Catastrophic health expenditures for children with disabilities in Iran: A national survey.

OBJECTIVE: The aim of this study was to investigate the percentage of households with disabled children aged 0-8 years who had faced catastrophic health expenditures (CHEs) due to the health costs of these children in Iran. METHODS: This cross-sectional study was carried out on 2000 households with disabled children aged 0-8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Determinants of CHE were identified using logistic regression. RESULTS: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR = 18.89, 95%CI: 10.88-29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR = 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR = 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR = 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR = 2.71, 95%CI, 1.60-4.69), and type of basic health insurance (having Iranian Health Insurance: Adjusted OR = 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR = 1.66, 95%CI, 1.06-2.61) significantly increased the chances of facing CHE. CONCLUSION: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

Comparison of Iron alone and Zinc Plus Iron Supplementation Effect on the Clinical and Laboratory Features of Children with Iron Deficiency Anemia.

Background: Childhood Iron deficiency anemia is one of the main health problems around the world especially underdeveloped countries. Supplementation with micronutrients specifically iron supplementation can be considered as a therapeutic strategy to prevent and treatment of this type of anemia. The aim of the present study is to compare the therapeutic effects of zinc plus iron and iron alone supplementation on the clinical and laboratory features of children with iron deficiency anemia referred to our Hospital in 2016. Materials and Methods: 88 patients aged 6 months to 4 years old with iron deficiency anemia and after applying exclusion criteria were enrolled in the study. Patients were randomly divided into two groups to receive zinc plus iron sulfate or iron sulfate alone supplement for one month. After treatment, clinical symptoms and lab test data including CBC, TIBC and serum iron and ferritin levels were again evaluated. Statistical analyses were performed using SPSS15. Results: After one month of treatment, the clinical symptoms relived significantly in both groups. Also, there was significant changes between the mean value of laboratory parameters before and after treatment within each group (P <0.05). However, after one month of treatment there was no significant difference between the two groups (P> 0.05). Conclusion: The study revealed both iron alone and zinc plus iron supplementation are effective on the treatment of iron deficiency anemia but there are no significant difference and preference between these two types of treatment.

The relationship between B7 homologous 1 with interleukin-4, interleukin-17 and interferon gamma in patients with allergic rhinitis.

Background: The etiology of allergic rhinitis includes an increase in cytokine levels, including IL- 4, IL-13, IL-17, and reduction in B7 homologous 1 (B7-H1) or programmed cell death-1 ligand-1 (PD-L1), a new member of the CD28: B7 stimulant molecule family. The aim of this study was to determine the relationship between cytokines and PD-L1. Methods: In this experimental study, 80 patients with allergic rhinitis were enrolled according to inclusion and exclusion criteria. The severity and stage of the disease were determined by a specialist physician. A 5 cc venous blood sample was collected from the patients. IL-4, IL-17, INFγ and PD-L1 were measured using ELISA technique. Results: There was a significant correlation between SPD-L1 and INFγ, IL-4 and IL-17 in allergic rhinitis patients (P < 0.05). Statistical analysis based on the severity of the disease (Mild, Moderate and Severe) showed a significant positive correlation between the SPD-L1 and INFγ in all three levels (P < 0.001). There was also a significant negative correlation between SPD-L1 and two cytokines IL-4 and IL-17 (P < 0.001). Conclusion: PD-L1 may have a protective role against allergic rhinitis, although the precise mechanism requires further detailed studies.