Search

Abstract The pattern of poisoning varies in different societies. In this study, we investigated the clinical-epidemiological features and outcomes of poisoned patients based on the substances involved, whether pharmaceutical or non- pharmaceutical toxins. This cross-sectional study involved a retrospective chart review of all poisoned patients who presented to the poisoning emergency hospital in the center of Iran between January 2015 and December 2019. We collected data on socio-demographics, the nature of the poisoning, and the outcomes. Backward stepwise binary regression analysis was conducted to predict the mortality. Throughout the study period, 5777 patients with acute poisoning met the inclusion criteria. Of these, 3524 cases (61%) were attributed to pharmaceutical, and 2253 cases (39%) were due to non-pharmaceutical poisoning. The majority of pharmaceutical poisonings (82.9%) were intentional, whereas non-pharmaceutical poisonings accounted for 46.2% of intentional exposures (P

Abstract Background Several studies worldwide have investigated household product poisoning. We conducted a toxico-clinical study on the two-year prevalence of poisoning with household products. Methods This cross-sectional study was performed in Khorshid Hospital, the main referral center for poisoning cases in Isfahan, affiliated to Isfahan University of Medical Sciences, Isfahan, central Iran. All patients with intentional or unintentional household substance poisoning, referring to the poisoning emergency center of the hospital, were evaluated with respect to epidemiological and toxico-clinical features and outcomes. Results During the study period, 5946 patients were hospitalized, of which 83 (1.39%) had been poisoned with household products including 48 (57.8%) men and 35 (42.2%) women with a mean ± SD age of 34.40 ± 17.71 years. Most patients (54.2%) were in the 20–40-year-old age group. Accidental poisoning (63.9%) was the most common type of exposure (P = 0.02) predominantly in men (57.8%, P = 0.51). The most common household products were sodium hypochlorite (32.53%) followed by petroleum hydrocarbon (21.68%). Most of the accidental poisonings (77.8%) were due to petroleum hydrocarbon. 59% of cases were poisoned at home (P

Background: Recently, renal transplantation has increased worldwide. The incidence of metabolic syndrome is common after renal transplantation that might reduce renal function and increase cardiovascular complications. In this study, we compared renal function after renal transplantation in patients with or without metabolic syndrome. Methods: This cohort prospective study was conducted in 2017 among patients with renal transplantation aged more than 20 years in Isfahan City, Iran. Metabolic syndrome criteria including blood pressure, fasting blood sugar, high- and low-density lipoprotein, triglyceride, and waist circumference, as well as serum creatinine were measured in 30 patients with metabolic syndrome and 30 without metabolic syndrome in one-year follow-up period. Findings: 17 patients were women and 43 were men. The mean serum creatinine changes were not significantly different among the patients with or without metabolic syndrome (P = 0.227) in 1-year follow up. There was no significant association between serum creatinine level with metabolic syndrome criteria such as waist circumference (P = 0.214), diastolic blood pressure (P = 0.061), triglyceride (P = 0.409), high-density lipoprotein (P = 0.315), and fasting blood sugar (P = 0.284) in patients with metabolic syndrome, and only the association between serum creatinine level and systolic blood pressure was significant (P = 0.008). Conclusion: Serum creatinine did not increase significantly in patients with metabolic syndrome. We recommend to consider longer follow-up periods in future studies.

Background: There are several types of radiotherapy devices available for the treatment of cancer tumors. The present study aimed to evaluate the effectiveness of selected radiosurgery devices on the treatment of cancer tumors and Arteriovenous Malformations (AVM). Methods: The evaluation was performed in two steps; First, evaluating the effectiveness of CyberKnife, Gamma knife and Linear Accelerator (Linac) on various biological systems. Then, we compered the effectiveness of devices with each other. A systematic review was conducted in MEDLINE, EMBASE, CRD, NHSEED and Cochrane library databases. The search strategy was limited to clinical trials with less than 5 treatment sessions. All searches were conducted on December 21, 2014. Results: In total, 81 studies have been included to the review. Based on the obtained results of comparison between the reported percentages of local control rate, the safety and accuracy of CyberKnife and linac are higher than Gamma Knife. Conclusion: Our findings suggested that CyberKnife is not only more effective to cover various types of tumors in the whole body, but also is safer and easier to use for various tumors, as well as AVM treatment.

Background: The adverse health effects of abdominal obesity are well documented in adults, but such association remains to be determined in the pediatric age group. This study aims to perform a systematic review on the association between abdominal obesity and cardio-metabolic factors such as dyslipidemia, hypertension, and hyperglycemia among children and adolescents. Materials and Methods: A systematic literature search was conducted using PubMed, Scopus and Google Scholar databases to May 2014. Two independent reviewers identified relevant papers in several steps. After studying the titles and texts of documents, repeated and irrelevant ones were excluded. The search was refined to the English language. We did not consider any time limitation. Studies with different measuring methods of abdominal obesity were included. Studies with abdominal obese patients secondary to other disease were excluded from the study. In final, the data of association of cardio-metabolic risk factors and abdominal obesity extracted from studies. Results: Overall, 3966 articles were reviewed, and 61 of them were studied according to the inclusion and exclusion criteria. Waist circumference (WC), waist-to-height ratio, and waist-to-hip ratio were the most common indexes used for defining abdominal obesity. The association of high blood pressure with increasing WC was seen in several studies. The association of other cardio-metabolic risk factors was seen in some studies. Conclusion: Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors. Therefore, more attention should be paid to abdominal obesity of children and adolescents both in clinical practice and in epidemiological studies.

Background: Tramadol poisoning has increased in recent years. Seizure is one of the side-effects of tramadol toxicity. There is a controversy about possible preventive effect of naloxone in tramadol poisoning induced seizure. Therefore, this study was performed to compare seizure incidence in tramadol poisoning patients who received and did not receive naloxone, as an opioid antagonist. Methods: This study involved prospective data collection followed by retrospective analysis on 104 tramadol poisoning patients who were admitted in a referral poisoning center. The incidences of seizure were compared between patients received naloxone and those did not. Outcome was considered as survived without or with complications and death. Logistic Regression analysis was used to determine the effects of different variables on seizure incidence. Results: 70 (67.3%) of the patients were men. The mean age of the patients was 26.3 ± 9 years old. 18.3% of the patients received naloxone in their treatment period. Seizure incidence was significantly higher among tramadol poisoning patients who did not receive naloxone compare with those received naloxone (14.1% vs. 5.1%). Among different variable studied, age had a significant effect on predicting of seizure (odds ratio = 2.09; 95% of confidence interval: 1.82-2.26; P value, 0.004). Conclusions: Although the seizure incidence was lower in patients with tramadol poisoning who received naloxone, the logistic regression did not support the preventive effect of naloxone on seizure in tramadol poisoning cases.

Background: Hepatitis A virus (HAV) is a major cause of acute viral hepatitis worldwide. Annual medical and work loss costs of hepatitis A are significant even in low-endemic countries. It is recommended that each country should collect and review the information needed to estimate its national burden of hepatitis A to provide evidence for health policy makers to implement appropriate and cost-effective preventive strategy for HAV infection. The objective of this study was to estimate accurate prevalence of HAV infection in Iran for best preventive measures. Materials and Methods: MEDLINE, Institute of Scientific Information, Scopus, Iranmedex, Irandoc, Magiran and Scientific Information Database were searched. The seroprevalence of HAV were pooled by age, sex and residence using fixed and random effect models. Results: Sixteen papers representing 11857 subjects were included. The overall HAV seroprevalence was 51% (confidence interval [CI] 95%: 50-52%) in fixed and 66% (95% CI: 50-79%) in random effects models. The prevalence was 32% (CI 95%: 11-63%) in less than 20, 50% (CI 95%: 24-75%) in 20-30, and 67% (CI 95%: 17-95%) in more than 30 years of age. The difference was not significant in gender or residence subgroups. Conclusion: HAV infection in Iran may be considered as low or very low. Therefore, targeted vaccination of high-risk groups and more improvement in environmental sanitation would be the best preventive measure.

Background: In this study, we aim to compare insulin and leptin levels in adolescents with or without excess weight and in those with or without abdominal obesity. Materials and Methods : This case-control study was conducted among 486 samples. We randomly selected 243 overweight and an equal number of normal-weight adolescents from among participants of the third survey of a national surveillance program entitled "Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable diseases study." Serum insulin and leptin were compared between two groups and their correlation was determined with other variables. Results: The mean age and body mass index (BMI) of participants were 14.10 ± 2.82 years and 22.12 ± 6.49 kg/m 2 , respectively. Leptin and insulin levels were higher in overweight than in normal-weight adolescents (P < 0.05). Leptin level was higher in children with abdominal obesity than in their other counterparts (P < 0.001). Leptin level was correlated with age, fasting blood glucose, BMI, and insulin level. Conclusion: Insulin and leptin levels were higher among overweight and obese children, which may reflect insulin and leptin-resistance. Given the complications of excess weight from early life, prevention and controlling childhood obesity should be considered as a health priority.

Background: A growing body of evidence supports an association between oral health and cardiovascular diseases and diabetes in adults. This study aimed to investigate the relationship between tooth brushing frequency and cardiometabolic risk factors in adolescents. Methods: This nationwide population-based study was conducted among 5258 Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces in Iran. The association of tooth brushing frequency was assessed with anthropometric indexes and cardiometabolic risk factors after adjustment for potential confounders. Results: Higher frequency of tooth brushing was associated with lower mean levels of low-density lipoprotein cholesterol (LDL-C) in both genders ( P < 0.0001) and lower frequency of elevated LDL-C in girls ( P = 0.03). The frequency of elevated blood pressure decreased with higher tooth brushing frequency in boys ( P = 0.03). After adjustment for many potential cofounders such as age, gender, anthropometric indexes, screen time, socioeconomic status, and family history of non-communicable diseases, participants who washed their teeth at least once a day had lower risk of high LDL-C and low high-density lipoprotein cholesterol (HDL-C) levels in comparison to those who reported lower frequency of tooth brushing; some different associations were observed among girls and boys. Conclusions: Our findings suggest an independent and protective role of teeth brushing frequency for some cardiometabolic risk factors in adolescents. Increasing both the general health awareness and improving oral health should be considered in primordial and primary prevention of non-communicable diseases.

This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors. Methods: This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2–18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged. Results: Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14–18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement. Conclusion: Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services.

Introduction: The aim of our study was to determine the content of fat and fatty acid composition of breast milk , and its association with the mother′s diet. Materials and Methods: This cross-sectional study was conducted among pregnant mothers who came to health care centers for last prenatal care in Isfahan, Iran. Eight to 72 hours after delivery, 2 to 5 ml of colostrum was collected by hand into tubes. They were kept in an ice box and sent within half an hour to the collaborating health centre for freezing at -20°C until analysis, which was performed at the laboratory of NNFTRI in Tehran. The milk samples were homogenized by Vortex (Heidolph Vortex Shaker REAX 1. 220 V. 30 W Germany) at 2400 rpm for 30 sec. Results: The data of 86 out of 91 samples were complete. The mean maternal age and gestational age was 28.37 ± 5.55 years old and 38.7 ± 1.2 weeks, respectively. The content of fat was 2.17 ± 1.22 g/100 ml breast milk. Arachidonic acid (AA, 20:4n-6) and docosohexaanoic acid DHA (22:6n-3) made 0.8 ± 0.4% and 0.3 ± 0.2% of total fatty acids. Although the AA/DHA ratio in our study is suitable, but the content of DHA is nearly low. Conclusion: Dietary habits of women in reproductive age group should be improved, with special emphasis on the fatty acid content of breast milk. This may have long-term impact on health promotion and disease prevention.

Background: Patients' beliefs about the necessity of medicines and their concerns about adverse effects might influence the adherence and treatment outcomes. This study was carried out to investigate the impact of patient's beliefs on their adherence to prescribed medicines in three different chronic diseases and the role of demographic factors in this relationship. Methods: This cross-sectional descriptive study was done during 2008-2009. Data was gathered through interview with 213 patients referring to educational pharmacies of Isfahan University of Medical Sciences, Iran, and suffering from one of the chronic diseases including asthma, cancer and kidney transplantation. Three questionnaires including demographic factors, beliefs about medicines (BMQ) and Morisky's medication adherence assessment were used. Descriptive data and correlation analysis tests were made by using SPSS17. Findings: Age but not gender had a significant role in patients' adherence to medication. Education level was positively correlated with adherence to medicines in patients with asthma and whom with kidney transplantation but not in patients with cancer. The patients' belief about their medicines had a significant impact on their adherence to their prescription in all three subgroups of patients; however this relationship was stronger for patients with cancer and kidney transplantation than asthmatic patients. Conclusion: Patients' beliefs about their medicines could influence their adherence with medication especially for more serious diseases. It is also concluded that younger and higher educated patients are more adherent. It seems that educational interventions especially for older patients and in chronic disease states are beneficial to improve their adherence with medication.

Objectives: Emergency contraception (EC) is a special contraception method that prevents pregnancy after an unsafe sexual contact. Pharmacists, as the most available member of medical team have a unique role in patient education for appropriate use of contraceptive methods. In this study, we assessed the pharmacists′ knowledge about emergency contraception. Methods: A researcher made questionnaire was developed and used according to national guide line and electronic databanks. A group of experts and pharmacists validated the questionnaire. Reliability was measured by Half-Split Test. The questionnaires were filled by pharmacists. Results: Average knowledge score were 8.12 ± 0.28 for women and 7.83 ± 0.31 for men (from a maximum of 15) which showed no significant difference between men and women (P = 0.492). There was no significant difference between pharmacists who had precipitated in continuing education programs and that of those who had not (P = 0.286). Scores of pharmacists who graduated 13 years ago or more did not significantly differ from others (P = 0.287). Conclusions: Because of low scores of pharmacist′s knowledge about EC and the importance of unintended pregnancy prevention, its improvement is an urgent need. Regular and frequent continuing education programs could be one of the recommended interventions.

Background: This study aimed to compare the timing of puberty between various geographic locations and different ethnicities. Methods: This national survey was conducted in 20 provinces in Iran. Healthy Iranian girls were selected from public schools using cluster random sampling. A total number of 30 clusters including 7493 girls, aged 6.0-20 years, were selected. In order to compare different areas, the national classification of the provinces based on climate, ethnicity, geographic locations, and socioeconomic variables were used. Accordingly, there are 11 regions in Iran. Analysis of variance was used to compare the mean ages of menarche, pubarche, and thelarche in different regions. Results: Tehranian girls, with 11.99 ± 1.35 years (mean ± SD), had the lowest age of menarche which was statistically significantly. The second region with lowest age at menarche was Fars (12.40 ± 1.27 years). The mean age at breast bud stage (B2) was significantly lower in Ghazvin-Zanjan region (8.97 ± 1.45 years). In Fars region, the mean age at B2 stage of breast development (11.01 ± 1.88 years) was higher than other regions except for Mazendran-Guilan and Tehran-related cities. The mean age at public hair development at Tanner stage 2 (PH2) in Kordestan-Lorestan-Ilam region (10.70 ± 1.23 years) was significantly higher than other regions. Conclusions: We found significant differences in the age of pubertal stages of girls living in various regions with different ethnicity and geographic characteristics. Considering the impact of pubertal age on general health, more studies should be done about the lifestyle and environmental factors affecting the onset of puberty.

Background: This study aimed to determine the secular trends in the national prevalence of overweight and obesity among 6-year-old Iranian children, and to compare the results in Northern, Central and Southern parts of the country. Methods: The data were collected as part of a routine and mandatory national screening program on children entering elementary schools in 2007, 2008 and 2009. Results: The study population comprised 2,600,065 children including 862,433 in 2007, 782,244 in 2008 and 955,388 in 2009. Of total children 12.8%, 13.5% and 10.9% were overweight in 2007, 2008 and 2009, respectively (P > 0.05). The corresponding figures for obesity were 3.4%, 3.5% and 3.4%, respectively (P > 0.05). In all surveys, the prevalence of overweight was higher in Southern region than in the other two regions. P for trend was not significant for prevalence rates of overweight and obesity in any of the regions. Conclusions: To the best of our knowledge, this study was the first of its kind in presenting the nationwide trend of overweight and obesity in young children living in a developing country. It showed a considerably high prevalence of overweight and obesity, but with a constant rate in three years. The higher prevalence of overweight in Southern region than in Central and Northern regions might be related to the lower socioeconomic position of this population. At a very young age, children′s lifestyle is more under control of parents. Primordial and primary prevention efforts against the overweight epidemic can be effective and shall be further strengthened.

In celiac patient exposure to even only a small amount of gluten can lead to malabsorption of some important nutrients including calcium, iron, folic acid, and fat-soluble vitamins because of small-intestine inflammation. A strictly followed gluten-free (GF) diet throughout the patient's lifetime is the only effective treatment for celiac disease; however, elimination of gluten from cereal-based product leads to many technological and nutritional problems. This report discusses different substitutes to replace gluten functionality and examines the economic and social impacts of adherence to a GF diet. Better knowledge about the molecular basis of this disorder has encouraged the search for new methods of patient treatment. The new and common GF sources and different challenges encountered in production and consumption of these products and different solutions for improving their properties are discussed in this review.

Objectives: Fruits and vegetables are important components of a healthy diet, and their consumption could help prevent a wide range of diseases. In this study, fruit and vegetable consumption in elderly people were assessed.Methods: This cross-sectional study was conducted among elderly (≥65 year-old) people who came to pharmacies affiliated with Isfahan University of Medical Science. Face-to-face interview using a questionnaire including food frequency questionnaire and demographic and socioeconomic variables was administered.Results: Of the total 504 participants, 56.3% were male and 43.7% were female. The mean daily serving of fruit and vegetable (combined) consumption in men and women were 4.58±1.31 and 4.65±1.28, respectively. The prevalence of daily fruit and vegetable intake of 5 or more servings was 37.9%. Low educational and low income participants ate lower fruits and vegetables (combined). Age, gender, smoking, and chronic disease had no significant influence on their consumption. Educational level was the only independent predictor of fruit and vegetable consumption (OR: 3.81, CI: 1.64-8.84).Conclusions: Most elderly people consumed less than the recommended levels of fruits and vegetables. From the point of view of prevention of chronic disease, health education programs which targeted elderly people particularly for those at the risk of low consumption are needed and recommended.

Objectives: This study was conducted to explore the barriers to physical activity in a representative sample of Iranian children and adolescents.Methods: The studywas conducted in 2007 in urban and rural areas of Isfahan district in Iran. In the qualitative part,we used the grounded theory approach, including semi-structured focus group discussionsand in-depth interviews. The quantitative part comprised 600 randomly selected students.Results: The qualitative study included 34 school students (16 girls), 20 parents (11 mothers) and 11 school staff. All students disclosed that studying was a priority.They pointed to lack of safe and easy-access place for physical activity and unsupportive family as the main barriers. Lack of self-confidence and low self-worth were the two other concepts developed in this context.Parents pointed to lack of safe and easy-access place for activity followed by the priority of studying. The concepts derived from interviews with school staff included unhealthy modeling of parents, priority of studying, and inadequate public know-ledge about how to integrate physical activity in routine daily life.The quantitative survey comprised 600 students including 286 (47.8%) girls. Parents’ education level had inverse association with children’s physical activity level. Significant inverse associations of self-efficacy and physical activity levels were documented.Conclusions: Increasing the public knowledge about adopting physical activity habits in routinedaily life, informing the families and students about the benefits of physical activity to improvelearning, as well as providing safe places such as using the school facilities in non-school hoursshould be considered in planning effective preventive strategies and interventions.

Background: Visual impairments affect child development and limit their social activity, education and future life. In this study, the prevalence of visual impairments was determined among school-aged children in a screening program. Methods: All first and third grade students in primary schools, first grade students in secondary and high schools related to Iranian universities of medical science were selected. The data were gathered by universities in 2007. Findings:The prevalence of visual impairments was 4.7% and 3.8% in first grade and third grade students in primary schools. It was 5.8% and 4.1% in first grade students in secondary and high schools respectively. The highest prevalence (10.59%) was reported from Kermanshah University of Medical Sciences. Conclusion: It is considered more detailed interventions are necessary, especially in high prevalence regions, to determine the different types of visual impairments and their risk factors. Key words: Screening, Visual impairments, School children.

Objective: To evaluate the effect of emotional adjustment on IUD continuation to understand why persons with similar clinical problems have different interpretation and select different strategies to cope with their complaints. Materials and Methods: This historical cohort study was carried out on 12 randomly chosen health centers of Isfahan province in 2007. Two hundred forty eight literate and married women aged 15-49 years who had chosen IUD as a contraceptive method since 2002 entered the study. After explaining the aim of study and taking informed consent, women completed the demographic, individual characteristics and 32 questions in emotional domain of Bell’s Adjustment Inventory (adult form). May 2007 was considered the end time of IUD consumption as a defined outcome. Data analysis was performed with the SPSS version 15. T–test, chi–square, Mann–Whitney, General Linear Model, Regression were used for data analysis. Results: During this period 60% (146) of women preserved their IUD and 40% (98) of them removed their IUD. The mean score of emotional adjustment was 16.16±6.28 in IUD preserved women in comparison to 18.23±5.63 in IUD removed women. Poor ,moderate and good grades of emotional adjustment were 54%, 40% and 6% in IUD preserved woman vs 72.4% , 24.5% and 3.1% in IUD removed women. Conclusion: Psychological factors such as emotional adjustment can influence IUD survival; so improved counseling and good candidate selection before IUD insertion is recommended.

Anemia affects child development and limits their social activity, education and future life. In this study, the prevalence of anemia is determined among school aged children in a screening program. Background: All first and third grade students in primary schools, first grade students in secondary schools related to Iranian universities of medical science were selected. The data were gathered by universities in 1386. Methods: The prevalence of anemia was 1.8% and 2.4% in first grade and third grade students in primary schools. It was 1.6% in first grade students in secondary schools. The high prevalence was reported from Tehran, Shahid beheshti and Iran Universities of medical science. Findings: It is considered more detailed interventions are necessary especially in high prevalence regions to determine the different types of anemia and their risk factors. Conclusion: Screening, Anemia, School children, Iran Key words:

Abstract Asymptomatic bacteriuria (ABU) is one of the most common problems during pregnancy. In our public health system, screening of ABU by urinalysis (UA) is free for all pregnant women but urine culture (UC) is more sensitive and specific than UA. Determination of condition to screening asymptomatic bacteriuria with urine culture was the main field of the study. Background: 200 pregnant women in two groups were screened by Dipstick UA and UC. Costs (6) were calculated per groups, and prevented symptomatic bacteriuria was considered as effectiveness (E). Proportion of C/E was estimated. Sensitivity analysis was performed over wide ranges of prevalence of asymptomatic bacteriuria (ASB). Methods: Prevalence of bacteriuria was 4 percent. Direct costs in leukocyte esterase- nitrite dipstick group were 723600 Rials and in leukocyte esterase- nitrite dipstick + urine culture group were 1788800 Rials. The incremental costs in first group were 70200 Rials and cost savings in second group were 46800 Rials. The prevention ratio in first group was 55 percent, and in urinalysis +urine culture was 100 percent. The cost- effectiveness ratio in first group was 1.3 and in second group was 1.7. In sensitivity analysis, if prevalence of ASB was 13 percent، -effectiveness of these strategies were equal and if prevalence was 14 percent and higher, the cost- effectiveness with leukocyte esterase- nitrite dipstick+ urine culture was lower than leukocyte esterase- nitrite dipstick group. Findings: According to our findings, prevalence of ABU was low, screening of ABU by UA in public system is cost/effective at the present situation, but epidemiologic trend study is necessary to make decision about screening tools. Conclusion: Isfahan, ABU, screening, cost-effectiveness, urine culture, urine analysis, pregnancy. Key words: