Archives of Iranian Medicine
Volume:22 Issue: 9, Sep 2019

To present the differences in prenatal, labor and neonatal outcomes for Syrian refugees and Turkish citizens.

Between January 2013 and December 2016, all patients in our hospital were screened retrospectively. Totally, 17000 pregnant women included in the study were divided into three groups: group 1: 4802 pregnant in Syrian refugees group; group 2: 6752 pregnant in the low-income Turkish citizens (LI groups); and group 3: 5446 women in high-income Turkish citizens (HI groups). The groups were compared for demographic parameters, prenatal, labor and postnatal results.

Age, gestational week, birth weights, antenatal follow-up, antenatal iron supplementation and prenatal hemoglobin (Hb) values were significantly lower in the Syrian refugee group (P < 0.001). Only moderate preterm delivery and moderate low birth weight were higher in the refugee group (P = 0.023 and P = 0.001). Stillbirth rates were similar in all three groups (P = 0.203), but all other neonatal complications were higher in the Turkish citizens group.

In comparison to non-refugee control patients, adverse perinatal outcomes were not observed in pregnant refugees. The refugee health policies of the Republic of Turkey seem to be working. However, further larger multicenter studies may provide more convincing data about obstetric outcomes and health results in the Syrian refugee population.

Exclusive breastfeeding (EBF) is emphasized by the World Health Organization (WHO) as the most desirable way of infant feeding in the first 6 months. EBF has beneficial health effects on mothers and infants. The aim of this study was to examine factors influencing EBF, with emphasis on household food security status and maternal mental health.

This cross-sectional study was carried out on 325 women referring to community health centers in west Tehran. Data were collected using questionnaires, including Edinburgh Postnatal Depression Scale (EPDS) and the USDA (US Department of Agriculture) 18-item questionnaire. The data was analyzed using both descriptive and analytical methods such as the chi-squared test, t test and logistic regression with SPSS 22.

The prevalence of EBF was 82.5% (CI = 0.70, 0.94), 63.9% (CI = 0.57, 0.70) and 72.3% (CI = 0.62, 0.82) in 3-month, 3-6-month and 6-8-month-old infants, respectively. The results of this study showed a significant association between EBF and infant gender satisfaction (P < 0.001, OR = 4.85, CI = 2.12, 11.12), economic satisfaction score (P = 0.028, OR = 0.82, CI = 0.69, 0.98), infant birth weight (P = 0.013, OR = 0.99, CI = 0.99, 1.00) and unwanted pregnancy (P = 0.098, OR = 1.82, CI = 0.89, 3.70). However, we did not find any significant association between EBF and other variables such as household food security status, mother’s postpartum depression, parents’ education and age, type of delivery and pregnancy numbers.

Infant gender satisfaction, economic satisfaction, unwanted pregnancy and infant birth weight were the significant factors for predicting EBF in this study. Since EBF is important for infants and mothers’ health, policy-makers should devise strategies to promote and encourage EBF in the society.

There is controversial data available regarding the impact of age at menarche on cardio-metabolic parameters. This community-based study aimed to assess this association among Iranian women.

We recruited 5,344 eligible women out of 7718, aged 10–50 years who participated in the Tehran lipid and glucose study (TLGS), conducted in 1999–2000. Based on their age at menarche, these women were subdivided into five groups: <11 years, 11–12 years, 13–14 years, 15–16 years and ≥17 years. The status of metabolic syndrome (MetS) and its components were compared among study subgroups.

The crude prevalence of MetS was 11.9, 95% CI: 11.0–13.0. Prevalence values for MetS components were 20.1 for central obesity (95% CI: 19.0–21.3), 15.7 for high fasting blood sugar (FBS), (95% CI: 14.5–17.1), 15.1 for high triglycerides, (95% CI: 14.1–16.3), 53.5 for low high density lipoproteins (HDL) (95% CI: 51.9-55.0) and 9.5 for high blood pressure (BP) (95% CI: 8.5–10.4). After adjustment for covariates, menarche age <11 years, compared to 13–14 years, was significantly associated with higher risk of Mets (odds ratio [OR] = 2.3, 95% CI: 1.1–5.4) and its components; i.e. central obesity (OR = 2.5, 95% CI: 1.5–4.2), BP (OR = 2.9, 95% CI: 1.4–6.0) and FBS (OR = 3.0, 95% CI: 1.4–6.0). To compare our results with other studies, we calculated the standardized prevalence of MetS which was based on the WHO standardized population 11.5, 95%CI: 10.7–12.5 and the standardized prevalence of MetS by the population in Tehran was 11.7, 95% CI: 10.7–12.6.

Early menarche can be associated with an increase in metabolic disturbances later in life.

To estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and the associated risk factors among drug-abusing prisoners in Birjand correctional facility.

This is a cross-sectional study on 300 drug-abusing prisoners in 2016. Data were collected through questionnaires and interviews. HBV infection and HCV exposure status of the participants were determined by HBsAg, HBcAb, and HCVAb blood tests using third-generation enzyme immune assays (ELISA). The chi-square test was used to investigate the associations between risk factors and status of HBV infection and HCV exposure. All data were analyzed with SPSS software and P<0.05 was considered as significant difference.

The mean age of participants was 37.4 ± 9.4 years with a range of 20–78 years. The prevalence rates of HBV exposure (total HBcAb) and infection (HBsAg) were 20.7 and 3.3% respectively, and the prevalence of HCV exposure (HCV Ab) was 8%. No co-infection was observed. Seroprevalence results for injecting drug users (IDUs) was 13 (18.8%) for total HBcAb, 1 (1.4%) for HBsAg, and 13 (18.8%) for HCVAb. There was no significant difference between the IDUs and non-IDUs in terms of HBsAg and total HBcAb positive rate, but the prevalence of HCV was significantly higher in the IDUs (P < 0.001). In logistic regression analysis, the main risk factors for HCV exposure in the entire samples was injecting drug use and having tattoos (OR = 4.08, 95% CI: 1.64–10.17, P = 0.003)

We found a high rate of HBV and HCV infection in drug-using prison inmates compared to the general population of this area. The main risk factors associated with HCV infection in the prison populations with history of drug abuse were injecting drug use and having tattoo.

Children are among the most susceptible groups of family violence and this is an important and worrying issue all over the world. Children with disabilities are more vulnerable to family violence. Children with autism are exposed to various types of violence due to their wide range of disabilities, as well as high tensions that are imposed on their families. Family violence against children with autism has not been studied in Iran, therefore, this study was conducted to explain the concept of family violence against children with autism from the perspectives of parents in Iran.

This is a qualitative research study. Data were gathered using individual and semi-structured interviews. Eighteen parents of autistic children were selected using purposeful sampling. Qualitative content analysis was used to analyze and interpret the data.

Four themes for family violence were defined with 9 sub-categories including physical violence, emotional violence, verbal violence and Sexual violence.

Based on the findings of the present study from the perspective of parents, autistic children need to be cared and educated in a safe environment where they are free from any kind of violence. Their privacy and individual identities are respected, and they are provided with the required treatment and education. These conditions would maintain the dignity of such children and consequently result in appropriate behavioral outcomes. Therefore, it is suggested that a culturally sound, and stable background be provided, which when supported by professional caregivers, will ensure that the rights of autistic children are protected and emphasized.

Weight disorders in childhood are considered as a global health problem with several adverse health effects. The objective of this study is to review available studies on the prevalence of overweight, obesity and underweight in Iranian pediatric population.

Articles published in the international and national journals were collected via the electronic research engines including MEDLINE, Google Scholar, Scopus, Scientific Information Database (SID), and Magiran about the prevalence of childhood overweight, obesity and underweight in all regions of Iran. Only population-based studies were included.

Large variations were documented in the prevalence of weight disorders in children of different age and sex groups living in various regions of Iran. Our findings revealed increasing trend of childhood obesity and overweight, but this change was not very sharp. In addition, underweight is still one of the main nutritional problems in children of some areas including Sistan-vaBaluchistan and Kerman provinces.

Similar to many other developing countries, double burden of nutritional disorders exists in children living in some parts of Iran. While till now most health policies and educational programs related to children’s nutrition in Iran had focused on underweight and malnutrition, more attention should be paid to the problem of excess weight.

The genetic generalized epilepsies (GGEs) are a set of disorders presenting with generalized seizures, in addition to general spike-wave activity. The present study aims to investigate the clinical manifestations and genetic origin of generalized tonicclonic seizures and the subgroups of GGEs, including childhood absence epilepsy (CAE), juvenile absence epilepsy, and juvenile myoclonic epilepsy (JME). Information compiled from genome-wide association studies (GWASs) in the EPICure project revealed associations with many genes. Besides, copy number variant (CNV) discoveries have been the most inspiring turning point of epilepsy genetic research. This phenomenon could give us an idea about microdeletions/microduplications as genetic variants throughout the whole genome. Nowadays, next-generation sequencing (NGS) approaches support neurogeneticists to unravel the predisposed putative variants in GGE to establish a better diagnosis. Consequently, previous experiments supply data for antiepileptic drugs (AEDs) to test susceptible variants, which influence the response to drugs. As a final point, all these data should provide the current GGE patients with better genetic counseling and follow-up services.

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Most patients present with steroid hormone excess or abdominal mass effect. Pure androgen-secreting ACCs are rare, while hypoglycemia is an unusual presentation of this malignancy. We present a 26-year-old woman with hypoglycemia and history of adrenalectomy due to a large adrenal mass which was diagnosed as nonfunctional adrenal adenoma. She was admitted in our hospital 10 days after her fetal loss with repeated episodes of severe hypoglycemia. She had a high serum dehydroepiandrosterone sulfate (DHEA-S) and her hypoglycemia was associated with low insulin and C-peptide levels. Imaging revealed liver metastasis and immunohistochemical studies of the biopsied lesions confirmed the diagnosis of ACC.

The development of the most active period of Persian medicine occurred in the ancient city of Gondeshapur, between the third and seventh centuries. Rebuilt between 256 and 260 by Shapur I, the second Sassanid monarch, Gondeshapur is said to have welcomed the first hospital and the consequent study of medicine, mainly based on the Greek system. It has also been mentioned that these teachings would be expanded by his successor, Shapur II. However, both statements need solid confirmation. Nestorian priests-professors and other academics expelled from the Byzantine Empire gave fundamental encouragement to cultural and medical development in Gondeshapur. With Khosrow I, Gondeshapur became a cosmopolitan city with studies of medicine, philosophy, eloquence, and music. The medical studies were conducted in an academic setting, and practiced in a hospital, with the documentary support of a library which would be provided with the main texts, mainly of Greek, Syrian, and Indian origin. The Byzantine-inspired hospital system of Gondeshapur with its own management, organic system, and differentiated personnel, was later reproduced in several cities of the Middle East and medieval Europe under Islamic rule. The academic prestige and functionality of Gondeshapur, which peaked in the seventh century, began to decline in the following centuries apparently due to the creation of similar intellectual and hospital centres in Baghdad, by the Caliph al-Mansur, and the subsequent transfer of doctors, technicians, professors and other personnel from Gondeshapur, to ensure there the operation of hospitals and also medical studies. This cultural policy was continued and expanded by al-Mansur successors, in particular by the Caliph al-Ma’mun, until the tenth century.