The relationship between lifestyle and anthropometric factors with the sleep characteristics among university students in Iran: the MEPHASOUS study

Background: Healthy sleep habits have an important role in normal cognitive function, emotional performance, and well-being. The aims of this study were to describe the characteristics of sleep among university students in Iran. In addition, we assessed the relationship between lifestyle and anthropometric factors with the sleep characteristics. Methods: This population-based cross-sectional study was conducted using the data of �Mental and Physical Health Assessment of University Students in Iran� survey 2012�2013. This survey was conducted on newly admitted students in 74 public universities in 28 provinces. The participants were younger adults. Univariate and multivariate logistic regression models were utilized to recognize associated factors with sleep pattern and range. Result: Of total 78,848 students who completed the survey, 54.64 (n = 43,079) were females. The average age of the students was 21.53 ± 4.08 and 21.54 ± 3.99 among males and females, respectively. More than 90 (n = 70,923), were non-smokers. Out of the total respondents, 40.56 (n = 31,756) had irregular sleep pattern. Male students were less likely to have irregular sleep pattern than female students. Conclusion: Our findings indicated that irregular sleep pattern is associated with overweight and obesity. So, these results underscore the need to educate students on importance of healthy sleep pattern and duration on health conditions. © 2020, Springer Nature Switzerland AG

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding Bill & Melinda Gates Foundation

Prevalence of Asthma, COPD, and Chronic Bronchitis in Iran: A Systematic Review and Meta-analysis

In this study, we aimed to conduct a meta-analysis on the results of eligible studies to estimate the prevalence of asthma, COPD, and Chronic bronchitis in Iran . International and Iranian databases including PubMed, Scopus, Web of Science, Iranmedex, and scientific information database (SID) were searched for population based studies that had reported the prevalence of asthma and COPD from 1990 to 2015. We conducted the meta-analysis using metaprop application of Stata statistical software. I-Squared was used for calculating heterogeneity among the studies. To determine causes of heterogeneity, subgroup analysis and meta-regression method were used. Based on the results of random effect method, the overall prevalence of asthma ever was 4.56 (3.76-5.36) among men while it was 4.17 (3.42-4.91) among women. Pooled prevalence of current asthma was 7.95 while confidence interval changed from 5.85 to 10.06 (men 5.83 (2.75-8.92), women 9.13 (3.35-14.94)). Also based on the results of random effect model pooled prevalence of chronic bronchitis of five studies was 5.57. It seems that the total crude prevalence of current asthma in Iran is less than many other countries such as Kuwait, Lebanon, Thailand, Japan, Australia and Germany and is higher than some other countries such as Oman, Pakistan, South Korea, India, China, Taiwan, Indonesia, Spain, Russia, and Greece. On the other hand, Iran is in middle situation in terms of the prevalence current asthma. Our results can fill the information and knowledge gaps about the status of the prevalence of respiratory diseases in Iran. © Spring 2016, Iran J Allergy Asthma Immunol. All rights reserved

The economic burden of smoking-attribution and years of life lost due to chronic diseases in Mashhad, 2015-2016

Background: Tobacco smoking is one of the most preventable causes of mortality related to noncommunicable diseases (NCDs). This study aimed to estimate the direct economic burden and years of life lost (YLL) attributable to smoking in NCDs in Mashhad, 2015-2016. Methods: Hospital-based data were utilized to calculate the economic burden of four selected diseases related to smoking. An epidemiological population-attributable risk method was used to determine the smoking-attributable fraction (SAF). Moreover, the study was conducted by data related to disease-specific expenditures and patients' information on cost and the number of mortality for estimating the YLL for each disease, population and life expectancy data, the prevalence of smoking, and the relative risk of smoking. Data analysis was performed with STATA software, version 12. Results: The total costs attributable to smoking for stroke, myocardial infarction, chronic obstructive pulmonary disease (COPD), and lung cancer were 94148, 151272, 1191396, and 574784 US Dollars, respectively (per 100000). In 2015, the YLL per deaths due to COPD were 4217 and 3522 among males and females, respectively. Furthermore, in 2016, the YLL per deaths due to the stroke in males and females were 8317 and 7563, respectively. In the same year, the highest proportion of years of potential life lost per 100000 smoking-attributable deaths belonged to COPD. Conclusions: The results of this study can be used to inform policy-makers about smoking-attributable diseases in Iran. To decrease the smoking-attributable costs, which have resulted in the spread of NCDs, policy-makers should adopt and implement effective policies regarding smoking prevention and control. © 2021 Wolters Kluwer Medknow Publications. All rights reserved

Burden of Oral Diseases in Iran, 1990-2010: Findings from the Global Burden of Disease Study 2010

BACKGROUND: Oral diseases, as a group of chronic diseases, are among the major public health problems that lead to disability throughout the world. The major part of burden of oral diseases is caused by dental caries, periodontal diseases, edentulism, mouth cancer, cleft lip, and cleft palate. The aim of the present paper is to report the global results for the burden of oral disease in Iran from 1990 to 2010, derived from GBD study 2010 by sex and age. METHODS: The Global Burden of Disease Study 2010 (GBD 2010) was a systematic effort with a common framework to estimate disability adjusted life years (DALYs) for diseases in different parts of the world. Years of life lost due to premature mortality (YLLs) were assessed based on cause-of-death estimates and by means of a cause of death ensemble model (CODEm). Years of life lost due to disability (YLDs) were computed by multiplying the prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was conducted to estimate disease distribution using a Bayesian meta-regression method (DisMod-MR). Disability weights were measured by collecting data from population-based surveys. In this paper, we describe the results of GBD 2010 regarding oral diseases in Iran, critique the results, and provide some recommendations. RESULTS: Between 1990 and 2010 in Iran, an increase occurred in DALYs at all ages, attributed to dental caries (from 37,230 to 56,521) as well as periodontal diseases (from 21,482 to 43,308), and a decrease was found for edentulism (from 53,134 to 47,960). DALYs at all ages attributed to mouth cancer increased (from 5,597 to 7,771), while a decline was noted for cleft lip and cleft palate (from 6,157 to 5,034). The age-standardized DALY rates per 100,000 population did not considerably change for dental caries and periodontal diseases, while edentulism showed a reduction. The corresponding DALY rate due to mouth cancer decreased, while it remained almost unchanged for cleft lip and cleft palate over this period. DALY rates per 100,000 population due to dental caries and edentulism were higher among Iranian women than for Iranian men at all ages, while Iranian men suffered from a higher burden of periodontal disease, mouth cancer, cleft lip, and cleft palate. The most significant burden due to dental caries and periodontal diseases was found in Iranians aged 15-49 and 50-69 years, respectively and edentulism and mouth cancer led to the highest burden in Iranians older than 70 years of age. The highest burden caused by cleft lip and cleft palate occurred in children younger than 5 years old. CONCLUSION: The findings address the challenging changes in oral diseases and difficulties in responding to the urgent oral health needs in Iran. The burden of oral diseases should be considered as a priority in Iran. A need also exists to pay more attention to the oral health policies and principles of preventive oral care. Global analyses of disease burdens provide a useful framework to guide a suitable policy in response to disease changes. In fact, strong national and sub-national analyses will be required to provide more effective public health strategies

Death-specific rate due to asthma and chronic obstructive pulmonary disease in Iran

Background and objective: Asthma and chronic obstructive pulmonary disease (COPD) could be considered as a major health problem in industrialized and developing countries. This study was designed to analyze the trends of mortality from asthma and COPD at national and subnational levels in Iran based on National Death Registry, from 2001 to 2015. Materials and methods: We used Death Registration System (DRS) as the basic source of data. Death Registration System data were available from 1995 to 2010 in Iran's Ministry of Health. Although, Tehran and Isfahan, 2 most populated cities in Iran, had independent death registry systems in their cemeteries, by combining their data we achieved more comprehensive and representative data on death among Iranian people. We addressed incompleteness and misclassification of death registry system using demographic and statistical methods. We also employed spatio-temporal and Gaussian process regression to extrapolate and interpolate mortality rates for the missing data. Results: Age-standardized asthma mortality rate was 7.2 (5.6-9.2) in females and 8.8 (6.9-11.1) in males at the national level in 2015. Age-standardized COPD mortality rates in females and males, respectively, were 8.46 (6.6-10.9) and 12.38 (9.8-15.6) during the studied years. A reduction in age-standardized asthma mortality was observed during the period of study. In addition, the trend of COPD mortality was increasing. Conclusions: It seems that mortality rate attributable to COPD has risen during the past 15 years in Iran. It could have increased because of increased exposure of people to related risk factors such as air pollution which is a common problem in larger cities and border provinces. © 2018 John Wiley & Sons Ltd

Death-specific rate due to asthma and chronic obstructive pulmonary disease in Iran

Background and objective: Asthma and chronic obstructive pulmonary disease (COPD) could be considered as a major health problem in industrialized and developing countries. This study was designed to analyze the trends of mortality from asthma and COPD at national and subnational levels in Iran based on National Death Registry, from 2001 to 2015. Materials and methods: We used Death Registration System (DRS) as the basic source of data. Death Registration System data were available from 1995 to 2010 in Iran's Ministry of Health. Although, Tehran and Isfahan, 2 most populated cities in Iran, had independent death registry systems in their cemeteries, by combining their data we achieved more comprehensive and representative data on death among Iranian people. We addressed incompleteness and misclassification of death registry system using demographic and statistical methods. We also employed spatio-temporal and Gaussian process regression to extrapolate and interpolate mortality rates for the missing data. Results: Age-standardized asthma mortality rate was 7.2 (5.6-9.2) in females and 8.8 (6.9-11.1) in males at the national level in 2015. Age-standardized COPD mortality rates in females and males, respectively, were 8.46 (6.6-10.9) and 12.38 (9.8-15.6) during the studied years. A reduction in age-standardized asthma mortality was observed during the period of study. In addition, the trend of COPD mortality was increasing. Conclusions: It seems that mortality rate attributable to COPD has risen during the past 15 years in Iran. It could have increased because of increased exposure of people to related risk factors such as air pollution which is a common problem in larger cities and border provinces. © 2018 John Wiley & Sons Lt