Distribution incidence, mortality of tuberculosis and human development index in Iran: estimates from the global burden of disease study 2019.

BACKGROUND: Tuberculosis is one of the most serious challenges facing the global healthcare system. This study aims to investigate the incidence and mortality of tuberculosis in Iran from 2010 to 2019 as well as its relationship with the human development index (HDI). METHODS: The present study is an ecological study aiming at investigating the incidence and mortality of tuberculosis in Iran during the years 2010 to 2019. The related data were extracted from the Global Burden of Disease (GBD) website. The spatial pattern attributed to tuberculosis in the provinces of Iran was analyzed using ArcGIS software. In this study, the two-variable correlation method was used to analyze the data extracted to study the correlation between Tuberculosis and HDI. RESULT: Based on the results recorded in GBD, the incidence of tuberculosis in 2010, that is, 14.61 (12.72, 16.74), declined compared to 2019, namely 12.29 (10.71, 14.09). The age-standardized mortality rate which was 1.63 (1.52, 1.73) in 2010, has decreased compared to 2019: 1.17 (1.07, 1.32). The incidence and mortality rates of tuberculosis in Iran in all age groups have decreased in 2019 compared to 2010. The highest incidence and mortality among tuberculosis patients were recorded in Sistan and Baluchistan and Golestan provinces. The results indicated that there was a negative and significant correlation between the mortality rate of tuberculosis and the human development index in 2010 (r = -0.509, P-value = 0.003) and 2019 (r = -0.36, P-value = 0.001); however, this correlation between incidence and human development index was not significant (p > 0.05). CONCLUSION: Since mortality is mostly observed in areas with low HDI, health system policymakers must pay more attention to these areas in order to improve care and perform screenings to diagnose and treat patients thus reducing the mortality rate of tuberculosis and preventing an increase in its incidence in Iran.

The efficacy and safety of adding celecoxib to escitalopram for improving symptoms of major depressive disorder.

OBJECTIVE: There is growing evidence that adding non-steroidal anti-inflammatory drugs to some psychopharmacological treatments may help to improve symptoms in patients suffering from major depressive disorder. The present study examined the therapeutic efficacy of adding celecoxib to Ecitalopram and the safety of doing so. METHOD: In this double-blind randomized controlled trial, 60 patients with major depressive disorder were randomly assigned to either treatment with Ecitalopram plus celecoxib (intervention group) or Ecitalopram and placebo. All patients were evaluated blind to treatment group with the Hamilton Depression Rating Scale (HDRS) before the intervention as well at 4 and 8 weeks after initiating treatment. Chi-square and paired t-test were used to examine between-group differences at those assessment times. RESULTS: There was no significant difference in depressive symptoms between intervention and placebo groups at baseline. However, at 4 and 8 weeks after the beginning of treatment, there were significant between-group differences in HDRS scores, favoring the intervention group. No between-group differences were found in treatment-related side effects. CONCLUSIONS: Adding celecoxib to Ecitalopram may effectively improve symptoms of depression in patients suffering major depressive disorder without increasing the risk of drug-related side effects.

Application of artificial neural network and dynamic adsorption models to predict humic substances extraction from municipal solid waste leachate.

Sustainable municipal solid waste leachate (MSWL) management requires a paradigm shift from removing contaminants to effectively recovering resources and decreasing contaminants simultaneously. In this study, two types of humic substances, fulvic acid (FA) and humic acid (HA) were extracted from MSWL. HA was extracted using HCl and NaOH solution, followed by FA using a column bed under diversified operations such as flow rate, input concentration, and bed height. Also, this work aims to evaluate efficiency of Artificial Neural Network (ANN) and Dynamic adsorption models in predicting FA. With the flow rate of 0.3 mL/min, bed height of 15.5 cm, and input concentration of 4.27 g/mL, the maximum capacity of FA was obtained at 23.03 mg/g. FTIR analysis in HA and FA revealed several oxygen-containing functional groups including carboxylic, phenolic, aliphatic, and ketone. The high correlation coefficient value (R2) and a lower mean squared error value (MSE) were obtained using the ANN, indicating the superior ability of ANN to predict adsorption capacity compared to traditional modeling.

COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country.

BACKGROUND: Any disruption in continuity of care for patients with chronic conditions can lead to poor outcomes for the patients as well as great damage for the community and the health system. This study aims to determine the continuity of care for patients with chronic conditions such as hypertension and diabetes during COVID-19 pandemic. METHODS: Through a cross-sectional retrospective study, data registered in six health centers in Yazd, Iran were analyzed. Data included the number of patients with chronic conditions (hypertension and diabetes) and average daily admission during a year before COVID-19 pandemic and the similar period after COVID-19 outbreak. The experience of continuity of care was assessed applying a validated questionnaire from a sample of 198 patients. Data analysis was done using SPSS version 25. Descriptive statistics, independent T-Test and Multivariable regression were used for analysis. FINDINGS: Results indicate that both visit load of the patients with chronic conditions (hypertension and diabetes) and their average daily admission were decreased significantly during a year after COVID-19 pandemic compared to the similar period before COVID-19 outbreak. The moderate average score of the patients` experience towards continuity of care during the pandemic was also reported. Regression analysis showed that age for the diabetes patients and insurance status for the hypertension patients affect the COC mean scores. CONCLUSION: COVID-19 pandemic causes serious decline in the continuity of care for patients with chronic conditions. Such a deterioration not only can lead to make these patients` condition worse in a long-term period but also it can make irreparable damages to the whole community and the health system. To make the health systems resilient particularly in disasters, serious attention should be taken into consideration among them, developing the tele-health technologies, improving the primary health care capacity, designing the applied responsive models of continuity of care, making multilateral participations and inter-sectoral collaborations, allocating sustainable resources, and enabling the patients with selfcare skills are more highlighted.

Dietary Patterns in Association with Sleep Duration in Iranian Adults: Results from YaHS-TAMYZ and Shahadieh Cohort Studies.

Background: Little observational studies have been conducted on the association between diet and sleep. We conducted a cross-sectional study to evaluate the associations of dietary patterns with sleep duration in an Iranian population. Methods: This study was conducted on the baseline data of two population-based Iranian cohorts: the YaHS-TAMYS and Shahedieh studies. Dietary intakes were assessed in 10451 Yazdi people aged 20-75 years. Dietary habits were derived from answers to a food frequency questionnaire, and a factor analysis using principal component analysis (PCA) was used to identify dietary patterns. The reported sleep duration was categorized as short (<6 h), normal (6-8 h) or long (>8 h). Multivariable logistic regression was used to determine the relationship between dietary patterns and the odds of short and long sleep duration. Results: Four major dietary patterns were identified: "healthy," "western," "traditional," and "high-carbohydrate, high-fat." In the Shahedieh study, participants in the top quartile of the western dietary pattern had greater odds of short (<6 h) and long (>8 h) sleep duration (OR = 1.49; 95% CI: 1.17, 1.90; P trend <0.001 and OR = 1.46; 95% CI: 1.12, 1.90; P trend = 0.014, respectively) than those in the bottom quartile. Also, participants in the highest quartile of the high-carbohydrate, high-fat pattern had higher odds of long sleep duration compared with those in the lowest quartile (OR = 1.36; 95% CI: 1.05, 1.75; P trend = 0.005). Pooling the two studies revealed that the western dietary pattern was significantly associated with short sleep duration (OR = 1.31; 95% CI: 1.08, 1.59). Conclusions: The western dietary pattern might inversely be associated with sleep duration. Future prospective studies are recommended to confirm these results.

Evaluation of the Risk Factors for Type 2 Diabetes Using the Generalized Structure Equation Modeling in Iranian Adults based on Shahedieh Cohort Study.

Objective: Diabetes mellitus (DM) is an important global health risk factor in the twenty-first century and one of the 10 major causes of mortality world wide. The generalized structural equation model (GSEM) is a family of statistical techniques in the analysis of multivariate data, classified and sequential, which measures the hidden variables and the relationships between them. Finding risk factors for type 2 diabetes and providing a model for lifestyle changes is the aim of the study.. Methods: This exploratory, cross-sectional study was performed to evaluate the risk factors in a cohort of Iranian diabetic patients aged over 35 years (N = 9975). Among 9975 people over 35 years old participating in the first phase of the Yazd cohort study, 1736 people (17.95%) with diabetes and people who were unaware of their diabetes status and pregnant women were excluded and finally we selected 7431 non-diabetics who had FBG test. By presenting the model of initial generalized structural equations using stata software (version 15), we investigated the risk factors affecting type 2 diabetes. Results: The risk factors of BMI (Impact coefficients0.010), triglyceride (0.005), hypertension (0.086), and high cholesterol level (0.005) directly affected the DM status (P < 0.001). Meanwhile, BMI and triglyceride played a mediating role in this regard, and the factors of high-density lipoprotein cholesterol, physical activity (-0.23), and diet (0.001) indirectly affected the DM status. Conclusion: Using a large sample, this study provides a clear and direct model of the risk factors for diabetes. The main finding is that the risk factors for diabetes 2 that directly affect Iranians in this study are high blood pressure, BMI, triglycerides and cholesterol.

The effect of Nigella sativa on TAC and MDA in obese and overweight women: secondary analysis of a crossover, double blind, randomized clinical trial.

Purpose: Since obesity is a risk factor for various diseases and is associated with increased oxidative stress conditions, some herbs are considered to be effective in reducing obesity and its complications. Methods: This secondary analysis investigates the effect of Nigella sativa (N.S) oil supplement on total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in obese/overweight women. Obese and overweight healthy women were randomized to receive 2,000 mg/d of N.S supplement and placebo. The intervention periods lasted 8 weeks and were separated by a 4-week washout period. Also, each participant was given an iso-calorie diet. Baseline characteristics and TAC and MDA levels were measured. Pkcross analysis was performed for statistical analysis using Stata software. Also, Cohen's d was estimated as effect size for all results to assess the magnitude of the effects. Results: 39 women completed the study. N.S oil supplementation at a dose of 2000 mg/d significantly increased serum TAC (P effect = 0.017, Cohen's d = 1.81) and reduced serum MDA (P effect < 0/001, Cohen's d = - 0.32). Conclusion: Based on our findings taking N.S supplementation for 8 weeks can improve antioxidant conditions in obese and overweight adults. However, more studies with a larger population and the presence of both genders need to be done to confirm the results.Registration number: IRCT20180430039475N1.

Fabrication of ZnO/y-FeOOH nanoparticles embedded on the polyethylene terephthalate membrane: Evaluation of antifouling behavior and COD removal.

Nanofiltration contributes to the development of advanced treatment of wastewater. An antifouling mixed matrix recycled polyethylene terephthalate (rPET) membrane modified by the hydrophilic ZnO/y-FeOOH nanoparticles (NPs) was fabricated via the electrospinning method. The effect of ZnO/y-FeOOH NPS embedded in rPET as a modifier on the fabrication of nanocomposite membranes was investigated regarding water flux, membrane morphology, permeability, fouling resistance, and COD removal. The surface morphology of the rPET-ZnO/y-FeOOH membrane was evaluated by field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), water contact angle (WCA), and porosity and pore structure.Due to the embedding of NPs, the resulting rPET-ZnO/y-FeOOH membrane, with a low WCA of 53.404° angle, conforms significantly improved hydrophilicity and water permeation flux. The FESEM image displayed the distribution of cuboidal and needle-like ZnO and FeOOH NPs on the rPET membrane. The performance of the nanofiltration system related to the removal efficiency of COD was studied. It was deduced that the rPET-ZnO/y-FeOOH membrane had a superior COD removal capability (95.7%) at a pressure of 2 bar. Protein rejection tests were performed on antifouling behavior. The nanocomposite membrane with a high antifouling capability was related to 0.5 wt·% ZnO/y-FeOOH NPs (flux recovery ratio [FRR] = 96.2%, Rr = 90.21%, and Rir = 3.001%). The modification procedure in this study (as a great improving technique) was proposed to fabricate the antifouling nanofiltration membrane.

The efficacy of teriparatide (Cinnopar®) on bone repair in mandibular fractures: A single blinded randomized clinical trial.

This study focused on the effects of teriparatide (CinnoPar) on healing and postoperative complications in mandibular bone fractures. In this single-blind randomized controlled trial, 30 patients with a mandibular fracture hospitalized for open reduction internal fixation were randomly assigned to the intervention (I) (n = 15) and control (C) (n = 15) groups. Both groups received daily acetaminophen and cephalexin for 1 week. For 1 month, Group I received daily subcutaneous teriparatide injections. The Radiographic Union Scale of the Mandible (RUSM) was used to assess mandibular bone fusion subjectively, and the Hounsfield unit (HU) was used to objectively assess radiodensity in a computed tomography (CT) scan. In both groups, the visual analog scale (VAS) score was used to assess postoperative complications such as pain, swelling, wound opening, pus secretion, and bitter taste. There was no significant difference in bone repair between the two groups in this study (P > 0.05). Teriparatide also had no effect on the postoperative complication rate in the control group (P > 0.05). Within the limitations of the study it seems that in mandibular fractures, teriparatide did not affect bone fusion or postoperative complications, so its use is not recommended for better bone fusion and fewer postoperative complications of mandibular fracture during the first month.

Dietary glycemic index and glycemic load in association with sleep duration: YaHS-TAMYZ and Shahedieh observational studies.

BACKGROUND & AIMS: Current data on the association between dietary glycemic index (GI) and glycemic load (GL) and sleep duration are limited and controversial. The present cross-sectional study aimed to investigate the relationship between dietary GI and GL with sleep duration in a large number of adults living in central Iran. METHODS: Baseline data from two Iranian cohorts were pooled for the current analysis: the YaHS-TAMYZ (n = 9962) and Shahedieh (n = 9977) studies. Demographic data as well as dietary intakes, sleep duration, and possible confounders, were collected by interview. Anthropometric measurements were also conducted by trained interviewers. Participants were categorized based on sleep duration [short (<6 h), normal (6-8 h), and long (>8 h)]. Multivariable logistic regression was used to determine the relationship between dietary GI/GL and the likelihood of short and long sleep duration. RESULTS: In total, 10,451 participants aged 20-70 years were included in the analyses. After controlling for all possible confounders, no significant association was observed between dietary GI and short or long sleep duration (P > 0.05). Individuals in the highest quartile of dietary GL had a higher chance for long sleep duration compared to participants in the lowest quartile (OR = 1.41; 95% CI: 1.14, 1.74, Ptrend = 0.001). No significant association was observed between dietary GL and short sleep duration. CONCLUSION: Dietary GL is positively associated with the likelihood of long sleep duration. Future prospective studies are required to confirm the current findings.

Incentives to Reduce Salt Intake Resulting From Women's Experiences: A Qualitative Study.

INTRODUCTION: Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.

The effect of Nigella sativa supplementation on cardiovascular risk factors in obese and overweight women: a crossover, double-blind, placebo-controlled randomized clinical trial.

PURPOSE: To assess the effect of Nigella sativa (N.S) oil supplements on CVD risk factors in a crossover design for the first time. METHODS: Obese and overweight healthy women were randomized to receive N.S oil (2000 mg/day) and placebo. This intervention period lasted for 8 weeks and separated by a 4-week washout period. An iso-caloric diet was given to every individual throughout the study. Blood pressure, lipid profile, atherogenic indices and liver enzymes were measured. Pkcross procedure was performed for statistical analyses using Stata software. Cohen's d was estimated as effect size for all outcomes to measure the magnitude of the effects. RESULTS: Thirty-nine participants completed the study. Capsules of N.S increased serum high-density lipoprotein cholesterol (Cohen's d = 0.47, P = 0.009), reduced low-density lipoprotein cholesterol (Cohen's d = - 0.33, P = 0.031), reduced TC/HDL-C ratio (as an atherogenic index, Cohen's d = - 0.9, P < 0.001), reduced serum glutamic-oxaloacetic transaminase (Cohen's d = 0- 0.5, P = 0.038) and reduced systolic blood pressure (Cohen's d = - 0.4, P < 0.001). There was no effect on diastolic blood pressure measures (P = 0.96). CONCLUSION: The overall improvements in cardiovascular disease (CVD) risk factors showed beneficial effects of N.S supplements among adults with obesity to prevent possible cardiovascular diseases. More studies with different designs and in other populations are suggested to clarify the exact effects of N.S as a complementary therapy for modulating CVD risk factors in individuals with overweight and obesity. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20180528039884N1, Registered on February 15th, 2019.

The effect of Nigella sativa on appetite, anthropometric and body composition indices among overweight and obese women: A crossover, double-blind, placebo-controlled, randomized clinical trial.

OBJECTIVES: Obesity is a global concern which is associated with several complications and disease. DESIGN: Present study is the first crossover, double-blind, placebo-controlled, randomized clinical trial aimed to evaluate the effect of Nigella Sativa (N. sativa) intervention on anthropometric and body composition parameters as well as dietary intake and appetite in a crossover design. METHOD: Forty-five healthy women with obesity or overweight were randomized into two groups of intervention and placebo, and the study conducted in two 8-week periods of intervention separated by a 4-week washout period. Anthropometric and body composition indices and dietary intake were measured. Also, appetite sensation was evaluated via a standard visual analog scale (VAS) questionnaire. Pkcross procedure was performed for statistical analysis using STATA. Cohen's d effect size was estimated for all outcomes to determine the magnitude of the effects. RESULTS: Supplementation with 2000 mg of N. sativa oil found to have a considerable increment in the measures of body mass index (P < 0.001, Cohen's d = 0.5), body weight (P < 0.001, Cohen's d = 0.6) and waist circumference (P = 0.020, Cohen's d = 0.4) with a medium effect size measure, and a significant decrease in body fat mass (P = 0.019, Cohen's d = 0.2), body fat percent (P < 0.001, Cohen's d = 0.2) and visceral fat area (P = 0.011, Cohen's d = 0.2) with a small effect size measure. CONCLUSION: The overall improvements in anthropometric and body composition parameters and a significant decrease in appetite represents the beneficial effects of N. sativa supplements in the treatment of obesity. More studies with different dosages, a larger number of participants, and longer intervention duration are recommended to illustrate the exact effects of N. sativa as a complementary therapy for obesity.

Designing and modeling of a novel electrolysis reactor using porous cathode to produce H2O2 as an oxidant.

The entry of toxic organic pollutants and resistant to biodegradation has increased the concern about human health. The use of advanced oxidation (AO) processes to degrade these pollutants has been developing. One of the AO processes is based on the use of hydrogen peroxide in removing resistant organic pollutants. This study aimed to develop a new reactor capable of producing H2O2 in the solution. Therefore, a porous electrode made of stainless steel with the capability of air injection in the electrode center was used. The 30 cm rod graphite electrodes were also used as an anode electrode in a 4000 ml reactor. The effects of variables, including current density (30-40 mA/cm2), time (10-30 min), and electrolyte concentration (12-17 mM/L) on the amount of H2O2 production were evaluated by Box behenken design under response surface methodology using Design expert software. The results of this study showed that H2O2 can be produced at the electrode surface of porous cathode under optimal conditions of 36 mA/cm2 current density, 16 mM/l electrolyte concentration, in 23 min, and in the amount of 34 ppm. Using a porous cathode electrode causes the maximum contact among the solution, water, and air, and increases the production of H2O2. The release of resistant organic compounds to the waste water is a serious problem to the environment. By the application of the Electro-oxidation (EO)reactor with the ability to produce H2O2, this issue is resolved. Furthermore, this technique is applied for non-selective degradation of the toxic organic compounds. •The electro-oxidation process is a useful method for destruction of persistent organic matter from wastewater.•Due to use of porous cathode in this method, contact between the electrode and the sewage is at its maximum level which increases the efficiency and speed of sewage treatment.•This method can produce H2O2 as a high potential oxidant that can reduce persistent organic properties of sewage and make the wastewater suitable for biological treatment.

Independent and joint effects of serum 25-hydroxivitamin D and calcium on breast cancer ratio in an Iran population: A cross-sectional study.

BACKGROUND: It has been suggested that Vitamin D and calcium have protective effects against breast cancer. The results about breast cancer and serum Vitamin D and calcium levels are still controversial, indefinite, and insufficient to determine the amount of nutritional needs. Thus, we investigated the association between serum 25-hydroxyvitamin D(25-OH-D) and calcium on the ratio of breast cancer at diagnosis time. MATERIALS AND METHODS: We carried out a hospital-based cross-sectional study in a population of Iran. It comprised 57 breast cancer cases, who were newly diagnosed, and 85 controls in 2013. The serum 25-OH-D and calcium levels were measured. RESULTS: There was not any significant association between 25-OH-D and breast cancer ratio. Odds ratio (OR) comparing the highest quartile to the lowest quartile was 1.03(95% confidence interval[CI] 0.33-3.22, P-trend 0.95). Having sufficient (>75 nmol/L) serum 25-OH-D levels compared to insufficient serum 25-OH-D levels was not associated with a significantly decreased ratio of breast cancer (OR 0.55, 95% CI 0.23-1.29, P = 0.17). Furthermore, an association between calcium and breast cancer did not get statistical significance (OR 0.51, 95% CI 0.17-1.49, P-trend 0.31). The joint effect was negative interaction. CONCLUSION: Vitamin D and calcium do not act on decreasing ratio of breast cancer. Decreasing ratio of breast cancer in relation to serum calcium and Vitamin D level at diagnosis time needs more assessments.

Epidemiology of road traffic mortality and injuries in Yazd, Iran during 2003-2008.

OBJECTIVE: Road traffic crashes (RTCs) are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008. METHODS: Data were got from national health sources of Iran. These data included population, the number of RTCs, consequent fatalities, cause and place of death from 2003 to 2008. RESULTS: RTC incidence rate increased from 868.5 per 100 000 population in the year 2003 to 1 643.6 in 2008. A total of 2 565 deaths from RTC were recorded in Yazd from 2003 to 2008. RTC mortality rate increased from 46.1 per 100 000 population in 2003 to 46.9 in 2006, then declined to 38.8 in 2008. During this time period, overall traffic injury incidence per 100 000 population increased from 368.8 in 2003 to 647.9 in 2006, then declined to 527.9 in 2008. Head injuries were the most common cause of road traffic-related mortality from 2003 to 2008. Following road traffic accidents, most of the deaths occurred before arriving hospital. CONCLUSIONS: Road traffic crash-related mortality and morbidity in Yazd in the recent six years are increased, but decreased in the last two years. This decline is most probably the result of a variety of interventions, including laws, police enforcement, improvements in traffic and transport, health care resources and media and public education.

Quality of life after the menopause in Iran: a population study.

OBJECTIVE: Quality of life (QoL) decreases after the menopause as it has been assessed by several designed tools. The aim of the present research was to assess QoL and determine factors related to its impairment among postmenopausal Iranian women. METHODS: This cross-sectional study was conducted through cluster sampling among 480 postmenopausal women in Yazd, Islamic Republic of Iran, in 2008. Data were collected using the menopause quality of life questionnaire (MENQOL) by interviewing. Content validity and Cronbach's alpha were used, respectively, to ensure the validity and reliability of the questionnaires. Inferential and descriptive statistics via SPSS.15 software was used for data analysis. RESULTS: The results showed that the menopausal women have worse QoL scores in vasomotor dimension and higher QoL scores in physical dimension. Univariate analysis showed that there were significant differences in the MENQOL scores by age, number of children, education, postmenopausal stage, employment status, and BMI. Women aged 60-65 (P < 0.05), with a university level of education (P < 0.01), who had employment (P < 0.01), who had postmenopausal stage 5 or more years (P < 0.05), with a body mass index or=5 increased the risk for higher scores within the sexual domain, respectively. CONCLUSION: Menopause causes a decrease in quality of life, which is dependent to work and other socio-demographic variables. Therefore, it is necessary to develop effective intervention programs to improve quality of life after menopause.

Breast-feeding history and overweight in 11 to 13-year-old children in Iran.

BACKGROUND: The relationship between breast-feeding history and risk of overweight in pre-adolescent children was investigated. METHODS: Children's breast-feeding history and demographics were obtained in interviewer-administered questionnaires of a multistage cluster sample survey of 800 parents of children aged 11-13 years living in Yazd, Iran. Height and weight were measured in the children. Overweight was defined as body mass index >/=90th age- and sex-specific percentile of the 2000 Centers for Disease Control reference values. RESULTS: One hundred and four (13.0%) of 800 children were overweight. A total of 783 (97.9%) of the children had been breast fed. There was a markedly lower overweight prevalence among breast-fed than non breast-fed children. Controlling for age and sex, children breast fed for at least 24 months were substantially less likely to be overweight than children breast fed for less than 12 months (OR 0.56, 95% CI 0.31-0.9). A longer overall duration and duration of exclusive breast-feeding were associated significantly with the decreasing prevalence of overweight. CONCLUSION: This sample of Iranian children shows high rates of overweight at young ages but also high rates of breast-feeding. The duration of breast-feeding is inversely related with the prevalence of overweight in pre-adolescent children.

Age at natural menopause in Yazd, Islamic Republic of Iran.

OBJECTIVE: With increasing life expectancy, menopause is an increasingly important aspect of women's health. Although research suggests that age at menopause varies in different ethnic groups, data on age at menopause among Iranian women are limited. We recorded the age at natural menopause among women in a population-based study in Yazd, Islamic Republic of Iran, in 2006. DESIGN: This cross-sectional study estimates age at natural menopause among a sample of 346 menopausal women through cluster sampling and according to their age and the onset of menopause (12 months of consecutive menstrual cessation). RESULTS: We found that the mean (SD) age at menopause was 47.39 (5.089) years (95% CI: 46.85-47.92) and the median age was 48 years. The Iranian women demonstrated a moderate to high frequency of reporting four symptoms in vasomotor, vaginal, sleep-related, emotional, and somatic categories. Physical factors (height, weight, body mass index, handedness) and sociodemographic factors (educational level, income) were not significantly related to early mean age at menopause. CONCLUSIONS: This study provides an estimate of age at menopause for Iranian center women, which is similar to the overall estimates previously reported for Iranian populations. Different factors influence age at natural menopause; however, there has not been a study in which this factor has been confirmed as a significant factor.