Evaluation of urinary trace element levels in patients with opioid use disorder undergoing methadone treatment in western Iran.

The monitoring of essential and toxic elements in patients with Opioid Use Disorder (OUD) undergoing methadone treatment (MT) is important, and there is limited previous research on the urinary levels of these elements in MT patients. Therefore, the present study aimed to analyze certain elements in the context of methadone treatment compared to a healthy group. In this study, patients with opioid use disorder undergoing MT (n = 67) were compared with a healthy group of companions (n = 62) in terms of urinary concentrations of some essential elements (selenium (Se), zinc (Zn), copper (Cu), iron (Fe), manganese (Mn), calcium (Ca)) and toxic elements (lead (Pb), cadmium (Cd), arsenic (As), and chromium (Cr)). Urine samples were prepared using the acid digestion method with a mixture of nitric acid and perchloric acid and assessed using the ICP-MS method. Our results showed that the two groups had no significant differences in terms of gender, education level, occupation, and smoking status. Urinary concentrations of Se, Cu, and Fe levels were significantly lower in the MT group compared to the healthy subjects. However, the concentrations of Pb, Cd, As, Mn, Cr, and Ca in the MT group were higher than in the healthy group (p < 0.05). No significant difference was established between the levels of Zn in the two groups (p = 0.232). The results of regression analysis revealed that the differences between the concentration levels of all metals (except Zn) between two groups were still remained significant after adjusting for all variables (p < 0.05). The data obtained in the current study showed lower urinary concentrations of some essential elements and higher levels of some toxic elements in the MT group compared to the healthy subjects. These findings should be incorporated into harm-reduction interventions.

The effects of active and passive smoking on selected trace element levels in human milk.

Our study aimed to compare levels of six micro-elements and six potentially toxic elements in the breast milk of non-smoking women compared to those found in women who smoke tobacco and women exposed to second-hand smoke during pregnancy and lactation. This was a cross-sectional study conducted on 100 lactating women in western Iran. The studied subjects were in three groups: passive smokers, active smokers, and a control group. Concentrations of selected trace elements in breast milk (essential and non-essential metals) were determined using ICP-MS. Our results indicated that the parameters of education, fruit consumption, and cosmetics usage had a significant difference among the groups (p < 0.05). Moreover, for trace elements, the Kruskal-Wallis test was statistically significant for arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) (p < 0.05). The post hoc Dunn test revealed a significant difference in the levels of As, Cd, Hg, and Pb between non-smoker and passive/active smoker groups (p < 0.05). Our findings illustrate that exposure to cigarette smoke can cause an increase in the level of potentially toxic elements in human milk, which is dangerous for the consumption of premature newborns, but more research is needed to evaluate the potential toxic mechanisms of toxic metals.

Human health risk assessment of potentially toxic elements in the breast milk consumed by infants in Western Iran.

This study aimed to assess the human health risk of some toxic metals/metalloids [lead (Pb), mercury (Hg), cadmium (Cd), nickel (Ni), chromium (Cr), and arsenic (As)] on infants via consumption of the breast milk of women living in urban areas of Kermanshah city, west of Iran. After collecting milk samples, the carcinogenic and non-carcinogenic risk assessment as well as uncertainty analysis of toxic metal levels were carried out. The order of concentration of heavy metals/metalloids in the breast milk samples was Cr (41.07 ± 23.19) > Ni (19.25 ± 11.81) > Pb (11.5 ± 4.48) > As (1.96 ± 2.04) > Cd (.72 ± 0.42) > Hg (0.31 ± 0.26). The results revealed that the levels of Cr and Pb in the breast milk samples were exceeded the World Health Organization (WHO) tolerable daily intake. In the breast milk samples a high levels of one of the trace elements As, Cd, Cr, Pb, and Ni were observed (over 73%) and in 40% of them the levels of Cr, Pb, Cd, As, and Ni were all above WHO tolerable daily intake. Moreover, the As-related point assessment of target risk factor (THQ) was higher than the allowable limit only for 1-month-old male neonates and 2-month-old female neonates (THQ > 1). In addition, Cr-related THQ scores were higher at all age and gender groups (THQ > 1). In conclusion, our findings suggest a potential risk of some metals for infants via the consumption of mothers' breast milk.

Evaluation of some toxic metals in breast milk samples with dietary and sociodemographic characteristics: a case study of Kermanshah, Western Iran.

This study aimed to investigate the concentration of some toxic metals (gold (Au), cadmium (Cd), chromium (Cr), mercury (Hg), nickel (Ni), lead (Pb), tin (Sn), and vanadium (V)) and arsenic (As) in breast milk based on demographic characteristics and the diet of mothers. In this cross-sectional study, 100 lactating mothers from Kermanshah, Western Iran, were included. The mean age of the participants was 29.5 (ranging from 16 to 43 years) with a mean BMI of 26.9 (± 3.81) kg (range: 17.0-39.1). The results of the pairwise correlation coefficient of trace elements illustrated that correlation was mostly positive and weak to moderate. A few exceptions of strong correlations were Cr-Ni (r = 0.82), Au-As (r = 0.64), Cr-V (r = 0.64), and Ni-V (r = 0.58). Moreover, results indicated that BMI (p = 0.008), cooking oil (0.042), and potato intake (p = 0.010) affected the trace element levels significantly. The concentrations of V (p = 0.044), Sn (p = 0.036), Au (p < 0.001), and As (p < 0.001) in the breast milk of women was affected by the BMI. The results of univariate linear regression analysis showed that the concentration of Pb in the milk of mothers who use cosmetics was significant (p < 0.05). Since the lifestyle of lactating women, such as cosmetics usage can impact the content of some elements in breast milk, they should be educated in this part.

Blood lead concentrations in children with iron deficiency anemia: a systematic review and meta-analysis.

Iron deficiency is the most common nutritional disorder detrimental to the behavior, cognitive performance, immune system, and physical growth of infants and preschool- and school-age children. Iron deficiency anemia (IDA) increases children's susceptibility to some metals, including the highly toxic lead (Pb), but the character of this relationship is still disputed. Thus, this study aimed to review and meta-analyze the association between the IDA and blood lead levels (BLL) among children, based on papers indexed by international scientific databases and published up to September 2021. A search was performed of the literature in several databases including the ISI Web of Science, PubMed, and Scopus. The final papers were assessed concerning their quality based on the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Moreover, analyses were performed using R statistical software with the "meta" package. Of the 1528 articles found, only 12 studies met the inclusion criteria and were considered in the meta-analysis. Significantly higher BLL in IDA children (SMD = 2.40; CI 95%, 0.93-3.87 µg/L; p = 0.0014) was seen when compared to non-IDA children. Moreover, the pooled OR is equal to 2.75 (CI 95%, 1.10-6.85 µg/L; p = 0.0303) suggesting a higher risk of IDA development among children with BLL > 10 µg/dL. Thus, we recommend systematic monitoring of Fe and Pb levels among children, especially in countries with limited sources of nutritious food. Since only a few studies were available for this meta-analysis, further studies are necessary to examine the association between IDA and BLL in detail.

Metal Risk Assessment Study of Canned Fish Available on the Iranian Market.

Iran is the largest fishery producer in the region reaching nearly 1 million tons. Fish provide a good many nutrients that are beneficial for our health. Due to significant deposits of xenobiotics in the water environments, however, fish may also be a source of non-essential metals, causing a variety of disorders. The main challenges to Iranian fisheries are environmental pollution and quality control, so this study aims to estimate the concentration of cadmium (Cd), mercury (Hg), nickel (Ni), and lead (Pb) in canned tuna fish produced and consumed in Iran. We studied four popular brands (N = 4 × 20) with ICP-MS and then looked at the concentrations and calculated the risk assessment parameters. We found that the lowest concentration was observed for Cd (18 µg/kg) and the highest for Ni (132 µg/kg). Among the brands studied, Pb concentrations differed most (42.0 to 113.3 µg/kg) and Hg levels were more consistent (24.0 and 39.4 µg/kg). The concentrations of Cd, Hg, and Pb in all the brands tested were below EU permissible thresholds. The intake estimation risk assessment parameters (EDI, contribution to PTWI, and CR) and non-cancer risk assessment parameters based on reference doses (THQ and HI) demonstrated the safety of tested products in respect to all metal concentrations studied, while the parameters regarding the toxic effects (MoE, and ILCR) showed that the consumption might cause health risks in terms of Cd (ILCR), Ni (ILCR), and Pb (MoE). The consumption of the canned fish studied should therefore be maintained at a reasonable level (2-5 meals containing fish weekly), so that it may provide necessary nutrients, while avoiding the health risk due to metal content.

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers.

BACKGROUND: Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017-2018. METHODS: This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results. RESULTS: The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001). CONCLUSIONS: The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women.

The effect of educational intervention based on dramatic literature on parents of elementary schoolchildren skills in sex education.

BACKGROUND: Today, one of the biggest concerns of parents is protecting their children and properly educating them about sex. The aim of this study was to determine the effect of educational intervention on parental skills in sex education on their children in elementary schools in the northwest of Tehran-Iran in 2019 based on literature. MATERIALS AND METHODS: This quasi-experimental study was conducted on 125 parents of elementary schoolchildren in the northwestern of Tehran. The data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled up the pretest questionnaire; the data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled the pretest questionnaire, and then the parents participated in the educational program based on dramatic literature. Two months later, the same questionnaire was completed by the control and intervention groups. Finally, the data were analyzed by regression and one-way ANOVA test. RESULTS: The results showed that there was a statistically significant difference between the mean scores of knowledge in the experimental and control groups in the posttest (P < 0.01). There was also a statistically significant difference between the mean scores of attitude in the experimental and control groups at the posttest stage (P < 0.01). There was also a statistically significant difference between the mean scores of performance based on group membership (experimental group and control group) in the posttest phase (P < 0.01). CONCLUSIONS: The findings of the study showed that educational intervention on parental skills in sex education based on the dramatic literature to their children has significant effect on parental knowledge, attitude, and performance.

Urinary Metal Levels with Relation to Age, Occupation, and Smoking Habits of Male Inhabitants of Eastern Iran.

In low-income and middle-income countries such as Iran, smoking is becoming increasingly popular, especially among young people. This has led to additional exposure to a variety of substances, including metals which may exert a toxic influence and lead to severe diseases. In order to evaluate the influence of smoking on metal concentrations, a case-control study of levels of metal in urine was carried out in smokers (n = 64) and non-smokers (n = 35) from the city of Birjand (Iran). They were divided according to their age and socioeconomic status. Concentrations of cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), and zinc (Zn) were measured using ET-AAS. We found higher concentrations of Cd (0.03 vs. 0.12 µg/L), Co (0.6 vs. 1.22 µg/L), and Cr (14.00 vs. 18.17 µg/L) in the urine of smokers. Age and occupation are factors that also influence the levels of metals. Young smokers demonstrate higher Cd and Pb levels than other age groups. It would also appear that public sector workers and self-employed are the sectors most susceptible to high levels of metals.

Thyroid dysfunction: how concentration of toxic and essential elements contribute to risk of hypothyroidism, hyperthyroidism, and thyroid cancer.

This study was conducted to evaluate the levels of trace metals Fe, Cr, Co, Cd, Cu, Ni, Hg, Zn, and Pb in healthy individuals and patients with thyroid disease (hyperthyroidism, hypothyroidism, and cancerous). The serum levels of 110 participants living in Birjand City, east of Iran, were collected and analyzed using ICP-MS (Agilent 7900). Results showed that the concentration levels of Cr, Co, Zn, Cd, and Pb were significantly higher at case-patients (p < 0.05), but the levels of Fe, Ni, and Hg were similar between healthy and patient subjects (p > 0.05). In patients with high or low thyroid activity, strong mutual correlations between Cr, Ni, and Fe were noticeable (p < 0.05). In hypothyroid patients, no significant correlation between Zn and Hg, Co, and Cd was found, but Zn was moderately and positively correlated with other trace metals. The moderate negative correlations between Cd-Cr (p = - 0.46) and Cd-Fe (p = - 0.43) were also observed. Logistic regression analysis showed that the effect of Cr, Co, Pb, Cu, Zn, and Cd was significant in developing hyperthyroidism and hypothyroidism; whereas, in patients with thyroid cancer, the effect of Cr, Cd, and Pb was found to be significant. In conclusion, our findings suggest that toxic metals such as Pb, Cd, and Cr can increase the risk of developing hypothyroidism and thyroid cancer, but more research is needed to evaluate the potential toxicity mechanisms of Pb, Cd, and Cr.

Biomonitorization of metal ions in the serum of Iranian patients treated with fixed orthodontic appliances in comparison with controls in eastern Iran.

The present study aimed to assess the level of metal ions [chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn)] in the serum of patients with fixed orthodontic appliances. One hundred samples (32 males, 68 females) were collected from patients undergoing fixed orthodontic treatment for different periods. A reference (control) group (24 males, 16 females) who had no appliances was used to properly evaluate the changes in the level of these elements in orthodontic appliance users. The element concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). Higher concentrations of metal ions (except for Cr) were found in the serum of the orthodontic group. Bivariate scatter plot showed a highly significant (p < 0.001) correlation between Ni and other elements. The duration of orthodontic treatment increased significantly the Ni levels whereas the bracket type was found to have no significant impact on altering the concentration level of metal ions. The results of the SEM-EDS showed a high variation in the level of metal ions in the brackets and wires. In conclusion, fixed orthodontic appliances increased serum levels of Ni, Zn, Mn, Fe, and Cu but did not change Cr levels.

Obesity consequences from the people's perspective living in Kurdish regions of Iran: A qualitative content analysis.

BACKGROUND: Overweight and obesity are one of the most public health problems in the world. Considering obesity prevalence and its widespread health, economic, psychological, and social consequences, this study aimed to explain the consequences of obesity among women and men in the Kurdish region of Mukryan. SUBJECTS AND METHODS: The present qualitative study was conducted in the Mukryan Kurdish region in West Azerbaijan province in Iran from June 2017 to November 2017. Data were collected by deep interview, focus group and dialogue with 111 obese and thin men and women and various fields experts who were selected by purposive sampling, and analyzed by qualitative content analysis technique of conventional type and Graneheim and Lundman steps. RESULTS: Data analysis results were classified into two categories and 12 subcategories: Favorable consequences of normal obesity (social acceptance, internalization of obesity, and reproduction of the family institution), unfavorable consequences of extreme obesity (decreasing agency, physical-psychological dysfunctionalities, family fragility, prevalence of passive leisure, clothing obligation, social objectivity, exogenous and endogenous social exclusion, imposing economic costs, and devaluation of life). CONCLUSION: With due attention to unfavorable consequences of extreme obesity on health, illness, social issues and costs, simultaneously with the adoption of preventive approaches to obesity through targeted policies in education, health literacy, promotion of sport culture, development of sports context especially for women, improving recreational facilities, etc., appropriate planning and interventions should be designed and applied for changing the behavior, culture, and community beliefs in dealing with obesity phenomenon.

Toxicological effects of transition metal-doped titanium dioxide nanoparticles on goldfish (Carassius auratus) and common carp (Cyprinus carpio).

The aim of present study was to assess the toxicological effects of transition metal-doped titanium dioxide nanoparticles (TiO2 NPs) on histopathological changes, behavioral patterns, and antioxidant responses of goldfish (Carassius auratus) and common carp (Cyprinus carpio). The synthesized nanoparticles were confirmed by Transmission Electron Microscopy, Field Emission Scanning Electron Microscopy, X-ray diffraction, UV-visible, and Vibration Sample Magnetometer. Fish in four experimental groups exposed to sub-lethal concentrations of pure TiO2 NPs (10 mg L-1), chromium (Cr), iron (Fe), and nickel (Ni) doped TiO2 NPs for seven days. Statistical analysis of oxidative stress responses in gills showed significant differences in superoxide dismutase, total antioxidant capacity, and malondialdehyde parameters between two species and in all parameters than glutathione peroxidase between experimental groups and control group. In intestine, no significant difference was observed among groups, but oxidative responses were markedly different in all parameters among fish species. The histopathological analysis showed hyperplasia, fusion, and aneurism in the gills as well as degeneration, integration of villi, necrosis and erosion of the intestine. Our findings indicated that compare to pure TiO2 NPs, exposure to transition metals-doped TiO2 NPs induced oxidative stress and histopathological changes in both fish species.

Aloysia citriodora Palau (lemon verbena) for insomnia patients: A randomized, double-blind, placebo-controlled clinical trial of efficacy and safety.

Aloysia citriodora (A. citriodora) has a long history of traditional use for sedation and treatment of insomnia in different societies. This study was carried out to assess the efficacy of A. citriodora in patients with insomnia. One hundred patients were randomly divided into two groups of A. citriodora (total essential oil 1.66 mg/10 ml and total amount of flavonoid in terms of quercetin 3.22 mg/10 ml of the syrup) and placebo. They were advised to use 10 cc of the syrups; an hour before the bedtime for a period of 4 weeks. Participants were assessed using Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires at the baseline and then 2 and 4 weeks after the enrollment. Mean scores of global PSQI and its four components including sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality and also ISI score in the A. citriodora group improved significantly after 4 weeks of treatment when compared with the placebo group (p < 0.001, for all of them). Also, improvement of global score of PSQI and ISI was observed in the intervention group as compared with the placebo group, 2 weeks after the enrollment (p < 0.001). The results of this study showed that oral intake of A. citriodora can be suggested as a complementary treatment for patients with insomnia.

Sexual Risk Behaviors and Condom Use Barriers in Iranian Men with Substance Use Disorders.

BACKGROUND: We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs). METHODS: Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis. FINDINGS: The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participants' education and marital status (P < 0.001). Only the partner barrier subscale had a significant negative relationship (P = 0.003) with RSB. CONCLUSION: Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.

Seroprevalence of Varicella zoster virus antibody among young women before marriage in Sanandaj, Iran.

BACKGROUND AND OBJECTIVES: Varicella Zoster Virus (VZV) infection in pregnant women can cause complications for the mother and fetus. The aim of this study was to assess the immunity against VZV among young women before marriage. MATERIALS AND METHODS: In this cross-sectional study 250 women attending health centers in Sanandaj, Iran, for pre-marital medical check-up were randomly selected. The VZV IgG measured by ELISA and demographic characteristics of participants including their age, place of residence, number of siblings, occupation, education and history of chickenpox were also recorded. Data were analyzed using R statistical software. Association between VZV infection and participants' characteristics was assessed using Chi-square and Fisher's exact tests. RESULTS: Out of 250 participants, 178 individuals (71.2%) diagnosed as antibody positive and 72 (28.8%) negative. Our findings revealed that the immunity against VZV increased with individuals' age (P<0.0001) and their number of siblings (P= 0.03). Significant association was found between history of chickenpox and immunity (P <0.001). Positive and negative predictive values of self-reported history of chickenpox obtained by 94.60% and 49.25%, respectively. CONCLUSION: A notable percentage of women were found to be susceptible to VZV, hence they are at risk of getting infected during pregnancy which in turn may result in fetus abnormalities. Screening the immunity and further studies on the need of vaccination before marriage are recommended.

Estimation of a single motor unit's threshold and activation range, a study on patients with muscular disorders.

BACKGROUND: In clinical neurophysiology, threshold tracking studies are used to evaluate the functionality of a muscle through studying the functionality of its motor units (MUs) that govern the muscle. The functionality of an MU can be quantified by estimation of its excitability properties via MU's stimulus-response curve. In this study, we aim to develop a model-based approach to estimate MU's threshold mean and its activation range as indications of MU's excitability. This is a different approach from routine strategies in neurophysiology, which are mostly subjective. METHODS: To assess the excitability of a single MU, needle electromyography examination was used to obtain the axonal activity of that MU. To improve estimation, the examination was repeated several times on individuals. Replication of experiment introduces serial correlation between observations. We account for this correlation by using a mixed-effects model. We investigate the appropriateness of classical logistic mixed-effects model and its Bayesian formulation for estimation purpose. RESULTS: Both classical and Bayesian models can obtain a reliable estimation of MU's threshold. However, we found Bayesian approach to provide a better estimate of MU's activation range. Moreover, if data contain outliers both classical and Bayesian methods are vulnerable to some extent. CONCLUSIONS: Compared to the classical approach, Bayesian method is more flexible in dealing with overdispersion and provides more robust estimation of MU's parameters.

Comparison of metal concentrations in the organs of two fish species from the Zabol Chahnimeh reservoirs, Iran.

This study was conducted to measure the Cd, Pb, Cu, Zn, Cr, Co, Ni, and Fe concentrations in organs of Cyprinus carpio and Hypophthalmichthys molitrix, in Zabol Chahnimeh reservoirs, Iran. The highest Pb, Cu, Co, Ni, and Fe concentrations in both fish species were observed in the gill of C. carpio at 0.70, 3.7, 0.7, 0.8 and 31.2 µg/g, respectively; while the highest concentrations of Cd, Zn, and Cr were found in the gill of H. molitrix at 0.13, 22.5, and 0.5 µg/g, respectively. The maximum allowable fish consumption rate for an adult person (71.5 kg body weight) were 10.64, 0.677, 0.558, 1.17, and 0.92 kg/day based on Cd, Cu, Cr, Zn, and Fe levels respectively. Results showed that the Cd, Cu, Zn, and Pb (except of Pb in H. molitrix) concentrations in the muscle of both fish species are below levels of concern for human consumption.