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

Perceptions of Employees on Psychological Factors Affecting Obesity: A Qualitative Study

Introduction: Obesity has now become an epidemic in Iran and there is convincing evidence that psychological factors play an important role in obesity and overweight. Given the key role of employees, as valuable human resources, in providing services and the increasing sedentary lifestyle among them, the current study aimed to explore governmental employees’ perceptions of psychological factors that affect obesity. Method: This qualitative study was conducted through content analysis. In total, 4 focus group discussions were held with groups of 8 subjects (32 subjects). Semi-structured interviews were conducted on a diverse sample of 35 obese or overweight governmental employees between February 2014 and January 2015. All interviews were audio recorded and were analyzed using the Strauss and Corbin method. Results: As a result of data analysis, the 3 main categories of poor adaptability in stressful periods, low self-efficacy, and motivators emerged. Poor adaptability in stressful periods consisted of the 5 main subcategories of periods of university entrance exam, soldiering, career, marriage, and childbirth. Low self-efficacy was explored in the 2 main subcategories of lack of positive model and the sense of lack of control over circumstances. Motivators included the subcategories of pleasure and apprehension. Conclusion: This study showed that perceptions of employees on psychological factors influencing obesity differed. Therefore, further researches, both qualitative and quantitative, are required in this field. Keywords: Grounded theory, Obesity, Qualitative stud

Evaluation of heart rate reserve and exercise capacity in individuals with and without metabolic syndrome in Isfahan

Introduction: Heart rate progressively increases with exercise through the function of sympathetic and parasympathetic nerves. These nerves control the performance of sinoatrial node. Lack of heart rate increase proportionate to the exercise is associated with poor prognosis. Moreover, exercise capacity (EC) is considered as a predictor of cardiac events. The current study compares these two indices in individuals with and without metabolic syndrome in Isfahan. Methods: The study was performed on 203 people without metabolic syndrome and 123 patients with metabolic syndrome registered in the Isfahan Cohort Study. The demographic data, abdominal circumference, blood pressure, height, and weight of the participants were recorded. Moreover, the serum triglyceride, fasting blood sugar, total cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL)levels were measured. Exercise test was carried out according to the Bruce standard protocol and heart rate reserve (HRR) and exercise capacity (EC) were determined and recorded. The age-adjusted data were analyzed using SPSS software, version 15, by the generalized linear model. Findings: The two groups were not significantly different with regard to HRR (p= 0.27). The level of EC in the metabolic syndrome group was significantly lower than that observed in the group without metabolic syndrome (p= 0.022). Conclusion: We could not find relationship between HRR and metabolic syndrome or lack of the syndrome. However, the relationship between metabolic syndrome and the EC level indicates that in individuals with metabolic syndrome, when EC decreased, HRR did not change significantly

Effect of nitric oxide (NO) on the induction of callus and antioxidant capacity of Hyoscyamus niger under in vitro salt stress

Generation of reactive oxygen species (ROS) under salt stress can cause oxidative damage. Nitric oxide (NO) is considered as a functional molecule in alleviating the oxidative damage of salinity to plants through modulating antioxidant metabolism. In the present study, effects of sodium nitroprusside (SNP), a NO donor, on induction of callus and seed germination, and antioxidant capacity of Hyoscyamus niger seedlings were studied under 0, 50, 100 and 150 mM NaCl stress. NO stimulated the germination of NaCl-treated seeds. NaCl treatment significantly induced accumulation of H2O2 and thiobarbituric acid-reactive substances (TBARS) in Hyoscyamus niger, and application of 100 μM SNP stimulated ROS-scavenging enzymes and increased scavenging activity (DPPH), hydroxyl radical (OH•) scavenging activity and chelating activity of ferrous ions, resulting in lower lipid peroxidation induced by NaCl stress. Therefore, it can be concluded that the increased antioxidant capacity by NO might be responsible for its function in alleviating the inhibition of Hyoscyamus niger growth and cell damage by salt stress. Also the effect of SNP on the induction of callus of Hyoscyamus niger was investigated. Callus fresh weight increased significantly in the combined effect of 50 μM SNP with other plant growth regulators (PGR) compared to control. It is evident that SNP has a direct effect on the induction of callus by interacting with cytokinins and auxins

An LTB-entrapped protein in PLGA nanoparticles preserves against enterotoxin of enterotoxigenic Escherichia coli

Objective(s): Enterotoxigenic Escherichia coli (ETEC) is known as the most common bacterial causes of diarrheal diseases related to morbidity and mortality. Heat-labile enterotoxin (LT) is a part of major virulence factors in ETEC pathogenesis. Antigen entrapment into nanoparticles (NPs) can protect them and enhance their immunogenicity.Materials and Methods: In the present study, recombinant LTB protein was expressed in E. coli BL21 (DE3) and purified by an Ni-NTA agarose column. The protein was entrapped in PLGA polymer by the double emulsion method. NPs were characterized physicochemically and the protein release from the NPs was evaluated. ELISA assay was performed for investigation of raised antibody against the recombinant protein in mice. The anti-toxicity and anti-adherence attributes of the immune sera against ETEC were also evaluated.Results: It showed the successful cloning of a 313 bp DNA fragment encoding LTB protein in the pET28a vector. Over-expression in BL21 (DE3) led to the formation of corresponding 15.5 kDa protein bands in the SDS-PAGE gel. Western blotting by using anti-CTX confirmed the purified LTB. Protein-entrapped NPs had a spherical shape with the size of 238 nm mean diameter and 85% entrapment efficiency.  Immunological analyses showed the production of a high titer of specific IgG antibody in immunized animals. The neutralizing antibody in the sera of immunized animals was approved by GM1 binding and Ileal loop assays.Conclusion: The results indicate the efficacy of the entrapped LTB protein as an effective immunogen which induces the humoral responses

Comparison of the Efficacy of Sofosbuvir and Kaletra on the Outcome of COVID-19. Is Sofosbuvir A Potential Treatment For COVID-19?

Background: The COVID-19 is a family of large enveloped non-segmented positive-sense RNA viruses which was first reported in December 2019 in Wuhan, China with a cluster of unexplained pneumonia. Although various medications have been tried to manage the COVID-19 pandemic, there is no exclusive medication or vaccine so far. In this study, we aimed to focus on the effectiveness of Hydroxychloroquine + Kaletra (lopinavir/ritonavir) versus Hydroxychloroquine + Sofosbuvir in patients hospitalized with COVID-19 to given the urgent need for an effective drug against SARS-CoV-2 in the current pandemic context. Materials and Methods: Fifty-four eligible patients with moderate to severe COVID-19 symptoms, according to the WHO criteria entered the study. Patients were randomized into two treatment groups. Thirty-two patients received Hydroxicholoroquine (400 mg stat) and Kaletra (400/100 mg q 12 h) as a control group (group A) and the trial group of 22 patients, received Hydroxicholoroquine (200 mg q 12 h) plus Sofosbuvir (400 mg daily) (group B) for a period of 7 to 14 days. Eventually, collected data included demographic characteristics, underlying diseases, clinical symptoms, laboratory data, and mortality were analyzed. Results: There was no significant difference in age, sex, and underlying diseases between the two groups. There was no significant statistical difference between the two groups on the seventh day of treatment in terms of cough relief, leukocyte count, and improvement of lymphopenia however in terms of the time of defervescence of fever, there was a significant difference between the two groups. Conclusion: Therefore, it can be said that our study is one of the first studies in the world to evaluate the effectiveness of sofosbuvir in the treatment of patients with COVID-19. According to our results, although Kaletra was assumed as an effective therapy, its superiority over Sofosbuvir was confined to the earlier effervescence of the 7-day fever and sofosbuvir can be used as an effective treatment, especially in patients with underlying heart disease who are at risk for arrhythmias with Kaletra

Analysis of Cytogenetic Abnormalities in Iranian Patients with Syndromic Autism Spectrum Disorder: A Case Series

Objective Autism spectrum disorder is a heterogeneous neuropsychiatric group of pervasive development disorder, which is mostly diagnosed through the intricate behavioral phenotype. According to strong genetic involvement, detecting the chromosome regions and the key genes linked to autism can help to elucidate its etiology. The present study aims to investigate the value of cytogenetic analysis in syndromic autism as well as to find an association between autism and chromosome abnormalities. Materials & Methods Thirty-six autism patients from 30 families, diagnosed clinically with DSM-5 criteria, were recruited. The syndromic patients who had additional clinical features involving development delay, attention deficit, hyperactivity disorder, seizure, language, and intellectual impairment were selected due to elevating the detection rate. Cytogenetics analysis was performed using GTG banding on the patients' cultured fibroblasts. Moreover, array-comparative genomic hybridization was also performed for a patient with a de novo and novel variant.   Results Karyotype analysis in 36 syndromic autism patients detected chromosomal abnormalities in two (5.6%) families, including 46,XY,dup(15)(q11.1q11.2) and 46,XX,ins(7)(q11.1q21.3)dn. In the latter, array-comparative genomic hybridization detected three abnormalities on chromosome 7, including deletion and insertion on both arms; 46,XX,del(7)(q21.11q21.3),dup(7)(p11.2p14.1p12.3)dn. Conclusion We reported a novel and de novo cytogenetic abnormality on chromosome 7 in an Iranian patient diagnosed with syndromic autism. However, the detection rate in syndromic autism was low which implies that it cannot be utilized as the only diagnostic procedure

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18 : a geospatial modelling study

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.Methods We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km x 5 km resolution in 98 LMICs based on 2.1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.Findings Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205000 (95% uncertainty interval 147000-257000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.Interpretation Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC