Undesirable Knowledge and Practice of Mothers about Under 2 Years Old Children Nutrition are Related to Socio- Economic Factors in Shiraz, Southern Iran

Background: The assessment of mother's knowledge and practice about child nutritional requirement is important in identification of the education needs. This research was conducted to assess the knowledge and practice of mothers about nutrition of children under 2 years of age and its relationship with socioeconomic factors in Shiraz health care centers, southern Iran. Methods: In this descriptive-analytic cross-sectional study, 201 mothers with at list one under 2 years old child were selected by systematic random sampling from health centers in Shiraz, southern Iran. Knowledge and practice of mothers about the type and time of providing supplementary foods for the infants were assessed using a validated questionnaire via face to face interview. Also demographic and socioeconomic information were asked. Pearson correlation coefficient and ANOVA tests were used for data analysis. All analyses were performed using SPSS version 19. Results: According to the findings of this study, 11.4% of mothers had a low level of knowledge and 29.4% of them had a desirable practice. We observed significant relationship between knowledge and job (P=0.002) and level of education ( P<0.001), also between practice and job (P=0.01) and level of education (P=0.046). we observed that mother's knowledge has significant positive correlation with mother's practice (r=0.6, P=0.001) Conclusion: Since the knowledge of high percentage of mothers was moderate, and a high percentage of them had undesirable practice, continuing overall effort to increase mother's nutritional knowledge and practice in order to prevention of infants malnutrition seems to be necessary

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Diet Quality of Adolescents in Shiraz, Southern Iran Needs Moderate to Severe Improvement

Background: The importance of healthy eating habits increases in adolescence therefore, healthy eating index (HEI) and diet diversity score (DDS) are embedded in order to evaluate them. This study was undertaken to assess the diet quality of high school students in Shiraz,southern Iran. Methods: This cross-sectional study enrolled 696, fourteen to twenty years old teenage boys and girls in Shiraz, southern Iran. Anthropometric indices including weight, height and waist circumference (WC) were measured. A 168-item food frequency questionnaire (FFQ) was used to estimate usual dietary intakes, then HEI and DDS were calculated. Two physical activity questionnaires, one related to sitting activities and another about other activities were completed by participants. Results: Among 341 boys and 355 girls, 51.4%, 31.2% and 17.4% had were normal, underweight, and overweight or obese, respectively. Mean WC of participants was 71.7±10.71 cm. The mean of HEI score was 57.6±6.8. Only 0.2% of students had a good diet. The mean of DD Score was 6.4±1.3. About 23.5% of participants had highly diverse diet. A statistically significant higher HEI score (girls: 58.8±7.0, boys: 56.4±6.4) and lower DDS score (6.7±1.3 vs 6.1±1.2) were noticed in girls compared to boys. A positive association was seen between fruits and vegetables diversity score and negative relation between breads/grains, meat and dairies diversity scores with HEI. Conclusion: Dietary habits of most of junior and senior high school students in Shiraz needed moderate to severe improvements. So it is necessary to promote adolescents’ nutritional knowledge and attitudes

No relationship between most polymorphisms of steroidogenic acute regulatory (StAR) gene with polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine women’s disorders in reproductive age. Hyperandrogenism has a critical role in the etiology of PCOS and it can cause fault in Steroidogenesis process. During steroidogenesis, steroidogenic acute regulatory protein (StAR) seems to increase the delivery of cholesterol through mitochondrial membrane. Therefore, polymorphisms of StAR might effect on this protein and play a role in the etiology of PCOS. Objective: The aim of this study was to investigate the association between StAR SNPs with PCOS. Thus, seven polymorphisms in this gene: rs104894086, rs104894089, rs104894090, rs137852689, rs10489487, rs104894085 were detected. Materials and Methods: In this case control study, 45 PCOS women, 40 male factor/unexplained infertile women, and 40 fertile women as two control groups were participated from 2008-2012. Polymorphisms were detected using restriction fragment length polymorphism (PCR-RFLP) method. Results: Heterozygote genotyping for rs137852689 SNP (amino acid 218 C > T) was only seen in seven PCOS patients, one in normal ovulatory women, and five in male factor/unexplained infertile women (15.5%, 2.5%, 12.5%, respectively) (p= 0.12). While, it has shown no association between other SNPS with PCOs. Conclusion: The RFLP results for seven chosen SNPs, which located in exon 5 and 7 showed normal status in three groups, it means no heterozygous or homozygous forms of selected SNPs were observed. So, it seems evaluation of the active amino acid sites should be investigated and also the study population should be increased

Body mass index is important determinant of blood pressure in adolescents

Abstract Background and Objective: Obesity is an important risk factor for development of hypertension. We investigated the association between body mass index (BMI) and blood pressure in adolescents. Methods: The cross-sectional study was performed on 694 adolescents aged 12-18 years from middle and high schools located in 4 districts of Shiraz, Iran. Height, weight, and systolic and diastolic blood pressures were measured according to standard procedures. Results: The prevalence of overweight/obesity and elevated systolic and diastolic blood pressure was 22.0%, 16.8%, and 13.3%, respectively. Compared to girls, boys had higher rates of overweight/obesity and elevated blood pressure. With increasing age, the prevalence of overweight decreased (20.6% in 15-18 years compared to 34.3% in 12-14 years) and that of elevated blood pressure increased (33.2% vs.14.6% for systolic and 22.2% vs. 10.3% for diastolic blood pressure) in boys whereas the prevalence of overweight/obesity and elevated blood pressure did not change among girls. In both sexes, elevated blood pressure had a positive association with BMI categories independent of age and this association was observed even in normal versus low BMI categories. Conclusion: A strong association between BMI and elevated blood pressure advocates using strategies for the control of weight and prevention of obesity in adolescents

Evaluation of the association of single nucleotide polymorphisms in DDP4 and CDK5RAP2 genes with rheumatoid arthritis susceptibility in Iranian population

Background: Rheumatoid arthritis (RA) is known as a chronic autoimmune inflammatory disorder, which is characterized mainly by the progressive inflammation and destruction of the joints. In the pathogenesis of RA, a variety of cell types such as lymphocyte, dendritic cells, osteoclasts and synovial fibroblasts are involved. Genetic proneness has been implicated in the pathogenesis of RA. The aim of this study was to evaluate the association of single nucleotide polymorphisms (SNPs) in DPP4 and CDK5RAP2 genes and risk of RA in Iranian population. Methods: For genotyping, 623 RA patients and 412 healthy subjects were recruited. Genetic analysis of DPP4 gene rs12617656 and CDK5RAP2 gene rs12379034 polymorphisms was conducted using TaqMan allelic discrimination (for rs12617656) and ARMS-PCR (for rs12379034) methods. Results: Experiments demonstrated that alleles and genotypes of both SNPs were represented equally in RA patients and controls. Statistical analysis revealed that none of the rs12617656 and rs12379034 SNPs had significant differences in prevalence of both alleles and genotypes between RA patients and healthy controls. Conclusions: It appears that gene polymorphisms of DPP4 and CDK5RAP2 are not involved in the pathogenesis of RA in Iranian population. Keywords: Rheumatoid arthritis, Gene polymorphism, Inflammation, Autoimmunity, DPP4, CDK5RAP

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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