A New Scale for Measuring the Socio-economic Status in Health Studies Conducted in Tehran

Introduction: One of the most important determinants in health studies is health-related socio-economic status. The precise determination of health-related socio-economic classes is contingent upon updating the data and taking new cultural, social, and health factors. The objective of this study is to provide a practical method for determining the index and health-related socio-economic classes of the subjects under study. Materials and Methods: A questionnaire containing 68 items was developed as a tool to assess the socio-economic status index related to health. Data were collected from six hundred and four married individuals who were randomly recruited from the city of Tehran. To identify the prognostic variables of the model, linear regression method was used. Predicted values of the index were obtained using the model. Then, boundary lines were proposed to determine the five socio-economic classes using the K-means cluster method. Results: Education, employment, internet access at home, use of supplementary health insurance, and time spent in virtual reality (cyberspace) were among the significant variables. Conclusion: The socio-economic class determination table at the end of the manuscript presents a step-by-step method for calculating the index and determining the desired class with respect to gender

The effect of education for iron consumption based on the theory of planned behavior in pregnant women in Mashhad

Background and aim: Iron is an essential element for women of reproductive age, especially in the period before pregnancy and during this period. This study was aimed to investigate the consumption of iron to prevent iron deficiency anemia based on the theory of planned behavior on pregnant women in Mashhad city. Methods: This quasi-experimental study was done on 160 pregnant women referred to health center No. 1 in Mashhad town who were allocated to case (80) and control (80) groups randomly in 2014. Intervention was done in four 75- minute sessions. Data were collected using a questionnaire made by researcher based on the theory of planned behavior and blood lab exam (Ferritin). Questionnaires were distributed and completed immediately, and 3 months after educational intervention were repeated again. Results: The average rates of knowledge, attitude, perceived behavioral control and intention to use of iron intervention group was increased 3 months after the intervention significantly (P0.05). Conclusion: Regarding the effect of education in promoting iron consumption in pregnant women, it is suggested that iron supplementation promotion workshops should be held in health centers with the aim of preventing iron deficiency anemia in health centers

Association between anogenital distance as a noninvasive index in the diagnosis and prognosis of reproductive disorder: A systematic review

Background: There are 2 measures of anogenital distance (AGD) in men and women. AGD has been used as an indicator of fetal androgen dysfunction and an adverse outcome in adulthood. Some studies have shown the association of AGD as a predictor in the diagnosis and prognosis of diseases and disorders. Objective: To systematically summarize the latest evidence for presenting AGD as a new approach for prognosis and early diagnosis of diseases. Materials and Methods: A systematic review of the available literature was performed using Medline via PubMed, Scopus, and ISI Web of Knowledge up to July 2021, using search terms “anogenital distance” OR “anogenital index” OR “ano genital distance” OR “ano genital index”. Language restrictions were not imposed. Results: After reviewing the retrieved articles, 47 unique studies were included in this systematic review. Different outcomes, including endometriosis, prostate cancer, polycystic ovary syndrome, pelvic organ prolapse, hypospadias, cryptorchidism, fertility and semen parameters, maternal and birth development, and ovarian and gynecological-related disorders, have been studied in the included evidence. A negative association was observed between AGD and endometriosis and hypospadias and a positive association between AGD and prostate cancer, polycystic ovary syndrome, male fetal gender, and fertility parameters. Conclusion: Using quantitative indicators such as AGD may be a useful clinical tool for diagnosing diseases. Although many studies have shown an association between AGD and diseases, some factors, including different measurement methods, different measurement tools, age, and different definitions of AGD, can be involved in the variation of AGD. Key words: Genitalia, Prognosis, Early diagnosis, Reproductive health

Vandetanib alters the tumoricidal capacity of human breast cancer stem cells via inhibiting vasculogenic capacity

Introduction:The inhibition of vascularization into tumor stroma as well as dynamic cell growth is the center of attention. Here, we aimed to examine the role of vandetanib on angiogenesis capacity of breast cancer stem cell (CSCs). Methods: MDA-MB-231 cells were exposed to different doses of vandetanib and survival rate was monitored. Stimulatory effects of vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), and epidermal growth factor (EGF) were evaluated in vandetanib-treated MDA-MB-231 cells. In vitro tubulogenesis capacity was studied on the Matrigel surface. The synergistic effects of vandetanib on cell survival were also assessed after PI3K and/or Wnt3a inhibition. Vascular endothelial (VE)-cadherin, matrix metalloproteinase-2 (MMP-2), -9, Wnt3a, and p-Akt/Akt ratio were measured using western blotting. Results:Vandetanib reduced survival rate in a dose-dependent manner (P&lt;0.05). Proliferative effects associated with VEGF, FGF, and EGF were blunted in these cells pre-exposed to vandetanib (P&lt;0.05). The microcirculation pattern’s triple-negative breast cancer (TNBC) was suppressed by 1, 5 µM of vandetanib (P&lt;0.05). Hence 1, 5 µM of vandetanib potentially decreased the population of CD24– cells. 1 and 5 µM of vandetanib inhibited cell proliferation by blocking PI3K and Wnt3a pathways and decreased the p-Akt/Akt ratio, Wnta3 protein levels (P&lt;0.05). 1 and 5 µM vandetanib combined with PI3K inhibitor diminished metastatic markers including, MMP-2, and MMP-9. The concurrent treatment (PI3K, inhibitor+ 1, 5 µM vandetanib) also considerably reduced epithelial-mesenchymal transition (EMT) markers such as VE-cadherin (P&lt;0.05). Conclusion: Vandetanib suppressed vasculogenic mimicry (VM) networking through blunting stemness properties, coincided with suppression of VE-cadherin in CSCs(Figure Presented).</p

First report on the validity of a continuous Metabolic Syndrome score as an indicator for Metabolic Syndrome in a national sample of paediatric population — the CASPIAN-III study

Wstęp: Celem pracy była ocena trafności ciągłego wskaźnika zespołu metabolicznego (cMetS) na próbie reprezentatywnej irańskich dziecioraz zidentyfikowanie zależnych od płci i wieku optymalnych wartości odcięcia wskaźnika cMetS związanych z zespołem metabolicznym.Materiał i metody: Badanie zostało przeprowadzone z udziałem 3254 uczniów w wieku od 10 do 18 lat. cMetS był ustalany poprzezzagregowanie residuów standaryzowanych względem wieku i płci następujących parametrów: obwodu w pasie (WC, waist circumference),średniego ciśnienia tętniczego (MAP, mean arterial pressure), stężenia glukozy, stężenia cholesterolu frakcji lipoprotein wysokiejgęstości (HDL-C, high density lipoprotein cholesterol) oraz stężenia triglicerydów (TG). W celu ustalenia optymalnych punktów odcięciadla przewidywania obecności zespołu metabolicznego na podstawie cMetS zastosowano analizę krzywej ROC (receiver operatingcharacteristic) z oszacowaniem czułości i swoistości zmiennych.Wyniki: Wykazano stopniowany związek między wskaźnikiem cMetS a liczbą czynników ryzyka. W przypadku obu płci zaobserwowanowyraźny wzrost średnich wartości wskaźnika cMetS wraz ze wzrostem liczby komponentów. Ogólna optymalna wartość odcięcia wskaźnikacMetS dla przewidywania obecności zespołu metabolicznego wyniosła 2,93 [czułość = 92%, swoistość = 91%, pole powierzchni podkrzywą = 0,96 (0,95–0,97)]. Wartość dla chłopców wyniosła w badaniu 2,97, a dla dziewcząt — 3,26.Wniosek: W przeprowadzonym badaniu ogólnokrajowym potwierdzono trafność wskaźnika cMetS w populacji irańskich dzieci. WskaźnikcMetS wydaje się odpowiednim wskaźnikiem do zastosowania w badaniach epidemiologicznych nad związkiem pomiędzy potencjalnymiczynnikami ryzyka a występowaniem zespołu metabolicznego w Iranie.Introduction: The aim of this study was to assess the validity of a continuous Metabolic Syndrome score (cMetS) in a nationally representativesample of Iranian children and to identify sex and age-specific optimal cut-off points of cMetS that are associated with MetS.Material and methods: This study was conducted among 3,254 schoolchildren aged 10–18 years. cMetS was derived by aggregating ageand sex-standardised residuals of waist circumference (WC), mean arterial pressure (MAP), glucose, high density lipoprotein-cholesterol(HDL-C) and triglycerides (TG). To determine the optimal cut-off points of cMetS for predicting MetS, receiver operator characteristic(ROC) curve analysis was used with an estimation of the variables’ sensitivity and specificity.Results: A graded relationship was documented between cMetS and the number of risk factors. Increasing mean values of cMetS with increasingnumbers of components were apparent for both genders. The overall optimal cMetS cut-off point for predicting the presence of MetS was 2.93 [sensitivity= 92%, specificity = 91%, area of the curve = 0.96 (0.95–0.97)]. The values for boys and girls were 2.97 and 3.26 respectively in the total study.Conclusion: This nationwide study confirmed the validity of the cMetS score in a population-based sample of Iranian children. cMetSappears to be an appropriate index for investigating the association between potential risk factors and MetS in epidemiological researchin Iran

The Effect of Peer Group-Based Training Using Health Belief Model on Quality of Life and Foot Ulcer Self-Care Behaviour in Patients with Type 2 Diabetes: A Randomized Controlled Clinical Trial

Objective: The present study was aimed at investigating the effect of peer group-based training (PGBT) using the health belief model (HBM) on the quality of life (QOL) and foot ulcer self-care behavior  in patients with type 2 diabetes. Materials and methods: The present study was a randomized controlled clinical trial performed on patients with type 2 diabetes who were referred to the Diabetic Care Clinic in Shiraz (Iran) from September 2019 to June 2020. A total of 70 patients participated in the study and were randomly assigned to peer training (n = 35) and control groups (n = 35). Diabetes Quality of Life, and diabetes self‑care behaviors, which were completed by both groups before, immediately, 1 month, and 3 months after the intervention. The data were analyzed using the Chi‑square test, paired t-test, independent t‑test, ANOVA, and descriptive statistical methods. P &lt; 0.05 was considered statistically significant. Results: The results showed that mean scores of QOL, constructs of HBM (awareness, perceived susceptibility, perceives severity, perceived benefit, self-care behavior, and foot care) before the intervention did not reveal a significant difference between the two groups, but immediately one month after the educational intervention, the mean values for the intervention group were significantly higher than the control group (p &lt; 0.05). Conclusions: PGBT using HBM was effective in increasing the mean score of QOL and self-care behavior in patients with type 2 diabetes. Thus, this method is recommended to be utilized alongside other methods to train patients

Childhood Overweight and Obesity and Associated Factors in Iranian Children and Adolescents: A Multilevel Analysis; the CASPIAN-IV Study

Objective: The purpose of this paper is to explore multidimensional factors related to childhood obesity and overweight based on the data gathered on different aspects of the general health status were assessed among a large number of Iranian children and adolescents in the fourth phase of the “Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease” survey. It also aims to determine the degree to which each ecological context contributes to childhood overweight/obesity.Method: A total of 14,880 students and their parents were recruited. They filled out a questionnaire on their relationship with peers, body image, and psychosocial environment of school, dietary habits, life-style habits, physical activity pattern and socioeconomic status (SES). Their height, weight, was measured and body mass index (BMI) was calculated. Obesity and overweight was defined based on the WHO growth chart. Multilevel modeling using three-level random intercept logistic regression models were used to assess predictors of overweight and obesity. In our hierarchical models, children (first level) were conceptualized as being nested within provinces (second level) and provinces within quad regions (third level).Result: From among the 13,486 recruited students, 9.7% were overweight and 11.9% were obese. In multivariate model (adjusted model), being boy (OR:1.58), living in urban area (OR:1.58), having positive family history of obesity (OR = 2.04), breakfast skipping (OR: 1.46), socioeconomic status (OR moderateSES/lowSES = 1.44 and OR highSES/lowSES = 1.89), and birth weight (BW) (OR normalBW/lowBW = 1.33 and OR highBW/lowBW = 1.8) were associated with childhood obesity. Increasing age was the only factor in the obesity model that had a significant preventive effect on the odds of becoming obese (OR = 0.96, P &lt; 0.001). In multivariate model, living in urban area, increasing age, high and moderate SES, high BW and family history of obesity were the significant predictors of overweight.Conclusion: Our findings show that high BW, sociodemographic characteristics, breakfast skipping, and family history of obesity are associated with childhood obesity and overweight. Therefore, developing strategies that consider the effects of diverse sociodemographic and environmental factors on childhood overweight and obesity would be the most effective way to prevent and manage this multifactorial health concern

Metabolic Syndrome and Cardiovascular Risk Factors in a National Sample of Adolescent Population in the Middle East and North Africa: The CASPIAN III Study

Objective. The present study was designed to investigate the prevalence of different combinations of the metabolic syndrome (MetS) risk factors among a nationally representative sample of adolescents in the Middle East and North Africa (MENA). Methods. The study sample, obtained as part of the third study of the school-based surveillance system entitled CASPIAN III, was representative of the Iranian adolescent population aged from 10 to 18 years. The prevalence of different components of MetS was studied and their discriminative value was assessed by receiver operating characteristic (ROC) curve analysis. Results. The study participants consisted of 5738 students (2875 girls) with mean age of 14.7±2.4 years) living in 23 provinces in Iran; 17.4% of participants were underweight and 17.7% were overweight or obese. Based on the criteria of the International Diabetes Federation for the adolescent age group, 24.2% of participants had one risk factor, 8.0% had two, 2.1% had three, and 0.3% had all the four components of MetS. Low HDL-C was the most common component (43.2% among the overweight/obese versus 34.9% of the normal-weight participants), whereas high blood pressure was the least common component. The prevalence of MetS was 15.4% in the overweight/obese participants, the corresponding figure was 1.8% for the normal-weight students, and 2.5% in the whole population studied. Overweight/obese subjects had a 9.68 increased odds of (95% CI: 6.65–14.09) the MetS compared to their normal-weight counterparts. For all the three risk factors, AUC ranged between 0.84 and 0.88, 0.83 and 0.87, and 0.86 and 0.89 in waist circumference, abdominal obesity, and BMI for boys and between 0.78 and 0.97, 0.67 and 0.93, and 0.82 and 0.96 for girls, respectively. Conclusion. The findings from this study provide alarming evidence-based data on the considerable prevalence of obesity, MetS, and CVD risk factors in the adolescent age group. These results are confirmatory evidence for the necessity of primordial/primary prevention of noncommunicable disease should be considered as a health priority in communities facing a double burden of nutritional disorders