Prevalence of underweight and wasting in Iranian children aged below 5 years: a systematic review and meta-analysis

Purpose Wasting and underweight are the 2 main indicators of children’s undernutrition. We aimed to estimate the prevalence of undernutrition at the national level in Iran. Methods We performed a search for original articles published in international and Iranian databases including MEDLINE, Web of Science, Google Scholar, Scopus, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Scientific Information Database, Irandoc, Iranmedex, and Magiran during January 1989–August 2017. Seven keywords, in English and Persian, including malnutrition, protein energy malnutrition, growth disorders, underweight wasting, weight loss, children below 5 years old, and children, were used to search the databases. Results Finally, 17 articles were included in the meta-analysis, based on which the prevalence of underweight and wasting in Iranian children were estimated to be 11% and 5%, respectively. The prevalence rates of underweight among children in the central, western, southern, and northern parts of Iran and at the national level were 24%, 5%, 20%, 17%, and 6%, respectively. The prevalence rates of wasting in the central, western, southern, and northern parts of Iran and at the national level were 9%, 4%, 11%, 5%, and 4%, respectively. Conclusion Although the prevalence of underweight and wasting in Iran was low, some parts of the country showed high prevalence. The main reason behind this difference in the prevalence of malnutrition may be due to the level of development in different regions

Description of Epidemiological Features, Symptoms and Mortality of the Patients with COVID-19 in Some Provinces of Iran

Background: Clinical manifestations of COVID-19 are different. There are some risk factors for COVID-19. This study aimed to describe the epidemiological features, symptoms and mortality of the patients with COVID-19 in Iran. Methods: This were a cohort study performed on 103,179 patients with COVID-19. The demographic and clinical data were collected in selected provinces. The required data of all patients was extracted from the COVID registry system and analyzed using STATA version 14 and Excel 2016. Results: The mean age was 52.40 years for men and 52.41 years for women. About 55.2% of the study population were male and 44.8% were female. Totally, 60.9% (5085) of deaths happened in men and 39.1% (3263) in women. The mean time from onset of symptoms to hospitalization in men and women were 3.47 and 3.48 days, respectively. The mean time from onset of symptoms to isolation was 2.81 days in men and was 2.87 days in women, from onset of symptoms to death was 9.29 and 9.54 days, respectively, from onset of symptoms to discharge was 7.47 and 7.39 days, and from hospitalization to death was 6.76 and 7.05 days. Cough and shortness of breath were the most common symptoms in the patients. Conclusion: According to the results, the overall mortality rate was higher in men than women. Women with cardiovascular disease and diabetes were more likely to die. The mean time from onset of symptoms to hospitalization, isolation, and discharge was similar in men and women

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Joint effect of modifying selected risk factors on attributable burden of Cardiovascular Diseases

Background: There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases (CVDs). This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs. Methods : Estimates of avoidable burden to CVDs were made using potential impact fraction (PIF). In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3 rd national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated. Results : About 37% (95% uncertainty interval: 21.7-50.2) of attributable disability adjusted life years (DALYs) to CVDs in adult males and 59.4% (95% uncertainty interval: 30-76) in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% (95% uncertainty interval: 10.1-25.1) of CVDs′ attributable DALYs among adult males and 34% (95% uncertainty interval: 20-46.7) in adult females can be avoided. Conclusions : To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs

The Relationship between Occupational Stress & Related Injuries among Physician’s Assistants: A Case-Control Study

 Background and Objective: Job stress can have a direct impact on the incidence of work-related injuries and unsafe behavior and the highest rates of occupational injuries are in the health professions. Therefore, as we did not find any studies regarding the physician's assistants job stress; this research was performed to determine the relationship between job stress and occupational injuries among physician's assistants working at different units of hospitals affiliated to Shahid Beheshti University of Medical Sciences. Materials and Methods: This analytical study (case – control) was performed among physician's assistants working at 5 hospitals affiliated to Shahid Beheshti University of Medical Sciences. 50 cases (with occupational injuries) were compared with 50 controls (without occupational injuries) about job stress. Job stress was measured by Osipow questionnaire with 6 domains; validity (content) and reliability, were confirmed by Cronbach's alpha = 0.89. The Mann-Whitney test for comparison of means and chi-square test for comparison of proportions were used. Results: The mean stress scores did not show significant difference between the two groups in all domains except in role ambiguity and role boundary. After grouping stress scores, we observed significant differences in all domains, except in the responsibility (p=0.11). The stress score due to responsibility was very high for case (84.6%) and control (71.4%) groups. Maximum odds ratio was estimated in the role ambiguity field (OR= 8.36). Conclusion: Because of some unavoidable stressors in medical practice and the necessity of preventing mental and behavioral effects of stress; implementing measures and actions to improve the quality of working life, education and coping strategies, are the duties of the departments, and the director of the hospital, in order to maintain the health of the current staff and to prevent their displacement. REFERENCES1- Khalilzadeh R, Yavarian R, Khalkhali H. The Relationship of Job Stress, Depression and Anxiety of Nursing Staff of Urmia University of Medical Sciences.UNMF. 2005;3(1):10-7. [Full Text in Persian].2- Abedini S. Occupational stress in nurses working in hospitals in Bandar Abbas on 2003. Faslnamedena. 2006;2(3). [Full Text in Persian].3- Mcgrath A, Reid N, Boore. Occupational stess nursing.Int J Nurse Stud. 2003;40(5):555-65.4- Breslow M. 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Mortality and disability-adjusted life years for smoking-attributed cancers from 1990 to 2019 in the north Africa and middle east countries: a systematic analysis for the global burden of disease study 2019

Aim and background: Smoking is a modifiable risk factor for cancers. The aim of the study is to estimate the trend of mortality and DALYs of smoking-attributed cancers in the North Africa and Middle East (NAME) countries. Methods: In this study, estimates from the Global Burden of Disease 2019 (GBD-2019) study were used to report the mortality and DALYs for 16 smoking-attributed cancers. The mortality and DALYs rates from smoking-attributed cancers were evaluated by age, sex, and the 21 countries of the NAME countries from 1990 to 2019. Results: Age standardized mortality rates (ASMR) for the 29 smoking-attributed cancers in the NAME countries in 1990 and 2019 were estimated to be 24.7 (95% Uncertainty Interval: 21.5, 27.8) and 22.4 (95%UI: 19.8, 25.4) respectively, which shows a 9.2% decrease in the three decades. DALYs/100,000 for smoking-attributed cancers was, also, estimated to be 600.3 (95%UI: 521.6, 682.6) and 515.6 (95%UI: 454.9, 585.4) respectively, which indicates a 14.1% decreased in these three decades. In the last three decades, the percentage changes in DALYs/100,000 for smoking-attributed cancers in males and females were − 0.16 and − 0.03, respectively. Plus, The percentage changes in ASMR in males and females were − 12% and 8%, respectively. Furthermore, The highest ASMR and DALYs were observed in Lebanon, Turkey, and Palestine in 2019. Conclusion: The mortality rates of cancers from smoking have increased substantially among females, in most countries of the NAME region, in recent years. The burden caused by smoking can be reduced through modifying lifestyle and applying strict laws on smoking by governments and policymaker