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Introduction: Oxidative stress is involved in the pathogenesis of many diseases, including atherosclerosis. Lipid profile conditions, oxidative stress and antioxidant imbalances play a major role in the development of the disease. The purpose of this study was to compare the different time course of concurrent training on lipid profile and total antioxidant capacity of cardiac patients. Methods: The present study was a quasi-experimental study. Twenty male patients, mean age 56 ± 9.75, were voluntarily divided into the control and combination training groups The concurrent training group performed aerobic and resistance training for eight and three days a week. Aerobic exercise was performed for 15-20 minutes at 50-80% of maximal heart rate and resistance training program consisted of three upper extremity movements and two lower extremity movements with three sets and 10 repetitions. Blood samples were taken before and after four and eight weeks, and lipid profile and total antioxidant capacity were measured. Data were analyzed by repeated measures ANOVA using SPSS version 16 software. Results: Concurrent training has reduced the significant levels in LDL, cholesterol and triglycerides after four and eight weeks, and has also reduced a significant increase level in HDL. Concurrent exercise had a significantly effect on the amount of total antioxidant after eight weeks (P

Abstract Background: Congenital cardiovascular malformation is the most common group of birth defects. Fetal echocardiography is highly sensitive and specific in the diagnosis of congenital heart disease in low- and high-risk populations. Objective: This study aimed to assess abnormal findings in fetal echocardiography and maternal disease. Materials and Methods: This cross-sectional study was performed on 114 pregnant women referred to Afshar hospital, Yazd, Iran from October 2016 to March 2017. All pregnant women underwent fetal echocardiography through fetal heart screening protocol, which is administered by the international society of ultrasound in obstetrics and gynecology guidelines. Data collected included referral cause, gestational age, maternal age, gravida, and final diagnosis after an accurate fetal echocardiography. Results: The mean gestational age was 20 wk. The most common referral cause of pregnant women included diabetes (36.8%), fetal arrhythmia (14%), high maternal age (7%), and echogenic focus on ultrasound (6.1%). The most common postpartum findings were normal (68.4%), cardiac abnormalities (17.6%), and arrhythmias (14%). In postnatal echocardiography, the results were consistent with fetal echocardiography except in 2 women. Conclusion: This study showed that fetal echocardiography can be used in the early diagnosis and treatment of congenital heart diseases.

Background: Breast cancer is an uncontrolled and unnatural proliferation of cells in different breast tissues. The first measure to diagnose breast cancer is an examination by a surgeon followed by mammography, sonography, sampling, and other diagnosing methods. Given that there are several methods to diagnose breast cancer, and most of them are quite expensive, the present systematic review compares the expenses and effectiveness of different methods to diagnose breast cancer. Methods: The study was carried out as a systematic review through searching databases, i.e., PubMed, Web of Science, Magiran, Scopus, and Embase for articles published from March 1999 to May 31, 2017. The research articles regarding health technology assessment and economic assessment (n = 8) were examined. Results: Generally, conducting MRI screening and digital mammography every six months after the age of 30 are proved to be the most efficient and economical methods to screen carriers of BRCA (BReast CAncer) mutated genes. Besides, implementing both the techniques simultaneously was more cost-efficient with BRCA1 compared to BRCA2. Some studies have revealed that genetic tests and Oncotype tests, in particular, were the most cost-efficient methods to diagnose the disease, especially in its early stages. Conclusion: Consequently, indexing gene expression in individuals with BRCA gene mutation is revealed to more cost-efficient.

Introduction: Congenital heart disease is the most common congenital anomaly. About 50% of Neonates with congenital heart disease are asymptomatic in the first few days of life and are not diagnosed on initial examination. Pulse oximetry is a non-invasive method that can show the percentage of oxygen saturation in the blood and congenital heart disease. Methods: This was a descriptive cross-sectional study and the sampling method was census. Echocardiography was performed for all neonates with spo2 less than 95% and also neonates who were diagnosed with a problem by a cardiologist. After collecting the samples, the results obtained from pulse oximetry, physical examination and echocardiography were analyzed using SPSS software version 16 and statistical tests of Kolmogorov-Smirnov normality and Spearman correlation. Was investigated. Results: In pulse oximetry evaluation, 1.9% of neonates had spo2 (arterial oxygen saturation) less than 95%. 1.7% of neonates had heart problems in physical examination and 2.12% of neonates had heart problems in echocardiography. The highest correlation between pulse oximetry and echocardiography was 0.917. Conclusion: Considering the diagnostic importance of congenital heart diseases and their impact on a personchr('39')s life, it is recommended that pulse oximetry be added to physical examinations at birth as a screening method for heart disease.

Introduction: SARS-COV 19 is a new coronavirus that was reported first time in 30 December 2019 in Wuhan, China. The first case of coronary heart disease in Iran was reported with a definitive test on February 18 in Qom province and the first case in Yazd province on 24 February. The World Health Organization (WHO) declared a Covid infection on March 11 a pandemic. The aim of this study was to investigate the seroepidemiology of COVID 19 in Yazd province. Methods: The present study was a cross-sectional population-based study of seroepidemiological type that was conducted to investigate the serological prevalence of Covid-19 in the period of 3 to 20 May 2020 in Yazd Province. Sampling was clustered and it was without age and sex restrictions. Information was collected including demographic information, adherence to health protocols, and history of clinical symptoms of COVID 19. "Pishtaz ELISA Kit" was used to evaluate the IgG and IgM antibody titers against Covid 19. Chi-square, analysis of variance and T tests were used via SPSS.version.16 software Results: Mean age of the participants was 34.3± 17.5. Among the study participants, 507 (54.5%) were women. The serological prevalence of definite cases was 14.91% (95% CI: 12.91-16.91%) and suspicious cases were 2.85% (95% CI:1.85-3.85%). Ardakan City with 32% had the highest and Taft, Mehriz, Khatam with 7% had the lowest prevalence of COVID 19 (P

Background: The response to ovarian stimulation is different among women referring for assisted reproductive techniques. This difference could be due to different genotypes in genes related to reproduction such as estrogen receptor beta (ER β or ESR2) gene. Objective: In the present study, we explored the rate of ESR2 gene polymorphism in infertile women undergoing IVF treatment with different ovarian response to ovulation induction. Materials and Methods: A cross-sectional study was performed among 91 infertile women. The relationship between genotype distribution of the +1730 G/A polymorphism in the ESR2 gene (rs4986938) and the mean number of follicles and oocytes, their mean ratio, mean number of embryos, mean size of the follicles and pregnancy rates were measured. The ESR2 gene +1730 G/A polymorphism were identified by the amplification-refractory mutation system-polymerase chain reaction. Results: Genotypes GG, GA, and AA of the ESR2 gene presented frequencies of 27.5%, 67%, and 5.5%, respectively, in the infertile women. The results of the study showed that the mean number of follicles and oocytes, their mean ratio, mean number of embryos, mean size of the follicles, and pregnancy rates are not related to different genotypes. Conclusion: According to the endocrine and paracrine factors which are involved in the ovulation induction and maturation of oocytes, more studies with higher number of participants are required to confirm the results of the present study; in addition, further studies are required to find out other gene polymorphisms affecting estrogen receptor efficacy in the infertile women.

Introduction: Health care providers play a central role as the main members of the health care service providers team for the elderly and their knowledge and attitudes towards the aging phenomenon can play an important role in the quality of health care services provision for the elderly. Therefore, the present study aims to comparatively investigate knowledge and attitude of health care providers about the aging phenomenon in comprehensive health centers of Yazd and Hamadan, Iran. Methods: The cross-sectional study conducted on 220 health care providers who were enrolled in the study from comprehensive health centers in Yazd and Hamadan by cluster sampling. The data were collected by a questionnaire including demographic information, Kogan's attitude towards old people scale, and Palmore Facts on Aging Quiz .Data were analyzed by SPSS using descriptive statistics, independent t-test, ANOVA, and Pearson correlation coefficient. Results: Mean score of knowledge about aging (range: 0-25) was 12.24 ± 2.43 in Yazd and 12.17 ± 2.51 in Hamadan. Mean score of attitude towards aging (range: 34-204) was 121.49 ± 10.53 in Yazd and 119.40 ± 11.21 in Hamadan. There was no statistically significant difference in knowledge (p = 0.828) and its three dimensions (misconceptions about aging, psychosocial status and physical condition), and attitude (p = 0.152) and its three levels (negative, neutral and positive attitude) between health care providers in Yazd and Hamadan. There was a significant, positive correlation between knowledge and attitude in both Yazd (p < 0.01, r = 0.656) and Hamadan (p < 0.01, r = 0.718). Conclusion: The knowledge of health care providers in both cities was moderate and had positive attitude towards aging. Considering the moderate knowledge of health care providers about the aging, effective steps can be taken to promote knowledge and improve the attitudes of health care providers by providing educational curricula on physical, psychological, social and spiritual health of the elderly people and holding in-service training programs.

Introduction: Taking into consideration the high impact of Diabetes Mellitus type II (DM II) on human's health, identification of risk factors to prevent its development seems essential. Further studies are needed to ensure the positive role of uric acid in the onset of diabetes. This study targeted at investigating the attributed risk of hyperuricemia for the onset of DM II. Methods: In the present study, 1641 non-diabetic people, selected through multi-stage random cluster sampling, were followed up for 10 years (2006 - 2016). During the study, data on the variables of the study were collected and entered in SPSS 16 which was used to analyze the data. To calculate the attributions of hyperuricemia in the risk of developing diabetes, Levin's formulas and attributable risk related to the prevalence of exposure during these ten years were used. Results: Findings showed that 54.8% of people with hyperuricemia suffered from DM II., whereas 28.2% of people with normal uric acid level developed diabetes. The Attributable Risk (AR) of hyperuricemia and 75th percentile of serum uric acid for DM II were calculated by the weighted attributable risk formula which was 3.6 % and 24.2 %, respectively. With the treatment of high uric acid, the probability of the incidence of diabetes in hyperuricemia patients was reduced to 24.2% over a 10-year period. Conclusion: In this study, there was a significant correlation between high uric acid level and the risk of diabetes. Therefore, necessary measurements should be taken to treat the hyperuricemia patients in order to prevent the incidence of diabetes caused by high blood acid uric.

Introduction: Rapid changes in lifestyle, especially in nutritional aspects of the elderly, have led to many chronic diseases. Therefore, attention to nutritional needs of the elderly is an essential issue. The purpose of this study was to determine the predictors of healthy nutrition behaviors based on health belief model (HBM) in the elderlies of Kalat city, Razavi Khorasan Province, Iran.. Methods: The cross-sectional study was carried out on 200 elderlies aged 60 years and older who were covered by comprehensive health services centers in the city of Kalat. The participants were selected by multistage random sampling. The data collection tools included a researcher-made questionnaire for measuring HBM constructs regarding healthy nutrition and also a Food Frequency Questionnaire for measuring Healthy nutrition behaviors. Data were analyzed by SPSS software using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient and linear regression. Results: The mean score of nutritional knowledge of the elderlies was 7.75 ± 2.14 (possible score 0-15) and the mean score of healthy nutrition behaviors was 1.62 ± 1. 23 (possible score 0-5). Healthy nutrition behaviors were significantly correlated with perceived benefits (r = 0.254), self-efficacy (r = 0.244) and cues to action (r = 0.334) (p < 0.05). Linear regression showed that cues to action (β = 0.353), perceived benefits (β = 0.199) and self-efficacy (β = 0.181) were significant predictors of healthy nutrition behaviors. Conclusion: The level of healthy nutrition behaviors in the elderlies is not desirable, and cues to action, perceived benefits and self-efficacy are the most important predictors of these behaviors. Paying attention to these factors helps educators and other health professionals in designing appropriate intervention programs.

Introduction: Obesity as one of the most important public health problems is growing worldwide and it is associated with many non-communicable diseases. The aim of this study was investigating the prevalence of general obesity and central obesity and their related factors. Methods: The data of this research were extracted from a population health survey of Yazd province, Iran (YaHS), which was conducted on 9911 adults aged 20-70 years in 2014-2015. Body Mass Index (BMI) < 18.5 was considered underweight, in the range of 18.5 -24.9 healthy, from 25 to 29.9 overweight, and ≥30 was interpreted as obese. Central obesity was defined as the waist circumference (WC) of ≥ 102 cm for men and ≥ 88 cm for women as well as waist to hip ratio (WHO) ≥ 0.90 for men and ≥0.85 for women. Chi-square and one-way ANOVA tests were used for univariate analysis. Results: The prevalence of underweight, overweight, and obesity in both genders were 3.7 % (4.0% in men and 3.4% in women), 37.7% (39.9% in men and 35.6% in women), and 27 % (19.3% in men and 34.7% in women), respectively. The prevalence of abdominal obesity based on WC and WHR were 44.8 (23.9% in males and 65.4% in females) and 69.8% (69.4% in males and 70.2% in females), respectively. Gender (female), old age, being married for both genders, and low education in women were associated with an increase in both types of obesity. Conclusion: Overweight and obesity have affected more than half of the population (64%) and abdominal obesity has high prevalence in Yazd

Introduction: Considering the effects of skin diseases on health, activities, and quality of life of older adults, the study was conducted with the aim of determining knowledge, attitude, and practice status in older adults of Sarakhs city about skin care and prevalence of some skin problems among them. Methods: Totally 400 older adults aged 60 years and above (60-99 years) in a cross-sectional study were selected through cluster random sampling from urban and rural older adults in Sarakhs city, Razavi Khorasan Province, Iran. Data was collected through skin examination and a researcher-made questionnaire, which included four parts of demographic questions, attitude to, knowledge, and practice of skin care. Descriptive statistics, t-tests, analysis of variance, and Pearson correlation coefficient were used to analyze the data. Results: The most commonly detected skin problem was dryness (30.25%) followed by pruritus (5.9%) and flaking of the skin (8.25%). Average knowledge score was 18.15 ± 7.59 (possible score range of 0-56), average attitude score was 27.13 ± 3.17 (possible score range of 12 to 36), and average practice score was 33.9± 8.30 (possible score range of 13-67). There was a positive significant correlation between scores of knowledge and attitude (r = 0.283, p < 0.001), knowledge and practice (r = 0.222, p < 0.001), as well as attitude and practice (r = 0.298, p < 0.001). Conclusion: The commonest skin problems among older adults was skin dryness, pruritis and flaking. Knowledge and practice of skin care is at low level. An accurate and comprehensive training plan seems necessary to promote the level of these people’s knowledge and practices.

Dear Editor, According to the International Agency for Research on Cancer (IARC), Asia has the highest death rates and incidence of breast cancer; 27% of all cancers that occur among women in Iran are attributed to breast cancer. The role of obesity in breast cancer development has been known for decades. S strong evidence exists on the idea that obesity and weight gain during adulthood are associated with increased risk of postmenopausal breast cancer. Furthermore, growing evidence is available on the association of obesity with breast cancer and overall mortality rate in women’s premenopausal and postmenopausal periods (1). Evaluation of the breast cancer risk helps identification of the women with the high risk of developing breast cancer in the future. Some strategies to reduce this risk involve adopting a healthier lifestyle as well as involving diet and exercise in everyday life (2). Obesity and overweight are defined by Body Mass Index (BMI). The effect of high BMI on breast cancer was assessed in selected studies using the odds ratio (OR). The results of the data analysis using the random effects method showed that the risk of breast cancer was higher among the people with obesity (BMI ≥ 30): Pooled OR = 1.81, 95% CI = 1.24 - 2.64 and for overweight (30 > BMI ≥ 25): Pooled OR = 1.46, 95% CI = 1.13 - 1.89(3). According to the care plan for risk factors in non-communicable diseases (Steps 2016), the prevalence rates of obesity and overweight were 29.77% and 34.96% among Iranian women, respectively. Furthermore, population-attributable fractions of these diseases were 13.32% and 11.01%, respectively, which indicates that by eliminating obesity and overweight factors, we can expect 24.33% reduction in the population’s breast cancer. For instance, a well-designed randomized controlled trial in children with a particular disease found that 20% of the control group developed bad outcomes compared with only 12% of the individuals who received treatment. Absolute risk reduction (ARR) – also called risk difference (RD) – is the most useful way of presenting research results to help your decision-making. In this example, the ARR is 8% (20% - 12% = 8%), which means that, if 100 children were treated, 8 would be prevented from developing bad outcomes. Another way of expressing this is the number needed to treat (NNT); that is the number of people who must be treated to benefit one person. It is the inverse of absolute risk reduction. If 8 children out of 100 benefit from a treatment, the NNT for one child to benefit is about 13 (100 ÷ 8 = 12.5)(4). A randomized, controlled, primary prevention trial was conducted in 40 US clinical centers from 1993 to 2005. In this study, a total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer were enrolled. Women were randomly assigned into the dietary modification intervention group (40% [n = 19,541]) and the control group (60% [n = 29,294]) (5). The baseline characteristics of BMI and breast cancer incidence indicated that overweight ARR rate equals 0.0025 that is 0.25% (NNT: 400), obesity ARR equals 0.0012 i.e., 0.12% (NNT: 833.33) and obesity grade 2 and more equals 0.0033 that is 0.33% (NNT: 303.03). In other words, by treating 400 patients suffering from overweight and 833.33 patients suffering from obesity, we can prevent one case of breast cancer. Overweight, obesity, and abdominal fat are associated with the risk of developing breast cancer in women during the premenopausal and postmenopausal periods. Therefore, in order to prevent breast cancer and its complications, an intervention program should be implemented to control obesity and a breast cancer screening program should be conducted among the obese and overweight women (6). Governments are responsible for maintaining, restoring, and promoting health in the community. In order to make the right decisions and direct resources of the health sector, the most common cancer in women should be investigated as a priority for the health system. Therefore, a special study of breast cancer is necessary considering the mortality rate and disability. In this regard, we decided to investigate the most relevant risk factor and evaluate the risk associated with breast cancer by reviewing articles related to breast cancer. Later, we examined the most effective interventional strategies in this area. Consequently, given high prevalence of the overweight and obesity, intervention plans should be implemented to reduce the risk factors of the breast cancer.