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Background Asthma is a chronic airway disease characterized by an overreaction of the airways to a wide range of stimuli. Objective To determine the relationship between the incidence and mortality rate of asthma and the levels of PM2.5, ozone, and household air pollution (HAP) from 1990 to 2016 in the world. Materials and methods This ecological study was conducted across 194 countries. The asthma incidence and mortality rates were extracted from IHME Global Burden of Disease databases. Data on average annual population-weighted HAP, PM2.5, and ozone were obtained from the State of Global Air website. A model-based clustering with a finite mixture of matrix-variate normal distributions was used to identify countries with a similar pattern of three air pollution index values. The number of clusters was determined by the Bayesian information criterion, and R software was used for integrated completed likelihood criterion. The random-effects model was applied to evaluate the relationship between asthma incidence in groups and different years by using the SAS software. Results The countries were classified into five clusters in terms of the mean of PM2.5, ozone, and HAP. The incidence rates had a decreasing trend during 1990–2005 and an increasing trend during 2011–2016 in the clusters. The lowest incidence and mortality rates were observed for countries of cluster 3. The highest incidence and mortality rates were observed for countries in clusters 1 and 2, respectively. The incidence and mortality ratio trends experienced an increase in cluster 1 and a decrease in other clusters. Conclusions Depending on the mortality and incidence trends of asthma in countries in each cluster, effective national and international intervention measures are recommended to deal with such pollutants. [ABSTRACT FROM AUTHOR]

A new highly sensitive and powerful electroanalytical tool fabricated by two fold amplification of paste electrode (PE) with Pt/graphene nanocomposite (Pt/Gr-NC) and room temperature ionic liquid (1-Hexyl-3-methylimidazolium hexafluorophosphate (1H3MTIHFP) in this case) (Pt/Gr-NC/1H3MTIHFP/PE) for detection and determination of vitamin B6 in environmental and food samples. The modification with a synergistic effect in the designed sensor has caused the vitamin B6 signal to increase greatly, and the conditions for designing an ultra-sensitive sensor for the measurement with linear range 0.004–250 µM and the detection limit 0.5 nM created. On the other hand, this synergistic effect (1H3MTIHFP and Pt/Gr-NC) due to presence of has caused the vitamin B6 oxidation signal to improve about 4.9 times and its oxidation potential to decrease by 140 mV, which means creating a sensor with high selectivity and suitable detection limit. Finally, Pt/Gr-NC/1H3MTIHFP/PE was used as a perfect analytical tool in monitoring of real samples such as fruit juices and water. Results was completely confirm ability of Pt/Gr-NC/1H3MTIHFP/PE in sensing vitamin B6. [ABSTRACT FROM AUTHOR]

Effect of swimming training is considered on doxorubicin-induced toxicity in the liver, heart, and kidney of rats. Histopathological degeneration could partially be prevented in swimming-trained rats pretreated with garlic extract. Exercise combined with garlic extract reduced the malondialdehyde value and improved the activities of antioxidant enzymes. Doxorubicin treatment enhanced the mean values of blood ALT, AST, and ALP enzymes, as well as hepatic, cardiac, and renal TNF-α and HSP70 (p <.05). Swimming alone or supplemented with garlic extract can protect liver, heart, and kidney against doxorubicin toxicity by increasing antioxidants and reducing oxidative stress and inflammation. [ABSTRACT FROM AUTHOR]

Background: This study, for the first time, aimed to assess the effects of fermented camel milk (FCM) on glycemic and inflammatory parameters related to metabolic syndrome (MetS), an aggregation of cardiometabolic risk factors, in adolescents. Materials and Methods: In a double-blind, randomized crossover trial, overweight/obese adolescents (fulfilling MetS criteria, aged 11-18 years) were randomly assigned to receive FCM 250 cc per day for an 8-week period, a 4-week washout, and then diluted cow's yogurt (DCY) 250 cc/day for another 8-week period, or the reverse sequence. Fasting blood sugar (FBS), fasting insulin, insulin resistance by three equations, incretin hormone glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide-1 (GLP1) as well as inflammatory markers such as interleukin 6 (IL6) and tumor necrosis factor-alpha (TNF-α) were measured before and after each of the four periods. A 3-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS software considering the significance level of 0.05. Results: Twenty-four participants with a mean (standard deviation) age of 13.77 (1.87) years (range: 10.45-16.25 years) (58% girls) completed the study. It resulted in nonsignificant mean reduction in IL6 (-18.28 pg/mL [95% confidence interval [CI]: -47.48; 10.90]; P = 0.20) and nonsignificant increase in glucose metabolizing hormones such as GIP (683.10 pg/mL [95% CI: -457.84; 1824.0]; P = 0.22) and GLP1 (6.98 pg/mL [95% CI: -66.61; 80.57]; P = 0.84) by FCM consumption in comparison to DCY. Nonsignificant decrease was observed in TNF-α in the first periods of the study. The changes of FBS, fasting insulin, and insulin resistance indices were not statistically significant as well. Conclusion: According to preliminary positive influences of FCM on inflammatory markers, and findings related to glucose metabolism, we suggest conducting further studies on its clinical impacts. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major leading factor for global burden of diseases. Blood pressure (BP) tracks from childhood to adulthood. So, it is important to investigate its affecting factors. In this study we aimed to compare the BP status in the Iranian pediatric population according to the socioeconomic status (SES) of their living area. Materials and Methods: In this nationwide study, a representative sample of 14,880 students, aged 6-18 years was chosen by multistage random cluster sampling from 30 provinces in Iran. Anthropometric indices and BP were measured. A validated questionnaire, including the questions of the World Health Organization Global School-based Student Health Survey was completed. Findings were compared across the four regions of the country, categorized based on their elevating SES: Southeast, north-northeast, west, and central. Results: Participants consisted of 13,486 children and adolescents, that is, a participation rate of 90.6%, composed of 49.2% girls and 75.6% urban residents. The mean (standard deviation) age of participants was 12.47 (3.36) years. The region with highest SES (central) had the lowest rate of high BP (HBP), that is, 3.0% (95% of confidence interval [CI]: 2.4-3.9), and the region with lowest SES (southeast) had the highest rate, that is, 7.4% (4.4-12.2). The mean (95% CI) values of systolic BP for the four regions from lowest to highest SES were 100.5 (99.6-101.3), 100.9 (100.3-101.4), 101.7 (101.3-102), and 101.7 (101.2-102.1) mmHg. The corresponding mean Diastolic BP values were as follows: 65.4 (64.6-66.1), 63.4 (62.9-63.8), 65.6 (65.3-65.8), and 64.4 (64.0-64.7) mmHg. Conclusion: We found significant differences in mean BP and the frequency of HBP according to the SES of the living area. Further studies are necessary to find the underlying factors resulting in such differences. [ABSTRACT FROM AUTHOR]

Background: The global health burden has faced toward non-communicable diseases (NCDs). It is suggested that adulthood blood pressure (BP) is tracked from childhood. This study aims to evaluate the mean BP and the prevalence of prehypertension and hypertension in the Iranian pediatric population. Methods: In a national survey as the 4th phase of Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable diseases study and through random multistage cluster sampling, a national sample of Iranian school students, aged 6-18 years, were recruited. Data gathered by means of modified World Health Organization Global school-based student health survey questionnaire, a weight disorders determinants questionnaire and anthropometric and BP measurements. Prehypertension (HTN) was defined as BP equal or greater than 90th age and sex specific percentile or ⩾120/80 mmHg and HTN was defined as BP ⩾95th percentile. Results: A total of 13486 students entered the study (49.2% girls, 75.6% urban). Mean age of participants was 11.47 ± 3.36 years. A total rate of 4.17% (3.84-4.52 95% CI) for high systolic BP (SBP), 4.33% (3.99-4.68) for high diastolic BP (DBP) and 6.88% (6.45-7.32) for high SBP and/or DBP was depicted. Conclusions: The prevalence rate of high BP (pre-HTN together with HTN) is substantially high in this population. It is needed to study the causative situations and implement relevant interventions. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) and their risk factors are a major health threat at the global level, notably for developing countries. The tracking of cardiometabolic risk factors from childhood to adulthood is well documented. Therefore, more attention needs to be directed at primordial and primary prevention of NCDs. Given the high prevalence of NCDs and their risk factors in Iranian population, a study was designed to determine the attributable burden of cardiometabolic risk factors in Iranian pediatric population during past decades. Methods: This paper explains the definitions, organization, data sources, methods of data gathering or generating, data analyses, and the trend analysis of the study. A national expert working group addressed unmet needs and offered consultations on the selection of risk factors and the practical definition of disease. In the later stages, during the course of the study, they will supervise the statistical modeling methods, the interpretation of results, and the publication strategy. Also an international expert advisory group will collaborate with the project team. Conclusion: The findings of this study should provide basic information regarding NCD related risk factors, and their burden and trends in children, which is necessary for health policy decisions to reduce the burden of disease and to plan cost-effective preventive strategies. [ABSTRACT FROM AUTHOR]

Background: The prevalence of hypothyroidism in Iran is unknown. The aims of the present study were to estimate the prevalence of overt and subclinical hypothyroidism among the adult population of Isfahan, a large metropolitan city in Iran, 15 years after universal salt iodization. Methods: A cross-sectional survey was conducted from January 2006 through April 2006. The selection was conducted by stratified probability cluster sampling through household family members in Isfahan, Iran. Thyroid stimulating hormone (TSH) of 2523 men and women aged >20 years (mean: 39.0) was measured. Additional thyroid tests were done and serum levels of antithyroid antibodies were evaluated in individuals with elevated TSH. Elevated TSH with normal free T4 index (FT41) at the second measurement was considered as subclinical and high TSH with low FT41 as overt hypothyroidism. Results: The overall prevalence of hypothyroidism was 4.8% [95% confidence interval (CI) 3.7, 6.1] in men and 12.8% (95% CI 10.9, 14.6) in women; and 37.6% of hypothyroid men and women had positive antithyroperoxidase antibodies and/or antithyroglobulin antibody, while 19.3% of men and women were euthyroid. The mean (SE) of urinary iodine was 20.3(0.55) μg/dL and 20.1 (1.37) μg/dL for euthyroid and hypothyroid individuals, respectively (P=0.65). Older age, female sex, and goiter were strongly associated with both overt and subclinical hypothyroidism. Conclusion: Hypothyroidism appears to be common in Isfahan, Iran. The high prevalence of hypothyroidism in Isfahan may be due to autoimmunity with no correlation to iodine intake. [ABSTRACT FROM AUTHOR]

Background: Over the last decades, childhood obesity has become a worldwide epidemic health problem. Identifying the barriers to a healthy lifestyle among children and adolescents is necessary for further effective intervention to prevent overweight and obesity. This study aims to assess the barriers to healthy lifestyle habits, including physical activity (PA), eating, and sleep among adolescents from the perspective of their parents., Methods: In this cross-sectional study, the parents of obese and overweight middle school students were enrolled. Data were collected using a questionnaire about barriers of healthy nutrition and PA., Results: Overall, 172 parents completed the questionnaire. Lack of access to affordable facilities for PA, lack of access to the appropriate place for PA, and lack of sufficient information on how to do or increase PA were the main barriers to PA. The barrier factors for healthy eating were media advertisement of unhealthy foods, lack of motivation to use healthy nutrition, and lack of adequate information about healthy eating. Regarding poor sleep, lack of knowledge about the benefits of sleep, prolonged watching television, and late sleep time of family members were reported as the main barriers. These findings were not statistically different according to the family socioeconomic level., Conclusion: Our findings propose that for improving healthy lifestyle in obese children and adolescents, access to facilities, and appropriate places for PA should be provided at the community level. Moreover, training parents and students about healthy lifestyle behaviors is necessary for families of all socioeconomic levels., Competing Interests: There are no conflicts of interest.

Background: Poisoning has reported to be a major cause of death and burden of disease in low- and middle-Income countries. Rhabdomyolysis is a common consequence of many poisoning cases and serum creatine phosphokinase (CPK) is a marker for it. The aim of the study was to assess whether the admission creatine phosphokinase in comatose patients with acute poisoning is a predictive factor for the treatment outcome., Methods: In this prospective observational study, eighty poisoned comatose patients who were admitted with a serum CPK > 250 IU/L (not due to muscular trauma in accidents, myocardial ischemia and infarction, infections, hyperthermia, electrolytic disorders and diabetic ketoacidosis) were included. The severity of poisoning was assessed using Poisoning Severity Score. The admission CPK level; and outcome (survived with and without complication and death) for all patients were recorded. Patients were divided based on CPK levels into three categorizes: Low, medium and high., Results: Seventy five percent of the patients in high CPK level group, 29.5% in medium CPK level group and 35% in low CPK level group developed complications or death. Binary logistic regression results indicated that the chance of complications is much higher for patients with high admission CPK levels (more than 10000 IU/L) [OR, 5.57; 95% CI (1.29-23.93)] than whom with low levels., Conclusion: We concluded that the admission serum CPK level for a poisoned patient, seems to be an acceptable predictor for the outcome in poisoned patients. Further studies are still needed.

Background: Ulcerative colitis (UC) is a disabling disease with increasing incidence in Iran. In spite of combined medical therapy, some patients eventually undergo total colectomy. Infliximab has proved itself as a rescue therapy and even as an early aggressive therapy for severe extensive UC. Meantime, there are concerns about its complications. The aim of this study was to evaluate the efficacy of infliximab in Iranian refractory UC patients., Methods: This multi centric case-series study included 29 UC patients receiving two to three of the drugs prednisolone, AZT/6MP and 5ASA but yet having flare-ups. At first, the extent of colon involvement was determined by colonoscopy; then the drug was administered at baseline, 2nd week and 6th week and colonoscopy repeated afterwards. Clinical and laboratory data were also recorded., Results: In first endoscopy 18 patients (62%) out of 29 suffered from pancolitis and none had normal results. In second examination (done on 19 patients), one was normal and only 8 of 18 (27.6%) had pancolitis. Considering missing cases, at least in 33.3% of patients the drug has reduced the extreme extent of colon involvement. Also a wilcoxon signed ranks test revealed significant reduction of the disease extension after this treatment (p = 0.008). There were only one leucopenic and one hypotensive reactions in short term. The drug showed effectiveness in the term of disease modifying, too., Conclusions: These data show the usefulness of the drug in refractory UC. Longer follow ups and controlled trials are needed.