Economic Inequality in Healthy and Junk Foods Consumption and its determinants in Children and Adolescents: the CASPIAN- IV Study

Background: Nutritional habits and its determinants, especially in children and adolescents have recently turned into the one of the major concerns of health researches. We examine the diet contribution inequality in according to socio-demographic factors, age, gender, physical activity and body image to alleviate this gap in Iranian children and adolescents. Materials and Methods: Study sample was comprised of 14,880 students aged 6-18 years who selected from urban and rural districts of 30 provinces of Iran via stratified multi-stage sampling method. A short food frequency questionnaire was used for estimating the food group consumption. The Blinder-Oaxaca method was applied to investigate the inequality in the prevalence of healthy and junk foods consumption between the first and fifth socio-economic status (SES) quintiles. Results: The frequency of healthy and junk foods consumption showed considerable differences between the SES quintiles. The highest differences were found in the frequency of fresh fruit (25.38%), vegetable (12.92%), and milk (10.74%) consumption, respectively. The daily consumption of vegetables, and fresh and dried fruits increased linearly by increasing the SES quintiles. The highest absolute difference was seen in the frequency of fresh fruit consumption between the bottom and top of the socioeconomic groups (SII value=-32%).  The estimated SII was statistically significant for the consumption of all healthy and junk foods except for fast foods and milk consumption. The estimated C index for consumption of healthy and junk foods was positive and negative, respectively. Conclusion: This study provides the considerable information on the consumption of healthy and junk foods and its determinants among Iranian children and adolescents for better programming, developing health policies, and future complementary analyses

Frequency and Clinical Manifestations of Pediatric Brucellosis in Iran: A Systematic Review

Background Brucellosis is a zoonotic disease that is widely distributed throughout the developing countries. Children are considered as at risk groups for infection. The aim of this study was to assess the frequency and clinical manifestations of Brucellosis in Iranian children and adolescents. Materials and Methods: We systematically searched international databases; ISI, Medline (via PubMed), Scopus, and national databases Irandoc, Barakat knowledge network system, Magiran, and Scientific Information Database (SID). The search strategy was developed based on main terms of "Brucellosis," "Brucella fever", "Gibraltar", "Rock Fever", "Undulant Fever", "Cyprus Fever", "Malta Fever", and "Bang Disease". Results: A total of 885 studies were identified, from them a total of 12 studies that were conducted between 2001 and 2016 were included. Following the relevancy assessments and quality control, data from the 1,429 participants were presented in our review. The age of the patients ranged from 2 to 18 years. Only one out of twelve studies provided the prevalence of 4.30% and 3.4 incidence. Studies varied greatly in reporting high risk behavior of animal contact (8.4 to76.0%) and unpasteurized dairy (22.4 to 91.6%). Conclusion Our finding reveals the disparity of reported prevalence and clinical manifestations of Brucellosis in Iranian children. Fever and joint pain were the most frequent reported signs. Differences in study design, measurement tools and methods, and sub population sampling, does not provide the possibility of aggregation of data for more comprehensive inference

Unilateral Osteomyelitis of the Clavicle in Childhood:A Case Report

Infection of clavicle is a rare complication in children that is difficult to diagnose. The exact incidence is unknown. We report a case of osteomyelitis of the clavicle without any long term disability

Effect of vitamin D supplementation on cardiac-metabolic risk factors in elderly: a systematic review and meta-analysis of clinical trials

Background: There has been a longstanding interest in the potential effect of vitamin D in preventing cardiac-metabolic diseases. However, there are divergent results regarding the impact of vitamin D supplementation (VDS) on managing cardiac-metabolic outcomes in the elderly population. Material and method: We systematically searched electronic databases; Web of Science, PubMed, Scopus, EMBASE, Cochrane, and ProQuest. We included all trials that evaluated the effect of VDS on cardiac-metabolic risk factors in the elderly population, which were published until 30 September 2021. The effects of VDS on cardiac-metabolic outcomes were assessed using standardized mean difference (SMD). A random-effect model was used to pool the SMD and 95% confidence interval (CI). Result: The literature search identified 4409 studies, of which 12 trials met inclusion criteria. Results of random effect meta-analysis indicated a significant reduction in total cholesterol (TC) (SMD: − 0.14 mg/dl; 95% CI: − 0.25, − 0.02) and triglyceride (TG) (SMD: − 0.45 mg/dl; 95% CI: − 0.86, − 0.04) with VDS compared to the placebo. The subgroup analyses revealed that the reduction of TG in patients with diabetes and vitamin D deficiency was significant. Furthermore, short-term intervention (≤ 6 months) induced a significantly lower level of TG and insulin in comparison to longer duration (> 6 months). Conclusion: The study suggests that VDS could improve insulin concentration and dyslipidemia in the elderly population. The systematic review was registered in Alborz university of medical sciences with 2060-01-03-1397 number and the Ethics council IR.ABZUMS.REC.1397.207 number

Effect of Combined versus Monotherapy with Deferoxamine and Deferiprone in Iron Overloaded Thalassemia Patients: a Randomized Clinical Trial

Background: Patients with transfusional iron overload have depended on iron chelation therapy and improving chelation regimens have been of the highest priority. The aim of this study was to compare effect of combined versus monotherapy with Deferoxamine (DFO) and Deferiprone (DFP) in iron overloaded beta thalassemia (BT) major patients Materials and Methods We studied 36 BT major patients (mean age 7.6±4.6; range 3–16 years) attending the Ormieh Motahari hospital for regular transfusional support. Patients were randomly allocated to receive one of the following two treatments: DFO in combination with DFP (n=12), DFO alone (n=12) and DFP alone (n=12). Serum ferritin level, liver enzymes, blood urea nitrogen, and creatinine and side effects were monitored over a 12 months period. Results: After one year, serum ferritin decreased more significantly in patients on DFO+DFP therapy compared to patients who only received DFO or DFP alone (

Image_9_Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies.PNG

IntroductionWaist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.MethodsComprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.ResultsThe overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93–0.96), 0.88 (95% CI: 0.85–0.91) and 102.6 (95% CI: 50.7–207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.DiscussionThe current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.</p

Image_5_Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies.TIF

IntroductionWaist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.MethodsComprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.ResultsThe overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93–0.96), 0.88 (95% CI: 0.85–0.91) and 102.6 (95% CI: 50.7–207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.DiscussionThe current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.</p

Image_1_Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies.JPEG

IntroductionWaist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.MethodsComprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.ResultsThe overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93–0.96), 0.88 (95% CI: 0.85–0.91) and 102.6 (95% CI: 50.7–207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.DiscussionThe current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.</p

Image_2_Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies.JPEG

IntroductionWaist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.MethodsComprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.ResultsThe overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93–0.96), 0.88 (95% CI: 0.85–0.91) and 102.6 (95% CI: 50.7–207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.DiscussionThe current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.</p