Efficacy and safety of low dose oral ketamine for controlling pain and distress during intravenous cannulation in children:a double-blind, randomized, placebo-controlled trial

Background@#Ketamine is widely used in infants and young children for procedural sedation and anesthesia. The aim of this study was to evaluate the efficacy and safety of low dose oral ketamine to control pain and distress in children during intravenous (IV) cannulation. @*Methods@#This is a prospective, randomized, double-blind study, including children aged between 3 and 6 years requiring a non-emergent IV-line placement. Children were randomly assigned to two groups, treated either with oral ketamine or a placebo. All patients were monitored for vital signs. Pain was assessed using the Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker Faces Pain Rating Scale (WBFS) scales and sedation using a 5-point sedation score. The facility of IV-line placement was measured by a 3-point scale. Adverse effects were recorded after 1 and 24 hours. @*Results@#A total of 79 and 81 children were entered in the ketamine and placebo groups, respectively. The heart and respiratory rates increased significantly in the placebo group. The median CHEOPS 4 (95% confidence interval [CI]: 3, 4, P < 0.001) and WBFS 6 (95% CI: 4, 6, P < 0.001) scores decreased statistically in the ketamine group. IV-line placement was 50% easier in the ketamine group (95% CI: 37%, 63%, P < 0.001). No serious adverse effects were observed in all cases. @*Conclusions@#Low dose oral ketamine effectively decreased the pain and distress during IV cannulation in children without any significant adverse reactions.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study

OBJECTIVES: Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents. METHODS: This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight. RESULTS: The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66). CONCLUSION: Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Association between fibromyalgia and autoimmune thyroid disease

Objective: To investigate the prevalence of fibromyalgia [FM] among patients with Hashimoto's thyroiditis [HT] and association of thyroid antibodies with FM severity among affected individuals

Design: Cross-sectional

Setting: Two endocrinology outpatient clinics

Subjects: Euthyroid patients with HT were recruited

Intervention: Assessment for detection of fibromyalgia

Main outcome measure[s]: Prevalence of fibromyalgia and association with Hashimoto's thyroiditis. Diagnosis of FM was made using the 2010 American College of Rheumatology criteria. Serum concentrations of thyroid stimulating hormone [TSH] and anti-thyroid peroxidase [anti-TPO] antibodies were determined

Results: Average age of the patients was 38.5 years and 93.1% were female. Among the 102 patients, diagnosis of FM was made in five patients [prevalence rate, 95% CI: 4.9%, 0.7 - 9.1]. Age, sex, level of education, marital status, menopause status, duration of thyroid disease, TSH, and anti-TPO concentrations were comparable between patients with and without FM [p >0.05 in all tests]. Among patients with FM, the indices of FM severity [widespread pain index, and symptom severity] were not significantly correlated with wither TSH or anti-TPO concentrations

Conclusion: Despite previous reports suggesting an increased risk of FM in HT, among Iranian patients with HT, the prevalence of FM seems to be comparable with the prevalence reported in the female general population. A possible link between HT and FM needs further investigation in large population-based studies

effectiveness of a peer coaching education on control and management of type 2 diabetes in women: a protocol for a randomized controlled trial

Background: Diabetes Education by Peer Coaching is a strategy which helps the patients with diabetes in the field of behavioral and emotional problems. However, the results of studies in this field in other countries could not be generalized in our context. So, the current study aimed to examine the effectiveness of Diabetes Education by Peer Coaching on Diabetes Management

Methods: Outcome variables for patients and peer coaches are measured at baseline and in3,6 and 12 months. The primary outcome consisted of Fasting Blood Sugar [FBS] and HbA1c. Secondary outcomes included Blood Pressure [BP], Body Mass Index [BMI,] Waist-Hip Ratio [WHR], Lipid Profile, diabetes self-care activities, diabetes-related quality of life, depression, and Social Capital levels. Initial analyses compared the frequency of baseline levels of outcome and other variables using a simple Chi-square test, t-test and the Mann-Whitney- U test. Sequential measurements in each group were evaluated by two-way analysis of variance. If significant differences in baseline characteristics were found, analyses were repeated adjusting for these differences using ANOVA and logistic regression for multivariate analyses. Additional analyses were conducted to look for the evidence of effect modification by prespecified subgroups.

Conclusion: The fact is that self-control and self-efficacy in diabetes management and treatment of diabetes could be important components. It seems that this research in this special setting with cultural differences would provide more evidence about peer-coaching model. It seems that if the peer-coaching model improves learning situations between patients with diabetes by offering one-on-one Diabetes Self Management Education, it could be an interactive approach to diabetic education

Survey of behavioral problems and sensory processing in children with attention deficit/hyperactivity disorder

Objectives: All individuals need to have the ability of appropriate sensory processing for proper functioning in the environment and participation in daily activities. Moreover, behavioral functions can be affected by sensory processing problems

This Study aimed to determine the relationship between behavioral problems and sensory processing in 7 to 10 years old children with Attention Deficit/Hyperactivity Disorder [ADHD]

Methods: This descriptive [cross-sectional] Study included 60 children with ADHD aged 7 to 10 years, who were referred to a comprehensive psychiatric center. Short Sensory Profile [SSP] and Child Behavior Checklist [CBCL] questionnaires were used for assessing the patterns of sensory processing and behavioral problems in the patients

Results: There was a negative correlation between internalizing behavioral problems [r=-0.426] and externalizing behavioral problems [r=-0.465], and the total score of sensory processing in ADHD children [P<0.05]

Discussion: The findings of this Study showed that some behaviors in children with ADHD could be due to certain defects in their sensory processing

Health impacts of obesity

The aim of this communication is to provide some evidence linking the overweight/obesity and their impacts on different dimensions of health. We reviewed the related studies published from 1990 up till now through PubMed Central/Medline, which provide evidence linking obesity with health related issues. It is a risk factor for metabolic disorders and leads to serious health consequences for individuals and burden for the health care system as a whole. Literature search showed that it is related to at least 18 co-morbidities which are attributable to overweight and obesity. Moreover obese individuals more often suffer from significant joint pains, disorders and it also has social as well as psychological impairments. It is high time that countries facing the problems of obesity initiate some intervention measures to monitor and control this growing epidemic

[Assessment of the causes and risk factors associated with end stage renal disease [ESRD] in hemodialysis patients from 2000 to 2009 in Iran]

Background and Aim: According to the recorded data on the Health Ministry database, a better understanding of clinical and epidemiological factors associated with ESRD can be helpful for decision making about the treatment and preventive interventions with the aim of public health promotion and development of health programs. This study aimed to evaluate the prevalence of ESRD and dialysis-related factors from 2000 to 2009

Material and methods: In this cross sectional study, data were obtained from specific diseases office of the Ministry of Health and Medical Education of the Islamic Republic of Iran from 2000 to 2009. There was no limitation on patient entry. Finally data were analyzed using SPSS software

Results: This study included 12797 patients [57.07% male and 42.57% female] from 2000 to 2009. The overall incidence of ESRD in men [compared to the gender distribution in the normal population] with a mean age of 58.8 [SD = 17.61] was higher in comparison to women. The most common etiologies were diabetes [25.5%], and hypertension [23.3%] respectively. There were no significant changes in diabetes and hypertension frequencies in the patients between 2000 and 2009. No significant relationship was found between blood groups and ESRD. Prevalence of anemia was higher in the women with ESRD and hemoglobin levels were directly correlated with educational status [P <0.001]

Conclusion: The incidence of ESRD has been on the increase during this study. Also we found a decrease in the middle and an increase at the end of the study in the prevalence of HIV which calls for further assessments

Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study

BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.

Association of overweight and obesity with mental distress in Iranian adolescents: the CASPIAN-III study

Excess weight may be associated with mental distress and this relationship varies according to the socio-cultural background of different populations. This study aims to assess the relationship of overweight and obesity with some psychological disorders in a nationally representative sample of Iranian adolescents. This nationwide study was conducted in 2009-2010 among 5570 students, aged 10-18 years, living in 27provinces in Iran. Data were collected by using the translated and validated questionnaire of the World Health Organization Global School-based Health Survey. Data of 5528 students [49.7% girls] were complete for this study. Their mean age was 14.7 [2.4] years. Overall 7.9% of participants were overweight and 8.8% were obese. 58.7% of students had anxiety, without significant association of overweight [odds ratio [OR]: 0.86, 95% confidence interval [CI]: 0.68-1.09] and obesity [OR: 1.11, 95% CI: 0.88-1.40] with an anxiety. Nearly 62.6% of students reported to have depression, there was no significant relationship between overweight [OR: 1.11, 95% CI: 0.86-1.43] obesity and [OR: 1.01, 95% CI: 0.79-1.29] with the depression. About 49.4% of students had insomnia, without significant association of overweight [OR: 1.17, 95% CI:, 0.91-1.51] and obesity [OR: 0.91, 95% CI: 0.71-1.17] with the insomnia. In Iranian adolescents, excess weight did not increase the risk of psychological distress. This finding might be due to the positive attitude of family and peers to fatness in adolescence

Ethnical variations in the incidence of congenital heart defects in Gorgan, northern Iran: a single-center study

Congenital heart disease [CHD] is the most common congenital anomaly in newborns. This study was performed to determine the live birth incidence of CHD by ethnicity and sex in Gorgan, Northern Iran. In this longitudinal, hospital-based study, 18162 live births in Dezyani Hospital in Gorgan, North of Iran, were screened for CHD, from 2007 through 2009. Clinical examination, echocardiography, color Doppler, and cardio catheterization were used as diagnostic tools. Sex, ethnicity, and type of CHD for each case were recorded in a pre-designed questionnaire. The incidence rates of CHD in the native Fars, Sistani, and Turkmen subjects were 5.73 [95%CI: 4.53-7.15], 12.27 [95%CI: 8.74-16.73], and 15.93 [95%CI: 10.00-24.02] per 1000 live births, respectively. The Turkmen to native Fars and Sistani to native Fars relative risk for congenital CHD malformations was 2.77 [95%CI: 1.73-4.44; p value < 0.001] and 1.29 [95%CI: 0.77-2.18; p value < 0.323], respectively. While atrial septal defect was the most common lesion in the native Fars subjects [2.14 per 1000 [95%CI: 1.42-3.06]] and in the Sistani subjects [2.84 per 1000 [95%CI: 1.29-5.36]], in the Turkmen subjects, ventricular septal defect [4.36 per 1000 [95%CI: 1.59-9.43]], followed by atrial septal defect, was the most frequent lesion. This study showed that the incidence and pattern of CHD among live births in Gorgan, North of Iran, varied according to ethnicity. The risk of CHD was higher in the Turkmen and Sistani groups than in the Fars population

Frequency, causes, and places of unintentional injuries in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study

This study aims to assess the frequency, causes, and places of injuries in a nationally representative sample of Iranian children and adolescents, as well as the referral, places allocated for injured individuals. This nationwide study was conducted in 2011-2012 among 13486 elementary, secondary and high-school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. The Global School-based Health Survey questionnaire of the World Health Organization was used. The study participants consisted of 50.8% boys, 75.6% urban resident with a mean age of 12.5 years. Overall, 20.25% of participants reported that they were minimally injured once in the last 12 months; this prevalence was higher in boys than in girls [25.74% vs. 14.58%, respectively, P < 0.001], without significant difference in urban [20.11%] and rural [20.69%] areas. Most of them [39.92%] were injured at homes or house yards with higher prevalence in girls than in boys [48.61% vs. 35.17%, respectively, P < 0.001] and in rural than in urban areas [27.30% vs. 20.89%, respectively, P < 0.001]. Schools were reported as the second prevalent site of injury occurrence [22.50%]. Emergency departments and physician offices were the most prevalent referral places for injured individuals [32.31% and 22.38%, respectively]. Most of the school injuries occurred during play or sport activities [45.92%]. Prevention of unintentional injuries should be considered as a health priority. Appropriate preventive strategies should be enhanced at homes and schools

Indoor smoke exposure and risk of anthracosis

The association between indoor smoke exposure due to traditional baking [baking homemade bread] and anthracosis has rarely been investigated. The aim of the present study is to quantify such association among the Iranian population. A hospital based case-control study was carried out on 83 anthracotic cases and 155 controls [83 individuals with non-anthracotic pulmonary disorders from the pulmonary ward and 72 persons from the surgical ward without any known pulmonary disorders]. The interview was performed using the "American Thoracic Society" questionnaire, comprising demographic information, occupational history, cigarette smoking, and indoor smoke exposure due to traditional baking. Multivariate analysis was performed by logistic regression. Comparison between cases and pulmonary ward controls showed that only the association between indoor smoke exposure due to traditional baking and anthracosis in women was statistically significant [OR: 4.30, 95% CI: 1.31 to 14.10]. This was concluded after adjusting for other risk factors such as occupational exposure to dust, age, and education. When surgical ward controls were considered as control, after controlling for the significant risk factors, we found a significant relationship between indoor smoke exposure due to traditional baking and anthracosis [OR: 3.35, 95% CI: 1.49 to 7.55]. Based on the findings from this study, it is concluded that there is an association between indoor smoke exposure and anthracosis. Women are significantly more susceptible to anthracosis than men are when exposed to smoke exposure

Impact of extension splint on upper extremity motor components and function in chronic stroke patients

Spasticity and contracture in flexor muscles of the wrist may occur after stroke, especially in which early recovery did not appear. Splints are prescribed to reduce spasticity and to prevent contracture after stroke. Although there is a few research in this field. The aim of this study was to examine the impact of the Extension splint on function, spasticity, and range of motion of upper extremity in chronic stroke patients. Fourteen patients with chronic cerebro-vascular accident according to inclusion criteria participated in this study, and after initial assessments they were given splints. Goniometry was the method of assessing range of motion, and Fugl-Meyer assessment was used to examine the function of upper extremity, and spasticity of upper limb was evaluated by Modified Ashworth Scale. Patients were instructed to wear the extension splints for 1 month and 2 hours a day and all night [6 to 8 hours]. Assessments were repeated at the end of the first, third and fourth weeks. The difference of wrist`s spasticity level and passive range of motion of wrist were significant before and after 1 month [P<0.001, P=0.01]. And other items did not significantly improve [P>0.05]. Also a result indicates that there are improvements in all outcomes to some extent and these results were not significantly different in the outcomes. The results show that 1-month using of this splint with 30-degrees of wrist extension reduces spasticity and improves passive wrist range of motion. But changes in other outcomes were not significant

Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study

More than 80% cardiovascular disease [CVD] is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of [Iran] were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged > 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia [>/= 200 mg/dl], hypertriglyceridemia [>/= 150 mg/dl], high levels of low density lipoprotein cholesterol [[LDL-C] [>/= 130 mg/dl]] and low levels of high density lipoprotein cholesterol [[HDL-C] <40 mg/dl in males, <50 mg/dl in females], in Iranian people were 41.6% [36.1-47.0], 46.0% [43.3-48.7], 35.5% [24.0-47.1] and 43.9% [33.4-54.4], respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden

nationwide survey on the daily screen time of Iranian children and adolescents: the Caspian - IV study

Leisure time activity is an important life-style habit. This study aims to determine the screen time of a nationally representative sample of Iranian children and adolescents. This nationwide cross-sectional study was conducted as part of the fourth survey of a surveillance system. The participants consisted of 14880 students, with aged range from 6 to 18 years, living in 30 provinces in Iran. Screen time, i.e. the time spent on watching television [TV]/video and computer games during leisure time, was assessed by using the questionnaire of the Globasl Student Health Survey of the World Health Organization. The study participants were 13486 school students [participation rate of90.6%] with a mean age of12. 47 [3.36] years. Overall, 75.6% of students were from urban and 24.4% from rural areas and 50.8% were boys respectively. Overall, 33.4% and 53% of students watched TV/video more than 2 h a day in their leisure time during school days and holidays, respectively. Likewise, 6.3% and 10.9% of students used computer more than 2 h a day in their leisure time during the school days and holidays, respectively. Overall, 47.1% of urban students and 24.2% of rural students used personal computer in their leisure time during the school days. The corresponding figures were 50.8% and 27.2% in weekends and holidays, respectively. The time spent on screen activities is long in a considerably high number of Iranian children and adolescents. It should be reduced by increasing the public awareness and by providing facilities for regular daily physic activity for students' leisure times

nationwide survey on some hygienic behaviors of iranian children and adolescents: the caspian-iv study

This study aims to assess the frequency of some hygienic behaviors that is, tooth brushing and hand-washing, in Iranian school students at national level. This nationwide study was conducted in 2011-2012 among 14,880 elementary, secondary and high school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. We used the global school-based health survey questionnaire of the World Health Organization. The population of this survey consisted of 13,486 children and adolescents [participation rate of 90.6%] including 49.2% girls and 75.6% urban inhabitants. The mean age of participants was 12.5 years [12.3-12.6, 95% confidence interval] According to the self-report of students, 26.9% of them [20.2% of boys and 33.9% of girls] brushed their teeth more than once a day, 37.8% of boys and 42.1% of girls brushed their teeth once a day. In general, girls brushed their teeth more than boys. The frequency of those students who never brushed their teeth was twice in rural than in urban students [11.4% vs. 6.2%, respectively]. In total, 3.4% of the students stated that their school had not an appropriate place for washing hands after toilet, with three-fold higher frequency in rural than in urban schools [6.8% vs. 2.3%, respectively]. 85% of students [87% of girls vs. 83% of boys] reported that they had always washed their hands after toilet, 10.1% did it occasionally and 4.1% did not. This nationwide survey revealed that Iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however, still it is necessary to improve school health facilities and hygienic habits in Iranian students

Tooth brushing and cardiometabolic risk factors in adolescents: Is there an association? The CASPIAN-III study

A growing body of evidence supports an association between oral health and cardiovascular diseases and diabetes in adults. This study aimed to investigate the relationship between tooth brushing frequency and cardiometabolic risk factors in adolescents. This nationwide population-based study was conducted among 5258 Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces in Iran. The association of tooth brushing frequency was assessed with anthropometric indexes and cardiometabolic risk factors after adjustment for potential confounders. Higher frequency of tooth brushing was associated with lower mean levels of low-density lipoprotein cholesterol [LDL-C] in both genders [P < 0.0001] and lower frequency of elevated LDL-C in girls [P = 0.03]. The frequency of elevated blood pressure decreased with higher tooth brushing frequency in boys [P = 0.03]. After adjustment for many potential cofounders such as age, gender, anthropometric indexes, screen time, socioeconomic status, and family history of non-communicable diseases, participants who washed their teeth at least once a day had lower risk of high LDL-C and low high-density lipoprotein cholesterol [HDL-C] levels in comparison to those who reported lower frequency of tooth brushing; some different associations were observed among girls and boys. Our findings suggest an independent and protective role of teeth brushing frequency for some cardiometabolic risk factors in adolescents. Increasing both the general health awareness and improving oral health should be considered in primordial and primary prevention of non-communicable diseases

new formula for estimating fetal weight: the impression of biparietal diameter, abdominal circumference, mid-thigh soft tissue thickness and femoral length on birth weight

Abdominal circumference [AC], biparietal diameters [BPD] and femoral length [FL] are now the main parameters used to obtain estimated fetal weight [EFW]. Although the role of soft tissue parameters in determining fetal weight was proved but clinical attention to mid-thigh soft tissue thickness [STT] is limited. To find the impression of STT on birth weight [BW] and represent a new predictive formula. One hundred and fourteen normal singleton term [36-42w] pregnancies with delivery within 72 hours were randomly selected to participate in this prospective cohort study. Variables measured by ultrasonography before birth included: AC, BPD, FL and STT. The actual neonatal BW was also measured after birth. Linear regression model was used and R square and p-value were reported The mean [SD] of BW was 3406 [405] gr. R square was best fit for the model that STT was added to AC, BPD, FL [r[2]: 0.77]. R square for the model using BPD, AC, FL and model using BPD, STT, FL was the same [r[2]: 0.7]. Best fit formula was Log [BW]= 2.461+0.003BPD+0.001AC+0.007STT+0.005FL. AC [R: 0.67, p<0.001], STT [R: 0.50, p<0.001], BPD [R: 0.59, p<0.001], FL [R: 0.66, p<0.001] were significantly correlated with birth weight. AC had also significant correlation with STT [p=0.001] This study showed adding STT to other variables in predictive models of fetal weight would provide a nice estimation [r[2]=0.77] and in cases that measuring AC is suboptimal STT may be a good replacement

Methodology and early findings of the fourth survey of childhood and adolescence surveillance and prevention of adult non-communicable disease in Iran: the CASPIAN-IV study

The fourth survey of the surveillance system named ''childhood and adolescence surveillance and prevention of adult non-communicable disease'' [CASPIAN-IV study], was conducted among a national representative sample of Iranian students. This paper describes the methods and early findings of this survey. This nationwide school-based study was conducted in 2011-2012 in 30 provinces of Iran among 13,486 students, 6-18 years [6640 girls, 75.6% from urban areas] and one of their parents. Mean age of students was 12.5 years. Based on the World Health Organization growth curves, 12.2% were underweight, 9.7% overweight and 11.9% were obese. Abdominal obesity was observed in 19.1% of students. The dominant type of cooking oil in urban families was liquid oil and hydrogenated fat [39% and 32%], most rural families used hydrogenated fat [53%], respectively. A total of 18% of students had at least 30 min of daily physical activity; 41% of students used computer in weekdays and 44% used it in weekends. Almost 34.5% of students reported to have at least one cigarette smoker and 21.5% reported to have a waterpipe smoker in their relatives. Moreover, 20.3% of students reported that they had suffered an injury needing the help of school health providers during the year prior to the study. Current evidence on the health risky behaviors among Iranian children and adolescents confirms the importance of conducting comprehensive surveillance surveys to identify health risk behaviors. Data of this survey and the trend of variables provide necessary information for health policy makers to implement action-oriented interventions

Dietary predictors of childhood obesity in a representative sample of children in north east of Iran / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The prevalence of obesity is increasing in Iranian youngsters. This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour, a city in northeastern, Iran.</p><p><b>METHODS</b>This case-control study was conducted among 114 school students, aged 6-12 years, with a body mass index (BMI) ≥95th (based on percentile of Iranian children) as the case group and 102 age- and gender-matched controls, who were selected from their non-obese classmates. Nutrient intake data were collected by trained nutritionists by using two 24-hour-dietary recalls through maternal interviews in the presence of their child. A food frequency questionnaire was used for detecting the snack consumption patterns. Statistical analysis was done using univariate and multivariate logistic regression (MLR) by SPSS version 16.</p><p><b>RESULTS</b>In univariate logistic regression, total energy, protein, carbohydrate, fat (including saturated, mono- and poly-unsaturated fat), and dietary fiber were the positive predictors of obesity in studied children. The estimated crude ORs for frequency of corn-based extruded snacks, carbonated beverages, potato chips, fast foods, and chocolate consumption were statistically significant. After MLR analysis, the association of obesity remained significant with energy intake (OR = 2.489, 95%CI: 1.667-3.716), frequency of corn-based extruded snacks (OR = 1.122, 95%CI: 1.007-1.250), and potato chips (OR = 1.143, 95%CI:1.024-1.276). The MLR analysis showed that dietary fiber (OR = 0.601, 95%CI: 0.368-0.983) and natural fruit juice intake (OR = 0.909, 95%CI: 0.835-0.988) were protective factors against obesity.</p><p><b>CONCLUSIONS</b>The findings serve to confirm the role of an unhealthy diet, notably calorie-dense snacks, in childhood obesity. Healthy dietary habits, such as the consumption of high-fiber foods, should be encouraged among children.</p>