzyme glucose-6-phosphate dehydrogenase (G6PD) is among the most common genetic diseases in human. The deficiency of G6PD enzyme is one of the most common encountered enzymes, affecting about 400 million people and causing a wide range of undesirable clinical complications worldwide. The performed studies have reported a variety of statements about the relationship between malaria and survival of people with defect, but these kinds of studies are limited in Iran. This study aimed to estimate the incidence of G6PD deficiency among newborns in malarious areas of Fars province.
The present study was conducted ecologically and descriptively-analytically on 59745 neonates with G6PD deficiency in Fars province, Iran from April 2011 to March 2015. To determine the defect, a point fluorescence test and Kimia commercial kit (KimiaPajoohan Co., Tehran, Iran) were used. To determine the areas with malaria, factors associated with malaria-causing cells in Fars province, including the presence of carriers, the presence of malaria, the incidence of new malaria and the presence of malaria activated sites were studied. The incidence of defect was calculated using the statistical method of estimating the annual incidence rate. ArcGIS software, version 10.3 (ESRI, Redlands, CA, USA) was used to provide geographic mappings and distribution patterns in malarious areas.
The total incidence of G6PD deficiency in newborns was estimated as 15.58 per 100 live births, including 16.25 for boys and 14.85 for girls. The incidence of this defect in malaria-prone areas was higher than other areas. As a region was more malaria-prone, the incidence of G6PD deficiency increased too, which was statistically significant (P= 0.039).
Based on the findings of this study, Fars province is among areas with high incidence of G6PD deficiency. The incidence of G6PD deficiency in malaria-prone areas of Fars province, Iran, is higher than other regions, which indicates better survival of patients against malaria in the past.

Suicide is one of the main health problems in different societies and is associated with different risk factors. The result of a suicide attempt is directly related to the selected method. Invasive suicides are known as violent methods of self-harm and are usually happened in different patterns of age and gender. The aim of this study was to investigate the outcome and varieties of suicide via invasive methods in a long-term period in Ilam province, Iran.
In this retrospective study, the required data, including demographic variables, outcomes and the kind of invasive method was extracted from a comprehensive registration system of suicide cases, recorded by Ilam University of Medical Sciences (IUMS), to investigate the invasive suicides during the 1993-2013 years. The study was approved by the Ethics Committee of Ilam University of Medical Sciences and based on this approval the permission to access the suicide data was issued. Data were entered into the SPSS 20 software (SPSS Inc., Chicago, IL, USA) and using descriptive statistical methods and chi-square were analyzed based on completed or attempted outcome of suicide.
Among a total of 1516 cases of invasive suicide, 643 (42.6%) were attempted and 867 (57.4%) were completed suicides. Self-immolation method showed the highest frequency of suicide (both completed and attempted). The highest frequency of completed suicide was occurred in females (52.8%) but the attempted suicide was higher in males (63.6%). The age groups of 25-34 years and above 65 years indicated the highest frequencies of attempted and completed suicides respectively.
One of the main objectives of this study was identification of high risk groups who used the invasive methods for suicide commitments, based on their epidemiological characteristics such as gender and age. The results showed that women and elderly individuals were among the high-risk groups who committed completed suicide using the invasive methods and self-immolation attributed the most frequent method among invasive methods for suicide in Ilam province which resulted in death.

Cancers have a special place in health programs because of the costs of diagnosis and treatment as well as their irreversible complications. Distribution of diseases and their relationship with certain geographical areas is a confirmed subject producing a scientific background for medical geography. This study aimed to determine the five-year incidence of gastric cancer and its relationship with geographical factors in Khuzestan Province between 2009 and 2013.
In this cross-sectional study we assessed the incidence rate and relationship of gastric cancer with environmental, geographic and climatic factors. The study included all patients with gastric cancer in Khuzestan Province, between 2009 and 2013. The demographic and pathologic data of the patients had been recorded in a comprehensive cancer registration system. Using SPSS version 16, data were analyzed by independent T-test, Kruskai-Wallis test and ANOVA. Mapping of climatic factors was performed by Arc GIS.ver10.3 software.
1587 patients with gastric cancer had been recorded between 2009 and 2013 in the province's comprehensive cancer registration system. The mean age of the patients was 62.57± 14.17 years. 1047 patients (66%) were male, and 540 (34%) were female. The cumulative incidence of gastric cancer, was estimated as 35 per hundred thousand people. The relationship between gastric cancer and mean rainfall was statistically significant (p: 0.04).
The incidence rates of gastric cancer in different regions of the Khuzestan Province were not the same which can be related to the demographic variables as well as different geographic and climatic factors. Therefore, in order to identify the related risk factors in different regions further epedemeological and etiological studies are recommended.

In recent years, increasing dust storms originating from the Iran's neighbors in the west have led to social, economic, and health concerns. The aim of this study was to assess the acute health effects of dust and estimate the mortality rate associated with cardiovascular and pulmonary disorders, attributed to dust particles in Ilam city, by using WHO protocols. In this study, concentrations of PM10, PM2.5, and PM1 were measured from March 2012 to Feb 2013. The measurement was performed using the Grimm aerosol spectrometer model 1.108. Air Quality Health Impact Assessment software (Air Q 2.2.3) was used for quantification of health outcomes attributed to PM10 in Ilam, Iran. Using the model, the number of cumulative excess mortality, mortality due to cardiovascular and pulmonary diseases, and all admitted patients due to cardiovascular and pulmonary diseases attributed to PM10 in Ilam were 69.2, 42.5, 12.3, 80.3 and 208.7 cases respectively. The additional cases of disorders attributed to PM10 showed an increasing trend with concentrations of more than 100 µg/m3. This trend was more severe with concentrations of more than 200 µg/m3. The estimated rates of health outcomes attributed to PM10 associated with dust storms necessitate urgent regional measures to bring the problem of harmful particles under control. In addition, personal care and training are of great importance.

Dust storms are among the main natural sources of air pollution in the Middle East which increase people's concern about their harm effects on public health. This study aimed to evaluate the quantitative values of and the effects of dusts on the quality of Ilam city weather. In this study, the concentration of PM10, PM2.5, and PM1 were measured from Mar 2013 through Feb 2014. The measurement was performed once per six days and the Grimm aerosol spectrometer model 1.108 was used in all dusty days. Meteorological data was taken from aerology directorate of Ilam province and for tracking of dust storms, satellite pictures were applied. Mean ±SD of PM10, PM2.5, and PM1, during collection data, were 146.6±139. 3, 29.7 ± 25.3 and 10±5.7 μg/m3 respectively. The mean proportion of PM2.5/PM10, PM1/PM10 and PM1/PM2.5 were 0.231, 0.108 and 0. 418 during study period and 0.191, 0.052 and 0.269 during dust storm days respectively. The concentration of PM10 was more than standard fair weather during 83 days and AQI index values indicated dangerous conditions in 5 days, during year of the study. According to our findings, Iraq country particularly Nainava and Al- Anbar provinces were the main sources of dust storms of Ilam province. Discussion & This study indicates the dust storm events situation in Ilam city and its negative impact on air quality, which can have harmful effects on population health. Therefore it is necessary to determine of dust storm effect on health and ways to deal with it are more studies done. Dust storms also create an increase in PM2.5-10 particles resulting in a reduction of PM2.5/PM10 proportion. The results of this study can be used by health policy makers for design of preventive issues; however, international or regionnal cooperation are needed for any interventional action against this harmful condition.

Impaired fasting glucose (IFG) is one of the most common disorders that its morbidity risk factors are different in different populations. The present study aimed to investigate the association of life style and fasting plasma glucose in Ilam County. By a case-control study، 150 IFG subjects and 450 controls using cluster sampling were investigated. Each of subjects، using a standard lifestyle questionnaire and face to face interview were investigated. Chi-square test and multivariable logistic regressions were used for the statistical analyses. All subjects were intake fruits and vegetables. The frequency of ghee intake saturated oil)، inactivity and smoking in IFG subjects was more than controls. Using multivariable logistic regression، ghee intake increased the risk of IFG up to 2. 2 fold (OR=1. 28، 95%CI: 0. 75-2. 2)، inactivity up to 2. 33 fold (OR=1. 33، 95%CI: 0. 75-2. 33) and smoking up to 3. 13 fold (OR=1. 46، 95%CI: 0. 68-3. 13). Such differences were not statistically significant. An increase in risk of IFG by life style risk factors is an important finding that needs to be considered seriously by policy health makers.