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1.  Serum IL-17, IL-23, and TGF-β Levels in Type 1 and Type 2 Diabetic Patients and Age-Matched Healthy Controls 
BioMed Research International  2014;2014:718946.
Type 1 diabetes is recognized as an autoimmune inflammatory disease and low grade inflammation is also observed in type 2 diabetic patients. Interleukin 17 (IL-17) is a new player in inflammation. Th17 cells, as the main source of IL-17, require transforming growth factor β (TGF-β) and interleukin 23 (IL-23). The aim of this study was to investigate serum IL-17, IL-23 and TGF-β levels in diabetic patients and controls. In this case-control study, serum levels of IL-17, IL-23, and TGF-β were measured in 24 type 1 diabetic patients and 30 healthy controls using the ELISA method. Simultaneously, the same methodology was used to compare serum concentration of these three cytokines in 38 type 2 diabetic patients and 40 healthy controls. There was no significant difference between serum levels of IL-17 and IL-23 cytokines between cases and controls. However, TGF-β was significantly lower in type 1 diabetic patients (P < 0.001). Serum IL-17 and IL-23 levels demonstrate no association with type 1 and type 2 diabetes, but, in line with previous studies, TGF-β levels were lower in type 1 diabetic patients.
doi:10.1155/2014/718946
PMCID: PMC4065742  PMID: 24995325
2.  Hepatitis B Knowledge Among Iranian Adolescents: A National Survey 
Background:
Hepatitis B is the most prevalent chronic infectious liver disease worldwide with serious sequelae. Prevention of the infection can be provided by universal vaccination and improvement in knowledge and behavior about disease transmission. Provision of any educational program requires inquiry about target group baseline knowledge.
Objectives:
The aim of this study was to assess Iranian adolescents’ knowledge about hepatitis B (HBV) and associated factors.
Patients and Methods:
We conducted a questionnaire-based national survey of 18-year-old adolescents according to stratified cluster random sampling in Iran during 2007.
Results:
Response rate was 87%. Most adolescents (60%) knew that HBV infects the liver. Percentage of adolescents who gave correct answers to major routes of HBV transmission were as follows: spouse of an infected person 59%, multi-partners 66%, intravenous drug use 73%, body piercing 55% and personal belongings 55%. Higher levels of education, living in rural areas, marriage and (except for body piercing) female gender were associated with better knowledge. The knowledge of HBV infected individuals about major routes of HBV transmission was low (P < 0.001).
Conclusions:
There are important deficits in adolescents’ knowledge about HBV that requires attention of health educators to tailor educational programs for specific groups.
doi:10.5812/ircmj.11558
PMCID: PMC3955498  PMID: 24693383
Hepatitis B virus; Knowledge; Health Care Surveys; Adolescent
3.  Magnetic Resonance Spectroscopic Findings of Chronic Lesions in Two Subtypes of Multiple Sclerosis: Primary Progressive Versus Relapsing Remitting 
Iranian Journal of Radiology  2013;10(3):128-132.
Background
Multiple sclerosis (MS) is a highly prevalent cause of neurological disability and has different clinical subtypes with potentially different underlying pathologies. Differentiation of primary progressive multiple sclerosis (PPMS) from relapsing remitting multiple sclerosis (RRMS) could be difficult especially in its early phases.
Objectives
We compared brain metabolite concentrations and ratios in patients with PPMS and RRMS by magnetic resonance spectroscopic imaging (MRSI).
Patients and Methods
Thirty patients with definite MS (15 with RRMS and 15 with PPMS) underwent MRSI and their non-enhancing lesion metabolites were measured. N-acetyl aspartate (NAA), Creatine (Cr), Choline (Cho), NAA/Cr and NAA/Cho were measured and compared between the two MS subtypes.
Results
When the two MS groups were compared together, we found that Cr was significantly increased (P value=0.008) and NAA/Cr was significantly decreased (P value=0.03) in non-enhancing lesions in PPMS compared with RRMS. There was no significant difference in NAA, Cho or NAA/Cho between the two MS subtypes.
Conclusion
MRS is a potential way to differentiate PPMS and RRMS.
doi:10.5812/iranjradiol.11336
PMCID: PMC3857974  PMID: 24348597
Multiple Sclerosis, Chronic Progressive; Multiple Sclerosis, Relapsing-Remitting; Magnetic Resonance Spectroscopy
4.  Prevalence and Associated Factors of Physical, Verbal and Relational Aggression among Iranian Preschoolers 
Iranian Journal of Psychiatry  2013;8(3):138-144.
Objective
Childhood aggression may lead to severe social disorders in adolescence and adulthood. Different psychiatric approaches are focused on preschool aged aggressive children. The aim of this study was to estimate the prevalence and associated factors of childhood direct and indirect aggression.
Methods
In this cross sectional study a total of 1403 children attending 43 kindergartens were assessed. Data were collected through a structured 46-item questionnaire investigating symptoms of physical, verbal and relational aggression which was completed by parents and teachers of day-care centers. Complex sample survey analysis and multivariate logistic regression method were used for data analysis.
Results
According to parents’ rating, the prevalence of physical,verbal and relational aggression, was 9.9% (95% CI=7.4%-12.4%), 6.3% (95% CI=5.0% -7.6%) and 1.6% (95%CI=1.0%-2.2%), respectively; while based on teachers’ rating the prevalence of physical,verbal and relational aggression were 10.9% (95% CI=8.9% -12.9%), 4.9%(95% CI=3.8% -6.0%) and 6% (95% CI=4.4% -7.6%), respectively. A wide range of family environment factors including living with a single parent, having a working mother, death of someone close to the child, and having less educated mother were significantly associated with different types of aggression; additionally, there was some evidence of a relationship between sex of the children and physical aggression, after controlling for other variables (p < 0.05).
Conclusion
This study revealed that children's family environment alongside internal factors plays an important role as an external factor in determining the child's potential aggressive behavior. Given this, to better prevent the aggressive behavior of children, intervention strategies should be planned for families and caregivers; specially mothers should receive training to use such strategies.
PMCID: PMC3887231  PMID: 24454423
Iranian children; Physical Aggression; Verbal Aggression; Relational Aggression; Children psychology
5.  A survey on the factors influencing the pattern of medicine's use: Concerns on irrational use of drugs 
Objective:
Pharmacists have a remarkable role in rational use of drugs by dissemination of drug information to guide patients, physicians, and policy makers. The present study was undertaken to evaluate the pharmacists’ view point about the main factors affecting current drug use pattern regarding rational drug use and the most effective strategies for improving and promoting rational drug use among pharmacists.
Methods:
In a cross-sectional survey, pre-designed questionnaires were filled in convenient sampling by pharmacists who had attended the congress of rational drug use in Tehran, Iran.
Findings:
A total of 144 pharmacists with the average age of 40.78 years old were enrolled to the study. Data indicated that the most priorities in irrational use of drugs from pharmacists’ view point were lack of appropriate cooperation and communication between physicians and pharmacists (39%), pharmacists’ low tariff and economic issues (34%), lack of public knowledge about drug usage (45%), and lack of supervisory regulations on pharmacy practice (15.8%).
Conclusion:
In this study, lack of public knowledge and awareness about appropriate use of medicines was the most important element from pharmacists’ viewpoint in occurrence of irrational drug use. Dissemination of information and compiling of diverse strategies in education, management, regulation, and finance can be very efficient due to a strong relationship between drug policies and performance of regulations and supervisions as well as drug services.
doi:10.4103/2279-042X.117385
PMCID: PMC4076903  PMID: 24991605
Drug consultation; drug information; drug policy; pharmacists’ roles; rational drug use
6.  The Effect of Epidural Bupivacaine on BIS Levels in the Awake Phase and on the Maintenance Doses of Propofol and Fentanyl During General Anesthesia 
Anesthesiology and Pain Medicine  2013;2(4):149-153.
Background
Simultaneous administration of epidural local anesthetic agents (LA) and general anesthetics (intravenous or inhaled) is a common procedure in patients undergoing major operations. The effects of epidural anesthesia during combined general-epidural anesthesia on the alertness level (CGEA) in the awake phase and the doses of anesthetics have been reported.
Objectives
The present study was designed to determine the effects of epidural bupivacaine on the alertness level measured by bispectral index (BIS) in the awake phase and the maintenance doses of propofol and fentanyl during general anesthesia for vascular operation on the lower limb.
Patients and Methods
A double-blinded randomized clinical trial was conducted on patients awaiting vascular surgery on lower extremities in a teaching hospital from October 2007 to October 2008. During the epidural anesthesia, the control group received 0.9% NS while 0.125% bupivacaine was injected in the case group via the epidural route. No sedative drug was utilized for epidural catheter placement. The BIS measurement was performed in both groups during the awake phase, before performing epidural anesthesia, and 10 minutes after epidural injection at 1-min intervals for 15 min. After induction of general anesthesia in both groups, anesthesia maintenance was established using the infusion of propofol with the aim of keeping the BIS level between 40 and 50 throughout the anesthesia. At the end of the study period, maintenance dose requirements of propofol and fentanyl were measured.
Results
Thirty-two patients were enrolled in the study. There was no difference in BIS levels of the two groups in the awake phase. There was a significant difference between the propofol and fentanyl requirements of the two groups.
Conclusions
Performing CGEA using bupivacaine was reported to reduce propofol and fentanyl doses required to maintain BIS levels between 40 and 50 considerably.
doi:10.5812/aapm.5461
PMCID: PMC3821134  PMID: 24223351
Anesthesia; Epidural; Bupivacaine
7.  Fixed Cut-Off for FEV1/FEV6 and FEV6 in Detection of Obstructive and Restrictive Patterns 
Background
Chronic obstructive pulmonary diseases (COPD) have been defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as irreversible conditions which are diagnosed by fixed cut-off points of FEV1/FVC.
Objective
The aim of this study was to determine the cut-off points for FEV1/FEV6 ratio and FEV6 as alternatives for FEV1/FVC and FVC in detection of airway obstruction and lung restriction, respectively.
Materials and Methods
A total of 318 Spiro metric examinations of subjects referred to Shariati hospital were analyzed. A subject was considered to have obstruction if FEV1/FVC was lower than 70%. The restriction was defined as FVC < 80% in the absence of obstruction. The Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FEV1/FEV6 and FEV6 were calculated.
Results
This study shows that the current cut-off points used to detect obstruction and restriction can be replaced by FEV1/FEV6 < 71% and FEV6 < 83%, respectively. FEV1/FEV6 had sensitivity of 95.5% and specificity of 99.4%; the PPV and NPVs were 99.3% and 96.3%. The prevalence of obstruction was 49.4%. For restrictive pattern, FEV6 had sensitivity of 93%, specificity of 79.5% with PPV of 18% and NPV of 99.5%. The prevalence of restriction was 6.3%.
Conclusions
The FEV1/FEV6 ratio can be used as a valid surrogate for FEV1/FVC in the diagnosis of airway obstruction, especially for screening purposes in high-risk populations for COPD. Moreover, FEV6 is an acceptable alternative for FVC in detection of restrictive pattern.
doi:10.5812/ircmj.8163
PMCID: PMC3652503  PMID: 23682328
Pulmonary Disease, Chronic Obstructive; Pulmonary Function Tests
8.  Evaluation of the Persian version of modified fatigue impact scale in Iranian patients with multiple sclerosis 
Iranian Journal of Neurology  2013;12(1):32-34.
Background
Fatigue, a major cause of disability in individuals with multiple sclerosis (MS), is associated with reduced quality of life. The aim of this study was to evaluate the reliability and reproducibility of the Persian version of Modified Fatigue Impact Scale (MFIS) in Iranian patients with MS.
Methods
This study included 15 subjects with clinically definite MS, 15 hospitalized patients with MS, and 15 hospitalized patients with other chronic illnesses (as controls). They filled in the Persian version of the MFIS twice with a three-day interval. MFIS items were analyzed and the correlation coefficient was calculated.
Results
There was a good correlation between the scores of the two measurements (correlation coefficient: 0.984, P < 0.001) especially in physical and cognitive subgroups. The reproducibility of psychosocial subscale was lower than physical and cognitive subscales.
Conclusion
According to our findings, the Persian version of the MFIS has a good reliability and reproducibility for assessment of fatigue in patients with MS.
PMCID: PMC3829268  PMID: 24250896
Multiple Sclerosis; Fatigue; Persian Translation; Modified Fatigue Impact Scale
9.  The effect of body fat mass and fat free mass on migraine headache 
Iranian Journal of Neurology  2013;12(1):23-27.
Background
Obesity seems to be associated to migraine headache. Increase in body fat, especially in gluteofemoral region, elevates adiponectin and leptin secretion which in turn impair inflammatory processes that could be contributing to migraine risk. This study was designed to assess the relationship between body composition and risk of migraine for the first time.
Methods
In this cross-sectional study, 1510 middle-aged women who were visited in a weight reduction clinic of university were recruited. Migraine was diagnosed with HIS criteria. Body composition parameters including total fat mass (FATM), total fat free mass (FFM), truncal fat mass (TFATM), and truncal fat free mass (TFFM) was assessed using bioelectric impedance. We further assessed cardiovascular risk factors and smoking as confounding factors. To determine the real association between different variables and risk of migraine, the associations were adjusted by multivariate logistic regression analysis.
Results
Elevation in fasting blood sugar, total cholesterol, LDL cholesterol, FFM, TFFM, and waist-to-hip ratio increased the risk of migraine. When the associations were adjusted for other factors, only the association between migraine and FFM remained statistically significant.
Conclusion
Lower FFM increased the risk of migraine in overweight and obese individuals. In the other words, higher fat free mass could be a protective factor for migraine.
PMCID: PMC3829270  PMID: 24250893
Migraine; Fat Free Mass; Truncal Fat Free Mass; Obesity
10.  Quality of life comparison in common rhinologic surgeries 
Allergy & Rhinology  2012;3(1):e1-e7.
Various questionnaires are used in patients who undergo rhinologic surgeries but a unique comprehensive questionnaire is needed to evaluate quality of life (QOL) in rhinologic surgeries. The purpose of this study was to prepare a comprehensive questionnaire and compare QOL among four common rhinologic surgeries including functional endoscopic sinus surgery, septoplasty, septorhinoplasty, and septoplasty with turbinoplasty preoperatively and 6 months postoperatively. This was a prospective interventional before-and-after study. Preoperative and 6 months postoperative evaluations were performed with a Modified Health-Related Quality of Life (HRQL) questionnaire designed to cover all needed QOL aspects and the 22-item Sino-nasal Outcome Test questionnaire to cover all needed QOL aspects. The Modified HRQL included 33 items in six subgroups (nasal symptoms, sleep problems, headache, nonnasal symptoms, and practical and emotional problems) and general feeling. From 202 patients who completed the questionnaire before the procedures, 146 (72% of all patients) who were interviewed 6 months postoperatively were included in this study. Comparing preoperative data between followed up patients and missed patients showed no statistical difference among surgeries (p = 0.90). Comparison of patient's pre- and postoperative QOL showed a significant improvement in global QOL and in all questionnaire items (p < 0.0001 in all comparisons). Comparison of QOL changes before and after surgery among different surgeries revealed no statistical difference (p = 0.282). Our data showed a significant improvement in each surgery but the amount of improvement in different surgeries was almost constant.
doi:10.2500/ar.2012.3.0020
PMCID: PMC3404471  PMID: 22852123
Functional endoscopic sinus surgery; Modified Health-Related Quality of Life questionnaire; quality of life; rhinologic surgeries; septoplasty; septorhinoplasty; turbinoplasty
11.  Prevalence of Attention-Deficit/Hyperactivity Disorder Symptoms in Preschool-aged Iranian Children 
Iranian Journal of Pediatrics  2011;21(4):467-472.
Objective
The aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms in Iranian preschool children based on evaluations by parents and teachers because a thorough understanding of epidemiologic features of ADHD symptoms in preschool children is important for prevention and management.
Methods
Children between the ages of three and six attending kindergarten participated in this study. For the survey, 37 kindergartens were selected by multistage (stratified cluster random) sampling, consisting of 2213 children with a design effect equal to 1.5. A 19-item observer-rating questionnaire was generated to assess ADHD symptoms in children within the last 6 months. This questionnaire was used by both teachers and parents to assess ADHD behavior in participating children.
Findings
Of 1403 children aged 3–6 years, 362 were classified as having ADHD symptoms according to their parent evaluation [25.8% (23.6–28.1%)] and 239 according to their teachers evaluation [17% (14.1–20.4%)]. Child rank among siblings, mother's education level, and interest in aggressive television programs were all independent explanatory variables according to parents’ evaluation. Gender, parent education, child rank, single parent and interest in aggressive television programs were all independent explanatory variables according to teachers’ evaluation.
Conclusion
Our findings reveal a large discrepancy in the prevalence of ADHD symptoms in preschool children based on evaluation by parents and teachers. Thus, it seems that the ADHD screening should be performed in multiple settings in order to identify children who need further investigations.
PMCID: PMC3446126  PMID: 23056833
Attention deficit hyperactivity disorder; Preschool age; Iranian Children
12.  Serum heat shock protein 70 and oxidized LDL in patients with type 2 diabetes: does sex matter? 
Cell Stress & Chaperones  2010;16(2):195-201.
Several studies suggest that the response to various stressors differs between the sexes. We aimed to study serum HSP70 and levels of oxidized-LDL (ox-LDL) as markers of oxidative stress in men and women with type 2 diabetes. We quantified serum HSP70 and levels of ox-LDL in three cohorts; patients with newly diagnosed diabetes, patients with long-standing diabetes and normal controls. The cohort of patients with newly diagnosed diabetes was followed up for 3 months under glucose-lowering therapy with metformin. Our findings showed that serum HSP70 level was increased in women with long-standing diabetes in comparison with men. HSP70 did not decrease after glucose lowering therapy in women with newly diagnosed diabetes, but it did decrease in men. There was no significant difference on ox-LDL between men and women in any of the studied cohorts. It decreased significantly in the cohort of patients with newly diagnosed diabetes after treatment, regardless of sex. There was no significant correlation between HSP70 and ox-LDL in any of the studied cohorts except among normal women. We suggest that diabetes induces an immune response and impairs cellular defense mechanisms against oxidative stress more commonly in women with type 2 diabetes than in men.
doi:10.1007/s12192-010-0232-8
PMCID: PMC3059792  PMID: 20872261
HSP70; Ox-LDL; Oxidative stress; Type 2 diabetes; Female
13.  Clustering of metabolic syndrome components in a Middle Eastern diabetic and non-diabetic population 
Background
Metabolic syndrome (MetS) encompasses a cluster of coronary heart disease and diabetes mellitus risk factors. In this study, we aimed to elucidate the factors underlying the clustering of MetS components in diabetic and non-diabetic individuals.
Methods
Factor analysis was performed on 2978 (1652 non-diabetic and 1326 diabetic) participants. Entering waist circumference, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, high-density lipoprotein-cholesterol (HDL-C) and systolic blood pressure (SBP), we performed exploratory factor analysis in diabetic and non-diabetic individuals separately. The analysis was repeated after replacing triglycerides and HDL-C with triglycerides to HDL-C ratio (triglycerides/HDL-C). MetS was defined by either adult treatment panel III (ATPIII), international diabetes federation (IDF) criteria, or by the modified form of IDF using waist circumference cut-off points for Iranian population.
Results
The selection of triglycerides and HDL-C as two distinct variables led to identifying two factors explaining 61.3% and 55.4% of the total variance in non-diabetic and diabetic participants, respectively. In both diabetic and non-diabetic subjects, waist circumference, HOMA-IR and SBP loaded on factor 1. Factor 2 was mainly determined by triglycerides and HDL-C. Factor 1 and 2 were directly and inversely associated with MetS, respectively. When triglycerides and HDL-C were replaced by triglycerides/HDL-C, one factor was extracted, which explained 47.6% and 38.8% of the total variance in non-diabetic and diabetic participants, respectively.
Conclusion
This study confirms that in both diabetic and non-diabetic participants the concept of a single underlying factor representing MetS is plausible.
doi:10.1186/1758-5996-2-36
PMCID: PMC2897775  PMID: 20529329
14.  How Do Parents Think about the Effect of Food and Alternative Medicine on their Epileptic Children? 
Iranian Journal of Pediatrics  2010;20(2):193-198.
Objective
Parents of epileptic children are willing to know if specific foods precipitate or aggravate their kids' seizures. Nonetheless conclusive data are limited. Alternative medicine has become a popular approach to many diseases in the world and there are limited data about this approach to epilepsy in Iran. We tried to evaluate attitude of parents of epileptic children to food-epilepsy relationship and alternative therapeutic approach to epilepsy.
Methods
We carried out a cross-sectional study with analytic aspect at Children's Medical Center, Tehran, Iran in 2008, by asking the parents of epileptic children to fill out a valid and excellently reliable questionnaire. We collected parents‘ attitude and analyzed it using SPSS software.
Findings
One-hundred and fifty one families participated in the study. Fifty-nine of participants (39.1%) believed that foods had no effect on epilepsy. Fifty one cases (33.8%) said that foods might have negative or positive effect on epilepsy and 27.1% (41 cases) had no idea. Higher percent of parents believed in food-epilepsy relation in cases that fathers had educational levels above high school graduation. Sixteen cases (10.6%) said that alternative medicine might improve epilepsy and 55% had no idea about efficacy of this approach to epilepsy.
Conclusion
Compared with previous published study from Iran, parents of epileptic children believed less in food-epilepsy relation. Majority of parents either believed that foods had no effect on epilepsy or had no idea. More than half of parents had no idea about efficacy of alternative medicine to epilepsy. Only a few of them believed in ameliorating effects of alternative medicine on epilepsy.
PMCID: PMC3446031  PMID: 23056703
Epilepsy; Attitude; Food; Alternative Medicine
15.  Pattern of tobacco use among the Iranian adult population: results of the national Survey of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) 
Tobacco Control  2010;19(2):125-128.
Background
Previous studies report on smoking in Iran but recent national data on tobacco use (including cigarette, water-pipe and pipe) have not been reported.
Methods
In 2007, 5287 Iranians aged 15–64 years were sampled from all provinces as part of a national cross-sectional survey of non-communicable disease (NCD) risk factors. Data were collected using the standardised stepwise protocol for NCD risk factor surveillance of the World Health Organization. Use of tobacco products was calculated as the sum of smoking cigarettes/cigars (smoking currently or daily any amount of factory/hand-made cigarettes or cigars), pipes (daily) and water pipes (daily).
Results
Total current and daily tobacco use was 14.8% (burden 7.3 million) and 13.7% (burden 6.7 million) when extrapolated to the Iranian population aged 15–64. The prevalence of current and daily cigarette smoking was 12.5% (6.1 million; 23.4% males and 1.4% females) and 11.3% (5.6 million; 21.4 males and 1.4 females); former smokers comprised 1.7 million or 3.4% of the Iranian population (6.2% males and 0.6% females; mean cessation age 34.1). The mean age of starting to smoke was 20.5 years (24.2 males and 20.4 females). The prevalence of water-pipe smoking was 2.7% (burden 1.3 million; 3.5% males and 1.9% females). Water-pipe smokers used the water-pipe on average 3.5 times a day (2.8 males and 4.5 females).
Conclusion
The prevalence of tobacco use has not escalated over the past two decades. Nonetheless, the burden is high and therefore warrants preventive public health policies.
doi:10.1136/tc.2009.030759
PMCID: PMC2989156  PMID: 20008159
Smoking; prevalence; Iran
16.  Third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia 
BMC Public Health  2009;9:167.
Background
The burden of non-communicable diseases is rising globally. This trend seems to be faster in developing countries of the Middle East. In this study, we presented the latest prevalence rates of a number of important non-communicable diseases and their risk factors in the Iranian population.
Methods
The results of this study are extracted from the third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007), conducted in 2007. A total of 5,287 Iranian citizens, aged 15–64 years, were included in this survey. Interviewer-administered questionnaires were applied to collect the data of participants including the demographics, diet, physical activity, smoking, history of hypertension, and history of diabetes. Anthropometric characteristics were measured and serum biochemistry profiles were determined on venous blood samples. Diabetes (fasting plasma glucose ≥ 126 mg/dl), hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of anti-hypertensive drugs), dyslipidemia (hypertriglyceridemia: triglycerides ≥ 150 mg/dl, hypercholesterolemia: total cholesterol ≥ 200 mg/dl), obesity (body mass index ≥ 30 kg/m2), and central obesity (waist circumference ≥ 80 cm in females and ≥ 94 cm in males) were identified and the national prevalence rates were estimated.
Results
The prevalence of diabetes, hypertension, obesity, and central obesity was 8.7% (95%CI = 7.4–10.2%), 26.6% (95%CI = 24.4–28.9%), 22.3% (95%CI = 20.2–24.5%), and 53.6% (95%CI = 50.4–56.8%), respectively. The prevalence of hypertriglyceridemia and hypercholesterolemia was 36.4% (95%CI = 34.1–38.9%) and 42.9% (95%CI = 40.4–45.4%), respectively. All of the mentioned prevalence rates were higher among females (except hypertriglyceridemia) and urban residents.
Conclusion
We documented a strikingly high prevalence of a number of chronic non-communicable diseases and their risk factors among Iranian adults. Urgent preventive interventions should be implemented to combat the growing public health problems in Iran.
doi:10.1186/1471-2458-9-167
PMCID: PMC2697989  PMID: 19480675
17.  Albuminuria and its correlates in an Iranian type 2 diabetic population 
Objective
To study the prevalence and correlates of increased urinary albumin excretion (UAE) in an Iranian type 2 diabetic population.
Methods
Over a one year period since October 2002, 400 consecutive type 2 diabetic patients referred to an outpatient diabetes clinic, were enrolled in a cross sectional study. Subjects had no history of renal impairment or overt proteinuria. Data concerning demographic characteristics and cardiovascular risk factors were recorded and height, weight and blood pressure were measured. Glucose, cholesterol, HDL-C, LDL-C, triglyceride, apoprotein B, lipoprotein a, creatinine, and HbA1c were measured in fasting blood samples. Overnight twelve-hour UAE were assessed by immunoturbidometry method. Regression analyses were employed to determine the correlates of UAE.
Results
Out of 400 patients, 156 (40%) subjects had increased UAE (UAE ≥ 30 mg/24 hour). The UAE was higher in males compared to females (145.5 vs. 72.1 mg/day; p < 0.05); however, the age and HDL adjusted UAE levels were not significantly different between men and women (120.1 vs. and 87.9 mg/day; p = 0.37). Increased UAE was correlated with decreasing HDL-C and a longer duration of diabetes independent of other variables; increased UAE was correlated with HbA1c as well. Age, systolic and diastolic blood pressure, total cholesterol, LDL-C, triglyceride, apoprotein B, lipoprotein a, and GFR did not correlate with increased UAE.
Conclusion
In this study, increased UAE was considerably frequent among type 2 diabetic patients without any significant history of renal dysfunction. Albuminuria was found to be associated with dyslipidemia (low HDL-C), long duration of diabetes, and uncontrolled glycemia revealed by higher HbA1c.
doi:10.1186/1476-511X-7-28
PMCID: PMC2527557  PMID: 18691434
18.  Depression in mothers of children with thalassemia or blood malignancies: a study from Iran 
Background
Several studies have found that parents of children with chronic diseases or disabilities have higher depression scores than control parents. Mothers usually take on the considerable part of the extra care and support that these children need and thus are at markedly increased risks of suffering from psychological distress and depression. The main aim of the present study was to investigate if mothers of children with thalassemia or blood malignancies have higher scores of depression compared with a group of control mothers.
Methods and materials
In this cross – sectional study, 294 mothers were recruited in three groups and assessed using the Beck Depression Inventory (BDI): mothers of children with thalassemia, mothers of children with blood malignancies and a control group. SPSS version 11.5 with chi square, ANOVA, linear and logistic regression were used for statistical analysis.
Results
The only variable bearing a statistically significant relationship with the depression score of mothers was the child's disease: for thalassemia with OR of 2.17 (95% CI = 1.16–4.0, P = 0.015), for blood malignancies with OR of 2.71 (95% CI = 1.48–4.99, P = 0.001).
Discussion and conclusion
The results of this study can contribute to the development of a screening program for decreasing depression burden and promoting quality of life for mothers of children with thalassemia or blood malignancies.
doi:10.1186/1745-0179-2-27
PMCID: PMC1599717  PMID: 17020622

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