ramin heshmat

 For cell-based therapies of lung injury, several cell sources have been extensively studied. However, the potential of human fetal respiratory cells has not been systematically explored for this purpose. Here, we hypothesize that these cells could be one of the top sources and hence, we extensively updated the definition of their phenotype.

 Human fetal lower respiratory tissues from pseudoglandular and canalicular stages and their isolated epithelial cells were evaluated by immunostaining, electron microscopy, flow cytometry, organoid assay, and gene expression studies. The regenerative potential of the isolated cells has been evaluated in a rat model of bleomycin-induced pulmonary injury by tracheal instillation on days 0 and 14 after injury and harvest of the lungs on day 28.

 We determined the relative and temporal, and spatial pattern of expression of markers of basal (KRT5, KRT14, TRP63), non-basal (AQP3 and pro-SFTPC), and early progenitor (NKX2.1, SOX2, SOX9) cells. Also, we showed the potential of respiratory-derived cells to contribute to in vitro formation of alveolar and airway-like structures in organoids. Cell therapy decreased fibrosis formation in rat lungs and improved the alveolar structures. It also upregulated the expression of IL-10 (up to 17.22 folds) and surfactant protein C (up to 2.71 folds) and downregulated the expression of TGF-β (up to 5.89 folds) and AQP5 (up to 3.28 folds).

 We provide substantial evidence that human fetal respiratory tract cells can improve the regenerative process after lung injury. Also, our extensive characterization provides an updated phenotypic profile of these cells.

Due to the invariably progressive nature of multiple sclerosis (MS) and the high economic burden of chronic diseases, this study was performed to estimate the economic burden of MS medications in Iran.

The present research is a descriptive study performed using comprehensive national data of Iran’s Health Insurance Organization (IHIO). The timeframe for study was 2011-2019. In order to calculate the economic burden of MS medications, the cost of illness (COI) method based on the prevalence approach was used. In this study, economic burden estimation was performed according to available data on medication costs. Data mining was also used to perform different stages of study.

The number of patients receiving MS medications covered by IHIO has increased from 19,367 in 2011 to 50,642 in 2019. The economic burden of MS medications of patients covered by the IHIO increased from $81 million to $96 million between 2011 and 2019, respectively. Among the 9 medications studied, Interferon accounted for a very high share of costs in all years. The cost per patient receiving medication has also increased from $7,000 in 2011 to $18,000 in 2019.

Calculations of the economic burden of MS medications in Iran showed an upward trend during the 9 years of the study, which due to the increasing number of patients in Iran, the arrival of new medications and also the increase in prices.

In 2017, the American Academy of Pediatrics (AAP) updated clinical practice guidelines for the diagnosis and management of hypertension in children. The present study aimed to assess the prevalence of hypertension in Iranian children based on the latest guidelines.

Data on 7301 student participants (3589 boys and 3712 girls) aged between 7-12 yr were assessed. The data were extracted from the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN V) school-based study conducted in the 30 provinces of Iran in 2015. Blood pressure (BP) was classified as normal, elevated BP, and stage 1 and 2 hypertension using weighted analysis and the 2017 AAP guidelines. All analyses were performed in STATA 14.0 statistical software, with findings presented in terms of prevalence.

The overall prevalence of high BP in Iranian children was 14.7%. In addition, 15.1% of boys had high BP, with 9.4% and 1.7% of them with stage 1 and 2 hypertension, respectively. Moreover, 14.3% of girls had high BP, of which 10% had stage 1 and 1.3% with stage 2 hypertension. For elevated hypertension, it was observed in 4% of boys and 3% of girls.

Using the 2017 AAP guidelines demonstrated a higher prevalence of hypertension in children (14.7%) in Iran. The prevalence of hypertension in boys was slightly higher compared to girls.

In Iran, the incidence of colorectal cancer has been increasing over the last 25 years. Although left-sided colon cancers are still more common, several studies in recent years have shown a shift toward right colon. This rightward shift could have important clinical and healthcare consequences, as right-sided tumors generally have poorer prognoses compared to left-sided tumors and besides, are more likely to be missed in screening colonoscopy.

This retrospective study aimed at describing the demographic and clinicopathologic characteristics of patients with colon cancer based on tumor sidedness in two referral hospitals in Tehran.

Data of the patients with colon cancer who had been treated from 2010 to 2020 in two referral hospitals in Tehran, Iran were retrospectively reviewed. Collected data included patients’ demographics, tumor histology and differentiation, tumor location, stage, and disease-free survival (DFS).

A total of 1535 cases entered the study including 849 (55.3%) males and 686 (44.7%) females with a mean age of 58.22 years (range: 22 - 89). Regarding the sidedness, 800 (52.1%) had left-sided and 735 (47.9%) had right-sided tumors. Although there were more cases of left-sided tumors compared to right-sided ones on total, there existed a trend toward shifting to the right side, which was statistically significant. There existed more cases of poorly differentiated tumors in the right side and besides, right-sided tumors had poorer DFS compared to the left-sided tumors (68.3% vs 78.3%).

Left and right colon tumors differ in molecular mechanisms involved in tumorigenesis. These differences in epidemiological, molecular and histological parameters can have clinical implications. Tumor-sidedness should be acknowledged as an important epidemiological parameter with significant impacts on screening, tumorgenesis, response to treatment, and prognosis.

Based on previous studies in the sepsis population, Vitamin C could prevent injuries when administered in high doses and before the damage is established. This study aimed to evaluate the protective potentials of high-dose Vitamin C in the progression of coronavirus disease 2019 (COVID-19).

A double-blind, placebo-controlled clinical trial was conducted. Patients with moderate-to-severe disease severity based on the World Health Organization definition were enrolled and received 12 g/d Vitamin C (high‑dose intravenous Vitamin C [HDIVC]) or placebo for 4 days. Sequential Organ Failure Assessment (SOFA) score as a primary outcome, National Early Warning Score, Ordinal Scale of Clinical Improvement, and cytokine storm biomarkers were recorded on days 0, 3, and 5. Survival was also assessed on day 28 after enrollment.

Seventy-four patients (37 patients in each group) were enrolled from April 5, 2020, to November 19, 2020, and all patients completed follow-up. A lower increase in SOFA score during the first 3 days of treatment (+0.026 vs. +0.204) and a higher decrease in this parameter in the last 2 days (−0.462 vs. −0.036) were observed in the treatment group. However, these differences did not reach a significance level (P = 0.57 and 0.12, respectively). Other indices of clinical and biological improvement, length of hospitalization, and intensive care unit admission days were the same between the two groups. Treatment did not affect the 28-day mortality.

Among patients with moderate-to-severe disease of COVID‑19, the use of HDIVC plus standard care resulted in no significant difference in SOFA score or 28‑day mortality compared to the standard care alone.

 Quarantine restrictions have changed the usual lifestyle habits of children and adolescents. In this review, we summarize how the COVID-19 outbreak changed lifestyle during childhood and discuss potential short- and long-term effects of NCD high-risk behaviors on health outcomes. 

 literature search was conducted in Medline database (PubMed), Scopus, Embase, Web of Science, and Google Scholar. All studies that assessed the relationship between COVID-19 outbreak and lifestyle changes were included.  

 NCD risk factors such as unhealthy diet, physical inactivity, prolonged screen time and sedentary behavior, disrupted sleep schedules and sleep quality, as well as mental disorders during COVID19 in childhood, may increase the susceptibility to NCDs in adulthood. These changes in lifestyle behaviors have short and long-term cardio-metabolic and psychological health outcomes. Since it is not clear when COVID-19 is completely controlled, assessment of the interactions between COVID-19 and lifestyle activities in the pediatric age group is critical.

 The pandemic of coronavirus disease 2019 (COVID-19) has greatly influenced all levels of health systems. During the COVID-19 pandemic, prevention and management of non-communicable diseases (NCDs) will need to be prioritized even further.

Assessing the prevalence of infections, which are preventable by vaccination, is crucial to monitor the vaccination program efficacy, and it can demonstrate the gaps in population immunity. The current study attempted to assess the specific Immunoglobulin (IgG) antibody against measles, mumps, and rubella (MMR) in Iranian children and adolescents, years after their vaccination.

This cross-sectional study was conducted in Iran. Serum samples of 2100 students, aged 7-18 years, included in a national health survey, were tested for MMR antibodies by ELISA assay. Multistage random cluster sampling was used to select subjects from 30 provinces in Iran.

Overall, 1871, 1718, and 1678 serums were tested for measles, mumps, and rubella antibodies, respectively. The prevalence of positive test was 1231 (65.8%) for measles, 1327 (77.2%) for mumps and 1344 (80.1%) for rubella.

Despite high vaccination coverage in Iran, IgG antibody against measles, mumps, and rubella was not detected in a considerable proportion of children and adolescents aged 7-18 years. In case of contacts with residents of other countries, where measles or rubella have not yet been eliminated, it may create problems for Iranian children.

Advances in recombinant DNA technology led to the development of recombinant follitropin alfa. Recombinant human follicle-stimulating hormone products are used to stimulate follicular maturation.

To compare the efficacy and safety of a biosimilar-candidate recombinant human follicle-stimulating hormone (Cinnal-f®; CinnaGen, Iran) with the reference product (Gonal-f®; Merck Serono, Germany) in women undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI).

In this randomized controlled trial, a total sample size of 200 women (age < 35 yr, candidate for ICSI) was calculated. Participants began a pituitary downregulation protocol with buserelin. They received 150 IU daily of either Cinnal-f® or Gonal-f® from the second day of their cycle. The primary outcome of the study was the percentage of metaphase II (MII) oocytes. The secondary outcomes included the number and quality of oocytes retrieved, duration of stimulation, fertilization rate, embryo quality, the number of clinical and ongoing pregnancies, and the incidence of ovarian hyperstimulation syndrome (as an important safety marker).

A total of 208 women were enrolled, of whom, 200 completed the study period. Ovarian stimulation with Cinnal-f® resulted in a comparable percentage of MII oocytes as with Gonal-f® (78.64% vs 80.02%, respectively; p = 0.81). No statistically significant difference was seen in the secondary outcomes between the groups.

Cinnal-f® proved non-inferior to Gonal-f®, based on the percentage of MII oocytes in women aged < 35 yr undergoing ICSI. Our findings confirm that the efficacy and safety profiles of Cinnal-f® and Gonal-f® are similar.

It seems that the incidence of Guillain-Barré syndrome (GBS) has seasonal trends depending on weather as well as environmental and demographic factors such as upper respiratory tract infection (URI). The aim of this study was to evaluate seasonality of GBS and its electrophysiological subtypes.

In this cross-sectional study, the records of all admitted patients to all wards of Dr. Shariati Hospital from March 2009 to March 2019 according to ICD-10 codes for GBS and other similar neuropathies were investigated and 87 patients were registered based on fulfillment of Brighton criteria and symptom onset during the recent 4 weeks. Statistical analysis was performed by IBM SPSS version 20. A p-value < 0.05 was considered statistically significant.

Most of the patients (63.2%, n=55) were men. The mean age of them was 49.1±19.2 years, and 41.3% (n=36) and 10.3% (n=9) participants had recent URI and gastrointestinal infection, respectively. The frequency of GBS in different seasons was 35.6% (n=31) patients in the winter, 27.6% (n=24) in the autumn, 19.6% (n=17) in the spring, and 17.2% (n=15) in the summer. The most frequent electrophysiological subtype was acute inflammatory demyelinating polyneuropathy (AIDP) in all seasons. The most common GBS disability score was 1.

The highest and the lowest occurrence was seen in the winter and summer, respectively. AIDP was the most common electrophysiological subtype in all seasons. More studies are suggested to evaluate other aspects of GBS on more details.

Pertussis is a vaccine‑preventable respiratory infection and seroepidemiology of the infection could be a marker of the pertussis immunity in a population. In many countries, despite vaccination coverage, high prevalence of pertussis has been observed. The present study aimed to evaluate the immunoglobulin G (IgG) antibody against pertussis and the role of demographic and anthropometric variables on the immunity rate in the Iranian pediatric population to evaluate the impact of existing immunization program in order to envisage future vaccination strategies to prevent infection.

In a cross‑sectional multi‑centric study, 1593 samples of the students aged 7–18 years, who had been enrolled in a national survey (Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable disease‑V), were randomly selected and tested for IgG antibody against Bordetella pertussis (BP) by enzyme‑linked immunosorbent assay. The age, gender, education, residency, geographical region, and body mass index (BMI) were extracted from the questionnaires of the COSPIAN‑Survey. Multiple logistic regression models were used to assess the associations between the variables with the IgG antibody against BP. Data were presented by odds ratio (OR), 95% confidence interval (95% CI) and P values (P): (OR [95% CI]; P).

Subjects were consisted of 774 boys and 750 girls, with a mean (standard deviation) age of 12.39 (3.03) years. Overall, BP seroprevalence was 59.8%. There were higher BMI values in seronegative ones versus seropositive (18.62 ± 4.07 vs. 18.15 ± 3.94, P = 0.041, 95% CI = 0.23 [0.02–0.92]). However, the categorized BMI for age was not significantly associated with IgG levels (0.27 [0.25–0.29]; 0.27). BP seroprevalence was not significantly different between geographical regions (0.06 [0.05–0.07]; 0.06), genders (1.17 [0.93–1.47]; 0.18), area of residence (1.07 [0.82–1.4]; 0.61), and educational levels (0.94 [0.75–1.19]; 0.62).

IgG antibody against pertussis was not detected in nearly 40% of the subjects who had history of vaccination against pertussis. It is recommended to monitor the incidence of pertussis in high‑risk populations closely and administer a booster dose of acellular pertussis vaccine in adolescents.

This study aimed to investigate the association between prenatal/infancy factors and lipid profile in children and adolescents.

This multicentric national study was conducted in 30 provinces in Iran. It comprised 4200 participants, aged 7-18 years, from the fifth survey of a national surveillance program. History regarding birth weight, as well as the type of consumed milk and food during infancy was obtained from parents. In addition to physical examinations, fasting blood samples were obtained to assess the lipid profile of these students.

Data from 3844 participants were available (91.5% participation rate), 52.4 % of students were boys. Mean (SD) age of participants was 12.3(3.2) years. Consuming cow milk in the first two years significantly increased the risk of high triglycerides (TG) (odds ratio [OR]: 2.77, 95% CI: 1.32-5.85, P: 0.01), elevated low-density lipoprotein (LDL) (P<0.05) and low high-density lipoprotein (HDL) (P <0.05). Students who had consumed commercially made food as complementary feeding were 93% more likely to have high LDL (OR: 1.93, 95% CI=1.19-3.13, P: 0.01) and 90% more likely to have high TG than students who had consumed homemade food (OR: 1.90, 95% CI: 1.15-3.12, P: 0.01). The aforementioned figures were not significantly associated with an elevated total cholesterol (TC) level.

Our findings revealed that the history of using human milk and home-made food as complementary feeding was associated with better lipid profile in childhood and early adolescence. Increasing public knowledge in this regard might be useful for encouragement of healthier life prevention of chronic diseases.

 Cardio-metabolic syndrome indicates the clustering of several risk factors. The aims of this study were to identify the subgroups of the Iranian children and adolescents on the basis of the components of the cardio-metabolic syndrome and assess the role of demographic characteristics, socioeconomic status and life style related behaviors on the membership of participants in each latent class. 

 This cross sectional study was performed on 3730 Iranian students in 2015 using stratified cluster. All students in each class completed anonymous and structured questionnaires. Abdominal obesity, high triglyceride (TG), low high-density lipoprotein (HDL), high blood pressure (BP), high fasting blood sugar (FBS), high low-density lipoprotein (LDL), high cholesterol and obesity were used for assessing pattern of cardio metabolic risk as a latent variable. Data analysis was performed using PROC LCA in SAS software.

Four latent classes were identified in this study; namely 1) healthy (59.6%), 2) low risk (20.4%), 3) moderate risk (13.7%) and 4) high risk (6.4%). Being girl (OR=0.59, 95% CI: 0.46-0.74), living in rural area (OR=0.45, 95% CI;0.33-0.60), high screen time (OR=1.56, 95% CI:1.09-2.24), and parental obesity (OR=1.52, 95% CI: 1.18-1.95) were associated with moderate risk class. Only living in rural area (OR=0.71, 95% CI; 0.51-0.99) was associated with high risk class.

About 20% of the students are in the moderate risk and high risk classes.  Design and implementation of interventions according to risk-based class seems necessary with considering probably risk and protective factors for prevention of complications of cardiometabolic syndrome.

This study aims to determine the factors affecting the tendency to lose weight (TLW) and its methods in Iranian children and adolescents.

In this cross‑sectional nationwide study 14800 students, aged 7–18 years, living in 30 provinces of Iran were selected via multistage cluster random sampling method. The dietary and physical activity habits and TLW as well as psychosocial health status, anxiety, self‑satisfaction, and change in dietary behaviors were assessed by the global school‑based student health survey (WHO‑GSHS) questionnaire. Multivariate logistic regression model was used to identify factors influencing TLW.

Overall, 14274 students (participation rate of 99%), consisting of 51% boys and 71.4% urban residents, completed the study. Of them, 37.7% (51.4% Girls and 48.6% boys) tended to lose weight. In multivariate model, the odds for TLW was 12% higher in students aged 13–18 years than those aged 6–12 years (OR = 1.12, 95% CI: 1.02 to 1.23; P < 0.001). Students with high anxiety level were 43% more likely to have TLW (OR = 1.43, 95% CI: 1.28–1.59; P < 0.001). The odds of increasing physical activity for weight loss was 22% lower in obese than in normal weight students (OR = 0.78, 95% CI: 0.66 to 0.93; P < 0.001).

TLW was significantly higher in girls, as well as in those with higher anxiety level. In addition to dietary change, increasing physical activity should be encouraged among children and adolescents with excess weight. Public education regarding proper lifestyle change for reaching healthy weight should be underscored.

The present study assess lifestyle and eating habits of Iranian adolescent girls.

This cross-sectional study was conducted on 3207 adolescent girls, aged 12–18 years. Lifestyle and eating habits of adolescents were assessed.

The prevalence of overweight was 11.3% and that of obesity was 10.2%. The frequencies of daily intake of fruits, dairy products and vegetables were 60.9%, 45.6 % and 33.5%, respectively. Skipping breakfast (15.8%) was more frequent than skipping dinner or lunch. Moreover, 10.6% of subjects had fast food daily and 16.2% had fast food weekly. Overall, 55.2% of participants watched television for at least 2 hours a day; and 27.1% reported to have a sleeping time of less than 8 hours a day. Low physical activity, i.e. less than 30 minutes per day, was less frequent among participants with high socio-economic status (SES) compared to those with medium or low SES (57.6% vs. 61.3% and 64.1%, respectively, P value = 0.010).

Improvement of lifestyle habits should be considered in public health plans for health promotion of adolescent girls and the next generation. Primordial prevention of chronic diseases by improving healthy lifestyle of adolescent girls should be a national public health priority

This study aimed to find possible spatial variation in children’s weight disorders and in predicting the spatial distribution.

The study population of this ecological study consisted of 7-18-year-old students living in 30 provinces of Iran. We used Besag, York and Mollie (BYM) model, a Bayesian model, to study the relative risk (RR) of underweight and excess weight (overweight and obese). The model was fitted to data using OpenBUGS (3.2.1) software.

The highest RR of underweight was found in southeastern provinces. Whereas, the highest RR of excess weight was documented in northern, northwestern and capital provinces. Sistan-Balouchestan (RR=1.973; Bayesian confidence interval [BCI]: 1.682, 2.289), Hormozgan (RR=1.482; BCI: 1.239, 1.749), South Khorasan (RR=1.422; BCI: 1.18, 1.687) and Kerman (RR=1.413; BCI: 1.18, 1.669) had the highest RR of underweight. Mazandaran (RR=1.366; BCI: 1.172,1.581), Gilan (RR=1.346; BCI: 1.15,1.562), Tehran (RR=1.271; BCI: 1.086,1.472) and Alborz (RR=1.268; BCI: 1.079,1.475) provinces are high risk regions for excess weight.

The significant variations in geographical distribution of weight disorders are because of various sociodemographic and ethnic differences. The current findings should be considered in health policy making in different regions of the country

The assessment of the trend of changes in the prevalence of abdominal obesity can provide useful health information.

This study aimed to conduct an age-period-cohort (APC) analysis to provide the trend of the prevalence of abdominal obesity in the Iranian pediatric population through the three temporal dimensions of age, period, and cohort.

Data were gathered from a total number of 53,962 Iranian children and adolescents aged 5 to 19 years through four surveys of a national surveillance program (the CASPIAN study) conducted in 2003, 2007, 2011, and 2015. Abdominal obesity was defined as a waist-to-height ratio of ≥ 0.5. The APC analysis was performed using the “apc_ie”command in STATA software.

A significant correlation existed between age, period, and cohort effects and the prevalence of abdominal obesity in children and adolescents. With increasing age, regardless of considerable fluctuations, the prevalence of abdominal obesity followed an overall increasing trend in both genders. The age effect coefficient increased from -2.1 in the age group of 5 - 9 years to 1.1 in the age group of 10 - 14 years and then decreased to 1.0 in the age group of 15 - 19 years among boys; figures followed an increasing trend in girls from -2.2 to 0.8 and 1.5, respectively. As for the period effect, in both boys and girls, the prevalence of abdominal obesity followed an increasing trend when coming from the earlier periods to the recent ones (from -4.6 to 4.0 in boys and from -4.1 to 2.4 in girls). Likewise, this prevalence increased from earlier birth cohorts to the recent ones in both genders.

The prevalence of abdominal obesity is increasing among Iranian children and adolescents and this rising trend is affected by age, period, and birth cohort effects. The findings of this study emphasize the necessity of implementing comprehensive interventions for tackling the epidemic of childhood obesity.

Overweight, obesity, and underweight are common child health problems in Iran. Child‑feeding practices are one of the major factors affecting children’s weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49‑item measure comprising 12 subscales, assesses parental child‑feeding practices. It is used to determinefactors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2–5‑year‑old children.

This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test–retest reliability were conducted.

EFA resulted in a final questionnaire with 39 items distributed overseven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test–retest reliability.

The revised CFPQ is a valid tool for determining the variousaspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2–5‑year‑old children.

The purpose of this study was to obtain the cutoff points of visceral adiposity index (VAI), a new marker of indirect evaluation of visceral fat, to assess its association with metabolic syndrome (MetS) in a population of children and adolescents.

This cross sectional study was conducted on children and adolescents aged 7-18 years attended in the fifth phase of a national school-based surveillance survey. The odds ratio (OR) of cardiometabolic risk factors across tertile categories of VAI was determined using the logistic regression models and the valid cut-off values of VAI for predicting MetS was obtained using the receiver operation characteristic (ROC) curve analysis.

A total of 3843 students (52.3% boys, 12.3 [12.2-12.4] years) were included in the analysis. The mean of VAI was significantly higher in participants who had MetS (2.60 [2.42-2.78] vs 1.22 [1.19-1.25]; P <0.001). Participants in the third tertile compared to the first tertile category of VAI had higher odds of abdominal obesity (OR: 1.77, 95% CI: 1.43-2.20), impaired fasting blood glucose (OR: 2.00, 95% CI: 1.28-3.13) and low high-density lipoprotein cholesterol (OR: 15.93, 95% CI: 12.27-20.66). The cut-off points of the VAI for predicting MetS were 1.58, 1.30 and 1.78 in total population, boys and girls, respectively.

We determined the cut-off points of VAI as an easy tool for detecting MetS in children and adolescents and demonstrated that VAI is strongly associated with MetS. Prospective longitudinal studies are suggested to show the possible efficiency of the VAI as a predictor of MetS in pediatrics.

Background & Papillary thyroid cancer (PTC) is considered to be the most common type of thyroid malignancies. Epigenetic alteration, in which the chromatin conformation and gene expression change without changing the sequence of DNA, can occur in some tumor suppressor genes and oncogenes. Methylation is the most common type of epigenetic alterations that can be an excellent indicator of PTC invasive behavior. In this research, we determined the promoter methylation status of four tumor suppressor genes (SLC5A8, RASSF1, MGMT, and DNMT1) and compared the results of 55 PTC cases with 40 goiter patients. For methylation, we used the methylation-sensitive high resolution melting (MS-HRM) assay technique. The resulting graphs of each run were compared with those of 0%, 50%, and 100% methylated controls. Our data showed that the promoter methylation of SLC5A8, Ras association domain family member 1(RASSF1), and MGMT were significantly different between PTC tissue and goiter with P-value less than 0.05. The most significant differences were observed in RASSF1; 77.2% of hyper-methylated PTC patients versus 15.6% hyper-methylated goiter samples (P<0.001). RASSF1 promoter methylation can be a PTC genetic marker. RASSF1 promoter methylation is under the impact of the methyltransferase genes (DNMT1 and MGMT), protein expression, and promoter methylation.

Some tests and markers have proved to improve the diagnosis of prostate cancer (PCa). This meta-analysis aimed to review the diagnostic accuracy of three commercial tests, prostate health index (PHI), prostate cancer antigen 3 (PCA3), and prostate imaging reporting & data system V2 (PI-RADS) for detecting of PCa.

We did a comprehensive literature search of international databases including Scopus, Web of Science, and PubMed from January 2000 to Feb 2018. We included three groups of diagnostic accuracy studies that used PCA3, PHI, and PI-RADS to assess PCa. The l quality of the study was measured by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria.

Twenty-six studies on PHI, 24 articles on PI-RADS, and 26 papers on PCA3 were included for the meta-analysis. For the diagnosis of PCa, the sensitivity and specificity were 0.76 and 0.84 for PI-RADS, 0.48 and 0.85 for PHI, 0.49 and 0.79 for PCA3. Also, the derived area under curves (AUC) from the hierarchic summary ROCs (HSROCs) were 0.86 (95% CI, 0.83-0.89) for PI-RADS, 0.72 (0.68-0.76) for PCA3, and 0.70 (0.66-0.74) for PHI. Fagan’s nomograms showed that the post-test probability of cancer subjects with a positive test was 53%, 63%, and 45%, for PHI, PI-RADS, and PCA3 respectively.

Currently, available evidence suggests that the PI-RADS is superior in the diagnosis of PCa with high sensitivity, specificity, and AUC compared to PHI and PCA3.

This cross-sectional study aimed to assess the association between cardiovascular disease (CVD) risk factors and dinner consumption in a nationally representative sample of Iranian adolescents. The present study was conducted on 5642 adolescents aged 10-18 years old in 27 provinces in Iran. The subjects were included applying by multistage random cluster sampling. Participants who ate ≥5 dinners during a week were considered as a dinner consumer. Among 5642 subjects, 1412 (25%) did not consume dinner. Dinner consumers were less likely to be overweight or obese (P < 0.001) and abdominally obese (P < 0.001) as well as to have an abnormal level of HDL-C (P = 0.02). Dinner skipper youths had a higher risk for overweight or obesity (odds ratio [OR]: 1.62; 95% CI: 1.39-1.89) and abdominal obesity (OR: 1.59; 95% CI: 1.36-1.85) which remained significant after adjusting confounding factors (P <0001). No relationship was observed between dinner consumption and the rest of the CVD risk factors, neither in crude nor in adjusted models. A higher proportion of dinner-consumer adolescents had no CVD risk factors in comparison to dinner-skipper subjects (31.1% vs. 28%). Eating dinner might be inversely associated with some CVD risk factors among Iranian adolescents. Further prospective studies will need to prove this theory.

Leisure time activities might be associated with school performance. This study aimed to investigate the association between leisure time variables, including television and computer using time, homework time and cell phone using time, with children’s school performance in a nationally representative sample of Iranian children and adolescents. In this analytical cross-sectional study as the fifth survey of a national school-based surveillance program in Iran, participants were selected by multi-stage sampling approach among 7-18-year-old students from urban and rural areas. In addition to filling questionnaires obtained from World Health Organization Global School Health Survey and conducting physical examinations, the averages of school grades were categorized into "very good" (grade 17-20 out of 20), and "not very good" (under 17 out of 20) as school performance according to qualitative evaluation scales established recently in Iranian schools. The participation rate was 99%, 14,274 students completed the study. Urban students spent more time doing homework and using screen media, and they had better school performance than rural students (P < 0.001). Girls had higher homework time and better school performance than boys (P < 0.001). Prolongedscreen time, including watchingtelevision and computer use increased the odds of lower school performance (Odds ratio = 1.11). No other media type times or homework time had a significant association with school performance. In this study, prolongedscreen time represents an inverse association with school performance. Television viewing time, computer and cell phone using time and homework time might have no separate significant effects on school performance.

The purpose of this study was to assess socioeconomic status (SES) inequality in life satisfaction (LS) and good self‑perceived health (SPH) in Iranian children and adolescents. This nationwide study was conducted as part of a fourth national school‑based surveillance program performed on 14880 students aged 6–18 years who were living in urban and rural areas of 30 provinces of Iran between 2011 and 2012. Using principle component analysis, the SES of participants was constructed as single variable. SES inequality in LS and good SPH across the SES quintiles was assessed using the concentration index (C) and slope index of inequality (SII). The determinants of this inequality are investigated by the Oaxaca Blinder decomposition method. Frequency of LS along with the SES quintiles shifted signifcantly from 73.28% (95% CI: 71.49, 75.08) in the lowest quintile to 86.57% (95% CI:85.20, 87.93) in the highest SES quintile. Frequency of favorable SPH linearly increased from lowest SES quintile (76.18% (95% CI: 74.45, 77.92)) to highest SES quintile (83.39% (95% CI: 81.89, 84.89)). C index for LS and good SPH was negative, which suggests inequality was in favor of high SES group. SII for LS and SPH was 15.73 (95% CI: 12.10, 19.35) and 8.21 (95% CI: 5.46, 10.96)]. Living area and passive smoking were the most contributed factors in SES inequality of LS. Also passive smoking and physical activity were the most contributed factors in SES inequality of SPH. SES inequality in LS and good SPH was in favor of high SES group. These fndings are useful for health policies, better programming and future complementary analyses.

This study aims to determine the association of sleep duration with screen time in children and adolescents. Study design: A matched case-control study.   This nationwide study was conducted in 2015 among 14,274 students aged 7-18 years, and one of their parents who lived in 30 provinces in Iran. Data collection was performed using questionnaires and physical examination. Watching television and working with computer were categorized into two groups (<2 h/day and ≥2 h). Moreover short sleep duration was defined as sleep duration ≤ 8 h/day. The analysis was conducted based on the propensity score using a matched case–control study design. Data analysis was performed by a conditional logistic regression. Overall, 14,274 students and one of their parents completed the survey (participation rate: 99%). Mean (standard deviation) age of students was 12.3 (3.2) years, and the frequency of short sleep was (4672) 33.5% .In total, 54.3% of students watched TV ≥2 h/day and  9% of those used a computer ≥2 h/day in their leisure time. In the multivariate model, Individuals who watched TV ≥2 h/day had significantly higher odds of short sleep (OR 1.13, 95% CI 1.03, 1.24), and individuals who worked with computer ≥2 h/day had significantly higher odds of short sleep (OR 1.65, 95% CI 1.40, 1.94). This study revealed significant association between watching TV and using computer during leisure time with insufficient sleep. Public awareness should be provided regarding the adverse effects of screen use on sleep. Developing special guide lines and educational school programs on restricting screen time and increasing physical activities should be considered as a health priority for children and adolescents.