Comparing the efficacy of fluconazole and cryotherapy Versus cryotherapy alone on treating cutaneous leishmaniasis: a triple-blind randomized clinical trial.

OBJECTIVE: Cutaneous Leishmaniasis (CL) is one of the highly prevalent endemic diseases in the Middle East. The disease is a complex skin infection imposing a heavy burden on many developing countries. This study aimed to evaluate the impact of adding oral fluconazole to topical cryotherapy on the treatment efficacy and time to achieve complete recovery of CL lesions. METHOD: This triple-blind randomized clinical trial included 52 participants with CL. Participants were allocated to receive either weekly cryotherapy with liquid nitrogen and oral fluconazole at a dose of 6 mg/kg daily at a maximum of 400 mg for 6 weeks as the interventional arm or weekly cryotherapy with liquid nitrogen plus the placebo for the same period of 6 weeks as the control arm. RESULTS: Fifty-two eligible participants enrolled the study, with a CL lesion count of 1 to 8 (mean 1.96), and served as the interventional (n = 28) and control (n = 24) arms. The trend of the mean surface area of the lesions was significantly decreasing in both arms (P < 0.001), with no statistically significant difference between arms (P = 0.133) or all assessed time point pairwise comparisons (P > 0.05). There was no significant difference between the treatment arms in terms of the end-point recovery status (P = 0.491) or the frequency of post-treatment secretion (P = 0.437). No adverse effect was observed. CONCLUSION: Despite a slightly higher reduction in the lesion surface in the cryotherapy and fluconazole treatment arm, the addition of fluconazole did not provide statistically significant therapeutic value to cryotherapy in the treatment of CL. However, with adjustment for the initial lesion size, the efficacy of the regimen in the interventional arm was more pronounced, though it was still insignificant.

A cross-sectional study determining prevalence and factors associated with ST-segment elevation myocardial infarction and non-ST segment elevation myocardial infarction in Iran: results from fasa registry on acute myocardial infarction (FaRMI).

BACKGROUND: Acute myocardial infarction is still a leading cause of death worldwide, accounting for roughly three million deaths yearly. This study aimed to investigate the prevalence and factors associated with ST-Segment Elevation Myocardial Infarction and Non-ST Segment Elevation Myocardial Infarction in Iran. METHODS: This cross-sectional study was conducted using the databases of the Fasa Registry on Acute Myocardial Infarction (FaRMI) and the Fasa Adult Cohort Study (FACS). chi-squared and one-way ANOVA tests were utilized to calculate the unadjusted associations between the study variables. A multivariate multinomial logistic regression model was also employed to determine the adjusted association of each independent variable with the risk of ST-elevation myocardial infarction (STEMI). RESULTS: The prevalence of STEMI and non-STEMI was 31.60% and 11.80%, respectively. Multinomial logistic regression showed that older age, anemia, high WBC, and high creatinine levels were associated with higher odds of STEMI and non-STEMI compared to healthy individuals. In addition, based on the analysis being a woman(OR = 0.63,95%CI:0.51-0.78), anemia(OR = 0.67,95%CI:0.54-0.63)and hypertension (OR = 0.80,95%CI:0.65-0.97)decreased the likelihood of STEMI occurrence compared to non-STEMI, while high WBC(OR = 1.19,95%CI:1.15-1.23)increased the odds. CONCLUSION: In this study, significant predictors of MI risk included age, gender, anemia, lipid profile, inflammation, and renal function. Subsequent investigations ought to prioritize the comprehensive understanding of the underlying mechanisms that drive these connections and assess the effectiveness of specific interventions aimed at diminishing the occurrence of MI and improving patient outcomes.

Determinants of multimorbidity in older adults in Iran: a cross-sectional study using latent class analysis on the Bushehr Elderly Health (BEH) program.

BACKGROUND AND OBJECTIVES: Multimorbidity, defined as the presence of two or more long-term health conditions in an individual, is one of the most significant challenges facing health systems worldwide. This study aimed to identify determinants of classes of multimorbidity among older adults in Iran. RESEARCH DESIGN AND METHODS: In a cross-sectional sample of older adults (aged ≥ 60 years) from the second stage of the Bushehr Elderly Health (BEH) program in southern Iran, latent class analysis (LCA) was used to identify patterns of multimorbidity. Multinomial logistic regression was conducted to investigate factors associated with each multimorbidity class, including age, gender, education, household income, physical activity, smoking status, and polypharmacy. RESULTS: In 2,426 study participants (mean age 69 years, 52% female), the overall prevalence of multimorbidity was 80.2%. Among those with multimorbidity, 3 latent classes were identified. These comprised: class 1, individuals with a low burden of multisystem disease (56.9%); class 2, individuals with predominantly cardiovascular-metabolic disorders (25.8%) and class 3, individuals with predominantly cognitive and metabolic disorders (17.1%). Compared with men, women were more likely to belong to class 2 (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.52-2.54) and class 3 (OR 4.52, 95% CI 3.22-6.35). Polypharmacy was associated with membership class 2 (OR 3.52, 95% CI: 2.65-4.68) and class 3 (OR 1.84, 95% CI 1.28-2.63). Smoking was associated with membership in class 3 (OR 1.44, 95% CI 1.01-2.08). Individuals with higher education levels (59%) and higher levels of physical activity (39%) were less likely to belong to class 3 (OR 0.41; 95% CI: 0.28-0.62) and to class 2 (OR 0.61; 95% CI: 0.38-0.97), respectively. Those at older age were less likely to belong to class 2 (OR 0.95). DISCUSSION AND IMPLICATIONS: A large proportion of older adults in Iran have multimorbidity. Female sex, polypharmacy, sedentary lifestyle, and poor education levels were associated with cardiovascular-metabolic multimorbidity and cognitive and metabolic multimorbidity. A greater understanding of the determinants of multimorbidity may lead to strategies to prevent its development.

Mental Health Care Utilization and its Barriers among Iranian Breast Cancer Survivors: A Cross-sectional Study.

Background: Depression and anxiety are common comorbidities complicating the care of breast cancer patients, but many patients do not receive the needed care. We aimed to assess utilization of mental health care and its barriers in breast cancer survivors. Methods: This cross-sectional study was conducted on 311 patients with breast cancer, in Iran, November 2021 to March 2022. Perceived need and utilization of mental health care and barriers to service utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 and Multidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stress as well as social support, respectively. A linear and logistic regression model was used to analyze the data using SPSS version 22. A P-value less than 0.05 was considered statistically significant. Results: 70.1% of the participants perceived need for mental health care, 28.0% of them had used mental health services, and 72% were classified as having unmet needs. The most common perceived barrier to service use was patients' self-adequacy. The prevalence of extremely severe levels of depression, anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients received a high level of social support from friends, family, and significant others. Conclusion: Findings highlight a substantial unmet need for mental health care and low utilization of mental health services among breast cancer survivors. Given the significant prevalence of depression, anxiety, and stress in this population, it is imperative to address the underutilization of mental health services and to further examine the barriers preventing patients from seeking the care they require.

Characteristics of suicide attempts in Northwestern Iran: a five-year population-based survey.

BACKGROUND: Suicide is a serious public health problem in the world. This study aims to describe the characteristics of suicide attempters in North-Western Iran and identify latent classes of suicide attempts. METHODS: This cross-sectional study was conducted in Ardabil Province (Northwest Iran) during 2017-2021 based on a registration system for suicide attempts. We performed latent class analysis (LCA) using a procedure for LCA (PROC LCA) in SAS to investigate the subgroups of suicide attempters based on their characteristics and method, history, and outcome of suicide. RESULTS: Three latent classes were identified for males and females; the first class (non-lethal attempters with lower educational levels) comprised 41.3% of males and 55.4% of females. The second class (non-lethal attempters with higher educational levels) described 52.4% of males and 42.7% of females. Finally, the third class (lethal attempters) included 6.4% of males and 1.9% of females. The main method of suicide attempts was poisoning with medications (87.3%). The results show that only 2.8% of people have a history of suicide attempts. Also, the suicide rate reached 8.26 per 100,000 population in 2021. CONCLUSION: The present study showed an increasing trend of suicide attempt incidence rate in Ardabil Province from 2017 (99.49 per 100,000 population) to 2021 (247.41 per 100,000 population). This means that the rate of change was 147.92 per 100,000 population during the study period. The findings of LCA, stress the necessity of identification and prioritization of unmet needs of people who had an incomplete suicide in Ardabil.

Association between latent profile of dietary intake and cardiovascular diseases (CVDs): Results from Fasa Adults Cohort Study (FACS).

Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Dietary risks account for the most cause of CVDs mortalities. Evaluating overall dietary patterns (through the Latent profile of dietary intake) can provide a more accurate prediction regarding the prevalence of CVDs. The present cross-sectional study aimed to investigate the relationship between the latent profile of dietary intake and CVDs prevalence. The population of the Fasa Adults Cohort Study was employed to gather the data (n = 8319). A modified FFQ was employed to assess eating behaviors. Minerals, as well as the energy intake and total fiber, were measured using Nutritionist IV software (version 7.0). To estimate the prevalence of CVDs, accurate records of patients' histories were made. Individuals were clustered according to their dietary intake using latent profile analysis. The mean age was 48.75 ± 9.59 years, and 53.28% (4430) were women. 63.9% of participants with low Socioeconomic Status (SES) were in the low-intake profile (P < 0.001), and high SES increases the odds of being in the high-intake profile (ORhigh/low = 2.87, 95% CI 2.55-3.24). The low-intake group had the lowest amount of physical activity (Met) (P < 0.001). The result of multivariate logistic regression revealed that categorized in the low-intake group significantly increased the development of CVDs (OR = 1.32, 95% CI 1.07-1.63, P = 0.010). The mean micronutrients and total fiber, in individuals with a low intake profile, were significantly lower than other groups (P < 0.001). Overall, we estimated that a low intake of all food groups increases the odds of developing CVDs significantly.

The association of body composition and fat distribution with hypertension in community-dwelling older adults: the Bushehr Elderly Health (BEH) program.

BACKGROUND: A significant proportion of the global burden of disability and premature mortality has caused by hypertension. It seems that the relationship between obesity and hypertension is not only associated with excessive body fat mass (FM) but also with body adipose distribution patterns. The present study investigated the association between regional fat distribution using dual-energy X-ray absorptiometry and hypertension in older adults. METHODS: This cross-sectional study was performed using the data from Bushehr Elderly Health Program (BEH) on a total of 2419 participants aged 60 and over. Hypertension was defined as SBP of at least 140 mmHg and/or DBP of at least 90 mmHg. SBP between 120 and 139 mmHg and/or a DBP between 80 and 89 mmHg were considered prehypertension. Participants underwent body composition measurement by dual-energy x-ray absorptiometry to analyze FM, fat-free mass (FFM) in trunk and extremities composition. RESULTS: The results showed that 460 (19.02%) of participants had prehypertension, and 1,818 (75.15% ) had hypertension. The odds of having prehypertension (OR: 1.06, 95%CI: 1.01-1.12) and hypertension (OR: 1.08, 95%CI: 1.03-1.13) increased with a rise in total body FM percentage. Moreover, people with a higher FM to FFM ratio had increased odds of being prehypertensive (OR: 9.93, 95%CI: 1.28-76.99) and hypertensive (OR: 16.15, 95%CI: 2.47-105.52). Having a higher android to gynoid FM ratio was related to increased odds of being prehypertensive and hypertensive. CONCLUSIONS: This study showed that a higher body FM, particularly in the android region, is associated with higher odds of having hypertension in older adults.

Predictive value of triglycerides to high-density lipoprotein cholesterol and triglyceride glycemic index for diabetes incidence in pre-diabetes patients: a prospective cohort study.

BACKGROUND: The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. METHODS: A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. RESULTS: During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05). CONCLUSION: The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.

Lactational Exposure of Human Infants to Metal (loid)s: A Comparison of Industrial and Urban Inhabitants in North of the Persian Gulf.

In this study, postnatal metal (loid)s (MLs) exposure was compared between the petrochemical and gas area of Asaluyeh (PGA) and urban area of Kaki (UA) in Bushehr province, Iran. Two hundred human breast milk (BM) samples from the industrial and urban areas were analyzed for MLs using Inductivity Coupled Plasma-Optical Emission Spectrometry (ICP-OES). Boron (B), copper (Cu), iron (Fe), and nickel (Ni) were found at the highest levels in both study areas. Adjusted multiple linear regression models revealed that the mean concentration of total MLs in BM samples collected from the PGA was statistically significantly greater than that of the UA (655.85 vs. 338.17 µg/L). Also, the mean concentrations of all detected MLs in BM samples collected from the PGA were statistically significantly higher than those collected from the UA. The hazard index (HI) of combined MLs in the PGA and UA illustrated non-cancer risk for infants. Lead (Pb) and chromium (Cr) in the PGA and Cr in the UA showed the risk of cancer. So it can be concluded that nursing infants from an industrial area are most at risk for MLs exposure during entire lactation course than those from an urban area.

Association between inter-arm blood pressure difference and cardiovascular disease: result from baseline Fasa Adults Cohort Study.

The inter-arm blood pressure difference has been advocated to be associated with cardiovascular mortality and morbidity. Our study aimed to investigate the association between Inter-arm systolic and diastolic blood pressure differences and Cardio Vascular Disease (CVD). A total of 10,126 participants aged 35-70 years old were enrolled in a prospective Fasa Persian Adult Cohort. In this cross-sectional study, the cutoff values for inter-arm blood pressure difference were less than 5, greater than 5, greater than 10, and greater than 15 mm Hg. Descriptive statistics and logistic regression were used to analyze the data. Based on the results the prevalence of ≥ 15 mmHg inter-arm systolic and diastole blood pressure difference (inter-arm SBPD and inter-arm DBPD) were 8.08% and 2.61%. The results of logistic regression analysis showed that inter-arm SBPD ≥ 15 and (OR<5/≥15 = 1.412; 95%CI = 1.099-1.814) and inter-arm DBPD ≥ 10 (OR<5/≥10 = 1.518; 95%CI = 1.238-1.862) affected the risk of CVD. The results showed that the differences in BP between the arms had a strong positive relationship with CVD. Therefore, inter-arm blood pressure could be considered a marker for the prevention and diagnosis of CVD for physicians.

A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

Bone mineral density status in patients with recent-onset rheumatoid arthritis.

Background: Osteoporosis is a sizable comorbidity complication in Rheumatoid Arthritis (RA) sufferers. In the current study, the prevalence of osteopenia and osteoporosis in active RA sufferers and the association of disease-related factors of osteoporosis and reduced bone mineral density (BMD) have been examined. Methods: In this cross-sectional study, 300 new-onset symptoms (less than one year) RA patients without a history of glucocorticoids or DMARDs were selected. Biochemical blood measurements and BMD status were performed with dual-energy X-ray absorptiometry. According to the T-scores of the patients, they were divided into three groups: osteoporosis<-2.5, -2.5 < osteopenia <-1, and - 1 < normal. Also, the MDHAQ questionnaire, DAS-28, and FRAX criteria were calculated for all patients. Multivariate logistic regression was used to determine the associated factors of osteoporosis and osteopenia. Results: The Prevalence of osteoporosis and osteopenia was 27% (95%CI:22-32) and 45% (95%CI:39-51), respectively. The multivariate regression analysis showed that age could play a role as an associated factor for spine/hip Osteoporosis and Osteopenia. The female gender is also a predictor of Spine osteopenia Patients with Total hip Osteoporosis were more likely to have higher DAS-28 (OR 1.86, CI 1.16-3.14) and positive CRP (OR 11.42, CI 2.65-63.26). Conclusion: recent-onset RA patients are at risk for osteoporosis and its complications, regardless of using glucocorticoids or DMARDs. Demographic factors (e.g. age and female gender), patients' MDHAQ scores, and disease-related factors(e.g., DAS-28, positive CRP were associated with reduced BMD levels. Therefore, it is recommended that clinicians investigate early BMD measurements to have a reasonable judgment for further interventions. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01200-w.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

AIM: Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. DESIGN: This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. METHOD: By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. RESULTS: A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

The influence of home and environmental characteristics on 5-18 years old children's health during the COVID-19 pandemic: A cross-sectional study in Iran.

Background: The coronavirus disease (COVID-19) pandemic has dramatically changed the health and wellbeing of children. Therefore, this study aimed to investigate the relationship between the home environment and the environmental characteristics on 5-18 years old children health in Iran. Method: An online survey was conducted among parents of children aged 5 to 18 living in large cities in Iran in 2021. The statistical population of this cross-sectional study was 500 people. In this survey, questionnaires on the quality of the home environment, exterior and interior landscapes of homes, and the Child Health Questionnaire (CHQ) were used to investigate the relationship between the home environment and environmental characteristics on 5-18 years old children health during the COVID-19 pandemic. The t-test and analysis of variance were used in SPSS 24, and the structural equation modeling (SEM) was utilized in AMOS 24 for analyzing the data. Results: The average age of respondents was 37.13 ± 7.20, and that of children was 11.57 ± 3.47. 73.02% of the families were covered by insurance, and 74.08% of them lived in the metropolis. In addition, 65.04% of the families complied with the restrictions of the quarantine period. A share of 31% of the families live in villas, and 55% paid more attention to cleaning their homes during the COVID-19 pandemic than before. A positive and significant statistical relationship (ß = 0.414, p < 0.001) was observed between the residence environment and child health. Thus, explained 17.5% of variations in child health. Conclusion: The results showed that the children who lived in homes with an exterior landscape in nature had better health. In addition, the 5-18 years old children whose home landscape was a garden, compared to the other two groups (yard, balcony), had better health. Gardens are a potential source of health and not necessarily replaced by other natural environments, thus providing them along with green space is one of the crucial issues that should be considered.

Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study.

Introduction: A major shift in the routes of HIV transmission seams to be taking place in Iran. Our study aimed to investigate the 30-year trend of major HIV related behaviors in Iran. Methods: The national HIV/AIDS registry database (from September 1986 to July 2016 with data on 32,168 people newly diagnosed with HIV) was used to study the 30 years trend and demographic determinants of major HIV related behaviors. Results: The highest rate of drug injection (DI) among people living with HIV (PLHIV) was reported during 1996 to 1999 (p-for trend < 0.001) while the highest rate of sexual activity by minorities or hard to reach groups was during 2004 to 2011 (p-for trend < 0.001). Among males, drug injection was directly associated with being single (ORsingle/married = 1.34), being unemployed (ORunemployed/employed = 1.94) and having lower level of education (OR

Food insecurity status and its contributing factors in slums' dwellers of southwest Iran, 2021: a cross-sectional study.

BACKGROUND: One major factor causing food insecurity is believed to be poverty. Approximately 20 million Iranians live in slums with a vulnerable socioeconomic context. The outbreak of COVID-19, on top of the economic sanctions against Iran, has increased this vulnerability and made its inhabitants prone to food insecurity. The current study investigates food insecurity and its associated socioeconomic factors among slum residents of Shiraz, southwest Iran. METHODS: Random cluster sampling was used to select the participants in this cross-sectional study. The heads of the households completed the validated Household Food Insecurity Access Scale questionnaire to assess food insecurity. Univariate analysis was utilized to calculate the unadjusted associations between the study variables. Moreover, a multiple logistic regression model was employed to determine the adjusted association of each independent variable with the food insecurity risk. RESULTS: Among the 1227 households, the prevalence of food insecurity was 87.20%, with 53.87% experiencing moderate and 33.33% experiencing severe food insecurity. A significant relationship was observed between socioeconomic status and food insecurity, indicating that people with low socioeconomic status are more prone to food insecurity (P < 0.001). CONCLUSIONS: The current study revealed that food insecurity is highly prevalent in slum areas of southwest Iran. The socioeconomic status of households was the most important determinant of food insecurity among them. Noticeably, the coincidence of the COVID-19 pandemic with the economic crisis in Iran has amplified the poverty and food insecurity cycle. Hence, the government should consider equity-based interventions to reduce poverty and its related outcomes on food security. Furthermore, NGOs, charities, and governmental organizations should focus on local community-oriented programs to make basic food baskets available for the most vulnerable households.

Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students: A meta-analysis and systematic review.

Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07-32.49), 20.84 (16.01-25.66), and 16.36 (11.86-20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.

A comparative monitoring of maternal and cord serum polychlorinated biphenyls levels from Iranian pregnant women between industrial and urban areas.

The aim of this study was to compare maternal and fetal exposure to PCBs in pregnant women from a petrochemical and gas area (PGA) and an urban area (UA), by the analyses of serum samples from mother (MS) and cord (CS). After liquid-liquid extracting, samples were analyzed for 12 PCBs congeners by gas chromatography mass spectrometer. Adjusted multiple linear regression models showed the mean levels (µg/L) of total PCBs in the MS and CS samples from the PGA (1.70 ± 0.81 and 1.19 ± 0.43) were significantly higher than those from UA (1.64 ± 0.75 and 1.07 ± 0.38). PCB 44 was predominant in both MS and CS serum samples, and in both PGA (0.80 ± 0.70 and 0.76 ± 0.67) and UA (0.79 ± 0.39 and 0.67 ± 0.34). A negative correlation was found for PCB 52 as one-unit increase in the cord serum levels was associated with 0.024 g decrease in newborn weight. Similarly, one-unit increase in the maternal serum PCB 18 concentrations were associated with 0.09 and 0.086 cm decrease in newborn height and head circumference. The serum levels of PCB 18 and 52 in the mothers who consumed meat and milk at least 1 meal/week were higher than these who consumed meat and milk never or less than 1 meal/month. The findings in this study indicated that higher maternal exposure to PCBs, as result of living in an industrialized area, leads to higher PCBs accumulation in cord blood, which consequently passes to the developing fetus. These events may cause harmful effects on both them in-utero and afterbirth growth and development.

Multiple Substance Use Patterns and Its Relationship with Imprisonment in a High-Risk Group of Iranian Adults.

BACKGROUND: Substance use is recognized as an important factor associated with many diseases and premature deaths and the main risk factor for disability worldwide. This study aims to identify subgroups of substance use in adults and detect the effect of imprisonment on the membership of participants in latent classes of substance use. Study Design: A cross-sectional study. METHODS: This study was performed on 930 adult people who were referred to behavioral health counseling centers in Tehran province. All participants completed some checklists and questionnaires. Data analysis was performed using chi-square, Fisher's exact test, and latent class analysis (LCA). RESULTS: Four latent classes were identified, including non-users (58%), cigarette smokers (11.6%), users of low stigma substances (27.4%), and drug users (3.1%). After adjusting for other studied variables, having a history of imprisonment increased the odds of membership in the cigarette smoker class (Odds ratio [OR]=5.82, 95%, confidence interval [CI]: 3.19-10.63) and drug user class (OR=53.59, 95% CI: 18.00- 159.52) compared to non-user class. Among all participants, 84 (9.0%) had a history of imprisonment. CONCLUSION: Results from the present study indicate that 30.5% of the participants fell under the user of the low-stigma substance or drug user group. Focusing on increasing prisoner's knowledge of the dangers of using different substances and considering various programs for prisoners' leisure time may help reduce substance use prevalence.

Survival Rate of Liver Transplantation in Asia: A Systematic Review and Meta-Analysis.

Background: Liver transplantation is one of the most effective treatments for acute liver failure, chronic liver cirrhosis, and hepatocellular carcinoma. This study was implemented to evaluate the survival rate of liver transplant in Asia. Methods: Studies that investigated the survival rate of liver transplant were selected using a systematic search strategy in the following databases: Medline, Embase, Scopus, ProQuest, ISI Web of Science, and Cochrane to Nov 30th, 2020. Pooled survival rate and 95% confidence intervals were calculated using Der-Simonian and Laird method. Stata 16.0 (Stata Corp, College Station, TX, USA) was used for analysis. Results: One, 2, 3, 5, and 10-year survival rates of liver transplant were estimated to be 85%, 80%, 75%, 73%, and 71%, respectively. The results of the univariate meta-regression for defining the sources of heterogeneity for one-Year survival rate (SR) showed significant effects of bias (ß high risk/moderate risk =0.059, 95% CI: 0.002, 0.115, P-Value=0.04) and follow up time (ß= -0.0002, 95% CI: -0.0003, -0.00, P-Value=0.02) on heterogeneity. Conclusion: The survival rate of liver transplant in Asia is comparable with the corresponding rate reported in the United States and Europe. This study provides a better view of the efficiency of medical cares, regarding liver transplantation. Medical care be enhanced to increase the survival of liver transplant patients.