Rate, risk factors, and clinical outcomes of SARS-CoV-2 reinfection vs. primary infection in readmitted COVID-19 patients in Iran: a retrospective cohort study.

Background: Corona Virus Disease 2019 (COVID-19) has severely impacted global health, resulting in high morbidity and mortality, and overwhelming healthcare systems, particularly in Iran. Understanding reinfection is crucial as it has significant implications for immunity, public health strategies, and vaccine development. This study aims to identify rate and the risk factors associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reinfection and compare the clinical course of initial infection versus reinfection in readmitted COVID-19 patients in Iran. Methods: This retrospective cohort study was conducted from January 2020 to the end of 2022 in five hospitals in Iran. The study compared demographic and clinical data, vaccination status, and clinical outcomes between patients with reinfection (defined as a positive PCR test for SARS-CoV-2 at least 90 days after the primary admission) and a control group (patients who had an initial confirmed SARS-CoV-2 infection but were not readmitted with a positive PCR test for SARS-CoV-2 at least 90 days after their primary infection). Risk factors for reinfection were evaluated using a regression model. Propensity score matching (PSM) was used to compare post-clinical and laboratory outcomes between the matched case and control groups. Results: Out of 31,245 patients, 153 (0.49%) experienced reinfections. The reinfection rate was significantly higher during B.1.617.2 and B.1.1.529 variant wave (p < 0.001). After multivariable regression analysis, incomplete vaccination status (OR: 1.68, 95% CI: 1.34-2.31, p = 0.021) and lack of booster vaccination (OR: 2.48, 95% CI: 1.96-3.65, p = 0.001) were the risk factors for reinfection. Furthermore, reinfection was associated with atypical COVID-19 symptoms, and shorter ICU and hospital stays (p < 0.001). The B.1.1.529 variant was significantly more common among reinfected patients (p < 0.001). Conclusion: SARS-CoV-2 reinfections are more frequently observed during waves of novel variants and are associated with a milder clinical course and shorter hospital stays. Full vaccination and booster doses can effectively reduce the risk of SARS-CoV-2 reinfections.

Cerebral palsy: potential risk factors and functional status among children under three years, a case-control study in northwest Iran.

BACKGROUND: Cerebral palsy (CP) is one of the most common motor-postural disorders in childhood. It occurs due to impairment in the developing brain-before, during, or after birth-and has a significant burden on the public health system. This study aimed to investigate the potential risk factors and detect the associated CP-related disorders. METHODS: This case-control study was conducted on 46 children with CP and 175 matched healthy children less than three years old who referred to the Children's Hospital, Tabriz, Iran in 2022. Then, a checklist related to the mother's medical history during current and previous pregnancies, a questionnaire related to perinatal factors of the newborn, types of CP, concurrent disorders, the Gross Motor Function Classification System (GMFCS), and Age and Stage Questionaire (ASQ) were completed. Data was analyzed using Statistical Package for the Social Sciences) SPSS(-21 software by descriptive and analytical statistics consisted of Chi-square, Independent t-test, and Binary logistic regression. RESULTS: Finally, 35 children with CP and 122 healthy children completed the study and were analyzed. The mean (standard deviation: SD) age of children in the CP group was 15.3 (6.2) and in the healthy group was 14.4 (6.6) months (p = 0.635). Spastic CP (82.9%) was the common type, and the most common prevailing form of the involved limb was quadriplegia (54.3%). The severity of the functional disorder in 39.3% of CP cases was at levels 4 and 5 (severe form). The most prevalent comorbidities were inability to walk (31.4%), speech delay (22.9%), epilepsy (11.4), and strabismus (8.6%). Children with CP had abnormal development in gross motor (82.9%), problem-solving (68.6%), personal-social (65.7%), fine motor (60%), and communication (54.3%). Moreover, duration of pregnancy (p = 0.023), birth weight lower than 2500 g (p = 0.002), problems in the current pregnancy [adjusted odds ratio (aOR) [95% CI]: 3.06 (1.87 to 8.54); p = 0.013] and problems in previous pregnancy ([aOR (95% CI): 4.8 (1.6 to 14.2); p = 0.005) were potential risk factors. CONCLUSION: Due to accompanying movement, vision, and speech problems, especially high developmental disorders in children with CP, necessary measures to prevent the identified risk factors are very important.

Infertility treatments and risk of breast benign diseases: a case‒control study.

BACKGROUND: Theoretically, endocrine fluctuations occurring during infertility treatments, including ovulation induction (OI) and assisted reproductive techniques (ART), could be associated with an increased risk of benign breast diseases (BBDs). To date, no studies have been conducted on this association. Therefore, the present study investigated the association between different types of infertility treatments and BBDs. METHODS: This case‒control study was conducted in Arash Women's Hospital, Tehran, Iran. The case group included infertile women diagnosed with BBDs without atypia, and the control group included infertile women without breast disease. Breast imaging studies (mammography/ultrasound) were performed for BBD screening, and the diagnosis was confirmed by histopathological examination. Study variables were collected retrospectively from medical records, hospital databases, and questionnaires. RESULTS: Finally, 154 infertile women, including 50 cases (BBDs) and 104 controls (no BBDs), were compared. Our data showed that 66% of cases and 61.4% of controls had undergone at least one course of infertility treatment. There was no association between BBD risk and previous infertility treatments (OR = 1.21; 95% CI = 0.59-2.46), ART (OR = 1.14; 95% CI = 0.90-1.44), or OI cycles (OR = 1.13; 95% CI = 0.98-1.32). Stratification by confounding variables did not change these results. CONCLUSIONS: It seems that there is no association between BBDs in infertile women and the type, duration, or number of prior infertility treatments; however, considering the small sample size of the study, the clinical significance of this finding should not be neglected. Therefore, we consider it essential to carry out more extensive, detailed, and prospective studies to distinguish the association of BBDs with different infertility treatments and medications.

Epidemiology, clinical features, and outcome of the hospitalized patients with Kerion in Fars Province, Iran: an eleven-year retrospective study.

BACKGROUND: Kerion, a severe inflammatory type of tinea capitis, presents with purulent, boggy swelling and alopecia. Few articles in the literature provide information on this uncommon manifestation of tinea capitis (TC). This study aimed to determine the epidemiological and clinical characteristics of patients with Kerion over an 11-year period in an inpatient setting. METHODS: In this retrospective cross-sectional study, we enrolled all the admitted patients with inflammatory TC in the dermatology department of Shahid Faghihi referral hospital during 2011-2022. The data included demographic factors, animal contact, treatment, outcome, and past medical profiles. We used STATA 14.2 to analyze the data. RESULTS: One hundred and thirty-two patients with Kerion were enrolled in to the study. the mean age of patients was 7.6 ± 5.8 years. Boys (82.5%, n = 109) significantly outnumbered girls (17.5%, n = 23), and 82.2% of patients were under 11 years of age. Eight patients were one to two years old, two were infants under one year old, and five were adults. More than half (52.2%) of the patients were from rural areas. Most of the cases had heavily utilized systemic antifungal therapy, antibiotics, and corticosteroids. In addition, 43 patients reported positive animal contact. Over the course of an eleven-year period, there was a downward trend in the number of hospitalized patients. CONCLUSION: We report one of the largest studies on Kerion patients over an eleven-year period. We have expanded the information on Kerion patients' epidemiology, transmission mode, and clinical outcomes. To develop preventative strategies for Kerion, future studies should focus on additional risk factors and individual susceptibilities.

Intention to adherence to social distancing for prevention of Covid-19 in the urban areas of southern Iran: a structural equation modeling (SEM) analysis of theory of planned behavior.

BACKGROUND: Social distancing is a key behavior to minimize and controlling COVID-19 infections. The current study applied an integrated Theory of Planned Behavior to identify the determinants of social distancing behavior, and the processes involved, in the context of the COVID-19 pandemic. METHODS: a cross-sectional study was conducted in Southern Iran among 1000 people from Shiraz by employing a convenience sampling technique. Data were collected using a pre-tested and structured questionnaire based on the main constructs of the Theory of Planned Behavior. Statistical analysis was done using IBM SPSS software version 22 and Amos version 24. Level of statistical significance was declared at a P-value of less than 0.05. RESULTS: according to the results, the subjective norms (F = 2.696, effect size = 0.139) and attitude (F = 3.582, effect size = 0.155) play an important role in the samples' PBC (P ≤ 0.05). Final adjusted structural equation model of the effects of independent variables (Gender, subjective norms, attitude) on samples' intention to adherence social distancing for prevention of Covid-19 with the mediating role of one main variable of PBC. The PBC alone can be an important factor in creating intensive behavior in the samples (F = 3.560, effect size = 0.18). CONCLUSION: current findings highlight the importance of "attitude, subjective norms and PBC" as determinants of social distancing intention. Future research on long-range predictors of social distancing behavior and reciprocal effects in the integrated model is warranted. This evidence is relevant to public and private organizations in the process of developing strategies to promote and engage the population in adopting the behavior of "Adherence to Social Distancing" in Iran.

Impact of COVID-19 on the Participation of Iranian Adolescents in Daily Life: Development and Validation of the IAPAT-C Tool.

Background and Purpose: The present study is aimed at evaluating the effects of the COVID-19 pandemic on Iranian adolescents' participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool-COVID-19 (IAPAT-C) was developed and validated for this purpose. Methods: This study was conducted in two phases. In the first phase, the electronic version of the IAPAT-C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID-19 on adolescents' participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13-18, and the data were analyzed using SPSS19 and G⁣∗Power 3 software. Results: The IAPAT-C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID-19 pandemic. It utilizes a 5-point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6-0.94) and excellent internal consistency (Cronbach's alpha > 0.7). The tool's structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID-19 significantly impacted all aspects of adolescents' lives, except for work. Conclusion: The electronic version of the IAPAT-C was valid and reliable. COVID-19 significantly affected various aspects of Iranian adolescents' daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class.

Prevalence of Human Papillomavirus (HPV) Infection and its Association With Pap Smear Findings Among Women Attending a Gynecology Clinic in Khorasan Razavi-Iran.

BACKGROUND: Human papillomavirus (HPV) infection is the most common sexual transmitted disease and Pap smears and HPV testing are crucial for early detection. Advancements in HPV testing improve accuracy, but optimal screening strategies are still debated. This cross-sectional study explores HPV genotypes and predictors of infection among Iranian women undergoing gynecological screening. Study Design: A retrospective cross-sectional study. METHODS: Women undergoing their initial cervical screening enrolled in this study. Cervical cytology samples for Pap smear analysis were collected from women referred to the genetic laboratory of Academic Center for Education Culture and Research (ACECR), Khorasan Razavi, during gynecological visits, adhering to standardized liquid-based cytology protocols. These samples were obtained over a one-year period since January 2023. Statistical analyses were conducted using SPSS version 21.0, with a significance level set at P<0.05. RESULTS: A total of 328 women enrolled in this study. The mean age of participants was 36±11 years and the overall HPV prevalence was 37.5% (n=123). Among HPV-positive women, nearly half (48.7%) had a single HPV genotype. Genotypes 6 (13%), 16 (12.3%), and 53 (6.7%) were the most prevalent types. Notably, high-risk HPV genotypes (16 and 18 among all) were identified in one-fourth of the study population. Women with endocervical/transformation zone cells had 25% higher odds of having HPV infection, and having mild, moderate, and severe inflammation increased the odds of having HPV infection by 14%, 11%, and 20%, respectively. CONCLUSION: The considerably high prevalence of HPV infection highlights the significance of HPV prevention programs in this population. Neither bacterial vaginosis nor candida infection showed a direct link to HPV positivity.

Effective Reproduction Number of Smear-Positive Pulmonary Tuberculosis in Iran: A Registry-Based Study (2011-2021).

BACKGROUND: Tuberculosis (TB) remains a major public health issue in Iran, especially smear-positive pulmonary tuberculosis (SPPTB), due to its high transmission rate. Examining the effective reproduction number(Rt ) of SPPTB and patient characteristics is crucial for crafting targeted TB control measures. This study aimed to assess the Rt of SPPTB in Iran from 2011 to 2021 and profile SPPTB patient demographics, initial smear bacilli density, diagnosis delays, and spatial distribution. Study Design: This is a historical cohort study. METHODS: A time-dependent method was used to estimate Rt , and monthly data from the national TB registry were scrutinized from 2011 to 2021. RESULTS: A decline was observed in SPPTB incidence rates of 50909 SPPTB cases in Iran from 2011 to 2021. Approximately 29.1% of the cases were diagnosed within a month, while 44.5% experienced a one to three-month delay in diagnosis. The analysis revealed substantial heterogeneity in TB transmission dynamics across various provinces of Iran. Provinces such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi exhibited the highest effective reproduction numbers. Additionally, there was a decreasing trend in the effective reproduction numbers across all provinces from 2011 to 2020. CONCLUSION: Effective reproduction numbers declined in most provinces from 2011 to 2020 but increased moderately after the COVID-19 pandemic, highlighting the need for targeted public health interventions. Although SPPTB incidence rates are declining nationally, elevated incidence rates and effective reproduction numbers in regions such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi signify the need for persistent TB management efforts in Iran.

Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study.

BACKGROUND: Low birth weight (LBW) is a major public health issue associated with increased neonatal morbidity and mortality. This study aimed to examine the association between household food insecurity and LBW in Mashhad, Iran. Study Design: A population-based case-control study. METHODS: This study involved 6294 mothers (3247 cases and 3247 controls) who visited healthcare centers affiliated with Mashhad University of Medical Sciences for term births between March 2019 and March 2022. Cases included women who delivered neonates weighing<2500 g, while controls delivered babies≥2500 g. Food security was measured using the validated Household Food Insecurity Access Scale. Logistic regression models examined the associations between food insecurity and LBW. Geographic information system techniques mapped LBW distribution in Mashhad. RESULTS: Household food insecurity was significantly associated with higher odds of LBW (adjusted odds ratio [AOR]=1.25, 95% confidence interval [CI]: 1.03, 1.53). Other risk factors included younger maternal age (AOR=1.03, 95% CI: 1.01, 1.04), lower maternal education (AOR=0.55, 95% CI: 0.43, 0.71), cesarean delivery (AOR=1.70, 95% CI: 1.40, 2.06), and exposure to secondhand smoke (AOR=1.68, 95% CI: 1.02, 2.75). Gestational diabetes demonstrated a protective effect (AOR=0.37, 95% CI: 0.15, 0.91). Geographic mapping revealed that regions with higher food insecurity had elevated LBW prevalence. CONCLUSION: These findings underscore the importance of addressing food insecurity among pregnant women to reduce the risk of LBW and improve newborn outcomes.

Evaluation of Risk Factors Associated with Recurrence and Death in Patients with Thyroid Cancer From 2008 to 2023 in the West of Iran.

BACKGROUND: Thyroid carcinoma (TC) is a global clinical concern, and its incidence has progressively increased worldwide. Early detection of TC and subsequently decreased age at the diagnosis seem to result from extensive employment of imaging modalities, biopsy techniques, and improvements in the healthcare system. Study Design: A retrospective cohort study. METHODS: Overall, 400 patients diagnosed with TC following thyroidectomy in the Endocrinology Clinic, who were followed for fifteen years, were investigated in this study. The checklist included patients' demographic characteristics, clinical information, and response to treatment, recurrence, and death. RESULTS: There were 19.25% men and 80.75% women. The mean age was 41.005±15.58 years. The risk of death and recurrence was significantly higher in men, patients>65 years, smokers, patients with a family history of TC, undifferentiated cancer, multifocality, and stages III and IV (P<0.001). Each additional year of life was associated with a 21% increase in the risk of death (P<0.001). Smoking was associated with a 4.36-fold increase in the risk of death (P=0.05). For each additional year of life, the probability of recurrence increased by 3% (P=0.009). Men were 4.73 times more likely to recur (P<0.001) than women. CONCLUSION: To employ the proper therapeutic intervention and perform meticulous postoperative surveillance, it is crucial to consider the predictive influence of pertinent elements. Diagnosing TC in its early stages is essential for the healthcare system because of the increased incidence, younger age at diagnosis, and overall favorable prognosis of TC.

The first case of Mpox infection in Iran during the 2022 outbreak.

INTRODUCTION: The unexpected outbreak of human Mpox infection beginning in some European countries that were non-endemic for Mpox stunned the world during the Coronavirus Disease 2019 (COVID-19) pandemic in May 2022. The re-emerging Mpox outbreak, which has a greater capacity for human-to-human transmission, was mainly due to traveling. In this paper, we describe the first case of the disease was observed in an Iranian woman infected by her husband who had a history of traveling to Canada. CASE REPORT: The 34-year-old woman had flu-like syndrome with some skin rashes on her hand, finger, and arm. No antivirals were prescribed in this case, and supportive care was used to help her recover. RT-PCR and Sanger sequencing were used to analyze the sample from the oropharyngeal swab and the rash, and the results confirmed the Mpox infection. CONCLUSIONS: The risk of infectious disease outbreaks after COVID-19, such as Mpox, is of great importance, and health systems should be vigilant for timely identification and preparedness.

Assessing the impact of meteorological factors and air pollution on respiratory disease mortality rates: a random forest model analysis (2017-2021).

Air pollution poses a significant threat to the health of all living beings on our planet. It has been scientifically established as a crucial factor affecting mortality rates, respiratory illnesses, mental well-being, and overall health. This study aimed to investigate the impact of air pollution and meteorological factors on respiratory disease mortality rates in Mashhad in 2017-2021 using a Random Forest (RF) model. At first, the daily statistics of meteorological parameters (pressure, humidity, temperature, solar radiation) during 2017-2021 were collected. The information related to pollutants pollutants such as PM2.5 (which is defined as particulate matter with less than 2.5 micrometer diameter and potentially harmful to humans), PM10 (Particles with a diameter of 10 micrometers or less that can negatively impact both human health and environmental conditions.), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) was collected. the mortality statistics from respiratory diseases were collected from the Health system registaration (Sina). Then we used the RF regression model in Excel and Python software to investigate the interaction between the mentioned variables. The escalating trend of air pollution in Mashhad has led to an expected increase in respiratory-related hospitalizations. This necessitates urgent air pollution control measures. Concurrently, the study of pollutants and climatic elements, as substantiated by global epidemiological studies, is crucial. In Mashhad, the second most polluted city in Iran, climatic factors like humidity, sunshine duration, temperature, pressure, and sunlight intensity exacerbate atmospheric pollution levels, impacting human health and ecosystems. The R2, RSME, and MAE of RF model are 0.73, 2.52, and 2 which indicate that the model has successfully identified the relationship between input variables and the target variable, and it will exhibit high accuracy in predictions. In this study, the most influential factor was identified when the Variance Inflation (VI) factor reached a value of 0.548. This indicates a strong correlation between this factor and the death rate of patients during the specified period. Furthermore, we analyzed by excluding the day and month plans from our model. The results showed that the factor with the highest coefficient in the executive model was related to pressure, with a VI value of 0.049. This suggests that pressure plays a significant role in our model and has a substantial effect on the death rate of patients. In the study of various pollutants, it was found that PM10 had the most significant impact on the mortality rate of patients with respiratory conditions, with a VI of 0.039. Following PM10, the pollutants with the next highest coefficients of importance were NO2 (VI = 0.034), SO2 (VI = 0.033), PM2.5 (VI = 0.029), and CO (VI = 0.025), respectively. Furthermore, the study observed a notable increase in the mortality rate of respiratory patients over time. Specifically, for every five days, the death rate increased by 35.5%. Indeed, climate change and air pollution significantly contribute to the mortality rate from respiratory diseases. Therefore, it is crucial for individuals, particularly those with respiratory conditions, to heed meteorological warnings.

Estimating the burden of diseases attributed to PM2.5 using the AirQ + software in Mashhad during 2016-2021.

The study used the AirQ + software developed by the World Health Organization (WHO) to evaluate the health impacts associated with long-term exposure to PM2.5 in Mashhad, Iran. For this purpose, we analyzed the daily average concentrations of PM2.5 (with a diameter of 2.5 micrometers or less) registered by the air quality monitoring stations from 2016 to 2021. The levels of PM2.5 surpassed the Air Quality Guidelines (AQG) limit value of 5 µg/m3 (annual value) established by WHO. The findings revealed that the burden of mortality (from all-natural causes) at people above 30 years old associated with PM2.5 exposures was 2093 [95% confidence interval [CI]: 1627-2314] deaths in 2016 and 2750 [95% CI: 2139-3038] deaths in 2021. In general, the attributable mortality from specific causes of deaths (e.g., COPD (chronic obstructive pulmonary diseases), IHD (ischemic heart diseases) and stroke) in people above 25 years old increased between the years, but the mortality from lung cancer was stable at 46 [95% CI: 33-59] deaths in 2016 and 48 [95% CI: 34-61] deaths in 2021. The attributable mortality from ALRI (Acute Lower Respiratory Infection) in children below 5 years old increased between the years. We also found differences in mortality cases from IHD and stroke among the age groups and between the years 2016 and 2021. It was concluded that burden of disease methodologies are suitable tools for regional and national policymakers, who must take decisions to prevent and to control air pollution and to analyze the cost-effectiveness of interventions.

Distribution of HPV genotypes in Mashhad, Iran: insights from a 2022-2023 study.

BACKGROUND: Human papillomavirus (HPV), is one of the main causes of cervical cancer and also one of the most common sexually transmitted infections (STIs). HPV is responsible for almost all cases of cervical cancer and plays a principal role in causing other cancers including oropharynx, penis, larynx, oral cavity, anus, vulva, and vagina. The study aims to investigate the prevalence and distribution of HPV genotypes among patients referred to private laboratories in Mashhad, located in the northeast of Iran. METHODS AND MATERIALS: 428 samples including 382 females (89.3%) and 46 males (10.7%) between January 10, 2022, and February 11, 2023, in Mashhad, Iran were evaluated to detect HPV and determine its genotypes. Cervical swabs and urine samples were collected from females and males, respectively. Viral DNA was extracted by using a CedExtra purification kit (cedbio, Iran) and viral genotypes were identified with a High + Low Papillomastrip kit (Operon, Spain). Mann Whitney U test and Chi-square test were accomplished for statistical analysis. RESULT: From the total of 428 participants analyzed, the HPV test result was positive for 129 patients (30.1%) and negative for 299 people (69.9%). Among the participants, 115 female (30.1%) and 14 male (30.4%) were positive for HPV infection. The prevalence of HPV infection among the referring people was about 30%. The most common genotype identified was HPV-6 (10.3%), followed by HPV-16 (8.7%) and HPV-51 (7.7%), the second and third most common genotypes, respectively. Additionally, HPV-39 was detected at a frequency of 6.70%. HPV-11, HPV-61, HPV-91, and HPV-44 with a frequency of 1% were among the least genotypes identified among the patients. CONCLUSION: In line with the results of this study, the prevalence of HPV genotypes in both genders is 30%. The results likely reflect differences in the prevalence of high-risk HPV genotypes, that are less common. Also, HPV-6 and HPV-16 genotypes that are covered by the vaccine had a significant prevalence. On the other hand, with the prevalence of HPV-51 and HPV-39 genotypes in infected people who are not covered by the Gardasil (quadrivalent) vaccine, there is a risk of related cancers in the future.

Patterns of diabetes mellitus by age, sex, and province among Iranian Hajj pilgrims and health care delivery during 2012-2022: A retrospective study of 469,581 participants.

OBJECTIVE: Hajj is among the oldest pilgrimages in the world, there is a limited study that evaluates the epidemiological pattern of Diabetes Mellitus [1] and the medical care required and provided to pilgrims. The present study assessed the prevalence and pattern of DM in Iranian pilgrims from 2012-22. METHOD: All demographic information, risk factors, and the prevalence of DM were extracted from the database and medical records of the Hajj Pilgrimage Medical Centre, Iranian Red Crescent Society through file reading. Also, to investigate the effect of the risk factors considered in the study, the multiple logistic regression model was used. RESULTS: The present study included data from 469,581 Hajj pilgrims. Most pilgrims were in the age group of 45 to 70 years (73.25%). The prevalence of diabetes in patients over 70 years old was the highest (16.73%). The prevalence of DM was estimated at 14.64% in women and 12.51% in men. The lowest DM prevalence was in Lorestan (7.81%), North Khorasan (9.07%), Sistan and Baluchistan (9.29%), and Hamedan (9.41), respectively. The highest prevalence rate was in Khuzestan (20.12%), Yazd (19.14), and Mazandaran (17.55), respectively. Our analysis reveals that, for instance, with each yearly increase in the age of the pilgrims (assuming other variables remain constant), the odds of having DM increase by 0.04. For the gender, the odds of having DM among women is 0.33 higher than among men, when the other variable is constant. CONCLUSIONS: The study results show a significant difference in the prevalence of diabetes in age, gender, and distribution in different provinces. Therefore, appropriate screening, diagnosis, and management by primary care physicians are necessary to prevent adverse health outcomes and reduce the economic burden of mortality and morbidity.

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents.

BACKGROUND: Adolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression. MATERIALS AND METHODS: The present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS: The mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group. CONCLUSION: We found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.

Trend analysis, gender-specific patterns, and age dynamics of childhood and adolescent obesity: insights from the Tehran lipid and glucose study.

BACKGROUND: Childhood and adolescent obesity pose significant challenges to global health, with escalating prevalence and associated short- and long-term health consequences. This longitudinal study leveraged data from the Tehran Lipid and Glucose Study (TLGS) to investigate the trends of obesity among Tehranian children and adolescents over a 21-year period. METHODS: Utilizing data from TLGS phases I to VII (1999-2021), we included 3845 participants aged 3-18 years at the beginning of phase I. Anthropometric measures, including height and weight, were collected, and body mass index (BMI) was calculated. Childhood obesity (2-19 years) was defined as BMI-for-age > 2SD based on World Health Organization (WHO) standards, and adult obesity was defined as BMI ≥ 30. Descriptive statistics, trend analysis, prevalence calculations, odds ratios, and interaction analyses were employed for data interpretation. RESULTS: The mean BMI increased from 18.46 ± 4.37 kg/m² at Phase I to 26.36 ± 5.03 kg/m² at Phase VII. Boys exhibited a greater increase in BMI than girls, and age at study entry influenced BMI trajectories. The prevalence of obesity rose from 6.4% at Phase I to 21.5% at Phase VII, with a more pronounced increase in boys. Odds ratios for obesity steadily increased across phases, indicating a growing risk. Interaction analyses revealed age-specific dynamics, with older participants demonstrating lower odds ratios initially but higher odds ratios in later phases. CONCLUSION: Our study shows a worrisome increase in childhood obesity among Tehranian children and adolescents over 21 years. Sex- and age-specific trends emphasize the necessity for targeted interventions, informing policymakers, healthcare practitioners, and educators regarding public health strategies and interventions against the obesity epidemic.

Indirect estimation of the prevalence of type 2 diabetes mellitus in the sub-population of Tehran: using non-laboratory risk-score models in Iran.

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) in the population covered by the Tehran University of Medical Sciences is unclear but crucial for healthcare programs. This study aims to validate four non-laboratory risk-score models, the American Diabetes Association (ADA) Risk Score, Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK), Finnish Diabetes Risk Score (FINDRISC), and TOPICS Diabetes Screening Score, for identifying undiagnosed diabetes and indirectly estimate the prevalence of T2DM in a subset of the Tehranian population using the selected model. METHODS: This research consisted of two main parts. In the first part, non-laboratory risk-score models to identify undiagnosed T2DM were validated using Iranian data from STEPs 2016 survey. The model performance was evaluated through the Area Under the Curve (AUC) and calibration via the observed-to-expected (O/E) ratio. Additional independent data from STEPs 2011 survey in Iran were utilized to test the model results by comparing indirect prevalence estimates with observed estimates. In the second part, the prevalence of T2DM was estimated indirectly by applying the selected model to a representative random sample from a Tehranian population telephone survey conducted in 2023. RESULTS: Among the different models used, AUSDRISK showed the best performance in both discrimination (AUC (95% confidence interval (CI)): 0.80 (0.78, 0.81)) and calibration (O/E ratio = 1.01). After updating the original model, there was no change in the AUC value or calibration. Additionally, our findings indicate that the indirect estimates are nearly identical to the observed values in STEPs 2011 survey. In the second part of the study, by applying the recalibrated model to a subsample, the indirect prevalence of undiagnosed diabetes and T2DM (95% CI) were estimated at 4.18% (3.87, 4.49) and 11.1% (9.34, 13.1), respectively. CONCLUSION: Given the strong performance of the model, it appears that indirect method can provide a cost-effective and simple approach to assess disease prevalence and intervention effectiveness.

A national study on maternal vomiting during pregnancy in Iran: prevalence, determinants, adverse birth outcomes, and the trend.

BACKGROUND: Nausea and vomiting during pregnancy (NVP) is one of the most common complication of pregnancy. The present study was aimed to determine the association between vomiting during pregnancy and adverse birth outcomes. METHODS: A cross-sectional study was conducted on 3649 pregnant women across 11 provinces of Iran. Cluster sampling method was used to select samples and data collection was done using family record and face-to-face interviews. Data were analyzed by logistic regression, using STATA14.2 software. RESULTS: The prevalence of vomiting during pregnancy was 9.7% (95% CI: 8.8, 10.7), with an increasing trend by birth cohort. After adjusting for other confounders, the prevalence of vomiting revealed a decreasing trend by body mass index (OR = 0.63, 95%CI: 0.53, 0.78, P-trend < 0.001). In addition, long inter-pregnancy interval (IPI) significantly increased the odds of NVP (ORIPI of 1-3 year=2.42, ORIPI of >3 year=1.63). Multivariate analyses showed that the odds of stillbirth (AOR = 1.61, 95% CI: 1.17, 2.19) and the odds of infant mortality (AOR = 1.78, 95% CI: 1.29, 2.45) were significantly increased in women with daily vomiting during pregnancy. The odds of vomiting during pregnancy was significantly shown to reduce the odds of abortion by 45%. CONCLUSION: The prevalence of NVP was shown to have an increasing trend in Iran. This complication is associated with many adverse health outcomes during pregnancy and negatively affect maternal and fetal health. Given the importance of pregnancy period, nutrition education and increase the awareness of pregnant women towards NVP, especially pre-pregnancy training is suggested.

Association between human telomerase reverse transcriptase (hTERT) MNS16A polymorphism and risk of breast cancer.

BACKGROUND: It is well known that telomerase activity is suppressed in normal human tissues and reactivated in tumors, suggesting that the human telomerase reverse transcriptase (hTERT, MIM: 187270) gene may be involved in carcinogenesis. A polymorphic tandem repeat minisatellite located downstream of exon 16 of hTERT and upstream in the putative promoter region of an antisense hTERT transcript, termed MNS16A, results in a functional polymorphism. Because the association between the MNS16A genetic polymorphism and breast cancer (BC) risk remains an open question, the present case-control study was conducted in Shiraz (Fars Province, Southern Iran). METHODS: A total of 711 samples were collected, including 362 BC patients and 349 healthy individuals. Genotyping was performed by polymerase chain reaction method. Alleles were determined by classifying DNA amplicons of less than and greater than 300 bp as short (S) and long (L) alleles, respectively. RESULTS: Different inheritance models (codominant, dominant, recessive, overdominant genotype models and the allele model) were used to evaluate the association between the MNS16A polymorphism and the risk of BC. No significant association was observed in any of the analyses. It should be noted that the statistical power of the comparisons was low. CONCLUSION: The present study did not support the association between hTERT MNS16A polymorphism and breast cancer risk. Similar studies in other populations with larger sample sizes are needed to determine the association between the hTERT MNS16A polymorphism and susceptibility to breast cancer.