مریم قادرپناهی

Jaundice is one of the most common diseases of infants in the first week after birth. Almost 60% of preterm newborns suffer from jaundice. This research was conducted to study the prenatal factors related to jaundice in newborns. This case-control research was conducted on 197 newborns with jaundice (cases) and 250 healthy newborns (controls) by using household records of urban health center of Dastgerd-e-Barkhar in Isfahan province in 1391. The prenatal variables were included as mother’s age، parity، number of delivery، mean body temperature، pulse rate، systolic and diastolic blood pressures، breathing rate، mother’s weight and BMI، mother’s age >35 and <18 years، pregnancy interval <3 years، multiple pregnancy، mother’s low weight، gestational diabetes، cesarean history، stillbirth history، family history of diabetes، negative RH، preterm birth، cesarean birth، mother’s blood type and season of birth. Data was analyzed by SPSS 18. 0 via descriptive statistics and multivariate logistic regression. According to univariate analysis، mother’s weight during pregnancy، mother’s age، family history of diabetes and a thalassemia minor in mother were associated significantly with newborns jaundice. Using multivariate logistic regression by forward stepwise method، only mother’s low weight (OR = 2. 68) and family history of diabetes (OR = 1. 63) had significant relationship with newborns jaundice. One of the strengths of this study compared to other studies on neonatal jaundice in Iran was methodology and the existence of control group to assess the risk factors. It seems that further studies with larger sample size and variables can help us to understand the risk factors and prevent adverse consequences in the future.

High fruit and vegetable intake has been introduced as one of the key factors of healthy diet to prevent chronic disease. This study attempts to explore the fruit and vegetable intake in Arak city and its relationship with demography and socio-economic factors. In this cross sectional study، 660 people in 18 -70 age range were selected with a two-stage cluster sampling and were interviewed for demography and socio – economic questionnaires and a 56- items semi-quantitative food frequency questionnaire to assess fruit and vegetable intake. After univariate analysis، the association of the significant variables with fruit and vegetable intake was also evaluated with multiple linear regression. In this study، over 60 percent of subjects consumed less than the minimum recommended amount of fruit and vegetable (5 servings or 400 gr a day). The total consumption of fruit and vegetable indicated an inverse significant relationship with age (p =0. 04 and β = - 0. 02)، and a direct significant relationship with economic status (p <0. 001and β =0. 10). The father''s educational level (p =0. 005 and β =0. 38 for diploma level and p =0. 03 and β =0. 36 for academic education) and physical activity level (p =0. 001 and β =0. 03 per hour) were factors associated with fruit consumption. The gender was only associated with vegetable consumption so that women had higher consumption in this study (p =0. 03 and β=0. 23). The findings of this study indicate low fruit and vegetable consumption in the population under study. In this study، age، physical activity، and socioeconomic status and fathers’ education were the factors that were significantly associated with fruit and vegetable consumption.

Epidemiological studies have reported positive, negative, U-shaped or J-shaped association between high blood pressure and cognitive function as well as dementia whereas other studies have not reported any significant association. The aim of this study was to examine the association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation (KCF). This cross sectional study was done in Kahrizak Charity Foundation in suburban areas of Tehran, Iran during 2008. The data were collected over one week. Among the 850 elderly residents of the Foundation who were ≥ 65 years old, 185 individuals were chosen randomly. The Mini-Mental State Examination (MMSE) was completed for all. Mean of all blood pressure readings were recorded while anthropometric and biochemical measurements were performed. The findings indicated that in participants with cognitive impairment, systolic blood pressure, diastolic and mean blood pressures were higher than people with normal cognitive function but the differences were not significant statistically. The odds ratio of cognitive impairment in patients with and without hypertension was 1.52 and 1.58, respectively (P>0.05). This study did not show any significant association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation.

The relation of metabolic syndrome components, insulin resistance andleptin has been studied in elderly women. In this cross sectional study, among 225 subjects ≥ 60year old who were residents of Kahrizak Charity Foundation, 133 (56 men & 77women) were selected by cluster random sampling. Fasting serum TG, TotalCholesterol, HDL, and leptin levels were measured. In healthy individuals, mean age of men and women were 76.88± 6.56 and 79.49±7.96 years old and in metabolic syndrome ones were 71.00 ± 5.19 and77.94±7.24, respectively. A total of 133 subjects were studied. Fifteen men andthirty three women were diagnosed as metabolic syndrome. There was a strongsignificant correlation between serum leptin level and metabolic syndrome as wellas body mass index (BMI) in both sexeses (P<0.001). Among metabolic syndromecomponents, waist circumference showed similar correlation in both sexes. In bothsexes the association between metabolic syndrome (IDF) and serum leptin wassignificant even after adjustment for each metabolic syndrome component withsignificant correlation and these components collectively (P<0.005). The associationwas not significant after adjustment for waist circumference. The current study has found that the association between metabolic syndrome and leptin in elderly might be mediated through waist circumference.

The aim of this study was to compare of waist circumference with metabolic syndrome, as a predictor insulin resistance in agroup of elderly population. In a cross-sectional study among 225 elderlyaged 60 year old and more whose clinical data were complete, 94 subjects (42 males and 52 females) who were able to sign the consent form Mini Mental stat Examination > 20 and wanted to participate in studyentered the study. Insulin sensitivity was determined by using Homeostasis Model Assessment index. Insulin resistance was defined as topquartile of Homeostasis Model Assessment. Waist Circumference and Homeostasis Model assessment andHomeostasis Model Assessment index were highly positively correlated in both sexes. The optimal waist circumference was 94.5 cm for men and 90.5 cm for women. `The high sensitivity and specificity of Waist Circumference and Homeostasis Model assessment in males (0.80 & 0.84) indicates the proportion of Insulin Resistance which are correctlyidentified all non-IR males as such. In this study 94.5 cm determined as cut-off for insulin resistance index in males. It seems that optimal Waist Circumference andHomeostasis Model assessment determinination in Iran warrants further study in a larger sample of metabolic syndrome subjects.

The aims of this study were to investigate the association of Mini-Nutritional Assessment and activities of daily living as well as examining Mini Nutritional Assessment as a good prognostic tool ofactivities of daily living in elderly residents of nursing home. In a cross-sectional study, among 1200 recorded files, 247 subjects completed Mini Nutritional Assessment and Barthel index questionnaire. The relations between studied variables were assessed using Pearson and spearman correlation. These relations were confirmed by adjusted regression model. 130 elderly had Mini Nutritional Assessment ≥ 24.5 and 102 had Mini Nutritional Assessment < 23.5. Mini Nutritional Assessment and BI were positively correlated (r=0.26, P < 0.001). In an age- and sex-adjusted model, Barthel index is associated significantly with age (P< 0.006), Body Massive Index I (P< 0.009), and MNA (P< 0.001). Mini Nutritional Assessment can be a good predictor ofdaily living activities in elderly residents of Kahrizak Charity Foundation (KCF).

The current study was performed to investigate the relationship between mental impairment and each component of activity of daily living (ADL) in elderly residents of the KahrizakCharity Foundation.

Standardized Iranian Mini Mental examination and Barthel index were used to assest cognitive status and ADL in 184 elderly residents of Kahrizak, respectively.

Data showed that 31.7% of participants had normal cognitive status and 63.3% had cognitive impairment. There was significant relationship between cognitive status and ADL after adjustment for confounding factors (P=0.01, r=0.2).By using multiple logistic regression analysis, the relation between cognitive impairment and functional status was examined (P=0.05). Odd ratio of functional disability showed an increasing trend with increasing severity of cognitive impairment [Odd Ratio (OR) mild cognitive impairment: 1.13, Confidence Interval (CI): 0.54-2.37; OR moderate to severe cognitive impairment: 3.67, CI: 0.39-34.35]. Regarding the relation between Barthel components and cognitive status it was showed that there was a significant association between independent bathing and cognitive status (OR: 2.33, CI: 1.14 - 4.72) as well as movementability with cognitive impairment [OR: 2.96, CI: 1.30-6.75].

Cognitive status can be a predictive factor of ADL inelderly subjects.

In this study, we investigated the inter-relationships between C-reactive protein, metabolic syndrome, and chronic kidney disease among a group of Iranian elderly. In this cross-sectional study, 122 elderly among 1220 aged residents of Kahrizak Charity foundation with average age of 73.6 ± 9.71 were studied. Metabolic syndrome and chronic kidney diseasewere defined according to the criteria of National Cholesterol Education Program,Adult Treatment Panel III and an estimated glomerular filtration rate <60 mL/min/1.73 m2, respectively. C-reactive protein ≥ 3mg/dl was considered as a high CRP. Prevalence of Chronic Kidney Disease was 82.9 (59.3%) in subjects with and without metabolic syndrome, respectively (p<0.006). Subjects with metabolic syndrome and high C-reactive protein had 1.71-fold greater odds of having Chronic Kidney Disease. Metabolic syndrome was a risk factor for chronic kidney disease in elderly people of this study. The odds of chronic kidneydisease also increased significantly in presence of high C-reactive protein and metabolic syndrome.

In this study, the relation of late-life body mass index (BMI) and waist circumference with incident dementia risk was investigatedin a group of iranian elderly peopel. In cross-sectional present study 107 elderly residents of the Kahrizak Charity Foundation aged 80 and older were participated. Dementia was assessed using Mini-Mental State Examination questionnaire. Body mass index (BMI) was computed by weight (kg)/ height (m2). In a multivariate logistic regression model, late-life overweight was indicated an independent and significant protective factor against developing dementia (Odd Ratio: 0.24, 95% Confidence Interval: 0.06-0.93(, also there was no significant association between waistcircumference and risk of dementia incident. Overweight in late-life was shown as a protective factor against incident dementia risk incident.

This study was performed to investigate the effect of ω-3 fatty acids on lipid profiles, lipoprotein (a), apolipoprotein A-1 and apolipoprotein B, fasting glucose and insulin, and insulin resistance in a group of Iranian elderly subjects. In this clinical trial, 124 elderly residents of the KahrizakCharity Foundation, aged 65 and older were divided into two intervention (consumption of 1 gram per day of fish oil) and control (consumption of placebo) groups. Blood sampling was done at the baseline and at the end of the study. After 6 months, TG and apo A-1 increased significantly (p=0.01 and p=0.02, respectively) and high-density lipoprotein cholesterol decreased significantly in the control group (P=0.009). Overall and comparative effects of fish oil were positively significant (P =0.02). fish oil intake can be effective in reduction of serumtriglycerides in elderly.

The aim of the present study was to investigate the prevalence of hypertension and type II diabetes in elderly Iranianresidents of the Kahrizak Charity Foundation(KCF). In this cross-sectional study, a total of two hundred sixty eight men and women ≥60 years were studied. The data were collected during annual health examination of the elderly residents in KCF. Hypertension and diabetes were defined based on JNC VII andAmerican Diabetes Association, respectively. Crude prevalence of hypertension was 55% in men and 67% in women. In hypertensives, mean age and Body Mass Index (BMI) were significantly higher than normotensives. Diabetes prevalence was 21% in men and 16% in women. Means of age, body mass index (BMI), waist to hip ratio (WHR), total cholesterol, LDL-cholesterol in diabeticwere significantly more than normal ones. Body mass index and hypertension showed significant correlation and women were at higher risk for hypertension. Instead,men were at higher risk of diabetes and its related factors.

Cardiovascular disease including hypertension are complications of long-standing diabetes. A few Studies had shown the positive effects of L-carnitine on hypertension. In this study, the possible effects of L-carnitne on nitric oxide (NO) levels and angiotensin-converting enzyme (ACE) activity in serum as well as systolic blood pressure (SBP) in diabetic and normal rats were studied. In this study forty rats were used in four groups including non-treated control (C), L-carnitne treated control (CT), diabetic (D) and L-carnitne treated diabetic (DT). Diabetes was induced in rats by injection of stereptozotosin. Both of C & D groups had a free access to food and water and CT & DT groups were received daily dose of L-carnation in drinking water. At the end of 12 weeks SBP, serum NO and ACE activity were measured. Systolic blood pressure was significantly decreased in DT group compared to D group. Serum ACE activity was also significantly decreased in DT group compared to D group and the serum NO levels were significantly increased in DT & CT groups compared to D & C groups respectively. Finally it could be concluded that L-carnitine may reduce SBP in diabetic rats via elevation of serum NO levels and reduction of serum ACE activity.