فهرست مطالب armita shahesmaeili

The novel coronavirus disease (COVID-19), as a global concern, has affected different economic and social aspects, as well as health costs in various communities. Finding effective and available treatment is an urgent need. A recent study has demonstrated that the ketogenic diet (KD) activates innate immunity and has a protective property against virus infection. Accordingly, we conducted this study to find the effect of oral medium-chain triglyceride (MCT) on COVID-19 and its clinical manifestations.

This was a randomized clinical trial on 195 patients clinically suspected of COVID-19 referred to infectious disease clinics of Kerman. Patients were randomly assigned into two groups. The Control group received standard supportive treatment, the recommendation for carbohydrate avoiding and diet modification. Patients in the intervention group received all mentioned recommendations beside MCT oil. Patients` clinical symptoms, including body temperature, respiratory rate, body pain, and dyspnea, were recorded in a checklist and analyzed.

The mean age of patients was 37.78 ± 12.42 years in the intervention group and 40.81 ± 13.23 years in controls (P = 0.231). The patients in the intervention group had lower duration of weakness (P = 0.004), body pain (P = 0.004), dyspnea (P = 0.004), gastrointestinal manifestations (P<0.001), sore throat (P<0.001), increased respiratory rate (P<0.001), and high intensity of cough (P=0.002). Indeed, weakness, cough frequency, sore throat, and gastrointestinal complications were significantly lower in the females of the intervention group (P=0.006, P=0.030, P=0.005, and P=0.001, respectively). In contrast, in the males of the intervention group, manifestations such as respiratory rates, dyspnea, cough intensity, and sore throat were significantly lower than those in the control group.

Administration of MCT in outpatients suspected of COVID-19 alleviated clinical symptoms such as increased respiratory rate, cough intensity, dyspnea, body pain, and gastrointestinal symptoms and helps them overcome the probable disease morbidity.

Bladder cancer is the 10th most common cancer worldwide. We aimed to assess the prevalence of bladder cancer in the Kerman Province, in southeast Iran.

In this cross-sectional study, we used data on 1272 patients with bladder cancer registered in the Kerman population-based cancer registry from 2014 to 2017. There were two parts of data including observed data, including those cases whose information was recorded by the cancer registry, and the unobserved part, including cases before the registry department, was established, to calculate the complete prevalence. The latter was estimated using modeling to be included in the prevalence calculation. The complete prevalence of three-, five-, ten-, and twenty-year of bladder cancer up to the end of 2017 was calculated using rprev package.

A total of 185 (14.54%) women and 1,087 (85.45%) men were recruited. The overall three-, five-, ten-, and twenty-year prevalence of bladder cancer at the end of 2017 was 26.54, 43.46, 80.3, and 142.36 per 100,000 inhabitants, respectively. The prevalence was estimated to be at its lowest rate among both males and females under the age of 45, and at its highest rate among those over 61 and older. In all age groups, males were affected more than females.

The prevalence of bladder cancer in the Kerman Province was higher than the national average and increased with age. Regarding the aging population, policies and programs for prevention, early intervention, and awareness-raising in the community about this cancer are essential.

 The occurrence of some psychological and emotional crisis in pregnancy may lead to postpartum depression in mothers.

 This prospective cohort study aimed to estimate the incidence of postpartum depression (PPD) and its associated factors among Iranian mothers.

 A total of 164 women in their third trimester of pregnancy were recruited through quota sampling from February to July 2018 in Kerman, Iran. Women suffering from depression were excluded. The remained healthy women (n = 164) were traced up to two months after the delivery. The incidence of PPD was calculated by dividing the number of new cases of depression within the postpartum period by the number of initial healthy mothers. The Edinburgh Postnatal Depression Scale was applied to detect PPD. The Cox regression model was used to assess PPD-related factors. Crude and adjusted hazard ratios, as well as their 95% confidence intervals (95% CI) were reported. P-values of < 0.05 were considered statistically significant. SPSS version 22 was used to analyze the data.

 The incidence of PPD within the two months after delivery was 9.8% and was higher among mothers who had high-school diploma or lower (11.9% vs. 6.4%), had unplanned pregnancy (25% vs. 9.2%), underwent cesarean section (11.3% vs. 8.7%), or were multiparous (10.6% vs. 6.3%). The mean (SD) social support was lower among mothers with depression (69.1 ± 13.1 vs. 77.4 ± 16.6). There was significant association between type of delivery (adjusted hazard ratio [AHR] = 0.57, 95% confidence interval (95% CI) = 0.36; 0.97) and social support (AHR = 0.95, 95% CI = 0.93; 0.97) with PPD.

 In sum, the concerning incidence of PPD highlighted the need for establishment and strengthening of screening programs during the post-partum period. Families’ knowledge about the significance of providing sufficient social support for mothers may have prevented this disorder and therefore, it was recommended that it should be incorporated into prenatal cares.

Noninvasive risk prediction models have been widely used in various settings to identify individuals with undiagnosed diabetes.

We aimed to evaluate the discrimination, calibration, and clinical usefulness of the Finnish Diabetes Risk Score (FINDRISC) and Australian Diabetes Risk Assessment (AUSDRISK) to screen undiagnosed diabetes in Kerman, Iran.

We analyzed data from 2014 to 2018 in the second round of the Kerman Coronary Artery Disease Risk Factors Study (KERCADRS), Iran. Participants aged 35 - 65 with no history of confirmed diabetes were eligible. The area under the receiver operating characteristic curve (AUROC) and decision curve analysis were applied to evaluate the discrimination power and clinical usefulness of the models, respectively. The calibration was assessed by the Hosmer-Lemeshow test and the calibration plots.

Out of 3262 participants, 145 (4.44%) had undiagnosed diabetes. The estimated AUROCs were 0.67 and 0.62 for the AUSDRISK and FINDRISC models, respectively (P < 0.001). The chi-square test results for FINDRISC and AUSDRISC were 7.90 and 16.47 for the original model and 3.69 and 14.61 for the recalibrated model, respectively. Based on the decision curves, useful threshold ranges for the original models of FINDRIS and AUSDRISK were 4% to 10% and 3% to 13%, respectively. Useful thresholds for the recalibrated models of FINDRISC and AUSDRISK were 4% to 8% and 4% to 9%, respectively.

The original AUSDRISK model performs better than FINDRISC in identifying patients with undiagnosed diabetes and could be used as a simple and noninvasive tool where access to laboratory facilities is costly or limited.

Depression is one of the common problems during pregnancy that can have adverse effects on the fetus and mother and even after delivery can adversely affect the baby and mother. To this end, this study aimed to determine the frequency of depression and its related factors in women in the third trimester of pregnancy visiting the health centers affiliated with the Kerman University of Medical Sciences.

This descriptive-analytical cross-sectional study was conducted in 2017 in health centers affiliated with the Kerman University of Medical Sciences. The participants were pregnant women in the third trimester of pregnancy who were selected using convenience sampling. The data in this study were collected using the Edinburgh Postnatal Depression Scale (EPDS). The collected data were analyzed with SPSS software (version 22).

The frequency of depression in women in the third trimester of pregnancy was 12.7%. The frequency of depression was higher in the age group of over 30 years, the age of the spouse under 30 years, the age at the time of marriage over 20 years, housewives, the first pregnancy, and in planned pregnancy. Multivariate logistic regression analysis showed that the young age of the spouse was associated with a significant increase in depression during pregnancy (adjusted OR = 13.72, 95% CI: 2.60-27.72, P-value = 0.002).

Given the relatively high prevalence of depression in pregnant women in the third trimester, screening and identification of these women are very important. Furthermore, organizing training courses on depression for women and their husbands and effective behavioral and treatment solutions should be considered one of the priorities of health centers.

This study aimed to investigate the factors affecting cardiovascular disease risk assessment (CVDRA) in middle-aged women in Kerman based on the health belief model, in 2019.
This cross-sectional study was conducted on 400 middle-aged women in Kerman. The women were selected using multi-stage random sampling. The data in this study were collected using a researcher-made questionnaire developed based on the constructs of the health belief model. Moreover, the risk assessment data were extracted from the ministry of health, Integrated Health System (SIB System). The collected data were analyzed using SPSS software (version 20).
The mean age of the participants was 38.32±6.76 years. Most of the participants were married (87.8%) and 40% of them had a university education. Besides, 78% of middle-aged women had performed cardiovascular disease risk assessment (CVDRA). The results of the logistic regression analysis indicated the construct of perceived benefits was the main predictor of cardiovascular disease risk assessment in women (Odds ratio=1.02; P= 0.012). But, the other constructs of the health belief model were not significantly associated with cardiovascular disease risk assessment behavior in middle-aged women (P˃0.05).
Given that the construct of perceived benefits is the strongest predictor of cardiovascular disease risk assessment behavior in middle-aged women, health promotion interventions need to be planned and performed for cardiovascular disease risk assessment in middle-aged women with an emphasis on its perceived benefits.

 Tuberculosis is one of the oldest known diseases in humans, and early detection of tuberculosis is one of the main measures to decrease the spread of tuberculosis. In many parts of the world, including Iran, the diagnosis of tuberculosis is based on the detection of acid-fast bacillus in sputum smear microscopy and PCR. this study aimed to synthesize evidence on the diagnostic accuracy of sputum smear and PCR compared to sputum culture for the diagnosis of PT in Iranian patients.   

 This systematic review  and meta-analysis was conducted based on PRISMA guideline for systematic review and meta-analysis. Eligible studies were cross-sectional original diagnostic studies published in English and Persian in Iran which examined the sensitivity or specificity(study outcome) of sputum smear microscopy or PCR( as the test) relative to sputum culture (as the gold standard/comparator) among Iranian patients suspected of having tuberculosis( study population). Studies whose data were not complete or extractable were excluded.   

 A total of 3518 subjects were evaluated from 15 eligible studies. The pooled sensitivity of sputum smear and PCR was 75.12 (95% CI: 66.68-83.56) and 88.02 (95% CI: 82.87-93.27), respectively. The specificity for sputum smear and PCR was 93.94 (95% CI: 91.26-96.63) and 91.82 (95% CI: 87.29-96.35) respectively. The sensitivity of both sputum smears was higher in studies published after 2010, and had higher quality. The specificity of sputum smear was a bit lower in studies published after2010 but higher in studies with higher quality. The specificity of PCR was higher in studies published after 2010 but higher in studies with higher quality.   

 The increased sensitivity of sputum smear and PCR during recent years suggests the improvement of preparation and laboratory methods in recent years. However, the imperfect sensitivity of these tests highlights the need for a more accurate diagnostic method for the detection of pulmonary tuberculosis in Iran.

Early diagnosis of congenital heart disease (CHD) has a significant impact on the prognosis of the patient. This study aimed to determine the sensitivity and specificity of cardiomegaly according to Chest X-ray (CXR) indices in comparison with echocardiography in the diagnosis of CHD in infants. In this cross-sectional study, the clinical status of 166 infants aged 2 to 24 months who referred to the Pediatric Ward of Afzalipour Hospital in Kerman and needed CXR for any reason, was evaluated from November 2019 to November 2020. CXR and echocardiography were performed for all infants by a pediatric cardiologist and the probability of CHD was confirmed or ruled out. Therefore, the sensitivity and explicitness of CXR were determined. Data were analyzed using SPSS version 20. The most common anomalies observed in infants were Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD) and pulmonary stenosis (PS), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR, for determining cardiomegaly in these infants were 65.7%, 51.1%, 26.4%, and 84.8%, respectively. The results of this study showed that the sensitivity and specificity of CXR for determining cardiomegaly were 65.7% and 51.1%, respectively. Therefore, when echocardiography is not available, the chances of finding congenital heart abnormalities with the help of CXR will be quite high.

We aimed to identify the level of known risk factors of diabetes associated with doubled likelihood of diabetes type 2.

In this cross-sectional study, an analysis was performed on the data of 9930 individuals aged 15 yr and older participating from 2014 to 2018 in the second phase of the Kerman coronary artery disease risk factors study (KERCADRS), Kerman, Iran. Data were collected using a standard questionnaire. Multivariable logistic regression was performed to identify factors associated with doubled chance of diabetes.

The mean age of participants was 46.1±15.5 yr from which 59.5% were women. Overall, 1105 (11.1%) individuals had type 2 diabetes. An increase of 13.86 yr in age, an increase of 17.32 kg/m2 unit in the amount of body mass index, an increase of 0.17 in the waist-to-hip ratio, a 77 mmHg increase in systolic blood pressure and 6.07 unit increase in triglyceride to HDL ratio doubled the chances of developing type 2 diabetes.

Slight changes in the waist-to-hip circumference ratio (0.17), aging (14 yr), and increase in TG/HDL ratio (6.07 unit) were the most important risk factors, while intense physical activity was the most important protective factor associated with doubling of the chances of developing diabetes. Since most of these risk factors are modifiable, increase in physical activity and providing facilities to improve lifestyle in the community seems necessary.

Virtual social networks (VSNs) are among the most popular communication paths that have become an integral part of most people's lives, including students. This study aimed to investigate the prevalence of VSNs addiction and their related factors, and identify the patterns of addictive-related factors among the students in Kerman, Iran in 2019.

 This cross-sectional study was conducted on 400 students from Kerman University of Medical Sciences. The study instrument was a standardized questionnaire. Descriptive analysis, logistic regression models, and latent class analysis were used to analyze the data. The data were analyzed using SPSS26, Stata12 and WinLTA (v. 3.1) software.

 50% of the participants were male, staying in dormitory. The number of individuals in the levels of education in the four groups was equal. Around 0.5% of the students were addicted and 36.5% were at the risk of addiction to VSNs. The most commonly used VSNs was the Telegram (76.8%), and most students (28.8%) spent between 2-3 hours a day on VSNs. In the multivariate model, using 1-2 hours (AOR = 3.33, 95% CI: 1.07 - 10.19),  2-3 hours (AOR = 7.33, 95% CI: 2.50 - 21.52) and more than 3 hours a day (AOR = 18.54, 95% CI: 6.05 - 56.8) of VSNs were associated with an increased odds of being at the risk of VSNs addiction. The Latent Class Analysis showed that high-risk addictive factors including using Telegram for entertainment, providing accommodation in the dormitory, and having a graduate degree significantly influenced the classification.

 More than one-third of Kerman college students were found to be at the risk of VSNs addiction. Providing appropriate interventions including alternative activities as well as raising knowledge especially for undergraduate students is urgently needed.

This study aimed to estimate the incidence of thyroid cancer and completeness of thyroid cancer case registration in Kerman province, Iran using three source capture-recapture approach during years 2008-2015.

All new cases of thyroid cancers reported during 2008-2015 which were registered by pathology, nuclear medicine and medical records were included in this study. Using the personal identifiers, common cases between sources were linked. The log-linear Poisson regression analysis was applied to estimate the number of unregistered cases. The incidence rate per 100,000 population was calculated. To study the trend, Joint-point regression analysis was performed. 

Overall, 1153 new cases of thyroid cancer were reported by three sources. Most cases were female (81/7%). The mean age at diagnosis was 41.53±15.69 years. The estimated number of thyroid cancer cases was 1323. The estimated incidence per 100,000 population varied from 4.5 in 2011 to 11 in 2015. The female to male ratio varied from 3.1 in 2015 to 6.7 in 2011. The completeness of registration for all three sources varied from 33.7% in 2008 to 95.1% in 2013. The completeness of medical records, pathology reports, and nuclear medicine reports were 33.1%, 50.7%, and 66.2%, respectively.

Despite some improvements in completeness of thyroid cancer registration during the study period, there are still fluctuations within the study period. Furthermore, considering each source separately, the completeness of registration is not satisfactory. Therefore, more effort should be done to increase the completeness of thyroid cancer registration specially through the pathology source.

Patients with beta-thalassemia (BT) are susceptible to psychological disorders such as depression. The present study was conducted to estimate the pooled prevalence of depression among patients with BT in Iran.

Domestic and international databases were searched for relevant articles published from 1991 until June 2019. We searched international databases such as Scopus, ISI, and Embase; Iranian databases such as SID, Magiran, and IranDoc; and Google Scholar and PubMed search engines. The MeSH keywords used were “depression”, “mental health”, “depressive disorder”, “thalassemia”, “beta-thalassemia major”, “prevalence”, “epidemiology”, and “Iran”. Relevant cross-sectional or cohort studies were included in the analysis. Cochran’s Q test and the I2 index were used to assess heterogeneity. The pooled prevalence and its 95% confidence interval (CI) were calculated using “metaprop” commands in Stata 14. In cases, where the I2 statistic was greater than 50%, the random-effects model was used.

Eighteen eligible studies were included. The pooled prevalence of depression was 42% (95% CI: 33% to 52%), whereas the pooled prevalence of mild, moderate, severe, and extremely severe depression was 16% (95% CI: 11% to 22%), 13% (95% CI: 9% to 18%), 13% (95% CI: 9% to 17%), and 3% (95% CI: 0% to 8%), respectively. The pooled prevalence of depression in moderate- and high-quality studies was 45% (95% CI: 29% to 61%), and 39% (95% CI: 27% to 51%), respectively.

The high prevalence of depression highlights the urgent need for the establishment of interventions for the prevention, early detection, and treatment of depression among Iranian patients with BT.

Prisoners are at higher risk for sexually transmitted infections (STIs) than the general population. This study reported the prevalence and correlated factors of STI-related symptoms among male prisoners in Iran.

Participants were selected from 27 prisons across 16 Iranian provinces in 2013 using a multistage cluster sampling (N = 5490). Men aged ≥18 years who spent at least one week in prison and self-reported having had sex during the previous year were eligible and asked if they have had penile discharge (PD) or genital ulcers (GU) within the last year. Demographic variables, HIV/STIs-related knowledge, STIs care-seeking practices, HIV self-perceived risk, history of substance use, and sexual behaviors were collected by face-to-face interviews. HIV tests were completed using the ELISA method. Factors associated with STIs-related symptoms were examined using logistic regression models, and adjusted odds ratios (AOR) along with their 95% confidence intervals (CI) were reported.

Of 2,620 eligible male prisoners (mean age ± SD = 35.7 ± 8.9), 6.9% reported symptoms for PD, GU, or both; of whom 36.2% had not sought STIs care inside prison. A history of injection drug use (AOR = 2.14; 95% CI: 1.45, 3.14), having access to condoms inside prison (AOR = 1.57, 95% CI: 1.08, 2.82), self-perceived risk of HIV (AOR = 1.52, 95% CI: 1.03, 2.24), and HIV-seropositivity (AOR = 3.30, 95% CI: 1.02, 10.61) were positively and having sufficient STIs-related knowledge (AOR = 0.63, 95% CI: 0.44, 0.89) was negatively associated with reporting STIs-related symptoms.

Despite the low prevalence of STIs among Iranian prisoners, initiation of screening among high-risk prisoners, including people who inject drugs and prisoners living with HIV, may prevent subsequent health effects. Current HIV/STIs prevention policies across Iranian prisons to help improve prisoners’ HIV/STIs knowledge and encourage their HIV/STIs preventive practices should be reinforced.

Fertility patterns are a key to the estimation of future population size, but they are restricted by serious indecision. One-child families are one of these patterns that is caused by a set of factors and one of these factors is the fear of re-pregnancy. In this regard, this study aimed to use a mindfulness-based stress reduction (MBSR) program to reduce the fear of women who have been experiencing anxiety after their first pregnancy and delivery.

This interventional study was conducted on 67 one-child women, who at least 6 years have been passed since the birth of their child and according to the short form of the Pregnancy Related Anxiety Questionnaire (PRAQ-17), have been experienced anxiety. These women were randomly divided into control and intervention groups. For the intervention group, the MBSR program was conducted in 8 sessions, once every week, each session lasting 2.5 hours. At the end of the program, a second PRAQ-17 was completed by both groups.

The findings showed that the MBSR approach in the intervention group significantly decreased the anxiety score in total (p=0.001) and individually in all subcategories.

The MBSR approach can reduce the anxiety of one-child women who have experienced anxiety after their pregnancy and childbirth. Thus, using this method in helping women with pregnancy-related anxiety is recommended to increase the birth rate.

Addiction to virtual social networks (VSNs), especially among students, has become a crisis during the recent years.

This study aimed to assess the validity and reliability of a questionnaire on VSN addiction among Iranian university students.

The initial questionnaire was designed based on extensive literature review and consulting with experts. To measure the item and content validity indexes (I-CVI and S-CVI) and to measure the content validity ratio (CVR), a panel of 24 experts reviewed the questionnaire. To measure the test-retest reliability, the questionnaire was administered on 30 students within the interval of 14 - 21 days and the intra-class correlation coefficient (ICC) was calculated. Cronbach’s alpha and the corrected item-total correlation were calculated to measure internal consistency. All analysis was done using SPSS 20 software.

All items had satisfactory CVR and I-CVI. The S-CVI was 0.98. The value of Cronbach’s alpha was 0.88. The corrected item-total correlation for all items, except one, was in acceptable range. This item was removed from the final questionnaire. The test-retest reliability of the questionnaire was almost perfect (ICC = 0.9).

The current study provides a valid and reliable questionnaire to measure VSN addiction among university students. The designed instrument could be used in addiction evaluation studies.

An adequate perception of the degree to which one is at risk of having or contracting HIV is necessary for behavioural change and the adoption of safe behaviours. There are limited data regarding HIV risk perceptions among female sex workers in Iran. This study aimed to determine the HIV risk perception status and its association with sexual behaviours among female sex workers in Tehran.

A cross sectional study was conducted among 170 female sex workers in Tehran. Participants were recruited using a combination of snowball, purposeful, and convenience sampling methods. Multiple logistic regression was used to identify adjusted associations between background factors, sexual behaviours, and HIV risk perception. The analysis was conducted by the “logistf” package in the R statistical system. P-value less than .05 was considered as statistically significant.

Among the participants, 122 (77%) reported high HIV risk perception. Most female sex workers with high HIV risk perception reported that they did not consistently use condoms (n=120, 98%. Female sex workers with a higher frequency of sex work (AOR=1.18, 95% CI: 1.08, 1.31), inconsistent condom use (AOR=0.15, 95% CI: 0.02, 0.66),  a history of HIV testing (AOR=5.1, 95% CI: 1.2, 26.0), and low HIV knowledge (AOR=0.97, 95% CI=0.95, 0.996) were more likely to report high HIV risk perception.

Most female sex workers with risky sexual behaviours had a high HIV risk perception. Effective educational programs are suggested to enable female sex workers to correctly assess their own HIV risk and change risk behaviors based on self-assessment of actual risk.

Cardiovascular disease is one of the most common disorders associated with chronic obstructive pulmonary disease (COPD). There are few studies on the effects of physical exercises, especially aerobic exercises, on serum levels of apolipoprotein A1 and apolipoprotein B in patients with COPD. The current study aimed at determining the effect of aerobic exercises on serum levels of apolipoprotein A1 and B and apo-A1/apo-B ratio. In the current randomized, controlled, clinical trial, with a pretest posttest control group design, 22 males with COPD were randomly assigned to the aerobic exercise and control groups. The aerobic exercise program was performed within two months based on three 30-40-minute sessions per week. Serum levels were measured and evaluated before and after aerobic exercises. Data were analyzed using the paired samples t test. In the aerobic exercise group, the mean of Apo A1 and Apo B after the intervention (169.36±5.42 and 93.63±5.24 mg/dL, respectively) was significantly higher than that of before the intervention (146±6.09 and 83.27±4.44 mg/dL, respectively) (P-value=0.001). However, apoA1/Apo B ratio did not significantly change after the intervention compared with that of before the intervention (1.85±0.10 vs. 1.80±0.13) (P >0.05). There was no significant change in the mean Apo A1 and Apo B levels and Apo A1/Apo B ratio after the intervention in the control group. Regular aerobic physical exercises are effective in increasing the serum level of Apo A1 in patients with COPD. Due to the proven protective role of Apo A1 in patients with COPD, this biomarker can improve respiratory efficacy in such patients

The objective of this study was to compare various lipid ratios for detection of metabolic syndrome (MetS) in the Iranian general population. This cross-sectional study involved 5677 subjects aged ≥18 years from the general population in Kerman, Iran. Associations between lipid ratio quartiles and MetS were analyzed using logistic regression models. The areas under receiver operating characteristic (ROC) was calculated to determine the accuracy of lipid ratios in predicting MetS. The adjusted chance of having MetS across quartiles of all lipid ratios had an increasing significant pattern (P < 0.0001). The area under the curves of triglyceride/high-density-lipoprotein-cholesterol (TG/HDL-C) ratio was 0.85 (95% CI = 0.84–0.87) in men and 0.85 (95% CI = 0.84–0.86) in women, of total cholesterol (TC)/HDL-C ratio was 0.79 (95% CI = 0.77–0.81) in men and 0.79 (95% CI = 0.77–0.81) in women and of low-density-lipoprotein cholesterol (LDL-C)/HDL-C ratio was 0.73 (95% CI = 0.71–0.75) in men and 0.74 (95% CI = 0.72–0.76) in women. Our results indicate that the TG/HDL-C Ratio is a better marker than the LDL-C/HDL-C ratio and the TC/HDL-C ratio for identifying MetS in the Iranian population and could be used in clinical practice

Painful memories from previous childbirth can linger and impose negative effects on the mind of a woman throughout her life. They may also create a permanent fear of delivery and turn into a barrier to future pregnancies. The aim of this study was to investigate the impact of mindfulness-based stress reduction (MBSR) on the fear of delivery in single-child mothers with a history of vaginal delivery in the city of Kerman, Iran. This is an experimental, interventional study with pretest-posttest design and a control group. The statistical population encompassed all single-child women in the city of Kerman who had had childbirth at least six years earlier and had not become pregnant due to childbirth fear. The sample consisted of 41 participants, 20 of whom received the MBSR group training in eight sessions (each lasting for 90 minutes). Fear of childbirth was evaluated before and after the intervention using Harman's Childbirth Attitudes Questionnaire (CAQ). Data were analyzed by SPSS 22 using a paired t test, covariance, independent t test, and chi-square test. The mean scores of childbirth fear in the intervention and control groups were 37.58 ± 5.9 and 33.19 ± 6.55, respectively, before implementing the program and 36.25 ± 5.40 and 33.00 ± 6.47 after that. The level of fear after the intervention was significantly higher in the experimental group than in the control group (P < 0.001). Besides, the greatest effects of the instructions were observed on the fear of painful injections, loneliness, and worry over the hospital environment. Group training of MBSR is helpful in reducing childbirth fear, and thus it can be deployed as a procedure for encouraging childbearing in women who are not willing to re-experience pregnancy due to the fear of delivery.

The study aimed to evaluate the interval between first drug use and regular injection and factors associated with transition from first injection into premature regular injection among people who inject drugs (PWIDs). In a multicenter cross-sectional study, we recruited 400 PWIDs using snowball sampling. Age of first drug use, age of initiation of regular injection, and demographic and behavioral data were collected using face to face interview. Premature transition to regular injection was defined as initiation of regular injection within the five years of first injection. Data were analyzed using bivariate and multivariate logistic regression survey analysis. Findings: The mean age of first drug use and age of initiation of regular injection was 29.87 ± 6.54 years, respectively. Having history of sexual abuse in childhood [adjusted odds ratio (AOR) = 3.1], history of imprisonment (AOR = 3.4), use of heroin as the first drug (AOR = 4.3), and doing the first injection at friends’ houses (AOR = 2.2) or in ruins (AOR = 2.2) significantly increased the chance of premature transition to regular injection, while being a female decreased the chance of premature transition to regular injection (AOR = 0.4). Compared to curiosity, being friend with a drug user (AOR = 0.4), having withdrawal symptoms (AOR = 0.2), and low cost of injection (AOR = 0.3) at the first occasion of drug injection reduced the chance of premature transition to regular injection. New interventions to prevent injection initiation among drug users are needed and should be integrated in harm reduction programs.

Osteoporosis and osteopenia are the most common metabolic bone diseases making the patients vulnerable to bone fragility and fracture. In this study, the association of opium consumption and osteoporosis adjusted for other risk factors was studied.
In this cross-sectional study, 619 cases including 73 men and 546 women referred to densitometry center in Kerman, Iran, were studied. Demographic information, history of opium consumption, medications, and other risk factors were collected using a structured questionnaire.
Findings: In a univariate analysis, opium consumption, aging, and having a body mass index (BMI) lower than 24 accompanied an increased chance of osteoporosis, while taking physical exercises on a daily basis reduces the chance of osteoporosis. Through multivariable analysis, the two variables of age group and BMI group turned out to be of significance; that is, the chance of osteoporosis or osteopenia in the age group of higher than 60 years and 45-60 years being placed in one of the levels of osteoporosis or osteopenia was 4.9 and 3.1 times higher than the age groups lower than 45 years, respectively, after being adjusted to the other variables.
Considering the results of this study, though the risk of bone density reduction in the individuals consuming opium was higher, due to the disparity between opium consumption in the two sexes, the difference was not significant between the two groups, and it is proposed that studies on larger samples and in the both sexes be conducted to determine the impacts of opium on the bone density.

One of the main concerns of policymakers is to measure the impact of harm reduction programs and different interventions on the risk of HIV transmission among Injecting Drug Users (IDUs). Looking simultaneously at multiple factors and conditions that affect the risk of HIV transmission may provide policymakers a better insight into the mixed nature of HIV transmission. The present study aimed to design a simple, brief, and multi-dimensional scale for measuring HIV transmission risk among IDUs.Patients and From October 2013 to March 2014, we conducted face-to-face interviews with 147 IDUs. Eligible participants were individuals 18 years or older who had injected drugs at least once during the last year and had not participated in similar studies within the 2 months before the interview. To design a scale for measuring HIV transmission risk, we specified 11 items, which address different dimensions of HIV risk taking behaviors/situations based on experts’ opinion. We applied exploratory factor analysis (EFA) with principal component extraction to develop scales. Eigen values greater than 1 were used as a criterion for factor extraction.. We extracted 7 items based on first factor, which were accounted for 21% of the variations. The final scale contained 7 items: 4 items were related to injecting practice and 3 items related to sexual behaviors. The Cronbach’s α coefficient was 0.66, acceptable for such a brief scale.. Applying a simple and brief scale that incorporates the different dimensions of HIV transmission risk may provide policymakers and harm reductionists with a better understanding of HIV transmission in this key group and may be advantageous for evaluating intervention programs..

Opium abuse as a relatively common behavior among Iranian population may have an association with the other coronary artery disease (CAD) risk factors. Here, we reported the prevalence of opium abuse and its co-exposures with oral health and other CAD risk factors. We recruited 5900 inhabitant aged 15-75 years using a randomized cluster household survey. All were interviewed for level of physical activity (PA), depression, anxiety and opium use and assessed for hypertension, diabetes, hyperlipidemia, and oral health status. Regarding to opium abuse, participants were grouped into: “Non-,” “occasional,” and “dependent” users.Using logistic regression model for every CAD risk factor, we assessed whether the co-exposure of opium and CAD risk factor is significant. Overall, 10.6% reported ever opium use including 5.6% dependent and 5% occasional users. The prevalence of opium abuse was increased from 2.1% in 15-25 years to 24.5% in 55-64 years group. Opium abuse, in occasional and dependent forms, was associated with depression (adjusted odds ratio [AOR] 1.81 and 2.49) and low PS (AOR 1.43 and 1.71 respectively). Dependents were less obese than nonusers (P < 0.01). Opium abuse had no significant association with hypertension, diabetes, oral health status and lipid profile. Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

The role of food allergy in atopic dermatitis (AD) is controversial. The aim of this study was to determine the frequency of food allergens in children with AD. Fifty one atopic dermatitis children aged 6 months to 5 years entered our study. The severity of AD was determined by scoring index of AD (SCORAD). Skin prick test (SPT) was done using 15 allergens including the white of the egg, yolk, peanut, kiwi, strawberry, cow''s milk, walnut, fish, banana, wheat, orange, tomato, cereals, apple and cocoa. Thirty four patients (66.7%) had a positive reaction to one or more allergens and in 17 patients (33.3%), the SPT was negative to all allergens. Eleven patients (21.6%) had a positive SPT to one food allergen, 9 patients (17.6%) to two allergens, 9 patients (17.6%) to three allergens, 3 patients (5.9%) to four allergens, 1 patient (2%) to seven allergens and 1 patient (%2) to ten allergens. The most common food allergen among 15 allergens was white egg in 19 patients (37.3%). Yolk was the second most common allergen in 11 patients (21.6%). The relationship between the severity of the SPT with AD severity was observed only for cow''s milk, which showed a reverse relationship (R=-0.337). White egg was the most common allergen in all ages and both sexes. Food allergens may play a role in the pathogenesis of atopic dermatitis.

Backgrond: Drug abuse, especially opium abuse, is a major public health problem in Iran. Recent reports suggest that opium sellers cheat their customers by adding lead to the opium. Contaminated opium can threaten the health of consumers. The present study aimed to compare the serum level of lead between opium dependents and a control group. This was a cross-sectional study in which 50 opium dependents aged 20 to 60 years old were compared with a control group of 43 non-dependents who were matched with the case group in terms of sex and age. The serum level of lead and liver function tests including serum total bilirubin, AST, ALT, Alkaline-phosphatase and hemoglobin were measured for all subjects. The mean level of serum lead concentration in opium dependents and controls was 3929.358 ± 147.67 and 3532.721 ± 1141.53, respectively and the difference was not statistically significant. There was no significant correlation between serum level of lead and age, duration of opium dependency, serum total bilirubin, hemoglobin, AST, ALT, and Alkaline-phosphate. Although there was no significant relationship between opium consumption and serum level of lead, the concentration of lead in dependent's serum was higher than controls. Further studies are needed to approve this relationship to be used for screening and on time diagnosis of opium dependents.