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Background: Polycystic ovary syndrome (PCOS) increases the risk of metabolic syndrome (MetS). Insulin resistance (IR) plays a major role in the pathophysiology of both PCOS and MetS. Objective: This study was designed to compare the prevalence of MetS among different phenotypes of PCOS and its relationship with androgenic components. Materials and Methods: 182 participants eligible for this five-group comparative study were selected by convenience sampling method. They were classified according to the Rotterdam criteria: clinical and/or biochemical hyperandrogenism (H) + PCOS on ultrasound (P) + ovulation disorders (O) (n = 41), clinical and/or biochemical H + PCOS on P (n = 33), PCOS on P + O (n = 40), clinical and/or biochemical H + O (n = 37), and control (without PCOS) (n = 31). MetS was measured based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Androgenic components included free androgen- index (FAI), total-testosterone (TT) level and sex-hormone-binding-globulin (SHBG). Results: A significant difference was observed between the study groups in terms of MetS prevalence (p = 0.01). In phenotype H+P+O, there was a statistically significant positive association between TG and TT, and a significant negative association between SBP and DBP with SHBG. In phenotype O+P, WC was inversely associated with SHBG. In phenotype H+O, FBS and TG were positively associated with FAI but HDL was inversely associated with FAI. Moreover, WC and DBP were positively associated with TT in phenotype H+O. No associations were detected between MetS parameters and androgenic components in other PCOS subjects (phenotype H+P) and in the control group. TT was significantly higher in the PCOS group suffering from MetS (p = 0.04). Conclusion: According to the research results, hyperandrogenic components are potent predictors of metabolic disorders. Thus, we suggest that MetS screening is required for the prevention of MetS and its related complications in PCOS women. Key words: Polycystic ovary syndrome, Metabolic syndrome, Hyperandrogenism.

Background: Pregnancy is considered a period of emotional crisis. However, attention to the mental status of a pregnant mother is often neglected by health care providers. This study was conducted to determine the effect of narrative writing on the depression, anxiety, and stress of pregnant women referring to the pregnancy care clinics in the south health centers affiliated with Tehran University of Medical Sciences in Tehran, Iran. Methods: The research was a quasi-experimental field trial. A total of 120 eligible pregnant women referring to the south health centers of Tehran University of Medical Sciences were recruited by convenience sampling method. The health records of pregnant women were assessed at each center and the eligible subjects were identified. The sampling was performed during one week for the experimental group and during the next week for the control group. Mothers in the experimental group were asked to write a narrative about their deep thoughts and feelings, twice a week for two months according to the given instructions. The mothers in the control group received routine care. At first, both groups completed the Beck depression inventory and depression, anxiety, and stress scale 21 before the intervention. Then, at 4 and 8 weeks after the intervention, both groups just completed depression, anxiety, and stress scale 21. The obtained data were analyzed by the Mann-Whitney test, Chi-squared test, two-sample Kolmogorov-Smirnov test, and repeated measures ANOVA in SPSS V. 22. The significance level was set as 0.5 or less. Results: Pre-intervention levels of anxiety, stress, and depression were similar in both groups. Four weeks after the intervention, the variables of depression (P=0.014) and anxiety (P=0.004) were significantly reduced in the experimental group, but no statistically significant difference was found for the stress variable in this time interval. Finally, a significant decrease was observed in all three variables as the intervention continued for 8 weeks (P

An increasing interest in the field of molecular diagnosis of allergy has been developed in recent years and it goes to be as the routine in vitro protocol in allergy diagnosis. friendly allergen nano-bead array (FABER) is a new multiplex assay for the evaluation of specific IgE against 244 allergens including whole extracts and allergenic molecules. The research intended to assess the pattern of IgE sensitization to allergenic components of allergens in allergic adults using FABER 244.Sixty patients with allergic diseases entered this cross-sectional study. Specific IgE to 122 whole allergens extracts and 122 allergenic components were assessed using an allergen nano-bead array (FABER) for all patients. This test includes inhalant and food allergens.Thirty-seven patients were male (61.7%). The mean (SD) age of patients was 30.73(±6.87) years. As the allergen nano-bead array results showed, Lolium perenne (63.3%), Phleum pratense (60%) and Platanus acerifolia (51.7%) were considered as the most common IgE sensitizations to the aeroallergen extracts. Moreover, Lol p 1, Phl p 1.0102 and Cup a 1 were found as the most frequent allergenic components in our allergic patients. Among protein families, CCD-bearing proteins, expansin, cysteine protease and profilin families illustrated the highest allergic sensitization.The results of the present study demonstrated that despite the higher prevalence of sensitization to Salsola kali (47.2%) using extract-based assays in the previous phase of this research, allergenic components of grasses (Lol p 1, Phl p 1.0102), Cup a 1 as well as Sal k1 as the major components of Cupressuss arizonica and Salsola kali showed the higher sensitization, respectively, in adults' allergic patients using FABER test.

Non-negative continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical costs data. It is thus critical to incorporate the potential dependence of survival status and longitudinal medical costs in joint modeling, where censorship is death-related. Despite the wide use of conventional two-part joint models (CTJMs) to capture zero-inflation, they are limited to conditional interpretations of the regression coefficients in the model’s continuous part. In this paper, we propose a marginalized two-part joint model (MTJM) to jointly analyze semi-continuous longitudinal costs data and survival data. We compare it to the conventional two-part joint model (CTJM) for handling marginal inferences about covariate effects on average costs. We conducted a series of simulation studies to evaluate the superior performance of the proposed MTJM over the CTJM. To illustrate the applicability of the MTJM, we applied the model to a set of real electronic health record (EHR) data recently collected in Iran. We found that the MTJM yielded a smaller standard error, root-mean-square error of estimates, and AIC value, with unbiased parameter estimates. With this MTJM, we identified a significant positive correlation between costs and survival, which was consistent with the simulation results.

Several clinical tests have been proposed to diagnose lumbar instability, but their accuracy is still in question. The primary purpose of this study was to evaluate the diagnostic accuracy of the clinical lumbar instability tests. The secondary goal was to design a model to detect lumbar instability.A prospective diagnostic cross-sectional study.A sample of 202 patients with chronic low back pain were participated in the study. Five lumbar instability tests including Aberrant movement, Passive lumbar extension, Prone segmental instability, H and I and pheasant tests were compared to flexion/extension radiography as the gold standard for diagnosing lumbar instability using two by two tables. Multiple Logistic Regression analysis was applied to develop a model using demographic information as well as the patients' pain intensity, disability level, lumbar lordosis and the clinical tests.Among the five examined tests, Prone segmental instability, H and I and pheasant tests showed very small likelihood ratios and diagnostic odd's ratio. The largest values were for H and I test with the positive likelihood ratio of 1.28 (95% CI: 0.72 to 2.29) and diagnostic odd's ratio of 1.37 (95% CI: 0.66 to 2.83); the diagnostic accuracy measures were smaller for the other studied clinical tests. The model was developed using weight (t = 1.15, p = 0.03) and lumbar lordosis (t = 3.04, p = 0.00) (which showed a significant relationship with lumbar instability) and prone segmental instability test. The final model has the positive likelihood ratio of 2.07 (95% CI: 1.41 to 3.05) and diagnostic odd's ratio of 3.77 (95% CI: 2.03 to 7.01).Each individual test had very small to no power in discriminating patients with lumbar instability. The developed model just slightly improved the accuracy of radiological instability detection.

Following a diagnosis of cancer, distress is a common reaction. For Iranian women with endometrial cancer, treatment and survivorship can result in disabling symptoms of depression, anxiety, social, and spiritual crises. The aim of this study was to determine whether a combination of education and support intervention as a comprehensive program focusing on education, coping, and support had better short- and long-term effects on anxiety of these patients.The current randomized clinical trial was performed on a sample of 140 women with endometrial cancer. A two-part instrument was used - a demographic information form and "Beck's Anxiety" questionnaire. The intervention was an educational-supportive program in 3 weekly sessions in experimental group (N = 70), whereas control group (N = 70) received routine care. Descriptive statistics, Chi-square test, t-tests, and repeated measure analysis of variance were used to analyze data. P value less than 0.05 was considered as statistically significant.The total scores of anxiety (mean± standard deviation) was significantly lower in the experimental group immediately after intervention (8.46 ± 5.17, P0.001), 1 month (7.78 ± 4.59, P0.001) and 2 months (7.55 ± 4.55, P0.001) after intervention to compare with before intervention (16.82 ± 10.19).In this study, this program could decrease the anxiety in women with endometrial cancer.

Background Context : Previous studies have proposed that there is a relationship between low back pain (LBP) and morphology and composition of paraspinal muscles. However, results have been conflicting, especially regarding fatty infiltration of muscles. Purpose : The primary goal of this study was to review and analyze results from imaging studies which investigated morphological and composition changes in the multifidus, erector spinae and psoas major muscles in people with LBP. Study design/Setting : Systematic review with meta-analysis. Patient Sample : A patient sample was not required Outcome Measures : This review did not have outcome measures. Methods : PubMed, Scopus, Web of Sciences, EMBASE and ProQuest were searched for eligible studies up to 31st July 2020 (all languages). A systematic search of electronic databases was conducted to identify studies investigating the association between the morphology and fat content of lumbar muscles in people with LBP compared with a (no LBP) control group. 13,795 articles were identified. Based on the screening for inclusion/ exclusion, 25 were included. The quality of the studies was evaluated using the Newcastle-Ottawa Scale. From the 25 articles, 20 were included in the meta-analysis. Results : Results showed that the total cross-sectional area of the multifidus was smaller in people with LBP (Standardized mean difference, SMD= -0.24, 95% CI= -0.5 to 0.03). Combined SMDs showed a medium effect of LBP on increasing multifidus muscle fat infiltration (SMD= 0.61, 95% CI= 0.30 to 0.91). There were no LBP related differences identified in the morphology or composition of the lumbar erector spine and psoas major muscles. Conclusions : People with LBP were found to have somewhat smaller multifidus muscles with a significant amount of intramuscular fat infiltration. Varying sample size, age and BMI of participants, quality of studies and the procedures used to measure fat infiltration are possible reasons for inconsistencies in results of previous studies.

Background: The aim of this study was to assess the possible association between different factors such as age, sex, antibiotic consumption duration, angiogenesis and pain and “acceleration of wound healing” in pilonidal sinus patients after treating with platelet-rich plasma (PRP). Methods: In this clinical trial, 110 patients were randomly divided into treatment arm and control group. After surgery, control group underwent classic wound dressing and the treatment arm experienced PRP gel therapy. Before achieving complete healing, wound incisional biopsy was performed in order to evaluate angiogenesis. During the study, other data such as pain and antibiotic consumption duration were also collected. Wound healing time of pilonidal sinus disease was analyzed using Extended and Stratify Cox model. Data were analyzed using R and STATA software. p

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. The prevalence of PCOS among Iranian women is 14.6% based on the Rotterdam definition. PCOS can increase the risk of chronic metabolic complications. Metabolic syndrome (MetS) is one of the most important of them. Insulin resistance is fundamental in PCOS and MetS pathophysiology. MetS is a collection of chronic metabolic derangements, which promotes the risk of serious diseases such as cardiovascular disturbances and diabetes. The quality of diet is inversely correlated with obesity, which is one of the consequences of PCOS and it is a risk factor for metabolic syndrome. As the first study, the present study aimed to compare the dietary intake of macronutrients in PCOS women with and without MetS. Methods: In this nested case-control study, the convenience sampling method was used to select participants. The case group included 14 PCOS patients with MetS and the control group included 28 PCOS patients without MetS. The investigated macronutrients included fats (total fat, saturated fatty acids, mono and polyunsaturated fats, trans fatty acids), carbohydrate, protein, and fibers (total and soluble). The dietary intake assessment was carried out by a 168-item semi-quantitative food frequency questionnaire (FFQ). This study was performed on Arash Women's Hospital under support of Tarbiat Modares University, Tehran, Iran, from August 2014 to September 2015. Results: Dietary intake of total fat was significantly higher in PCOS women with MetS than the control group (P

Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases. At present, the cause of the disease is not fully understood, but many studies have shown that PCOS is associated with genetic and environmental factors. The present study aimed to assess the umbilical cord blood’s Anti-mullerian hormone (AMH) level in the newborns of mothers suffering from PCOS comparing to healthy mothers. Methods This prospective cohort study was conducted on 120 pregnant women with PCOS, who were selected through Rotterdam criteria, and 60 healthy pregnant women as the control group. The subjects in each group were divided into obese and non-obese mothers according to their body mass index (BMI) before pregnancy. The cord blood samples were collected from the offsprings on the time of childbirth. Finally, the circulating concentrations of AMH in both sexes of the newborns were determined by specific assays. Results The research results showed that the blood level of AMH was higher in the neonates of obese mothers with PCOS comparing to the controls (P P = 0.264). Also the level of the above biomarker was higher in both sexes of the neonates belonging to obese PCOS mothers compared with the neonates born from non-obese PCOS mothers (P Conclusion(s) It can be said that the cord blood AMH level of neonates from obese women with PCOS is higher than that in the newborns of non-obese PCOS mothers. Further longitudinal studies are needed to confirm the clinical findings of the present research.

Background The rate of cesarean section is increasing worldwide. Adiponectin is a hormone related to anti-inflammatory and anti-atherogenic effects; and it′s concentrations may change in response to inflammatory situations including surgical intervention. The aim of the current study was to investigate serum adiponectin levels in maternal and umbilical cord blood according to different modes of delivery and their relationship with anthropometric measurements and fetal sex. Methods The study population initially comprised 90 healthy pregnant women referred to the teaching hospital. Eventually, 40 participants in the vaginal delivery group and 35 subjects in the cesarean delivery group were recruited in to the study. Umbilical cord blood and maternal serum samples were analyzed according to the standard protocol from the manufacturer. The collected data were analyzed using SPSS-16 software. P-value Results Our results indicated a significant association between maternal adiponectin and the mode of delivery, with adiponectin levels significantly higher in vaginal delivery compared to cesarean section (P P = 0.51). A significant positive correlation was found between maternal serum adiponectin in the first day after birth and umbilical cord blood adiponectin in the vaginal delivery group (P = 0.007). Nevertheless, this correlation was not statistically significant in the cesarean delivery group (P = 0.62). There was also no significant correlation between fetal sex and anthropometric measurements with maternal adiponectin (P = 0.44) and umbilical cord blood adiponectin (P = 0.86). Conclusions The result of the current study revealed that maternal adiponectin concentration was significantly higher in vaginal delivery compared to cesarean section, which might be due to the increased levels of maternal adiponectin release during labor.

Background: Endometriosis, defined as the attendance of endometrial-like lesions in extra uterine locations, causes pain, infertility, and reduced quality of life. Objective: To evaluate the relationship between food consumption and nutrient intake with risk of endometriosis. Materials and Methods: Of the 156 women approached for the study, 78 women had endometriosis and 78 healthy women were included in the control group. Dietary data were collected using a validated 147-item semi-quantitative Food Frequency Questionnaire (FFQ) with the standard serving size. A logistic regression model was used to determine the association of macronutrients and energy intake with the risk of endometriosis. Results: In women with higher intake of protein, especially animal protein, monounsaturated fatty acids, soluble and insoluble fiber, oleic acid, eicosapentaenoic acid, and docosahexaenoic acid endometriosis is less common (p < 0.05). High consumption of vegetables, fruits, red meat, yellow vegetables, potatoes, legumes, dairy products, liquid oil, and low intake of fried potatoes was associated with a lower risk of endometriosis (p < 0.05). Conclusion: Regarding the association of dietary intake on endometriosis risk, counseling about improving the dietary structure can contribute toward the prevention and control of endometriosis. Key words: Endometriosis, Macronutrient, Diet, Case-control study.

Musculoskeletal Diseases (MSDs) is the most common occupational health problem affecting work and each day in workplace employees which are growing in Iran. This study aimed to Identification of the factors predicting the Stretching Exercise (SE) Behavior among Office employees with reinforcing and developing the performance of the Health Promotion Model (DHPM) in Shahid Beheshti University of Medical Sciences (SBUMS) of Iran. This cross-sectional study, data were collected a questionnaire-based on HPM for SE behaviors and Self Regulation, Counter-conditioning, and Stimulus control questionnaire (DHPM) From eligible 430 office employees working in comprehensive service centers for urban-rural health affiliated to SBUMS, selected by Multistage cluster sampling from May to Sep 2017. All structures were examined as predicting factors to decide whether or not they affect the likelihood of the prevalence of SE behavior. The data were analyzed using Confirmatory Factor Analysis the method by Amos software 22 and regression analysis with SPSS 19 software. Totally 420 office employees with mean age of 37.1±8.03 years old took part in the study. The effects of the validity of two versions of HPM (RMSEA= 0.067, x2/df=2.98, GFI&CFI=0.90) and DHPM in confirmatory factor analysis confirmed that i¬tness Indexes of the DHPM (RMSEA= 0.059, x2/df=2.38, GFI&CFI=0.98) were better. Regression analysis reflected that the coverage ratio of SE behavior variance of the DHPM is more than the HPM. This study showed that perceived barriers to action could prevent the studied participants from engaging in stretching exercise. Perceived self-efficacy, Commitment to a plan of action, interpersonal influences, and Stimulus control were significant predictors for SE behavior.

Objective: This study evaluated the antianxiety effect of Citrus aurantium aroma (neroli oil) inhalation on patients with acute coronary syndrome (ACS). Design: A double-blind, placebo-con...

Objectives: Evaluating the effect of botox injections on the satisfactory penetrating in women with vaginismus. Methods: A comprehensive systematic search in the electronic databases carrie...

Introduction Coronary artery disease is prevalent with high morbidity and coronary artery bypass grafting is one of its most important treatments. Anxiety and sleep disorders after surgery are very common and need appropriate control. The current study aimed to evaluate the efficacy of Melissa officinalis L. (Lemon Balm) for managing this problem. Methods A double-blind randomized placebo controlled clinical trial was conducted with 80 in-patients who underwent coronary artery bypass surgery. The patients were randomized into either the herbal medicine or the placebo group. Capsules containing 500 mg of Melissa officinalis L. dried leaf powder as herbal medicine or wheat starch as placebo were administered three times a day. Sleep quality and anxiety measures were the main outcomes and St Mary’s Hospital Sleep Quality and Hospital Anxiety Depression Scale were used questionnaires respectively. Results At baseline there were no significant differences in the anxiety scores between the two groups. After the intervention, anxiety scores were 7.15 ± 1.2 and 10.18 ± 3.1 in the herbal medicine and placebo groups respectively (P = 0.001). Moreover, the mean changes of sleep quality in the herbal medicine group was significantly higher than the placebo group; 14.40 ± 5.1 vs 7.52 ± 4.4 (P Conclusion The results of current study showed that seven-day treatment with 1.5 g/day dried leaf powder of Melissa officinalis appeared to reduce the levels of anxiety and improve the sleep quality in patients after coronary artery bypass surgery, by 49% and 54% respectively.

Background: Physical activity affects office employees in achieving a healthy lifestyle and preventing diseases such as Musculoskeletal Diseases (MSDS). Combining sports such as stretching exercises in healthy lifestyle programs is one of the most important decisions to prevent such disease.Purpose: This study aimed to predict factors of interpersonal and situational influences for stretching exercise (SE) among office employees at Shahid Beheshti University of Medical Sciences.Methods: A cross-sectional study was conducted among 420 office employees recruited by multi-stage cluster sampling. Self-administered questionnaires of SE and interpersonal and situational influences based on Pender’s Health Promotion Model, as well as socio-demographic data, were used in this study. The collected data were analyzed using Spearman correlation and logistic regression tests.Results: Results showed that among 420 participants, the scores of interpersonal and situational influences, and SE were 4.6±11.52, 4.5±14.21, and 2.48±17.64, respectively. There was a significant relationship between interpersonal influence and SE (r=0.54; p0.05), and interpersonal influences were a strong predictor for SE behavior.Conclusion: This study showed that the office employees who were more interpersonal influencers were more likely to do stretching exercise behavior. Therefore, interpersonal factors could be used as an educational principle in facilitating admission behavior of SE regarding Pender’s Model.

The prevalence of sensitization to aeroallergens in communities is incomprehensible. We aimed to assess the prevalence of sensitization to common aeroallergens according to the reliable studies performed in different cities of Iran. Literature review was performed by the inclusion of data sources such as PubMed, Web of Science, Google Scholar, ProQuest, Scopus, Iran Medex, and Magiran. All studies determining the prevalence of indoor and outdoor common aeroallergens were included in this review. STATA 14 and metaprop command were used for meta-analysis of data. Random pooled estimate (ES) (pooled prevalence), 95% confidence interval (95% CI), and p value were calculated. Forty-two reliable studies were included in this study. The random pooled estimate (ES) (pooled prevalence) of positive family history of allergy and positive specific IgE (in vivo tests and/or in vitro) to at least one allergen was 69% (95% CI 64–74%) and 74% (95% CI 66–81%), respectively. The pooled prevalence for weeds, trees, and grasses as outdoor allergens was 57% (95% CI 46–68%), 43% (95% CI 33–52%), and 41% (95% CI 32–50%), respectively. Salsola kali (S. kali) and Cynodon dactylon were the most prevalent weeds and grass allergens being found in 56% (95% CI 45–66%) and 40% (95% CI 29–52%) of sensitized patients, respectively. Meta-analysis of indoor allergens revealed that 27% (95% CI 14–43%), 38% (95% CI 21–57%), 21% (95% CI 16–26%), and 16% (95% CI 10–24%) of allergic patients were sensitized to mold, house dust mite (HDM), cockroach, and cat allergens, respectively. The results of the current meta-analysis revealed that S. kali is the most common aeroallergens in southwestern and northeastern areas as well as the capital city (Tehran) of Iran, while allergic patients living in northern and southern coastal areas of Iran were more prone to suffer from HDM sensitization.

Background and Objectives: Researchers use various questionnaires to examine the sleep of patients admitted to intensive care units. This study carried out aiming to compare between Richards-Campbell Sleep Questionnaire and St Mary's Hospital Sleep Questionnaire in order to assess the sleep quality in patients with acute coronary syndrome hospitalized in CCU ward. Methods: The present study was performed as a descriptive correlational study on 72 patients with acute coronary syndrome admitted to CCU of Vali-e-Asr Hospital in Qom from May 2017 to July 2018. In addition to demographic characteristics, sleep quality was assessed using Richards-Campbell Sleep Questionnaire and St Mary's Hospital Sleep Questionnaire, and psychometric properties of the two tools, were evaluated by the COSMIN Checklist. The correlation between the scores of two questionnaires was assessed using Spearman’s correlation coefficient. Results: In this study, 72 patients (72.2% male and 27.28% female) with the mean age of 59.59±1.17 (age range, 32-78 years) were studied. The COSMIN Checklist did not show all psychometric properties in both questionnaires and the correlation coefficient of the two questionnaires was weak (r=-0.44, p=0.23). Conclusion: The results of the present study showed that both Richards-Campbell Sleep Questionnaire and St Mary's Hospital Sleep Questionnaire are suitable for evaluation of the quality of sleep, but due to their high use in different studies, more researches are needed to be performed on these two questionnaires in order to determine all of their psychometric dimensions.

Objective: To determine the effect of preparation to play a maternal role in mothers fertilized through in vitro fertilization on maternal anxiety. Methods: A total of 60 mothers undergoing in vitro fertilization were assigned into intervention group and control group. Pregnancy concerns and stress questionnaires were research tools. Questionnaires were completed in both groups before organizing preparation program. Then, the preparation program was held for four sessions for the mothers in the intervention group, and the subjects in both groups were immediately investigated again after completion of preparation program and one month later. Data analyses about pregnancy stress and concerns of mothers and its dimensions were performed by repeated measure (analysis of variance), Mann-Whitney, Friedman and Wilcoxon tests. Analysis of demographic variables was performed by using independent t-test and Chi-square test in SPSS 21. Results: The score of pregnancy stress and concerns before the intervention was not significantly different between the two groups. There was a significant difference in the intervention group in the score of pregnancy stress and concerns before and after the intervention (P

Background & Aim: Womenchr('39')s health is important in middle age, and lifestyle, including healthy eating, has an impact on it. This research was aimed to determine the effect of an educational program based on BASNEF model on nutrition in middle-aged women. Methods & Materials: This clinical trial was conducted on 95 women under coverage of the healthcare centers affiliated to Tehran University of Medical Sciences in 2016. The demographic characterizes and the BASNEF constructs regarding nutritional behavior were measured by questionnaire before and eight weeks after the intervention. The intervention was performed in three one-hour sessions. Data were analyzed by descriptive statistics, Chi-square and Mann-Whitney U tests using the SPSS software version 16. Results: Before the intervention, both groups had not any significant differences in all variables and constructs. After the intervention, in the experimental group, the median and interquartile range were 10±3 for knowledge, 38±10 for attitude, 3±1 for subjective norms and 1±1 for behavioral intention. But in the control group, the scores were 6±2 for knowledge, 37±5 for attitude, 4±1 for subjective norms and 1±1 for behavioral intention. There was a significant difference between the two groups (P˂0.05). However, the scores of enabling factors were not significantly different between the two groups of intervention (3±1) and control (3±1) (P=0.4). Conclusion: Designing and implementing the educational program based on BASNEF model not only can improve the knowledge and attitude about healthy nutrition in middle-aged women, but also modify their behavioral intention. Clinical trial registry: IRCT2016042427566N1

BACKGROUND & OBJECTIVE: Apelin plays an important role in regulating energy intake and homeostasis. This study aims to investigate the relationship between maternal serum apelin-36 and infants’ anthropometric markers up to 18 months after birth.MATERIAL & METHODS: In this cohort study, 166 pregnant women aged 18-40 years old third trimester period referred to the Prenatal Clinic, participated in this study. The women were divided into two groups: an elective cesarean section group (as an exposure; n = 23), and a vaginal delivery group (as a non-exposure; n = 22). Maternal serum Apelin-36 levels were measured during the third trimester period and after delivery using ELISA. Infants were followed for up to 18 months during the postpartum period.RESULTS: The serum level of Apelin-36 after delivery was significantly and positively correlated with the weight of infants at 12 months, and 18 months P

Background The aim of this study was to provide a path model for assessing the direct and/or indirect effects of psychological/behavioral parameters on health-related quality of life among women with vaginismus. Methods A cross-sectional study was conducted on a sample of 236 women with vaginismus disorder attending to sex clinics in Tehran, Iran from April 2017 to March 2018. Data were collected using a demographic questionnaire, the marital satisfaction scale, the hospital anxiety and depression scale, the rosenberg self-esteem scale, the body image concern inventory, the short-form health survey (SF-12) and the female sexual quality of life questionnaire. In addition to descriptive statistical data, the fitness of the proposed model was investigated using path analysis. Results The results of path analysis demonstrated that the final model had a good fit to the data (Chi-Square/degrees of freedom (Normed Chi2) = 2.12, root mean square error of approximation = 0.069, goodness fit index = 0.99, both comparative fit index = 0.99 and Tucker–Lewis index = 0.96). In this model, anxiety and depression significantly predicted health-related quality of life as measured by the SF-12. Conclusions Anxiety and depression are important components in predicting health-related quality of life among those suffering from vaginismus.

Background: Several hematological indices have been already proposed to discriminate between iron deficiency anemia (IDA) and β‐thalassemia trait (βTT). The aim of the present study was to compare the diagnostic performance of different hematological discrimination indices with statistical methods such as decision trees to discriminate IDA from βTT.Methods: Consisting of 1178 patients with hypochromic microcytic anemia (708 patients with βTT and 470 patients with IDA), this cross-sectional study intended to compare the diagnostic performance of 43 hematological discrimination indices and tree-based methods such as J48, CART, Evtree, Ctree, QUEST, CRUISE as well as GUIDE to discriminate IDA from βTT. Moreover, multidimensional scaling and cluster analysis were used to identify the homogeneous subgroups of discrimination methods with similar performances.Results: All the classification tree algorithms showed acceptable accuracy measures for discrimination between IDA and βTT in comparison with other hematological discrimination indices. The results indicated that CRUISE tree algorithm had better diagnostic performance and efficiency among other discrimination methods. In turn, this tree algorithm showed the high Youden's index (88.03%), accuracy (94.57%), diagnostic odds ratio (311.63) and F-measure (95.54%) in the differential diagnosis of IDA from βTT. In addition, AUC of this algorithm indicated more precise classification with a value of 0.94 and this model was found to have excellent diagnostic accuracy. Also, CRUISE tree algorithm showed that Mean corpuscular volume can be considered as the main variable in discrimination as it extracted six homogenous subgroups of patients.Conclusions: CRUISE tree algorithm as a powerful method in data mining techniques can be used to develop accurate differential methods along with other laboratory parameters to discriminate IDA from βTT.

Background Several hematological indices have been already proposed to discriminate between iron deficiency anemia (IDA) and β‐thalassemia trait (βTT). This study compared the diagnostic performance of different hematological discrimination indices with decision trees and support vector machines, so as to discriminate IDA from βTT using multidimensional scaling and cluster analysis. In addition, decision trees were used to determine the diagnostic classification scheme of patients. Methods Consisting of 1178 patients with hypochromic microcytic anemia (708 patients with βTT and 470 patients with IDA), this cross-sectional study compared the diagnostic performance of 43 hematological discrimination indices with classification tree algorithms and support vector machines in order to discriminate IDA from βTT. Moreover, multidimensional scaling and cluster analysis were used to identify the homogeneous subgroups of discrimination methods with similar performance. Results All the classification tree algorithms except the LOTUS tree algorithm showed acceptable accuracy measures for discrimination between IDA and βTT in comparison with other hematological discrimination indices. The results indicated that the CRUISE and C5.0 tree algorithms had better diagnostic performance and efficiency among other discrimination methods. Moreover, the AUC of CRUISE and C5.0 tree algorithms indicated more precise classification with values of 0.940 and 0.999, indicating excellent diagnostic accuracy of such models. Moreover, the CRUISE and C5.0 tree algorithms showed that mean corpuscular volume can be considered as the main variable in discrimination between IDA and βTT. Conclusions CRUISE and C5.0 tree algorithms as powerful methods in data mining techniques can be used to develop accurate differential methods along with other laboratory parameters for the discrimination of IDA and βTT. In addition, the multidimensional scaling method and cluster analysis can be considered as the most appropriate techniques to determine the discrimination indices with similar performance for future hematological studies.

The world population is rapidly aging. In older people, age-related biological decline in most body systems causes functional decline, an increase in dependence, and an increased need for support, especially by their family members. The aim of this study was to explore the main aspects of family support for older parents in home care. This qualitative study was conducted using a deductive qualitative content analysis approach. Participants were 21 older parents living in their own homes, as well as four family members of some participants. Data were collected using semi-structured interviews and then were analyzed using the primary matrix developed based on the existing literature. The main aspects of family support for older parents were grouped into five predetermined categories and one new category: “instrumental support”, “financial support”, “psycho-emotional support”, “healthcare-related support”, “informational-technological support”, and “social preference support “. Family support for older people in home care is a multi-dimensional phenomenon. Family members can identify the needs of their older parents and provide them with appropriate support in collaboration with healthcare professionals to enhance their quality of life, autonomy, and satisfaction with life.

Despite the importance and prominent role as a clinical, theoretical, and research approach in nursing practice, humanistic care nature and boundaries are not explicit and challenging for nurses to understand. This study was conducted to clarify the concept of humanistic care in nursing.Based on Rogers's evolutionary concept analysis, keywords such as "humanistic car *," "caring behave *," "humanistic nurs *," "humanistic model of care," were searched in PubMed, SCOPUS, Science Direct, Web of Science, WILEY, Springer, SAGE, ProQuest, SID, Iranmedex without time limit until November 2018. Sixty-five documents in nursing and ten documents in the medical discipline were finalized for thematic analysis.Nine attributes of the humanistic care, including "excellence in clinical literacy," "creating a healing environment," "a comprehensive and unique viewpoint," "contribution to clients' adaptation and flourishing of their talents," "unrequited love and affection," "preservation of human dignity," "real presence," "constructive dynamic interaction," and "nurse's self-care," were recognized. Assessing the historical and evolutionary course of the concept's semantic tendency revealed three periods: The focus in first, second, and third was on the nurse-patient relationship, quantitative tendency/measurement, and metaphysics/spiritual humanism, respectively. The comparison of interdisciplinary differences indicated greater semantic comprehensiveness and depth in the nursing discipline.Clear and practical definition and identification of humanistic care in nursing can be helpful in the further development of existing knowledge, instrumentation, designing guidelines, clinical interventions, knowledge translation, and correction of concept misuse. The identified antecedents and consequences can be in various aspects of clinical management.

Most parents consider adolescence to be the most difficult stage of parenting. Parental practice is a determining factor in adolescents' outcomes. Mothers play the main role of parenting in Iran. Coinciding the transition of adolescence with the transition of middle-aged mothers can affect the mothers' parenting practice. The present study aimed at explaining the Iranian mothers' practice in parenting an adolescent child.This qualitative conventional content analysis was conducted from July 2018 to November 2019 in Kashan. 21 in-depth semi-structured interviews with mothers of adolescent children were performed using a purposive sampling method. The data were analyzed through conventional content analysis. Data collection and analysis were performed simultaneously using MAXQDAv10 software.Regarding the study objectives, two themes and six main categories were identified. The theme of 'laying the groundwork for upbringing' was detected by two main categories: 'meeting the needs and 'effective interaction with the adolescent'; also, the theme of 'individual-social capacity building' was explained by four main categories: 'helping to gain independence', 'modeling individual-social behavior', 'socializing the adolescent', and 'preparing to accept future roles'.Mothers' practice was mainly focused on adolescents' independence, college education, career prospects, and marriage preparation and respect for older adults. Consistent with this transition to modernity, and contrary to the collectivist values of Iranian society, mothers' practice was in line with developing adolescents' independence and building their self-confidence, which is close to the authoritative parenting style.

Background: Interpersonal influences are critical key points for stretching exercise predicting. In Iran, there's no measure to observe interpersonal Influences amongst workplace office employees. Objective: The purpose of this study was to investigate the short form psychometrics of Interpersonal Influences scale for Stretching Exercise predicting among based on Health Promotion Model (HPM) With Added Constructs. Methods: By multistage cluster sampling method, this cross-sectional study was done among 385 office employees were selected from the Health networks at Shahid Beheshti University of Medical Sciences of Iran (SBUMS). Results: The EFA is shown via the principle component approach one factor with 77% cumulative variance and Kaiser-Mayer-Olkin (KMO) became 90.7%; p -value< 0.001. This was the good fit index in Confirmatory Factor Analysis (CFA). Also With the help of Construct validity, factor was explanted. Within the CFA area, Root Mean Square Error of Approximation (REMSEA) result display= 0.059, Goodness of Fit Index (GFI) = 0.966, Adjusted Goodness of Fit Index (AGFI) = 0.985 confirmed with Cronbach’s alpha (α = 0.834%) and [ (ICC) =0.79 95% Confidence ICCnterval (CI) (0.58, 0.84)]. Conclusion: This study generated a Persian-language version of the Interpersonal Influences scale among the office employees Based on the of HPM.

The article's abstract is not available.

Background: Oral Squamous Cell Carcinoma (OSCC) is among the ten most common cancers worldwide. Hypermethylation of CpG sites in the promoter region and subse-quent down-regulation of a tumor suppressor gene, TGM-3 has been proposed to be linked to different types of human cancers including OSCC. In this study, methylation sta-tus of CpG sites in the promoter region of TGM-3 has been evaluated in a cohort of pa-tients with OSCC compared to normal controls. Methods: Forty fresh tissue samples were obtained from newly diagnosed OSCC patients and normal individuals referred to dentistry clinic for tooth extraction. DNA was extract-ed, bisulfite conversion was performed and it was subjected to PCR using bisulfite-sequencing PCR (BSP) primers. Prepared samples were sequenced on a DNA analyzer with both forward and reverse primers of the region of interest. The peak height values of cytosine and thymine were calculated and methylation levels for each CpG site within the DNA sequence was quantified. Results: Quantitative DNA methylation analyses in CpG islands revealed that it was sig-nificantly higher in OSCC patients compared to controls. DNA methylation at CpG1/CpG3/CpG5 (p=0.004-0.01) and CpG1/CpG3 (p=0.001-0.019) sites was associated with tumor stage and grade, respectively. Male OSCC patients had higher methylation rate at CpG3 (p=0.032), while smoker patients showed higher methylation rate at CpG6 (p=0.045). Conclusion: These results manifested the contribution of DNA methylation of TGM-3 in OSCC and its potential association with clinico-pathologic parameters in OSCC.

Orexin as an adipokin hormone plays an important role in appetite regulation, energy metabolism, obesity, diabetes, and cardiovascular disease. The main source of orexin secretion in nonpregnant and pregnant women is adipose tissue and placenta, respectively. This research was conducted to evaluate the association between orexin-A level and the mode of delivery, anthropometric indices, and sex of the infant.This prospective cohort study was conducted on 69 normal pregnant women. The samples of umbilical cord blood were obtained at the time of delivery, and maternal blood was taken within 24 h of delivery. Serum orexin-A levels were measured by using enzyme-linked immunosorbent assay. Statistical analyses were performed using SPSS and p 0.05 was considered as significant.We found a significant difference between postpartum maternal and umbilical cord orexin-A level both with the mode of delivery (p 0.001). Also, a significant positive correlation was seen between maternal and umbilical cord serum orexin-A levels (r = -0.61, p 0.001). There was no relationship between serum orexin-A levels with anthropometric indices and the sex of the neonate (p 0.05).Both maternal and umbilical cord serum orexin-A levels were associated with the mode of delivery. Maternal and cord blood orexin-A levels in normal vaginal delivery are higher than cesarean section.

Background: Comparison of LASSO, smoothly clipped absolute deviation (SCAD) and minimax concave penalty (MCP) logistic classifiers in order to reconnaissance of related genes with COPD disease and assessing the genes effects on the progression of the disease based on one of the main classes of cells involved in the disease, Sputum Cells. We used a genome-wide expression profiling to define gene networks relevant to the disease. The data retrieved from Gene Expression Omnibus (GEO) with accession numbers "GSE22148". From 143 samples in GOLD stage 2-4 COPD ex-smokers, 54,675 probes primary were assessed. After normalization, LASSO, SCAD and MCP logistic regressions were applied. K-fold cross-validation scheme was used to evaluate the performance of two methods. All of the computational processes were done using "ncvreg", "Affy," "Limma" and "SVA" R packages. Results: The results of LASSO (AUC=0.95, sensitivity= 0.91, specificity= 0.86) and SCAD (AUC=0.97, sensitivity= 0.95, specificity= 0.85) logistic regression were almost similar. There were 23 and 22 significantly associated genes for LASSO and SCAD, respectively. The only difference between these models is related to "stromal interaction molecule 2". Comparing to MCP approach, the most conservative method, we detected only 7 significant genes (AUC= 0.94, sensitivity= 0.94, specificity= 0.82). Conclusions: In the present study, the relative expressions of thousands of the genes were assessed and identified as associated genes with the progression of COPD. Differential analysis of gene expression data is able to reduce the number of genes but in a limited manner. In order to find an efficient and small subset of genes, we should use alternative approaches like logistic regression. Regularization solves the high dimensionality problem in using this kind of regression.

Sexual function is essential for species survival. Melanocortin, progesterone, and estrogen can improve sexual function and they are modulated by adiponectin hormone which can be increased by Turmeric. In various studies shows Turmeric ability that is easily accessible to increase serum adiponectin levels. Therefore, the researchers decided to conduct a study to determine the effect of turmeric on serum adiponectin levels, sexual behavior, and profile of steroid hormones in stressed mice. Thirty female mice, six in each group (1. control group, 2. mice that received stress, 3. stress mice received 100 mg/kg turmeric (extract daily) for 4 weeks, 4. stress mice received turmeric (extract daily) for 4 weeks and also received adiponectin antagonist, and 5. stress groups received adiponectin antagonist), were used in the current study. The mice first underwent blood sampling. Then all mice were subjected to stress testing before the intervention except one group, which considered as a control group. The intervention in this study was done as a 100 mg/kg turmeric extract that was gavaged daily for each mouse. After the intervention, all mice were tested for sexual behavior, and then blood samples were taken to check serum levels of adiponectin, estradiol, progesterone and prolactin. So, the results showed before the intervention there were no significant difference among 5 group in levels of adiponectin (p = 0.145), estradiol (p = 0.148), progesterone (p = 0.166) and prolactin (p = 0.206) but after intervention there were significant difference between 5 group in levels of adiponectin, estradiol and progesterone (p 0.001). Also there was significant difference among 5 groups in sexual behavior (p 0.001). Therefore, consumption of turmeric, which increases serum adiponectin in the stressed mice, can improve sexual function and estradiol hormones profiling.

Self-compassion enhances self-care behavior in patients with multiple sclerosis. This concept has been defined in previous studies; however, in order to effectively enhance it, patients' perceptions about and experiences with self-compassion should be first understood. Therefore, this study aims to explore the meaning of self-compassion experienced by patients with multiple sclerosis.This directed qualitative study was conducted in 2019 in Iran. Twenty-three patients with Multiple sclerosis were selected purposefully and interviewed individually. Qualitative content analysis was used for data analysis according to Hsieh and Shannon's method.Seventy-six primary codes were detected as well as the following eleven categories: self-kindness, self-judgment, common humanity, isolation, mindfulness, over-identification, seeking support, concealment, spiritual resilience, marital life concern, and turning into an example for others. These categories express the characteristics and meaning of self-compassion in patients with multiple sclerosis. Six of the 11 characteristics are in accordance with the theory of Neff's theory and five are related to patients and the cultural and social arena of the study environment.Results of the present study showed that new dimensions of self-compassion were found by exploring multiple sclerosis patients' experiences, which added to the suggested dimensions of others. This study is promising to nurses and paramedics as it will help them to better identify and to take better care of patients. The result will also help to design a valid tool to measure this issue of patients.

To compare traditional (1-month supervised) vs hybrid cardiac rehabilitation (CR; usual care) with an additional 3 months offered remotely based on the continuous care model (intervention) in patients who have undergone coronary artery bypass graft (CABG).Randomized controlled trial, with blinded outcome assessment.A major heart center in a middle-income country.Of 107 eligible patients who were referred to CR during the period of study, 82.2% (N=88) were enrolled (target sample size). Participants were randomly assigned 1:1 (concealed; 44 per parallel arm). There was 92.0% retention.After CR, participants were given a mobile application and communicated biweekly with the nurse from months 1-4 to control risk factors.Quality of life (QOL, Short Form-36, primary outcome); functional capacity (treadmill test); and the Depression, Anxiety and Stress Scale were evaluated pre-CR, after 1 month, and 3 months after CR (end of intervention), as well as rehospitalization.The analysis of variance interaction effects for the physical and mental component summary scores of QOL were.001, favoring intervention (per protocol); there were also significant increases from pre-CR to 1 month, and from 1 month to the final assessment in the intervention arm (P.001), with change in the control arm only to 1 month. The effect sizes were 0.115 and 0.248, respectively. Similarly, the interaction effect for functional capacity was significant (P.001), with a clinically significant 1.5 metabolic equivalent of task increase in the intervention arm. There were trends for group effects for the psychosocial indicators, with paired t tests revealing significant increases in each at both assessment points in the intervention arm. At 4 months, there were 4 (10.3%) rehospitalizations in the control arm and none in intervention (P=.049). Intended theoretical mechanisms were also affected by the intervention.Extending CR in this accessible manner, rendering it more comprehensive, was effective in improving outcomes.

Background The impact of COVID-19 pandemic on mental health of pregnant and lactating women is unclear. This study aimed to assess the impact of COVID-19 on psychological health, sexual function, and quality of life (QoL) in Iranian pregnant and lactating women and compare the results with non-pregnant/non-lactating women. Method This comparative cross-sectional study was carried out on pregnant and lactating women, with non-pregnant/non-lactating women from May to Jun 2020. Patients were asked to complete three questionnaires: Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and Short-Form Health Survey (SF-12). One-way ANOVA was used to reveal the statistical differences between the three groups. Result The mean age of patients was 20.81 ± 5.92 years old. The mean (SD) score of HADS in pregnant, lactating and non-pregnant / non-lactating women were 12.11 (6.72), 11.98 (8.44) and 9.38 (6.2) respectively, and the results showed that the scores in pregnant, lactating women were higher than non-pregnant / non-lactating women (P P Conclusion The COVID-19 epidemic increases the risk of depression, anxiety, FSD, and lowers QoL in pregnant and lactating women, with the general population. This suggests the urgent need for psychological intervention in the maternal population during the epidemic.

Background: Congenital malformations are one of the most important and common types of anomalies in infants, which are one of the main causes of disability and mortality in children. Objectives: This study aimed to investigate the risk factors affecting the incidence of congenital malformations, as well as the number of different infant anomalies recorded in neonatal health data in Khoy, Iran, during 2017. Methods: In this study, all neonates born in the maternity wards of hospitals in Khoy, Iran, during 2017 were evaluated in terms of gender, weight, and parental consanguinity. Hurdle and Zero-inflation approaches were utilized for the double Poisson model. Moreover, the data were collected using some checklists, and the analyses were performed in R-3-6-1 software. Result: According to the results of the present study, the Hurdle approach was better than Zero-inflation. The birth weight and parental consanguinity affected the incidence of congenital malformations in infants. Conclusion: Given that a significant proportion of infants are born without any congenital malformations, it is important to use count regression models based on excess zero approaches to assess congenital malformations. It is also necessary to take steps to reduce consanguineous marriages and the number of infants with low-birth-weight to prevent congenital malformations.

Background: Women' mental health during reproductive age is a major public health concern in both developing and developed countries. There is a relationship between mental health and marital satisfaction. This study aimed to assess mental health, anxiety, depression, and marital satisfaction among pregnant and lactating women and compared the results with non-pregnant/lactating (as control group) during the COVID-19 pandemic in Iran. Methods: A cross-sectional study among married women in range of 18 to 45 years via online questionnaires was conducted from 20 March to 25 April, 2020. A total of 604 valid questionnaires were analyzed, including 200 pregnant women, 203 lactating women, and 201 non-pregnant/lactating women. Mental health, COVID-19-related anxiety, and marital satisfaction were respectively assessed by the General Health Questionnaire (GHQ), the Corona Disease Anxiety Scale (CDAS), and ENRICH Marital Satisfaction Scale (EMS Scale). The data were analyzed using Statistical Package for Social Sciences (SPSS) software. Results: The scores of mental health problems in pregnant and lactating women were significantly higher than the control group (18.86±12.56 and 18.83±13.99 vs. 13.01±8.15, PConclusions: Pregnant and lactating women had more mental health problems, more anxiety and less marital satisfaction in comparison to non-pregnant/lactating women in the course of COVID-19 outbreaks. Further study is needed to investigate the effect of COVID-19 prevalence on mental health and marital satisfaction of pregnant and lactating women, considering the socioeconomic status.

Background Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women. It is one of the risk factors of metabolic syndrome (MetS). These two syndromes have an inflammatory etiologic foundation along with oxidative stress. The present study aimed to compare the dietary intake of antioxidant micronutrients in PCOS women with and without MetS. Materials and methods Overall, 42 participants eligible for this nested case control study were selected by the convenience sampling method. The case group included 14 PCOS patients with MetS and the control group included 28 PCOS patients without MetS. The dietary intake assessment of selenium, chromium, zinc, carotenoids, vitamin D and vitamin E was carried out by a 147-item Food Frequency Questionnaire (FFQ). PCOS and MetS were diagnosed using the Rotterdam criteria and NCEP ATP III, respectively. Statistical analysis was performed using SPSS16 software, T-test and Mann Whitney. Significant P-value was considered 0.05. Results Dietary intake of antioxidant micronutrients (selenium, zinc, chromium, carotenoids and vitamin E) was significantly lower in the PCOS women with MetS than in the control group (P Conclusion Since the PCOS patients without MetS had more intake of the aforementioned micronutrients than those with MetS, it is assumed that the dietary intake of these nutrients could probably have a protective effect on MetS.

Background Obesity is a significant risk factor for Noncommunicable diseases, and it is related to many adverse health consequences. The risk of obesity commonly changes with age, which is called a longitudinal or aging effect. Also, individuals born or enter to the study of the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. In the current study, an advanced statistical model is used to distinguish between longitudinal and cross-sectional effects of age on the risk of obesity for men and women. Methods Participants are a group of 6504 Iranian adults over 35 years of age in 2001, who live in the central region of Iran. They were followed up for 12 years in a large community-based study. Various medical indexes, including Body Mass Index, were collected in 2001, 2007, and 2013. The Marginal Logistic Regression model, which includes linear and quadratic effects of the Baseline Age and its difference with current age, is used. Results Between 2001 and 2013, the prevalence of obesity raised from 13% to 18% in men and from 31% to 44% in women. The odds of obesity for women was approximately three times the odds of obesity for men on average adjusting for the age effects. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the prevalence of obesity for individuals with Baseline Age 35 to 55 and a decline thereafter. Also, the odds ratio of obesity across one’s life course, had about 3% increase, on average, by each year aging, regardless of the age at baseline. Conclusions The high rate of obesity and its fast growth is a serious public health issue among Iranians, especially in adults age 35-55, and women. In the present study, Baseline Age was more strongly associated with the risk of obesity than aging. Considering both cross-sectional and longitudinal effects of age, helps us to understand the effect of age on obesity better and to identify the related factors.

Health literacy index (HLI) was developed to provide a proper framework for educational material in all levels. So, the aim of this study was to determine the effect of education based on (HLI) on the self-care ability among older adults.This randomized clinical trial was conducted with 68 older adults during the period of May-August 2019. The research setting was health centers in the south of Tehran, Iran. Samples were selected with considering the inclusion criteria. Then Block randomization was used to assign the participants into two groups. The intervention group for 4 weeks in groups of 8-10 in the intervention group. Self-care ability was measured using a self-care questionnaire in two stages, before and two months after the implementation of intervention. The control group received no education and only used the routine community house services. Statistical analyses were performed using the SPSS software (version 16.0). Data were analyzed using the Chi-square, Fisher's exact test and independent t-test.The mean total self-care ability scores in the intervention group were 165.38 ± 10.69 and 184.28 ± 10.07 before and after intervention, respectively. These scores in the control group were 163.65 ± 13.27 and 167.52 ± 13.58, respectively (The implementation of education based on HLI significantly improve the self-care behaviors in older adults. It is suggested that this approach should be established to fit of educational content appropriate to the age of the elderly in order to health promotion. Trial Registration: The trial was registered in the Iranian Registry of Clinical Trials on May 23, 2018, identifier: IRCT20170912036150N1.

Background Most parents consider adolescence to be the most difficult stage of parenting. The parental practice is a determining factor in adolescents’ academic achievement, self-esteem, independence attainment, social adjustment, and risky behaviors reduction. The main role of parenting in many societies is played by mothers. The present study aimed at explaining the Iranian mothers’ practice in parenting an adolescent child. Methods This qualitative conventional content analysis was conducted in 2019 in Kashan, in the central part of Iran. Totally, 20 in-depth semi-structured interviews with mothers of adolescent children were performed using a purposive sampling method. Interviews continued until data saturation was reached. Data collection and analysis were performed simultaneously using MAXQDA10 software. Results Regarding the study purpose, six main categories and two themes were identified. The theme of ‘laying the groundwork for upbringing’ was detected by two main categories: ‘meeting the needs’ and ‘effective interaction with the adolescent’ and the theme of ‘individual-social capacity building’ was explained by four main categories: ‘helping to gain independence’, ‘modeling individual-social behavior’, ‘socializing the adolescent’, and ‘preparing to accept future roles’. Conclusions A deeper understanding of maternal practice can help health professionals, especially family nurses, develop parenting programs to promote maternal literacy and adolescent health.

Background: Women during pregnancy and in the first year after childbirth are vulnerable to mental disorders in the outbreaks of infectious diseases such as Coronavirus Disease (COVID-19). There is a relationship between mental health and marital satisfaction. This study aimed to assess mental health, anxiety, depression, and marital satisfaction among pregnant and lactating women and compared the results with non-pregnant/lactating (as control group) during the COVID-19 pandemic in Iran.Methods: A cross-sectional study among married women in range of 18 to 45 years via online questionnaires was conducted from 20 March to 25 April, 2020. A total of 604 valid questionnaires were analyzed, including 200 pregnant women, 203 lactating women, and 201 non-pregnant/lactating women. Mental health, COVID-19-related anxiety, and marital satisfaction were respectively assessed by the General Health Questionnaire (GHQ), the Corona Disease Anxiety Scale (CDAS), and ENRICH Marital Satisfaction Scale (EMS Scale). The data were analyzed using Statistical Package for Social Sciences (SPSS) software. Results: The scores of mental health problems in pregnant and lactating women were significantly higher than the control group (18.86±12.56 and 18.83±13.99 vs. 13.01±8.15, PConclusions: Pregnant and lactating women had more mental health problems, more anxiety and less marital satisfaction in comparison to non-pregnant/lactating women in the course of COVID-19 outbreaks. Further study is needed to investigate the effect of COVID-19 prevalence on mental health and marital satisfaction of pregnant and lactating women, considering the socioeconomic status.

Background The impact of COVID-19 pandemic on mental health of pregnant and lactating women is unclear. This study aimed to assess the impact of COVID-19 on psychological health, sexual function, and quality of life (QoL) in Iranian pregnant and lactating women and compare the results with non-pregnant /lactating (as the control group). Method: This cross-sectional study was carried out on pregnant and lactating women as case groups, with non-pregnant /lactating women as control. Patients were asked to complete three questionnaires: Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and Short-Form Health Survey (SF-12). One-way ANOVA was used to reveal the statistical differences between the three groups. Result The mean age of patients was 20.81 ± 5.92 years old. Evaluation of the three groups with regard to HADS and SF-12 showed that all mean values were lower in pregnant women than in other groups. Also, the differences in scores in the three groups were statistically significant (P˂0.001). The comparison of FSFI scores showed that the mean of all domain and total scores were significantly lower in pregnant women compared with other groups. The differences between the three groups were statistically significant during desire, arousal, orgasm, pain, and total score (P˂0.001). Conclusion The COVID-19 epidemic increases the risk of depression, anxiety, FSD, and lowers QoL in pregnant and lactating women, with the general population. This suggests the urgent need for psychological intervention in the maternal population during the epidemic.

Background Gestational diabetes mellitus (GDM) is associated with adverse diabetic complications for both mother and child during pregnancy. The common Gold Standard (GS) for diagnosis of GDM is 75 g oral glucose tolerance test (OGTT) during 24–28 gestational weeks which seems a little late for any proper intervention. This study aimed to employ the Bayesian latent class models (LCMs) for estimating the early diagnostic power of combination of serum multiple marker in detecting GDM during 14–17 weeks of gestation. Methods Data from a sample of 523 pregnant women who participated in gestational diabetes screening tests at health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran from 2017 to 2018 were used. The beta-human chorionic gonadotropin (β-hCG), unconjugated estriol (uE3), and alfa-fetoprotein (AFP) values were extracted from case records for all participants. The Bayesian LCMs were applied for estimating sensitivity, specificity, and area under receiver operating characteristic curve (AUC) of combining the three biomarkers’ results in the absence of GS, adjusting for maternal age and body mass index. Results The mean (standard deviation) maternal age of the participants was 28.76 (±5.33) years. Additionally, the mean (standard deviation) BMI was 24.57 (±3.22) kg/m2. According to the Bayesian model, the cSensitivity, cSpecificity, and cAUC for the optimal composite diagnostic test were estimated as 94% (95% credible interval (CrI) [0.91–0.99]), 86% (95% CrI [0.80–0.92]), and 0.92 (95% CrI [0.87–0.98]), respectively. Conclusions Overall, the findings revealed that the combination of uE3, AFP, and β-hCG results might be considered as an acceptable predictor for detecting GDM with a rather high level of accuracy in the early second trimester of pregnancy without a GS.

Background This study aimed to compare the lifestyle factors and SQ between women with and without endometriosis. Also in this essay, the influence of food intake, socio-demographic and clinical characteristics on sleep quality of women with endometriosis was determined. Methods Of the 156 infertile women approached for the study, 78 women had endometriosis and 78 were included in the control group. At first, each participant completed a checklist including questions about demographics, physical activity, reproductive and menstrual status. SQ was assessed by the Pittsburgh Sleep Quality Index (PSQI). Dietary data were collected using a validated 147-item semi-quantitative FFQ. Results Irregular menstrual status, menorrhagia, dysmenorrhea, pelvic pain, history of abortion, family history of endometriosis were associated with endometriosis risk (P P P p Conclusion In endometriosis women, SQ was lower than healthy individuals. Lifestyle factors can effect on SQ of these patients.