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Objectives: Non-Communicable Diseases (NCDs) are the largest and fastest growing threat to human health. Iran's Ministry of Health and Medical Education (MoHME) established the Iranian Non-Communicable Diseases Committee (INCDC) in 2015 to tackle the high burden of NCDs. In line with the WHO's Global Action Plan, the INCDC developed "The National Action Plan for Prevention and Control of NCDs" and the related risk factors in Iran, 2015–2025", which was then revised to cover until 2030. Methods: In this policy synthesis study, we conducted a content analysis of upstream and other policy documents related to NCDs and relevant risk factors in Iran. Results: We used multiple streams model to illustrate the proactive approach that led to development of the national action plan. Conclusions: While countries are accelerating their efforts to reach SDG 3.4, Iran's pathway, as a WHO fast track country, will help, we envisage, other countries to scale up their active efforts to move steps forward to tackle the ever- highest burden of NCDs in their own settings. [ABSTRACT FROM AUTHOR]

Purpose: The current umbrella review aimed to evaluate the effect of metformin on all-cause mortality (ACM), cardiovascular mortality, and cardiovascular disease (CVD) incidence in DM patients. Methods: PubMed, Scopus, Cochrane, Google Scholar, and Web of Science databases were searched with special keywords. Related studies were included after screening by two independent investigators based on title and full texts. The AMSTAR2 checklist was used to assess the quality of studies, and Cochran tests were used to assess the heterogeneity between studies. Overall, seventeen systematic reviews and meta-analysis studies were included. The results revealed that the risk of ACM in patients who received metformin was lower than in patients who did not receive metformin. (OR: 0.80, 95% CI:0.744,0.855); also, the risk of CVD mortality in metformin patients was lower than in the other two groups (placebo and other anti-diabetic drugs) (OR: 0.771, 95% CI:0.688,0.853, P:0.001). The risk of CVD in metformin users was also lower than in the other two groups (OR: 0.828, 95% CI:0.781,0.785). Summary: This comprehensive review showed that the risk of ACM, death due to CVD, and incidents of CVD in DM who use metformin was lower than the patients who received a placebo only or other diabetic drugs, which can guide clinicians in medical decision-making. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the lifetime prevalence of conduct disorder according to sociodemographic characteristics, determine the sociodemographic predictors of conduct disorder, and estimate the rates of comorbidities of psychiatric disorders in children and adolescents with conduct disorder by age and gender. The National Epidemiology of Iranian Children and Adolescents Psychiatric Disorders was a cross-sectional, general population-based study on 30,532 children and adolescents aged 6–18 years from all provinces of Iran, which was done using multistage cluster sampling. Iranian citizens aged 6–18 years who resided at least 1 year in each province were included, and children and adolescents with severe physical illnesses that prevented them to participate in the study were excluded. The sample weighting adjustment was used, since we had randomly selected the equal number of 1000 participants of each province from the urban and rural areas. Trained psychologists conducted diagnostic interviews with the adolescents and the children's parents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version (K-SADS—PL). In this study, 54 children aged 6–9 years (0.58%, CI 0.47–0.77), 64 adolescents aged 10–14 years (0.57%, CI 0.47–0.77), and 117 adolescents aged 15–18 years (1.22%, CI 0.96–1.44) met the criteria of the lifetime conduct disorder. Conduct disorder was significantly more common in boys than in girls, and was significantly less prevalent among those participants whose fathers had no history of psychiatric hospitalization. Of the participants with conduct disorder, 83.4% met the criteria for at least one other psychiatric disorder. Conduct disorder had a high rate of comorbidity with oppositional defiant disorder (54.89%, CI 48.50–61.12), attention-deficit/hyperactivity disorder (32.34%, CI 26.68–38.56), tobacco use (20.43%, CI 15.77–26.04), and depressive disorders (18.30%, CI 13.88–23.74). Because of using the diagnostic instrument, we found a low total rate of prevalence for conduct disorder; however, higher rates of it were observed among boys and adolescents. Further studies are needed to explore the nature of comorbidities of conduct disorder and to consider them in a large clinical population. [ABSTRACT FROM AUTHOR]

Background: Impaired fasting glycaemia (IFG) has been defined as the fasting plasma glucose level between 6.1 (110 mgl/dl) and 6.9 mmol/l (125 mgl/dl). Control of hyperglycaemia during acute illness among diabetic and nondiabetic patients has been associated with improved outcome. The aim of this study was to investigate the prevalence of and factors related to hyperglycaemia, IFG and diabetes in west of Iran. Methods: This project was performed by a cross-sectional method in Ilam province including 2158 people ≥ 25 years old. From the list of all rural and urban health centers of each county, several were randomly selected. For each selected health centre, families numbered 1-20 completed questionnaire forms for all the members aging ≥ 25 years. FBS was measured for all the participants by standard method. All the demographic and laboratory results were analysed using SPSS 16. Descriptive and regression analysis were used for statistical analysis appropriately. Results: A total of 2158 people were evaluated in this study, among which 72% were female with a mean age of 45.5 ± 14 years. 40% of participants were from urban regions and the mean height, weight, FBS and waist size of the participants were respectively as follows: 164 ± 8.9 cm, 68.4 ± 12.3 kg, 5.7 ± 2.8 mmol/l (102.6 ± 49.9 mg/dl) and 82.3 ± 14.3 cm. The prevalence of IFG, diabetes and hyperglycaemia among participants were 7.8%, 11.8% and 19.6%, respectively and participants from urban area showed a significantly higher prevalence of hyperglycaemia compared to rural regions (P < 0.0001). Conclusion: The most effective factors associated with IFG and diabetes were family history of diabetes, age, hypertension, marital status, place of life and smoking, respectively. The prevalence of IFG, diabetes and hyperglycemia among the population living in Ilam province, west of Iran, were 7.8, 11.8 and 19.6% respectively which were directly increased with age. [ABSTRACT FROM AUTHOR]

To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among 5-11 year old children in Merseyside using the same respiratory health questionnaire completed by parents (sample size in brackets). Between 1993 and 2006, prevalence of PTB varied between 12.4 and 15.2 %, and of small for gestational age (SGA or growth restricted) babies between 2.1 and 4.6 %, and maternal asthma prevalence between 8.1 and 13.4 %. For the combined surveys mothers with asthma were more likely to have a PTB than non-asthmatic mothers (OR 1.39, 95 % CI 1.10-1.95, p < 0.001), and in the 2006 survey were more likely to have an SGA baby. 40.9 % of PTBs of asthmatic mothers developed doctor diagnosed asthma compared to 34.3 % for term babies (adjusted OR 1.65, 1.34-2.04, p < 0.001). The corresponding estimates for the symptom triad of cough, wheeze and breathlessness were 19.4 and 17.6 % (adjusted OR 1.78, 0.79-3.98). Conversely SGA babies were less likely to develop doctor diagnosed asthma (adjusted OR 0.49, 0.27-0.90, p < 0.021), or the symptom triad of cough, wheeze and breathlessness (adjusted OR 0.22, 0.05-0.97, p < 0.043), whether or not the mother was asthmatic. Maternal asthma is an independent risk factor for PTB which predisposes to childhood asthma. Intrauterine growth restriction was protective against childhood asthma. [ABSTRACT FROM AUTHOR]

DHD prevalence has risen in parallel with rising prevalence of pregnancy smoking and childhood obesity. The objective was to determine the epidemiological association of pregnancy smoking and childhood obesity with ADHD. A cross-sectional community study was conducted in 2006 using a parental questionnaire. A total of 1,074 schoolchildren aged 5-11 years were enrolled from 15 primary schools in a lower socio-economic area of Merseyside. ADHD was defined by the question 'does your child have Attention Deficit Hyperactivity Disorder, (ADHD), which has been diagnosed by a doctor?' The prevalence estimates for childhood obesity, maternal smoking during pregnancy and childhood ADHD were 14.9% (116/777), 28.0% (269/955), and 3.4% (32/945), respectively. ADHD prevalence increased fivefold in children with obesity (RR, 4.80, 95% CI 2.2-10.4, P < 0.001) and more than twofold in children of mothers who smoked during pregnancy (RR, 2.44, 95% CI 1.2-4.9, P = 0.02). Regression analysis adjusting for obesity, overweight, maternal smoking during pregnancy, heavy maternal smoking, household member smoking during pregnancy, doctor-diagnosed asthma, preterm birth, and low birthweight showed significant independent associations of ADHD prevalence with obesity (AOR, 4.66, 95% CI 1.57-13.89, P = 0.006) and pregnancy smoking (AOR, 3.19, 95% CI 1.08-9.49, P = 0.04). There was a positive dose-response association of ADHD with the number of maternal cigarettes smoked during pregnancy. Measures to reduce both smoking among pregnant women and childhood obesity might reduce prevalence of childhood ADHD. [ABSTRACT FROM AUTHOR]

Due to impaired airway function, children are at risk for adverse respiratory symptoms if exposed to environmental tobacco smoke (ETS). A community-based, cross-sectional study of 425 children (5–11 years) attending 15 primary schools in a low socio-economic area of Merseyside/UK was undertaken to investigate the association of adverse respiratory symptoms and ETS exposure using a parent-completed questionnaire and children’s salivary cotinine measurements. Overall, 28.9% of children had doctor-diagnosed asthma (DDA) and 11.3% a history of hospital admission for respiratory illnesses. The symptom triad of cough, wheeze and breathlessness (C+W+B+) occurred in 12.6% of children. The geometric mean cotinine level was 0.37 ng/ml (95% CI, 0.33–0.42 ng/ml) and it was estimated that 45.6% of children were ETS exposed. A history of asthma in the family was reported for 9.2% of fathers and 7.2% of mothers. Salivary cotinine level was significantly increased in children with DDA compared to those without ( P = 0.002). Cotinine-validated levels [adjusted odds ratio (AOR), 1.8; 95% CI, 1.4–2.5), low socio-economic (disadvantaged) status (AOR, 1.4; 1.1–2.9), child’s male gender (AOR, 1.6; 1.1–2.5) and maternal smoking (AOR, 2.2; 1.4–3.1) were significantly associated with DDA. The cotinine-validated level (AOR, 1.4; 1.1–2.9) as well as maternal smoking (AOR, 1.8; 1.1–2.5), were also independently associated with C+W+B+. The use of salivary cotinine as an indicator of ETS exposure could be used to inform parents of exposure risk to their asthmatic children and may help re-enforce deterrent efforts to reduce childhood parental smoking exposure. [ABSTRACT FROM AUTHOR]