mohammad moafi

Weight disorders are highly prevalent at the global level. Vitamin B groups are clearly involved in intracellular mechanisms, energy equation, and weight gain. The present study aims to evaluate the association of dietary vitamin B intake and obesity in a large pediatric population.

This cross-sectional study was conducted among children and adolescents, aged 6-18years, living in urban and rural areas of 30 provinces of Iran. The BMI-for-age classifications were as follow: percentile <0.1, (emaciated), 0.1 ≤percentile <2.35 (thin), 2.35 ≤percentile≤84.1 (normal), 84.1

Out of 5606 children and adolescents participated (mean age: 11.62, SD: 3.32),46.8% were girls. The intake of thiamin, pyridoxine, niacin and pantothenic acid increased the likelihood of obesity, compared with the normal-weight group. Odds ratios (ORs) (95% CI) of obesity for vitamin B1, B3, B5, and B6 were 1.32 (1.14-1.53), 1.01 (1.00-1.02), 1.04 (1.00-1.08),and 1.20 (1.04-1.38), respectively. Riboflavin, cyanocobalamin, biotin and folic acid did not have any significant association with weight disorders (B2: OR=1.09, 95% CI =0.99-1.20); B12:OR=1.00, 95% CI=0.98-1.03; B8: OR=1.00, 95% CI=0.99-1.00 B9: OR=1.00, 95% CI=1.00-1.00).

The current study showed a significant correlation between consumption of vitamin B group and increased risk of excess weight.

Leishmaniasis is considered as a zoonotic infection and neglected tropical disease. Leishmania treatment is not totally successful and imposes high expenditures, especially in developing countries. Since the natural infection leads to the robust immunity in most of the human cases, many bodies of research have been focusing on Leishmania vaccines, being capable to control Leishmania infection. First generation vaccines (such as Leishmune and CaniLeish) have proved robust protective immunity in dogs. In human, recombinant vaccines, including Leish‑F1 could confer some degrees of protective immunity against natural infection. Recently, ChAd63‑KH DNA vaccine has been accomplished in providing prevention against Leishmania infection; however, this vaccine should be further evaluated in other clinical trials.

Rabies is an almost invariably fatal disease that is associated with animal bites. Hence, gathering data about cases of animal bites can help in clarifying the relative status of the disease.
This study was conducted to provide an epidemiological overview on animal bites and rabies occurred in Hamedan province, Iran, during 2011 - 2013.
This cross sectional descriptive study was conducted in Hamedan province, Iran. The information was retrieved from the vice-chancellery for health (Hamedan University of Medical Sciences) and veterinary directorate general of Hamedan province. The data were analyzed using the SPSS software. The Chi-square test was used to determine statistically significant differences with P values less than 0.05.
There was just one report of rabies death during the mentioned period. The total number of reported animal bites was 14327 with the incidence of 2.69 cases/1000 individuals, which included 3287 (22.9%) women and 11040 (77.1%) men. Of these cases, 9868 (68.9%) resided in rural areas, while 4459 (31.3%) were urban residents. Most animal bites, 3516 (24.54%) cases, occurred in the 20 - 29 year-old age group. The lower limbs injuries were significantly higher than other sites with 7462 (52.08%) records. In addition, the majority of people were bitten by dogs (11040 cases, 77%).
This study indicated that the incidence of animal bites was increased during 2011 - 2013 in Hamedan province. Therefore, it seems necessary to take appropriate educational programs along with both pre-exposure immunization and postexposure prophylaxis to control this infection in the region.

Leishmaniasis is a worldwide disease prevalent in tropical and sub-tropical countries in the world. Characterization of inflammatory responses produced in cutaneous Leishmaniasis has not yet been completed. The current study aims to assess and compare pro-inflammatory cytokines between burning injuries and Leishmania infection..
the specific primers were designed for 10 proinflammatory genes including CCL4, CCL3, TNF-α, IL-1α, IL-12P35, IL-12P40, CCL5, CCR5, IL-1β, and IFN- γ. Their expressions were assessed and compared using RT-PCR in the lesions caused by either Leishmania or burning in BALB/c mice..
None of the proinflammatory genes were expressed in the healthy tissue and in the lesions caused by Leishmania, except IFN- γ. The other genes were down-regulated by the parasite in untreated mice. In mice treated with Glucantime, the expression of the proinflammatory genes restarted. In contrast, the figure of expression of proinflammatory genes in lesions caused by burning was different. The proinflammatory genes were expressed in untreated lesions and down regulated in cured lesions..
The findings of the current study indicated a role for Leishmania in suppression of proinflammatory genes and a role of proinflammatory genes in healing of burning lesions..

Conventional hepatitis B virus (HBV) vaccination fails to achieve efficient protection in about 5–10% of the world population. Hence, different strategies have been adopted to ameliorate HBV antibody titers. This study aimed to evaluate the concurrent application of tetanus‑diphtheria (Td) and HBV vaccination on hepatitis B surface (HBs) antibody titer in low‑responder healthy individuals.
This was a randomized clinical trial, which was implemented among 140 of medical staff working as health‑care workers assumed as low‑responders. The subjects were randomly allocated to either control or interventional groups. The control and interventional groups received HBV recombinant vaccine while the latter group was also vaccinated through Td. Enzyme‑linked immunosorbent assay was applied to measure HBs antibody (HBsAb) titers just before and 6 months after the last vaccination. All data were entered into SPSS software. Independent t‑test, paired t‑test, and Chi‑square or Fisher’s exact test were applied for data comparison.
Antibody titers of the subjects in the intervention and control groups soared from 49.08 ± 20.08 IU/L to 917.78 ± 204.80 IU/L and from 46.95 ± 18.55 to 586.81 ± 351.77 IU/L, respectively (both P Concurrent application of Td and HBV vaccine could effectively enhance protective levels of HBsAb titers in low‑responder individuals.

Childhood and adolescence injuries are still frequently occuring in developing countries. This study aims to assess the association of socio-economic status (SES) with injuriesin Iranian children and adolescents.
This multicentricsurvey was part of a national surveillance program, which was conducted in 2011-2012 amongst 14,880 students aged6-18 years. Participants were randomly selected from urban and rural areas of 30 provinces in Iran. Socio- economic status (SES) of participants was categorized to “low”, “middle” ,and “high” by using principle component analysis method by considering parental job and education as well as family assets. Prevalence, types and places of injuries were based on the questionnaire of the World Health Organization- Global School-based student Health Survey (WHO-GSHS).Multivariate modelwas used for comparison of variables between SES groups.
Overall, 13486 out of 14880 invited students (response rate: 90.6%) participated in this study.Their mean (SD) age was12.47 (3.36) years.Boys and urban residents constituted the majority of participants (50.8% and 75.6%, respectively). Compared with low SES group, oddsof sport injury was higher in students with middle (OR=1.44; 95%CI: 0.92-2.26) and highSES (OR=1.96; 95%CI: 1.27-3.01). Compared to participants withlow SES,odds of home injuries was significantly lower in high SES group (OR=0.78; 95%CI: 0.64-0.95).
This study revealedconsiderable differences in injuries of children and adolescents according to their SES, with higher prevalence of home injuries in low SES families and higher prevalence of sport injuries in middle and high SES levels. When implementing injury prevention programs, such differences should be taken into account.

Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging, which aimed at amelioration of patient’s behavior and consciousness, which could lead to suicide prevention.
This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction (F = 12.30, P It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary methodology aiming depression treatment.

Metabolic disorders, which involve many different organs, can be ascribed to enzyme deficiency or dysfunction and manifest with a wide range of clinical symptoms. This study evaluated some of the demographic and clinical findings in pediatric patients affected by organic acidemia.
This cross-sectional study was part of a larger study conducted in patients with metabolic disorders during a period of 7 years from 2007 to 2014 in Isfahan Province, Iran. Our study covered a wide range of cases from newborn infants (one-week old) to adolescents (children up to the age of 17 years). This study evaluated patients’ demographic information, history of disease, developmental and educational status, clinical and general conditions. Phone and in-person interviews were used to gather information.
Out of 5100 patients screened in this study, 392 patients were affected by one of the different metabolic disorders and 167 individuals were diagnosed as organic acidemia. Propionic acidemia/methyl malonic acidemia (PA/MMA) was the most prevalent form of this metabolic disorder. The frequency of consanguinity was 84.7% in the group of patients. The mortality rate was 18.8% in patients with organic academia.
Each of the metabolic diseases, as a separate entity, is rare; nevertheless, in aggregate they have a somewhat high overall prevalence. These diseases result in mental and developmental disorders in the absence of quick diagnosis and initiation of treatment. Furthermore, more mutations should be identified in societies affected by consanguinity. Further research should also be conducted to determine worthwhile and more-efficient screening methods as well as longterm neurological prognosis.

Hepatitis B virus (HBV) fails to produce appropriate immune responses in some healthy individuals; thus, different strategies have been adopted to promote immune responses. The current study aimed at evaluating the efficacy of HBV vaccine coadministered with tetanus-diphtheria (Td) vaccine compared with HBV vaccine in healthy individuals through measuring hepatitis B surface antibody (HBsAb) levels. This was a randomized controlled clinical trial, which was implemented in Isfahan, Isfahan Province (Iran) in 2013. One hundred and forty healthy individuals, whose HBsAb titers were less than 10 IU/L were recruited. The subjects were randomly assigned to either in intervention or control trials. The control group received 40 µg of recombinant HBV vaccines intramuscularly injected at 0, 1, and 6 months; however, the intervention group was simultaneously vaccinated by Td with the first dose of HBV vaccine. HBV antibody levels (titer) were measured before the vaccination and 6 months after the last vaccination. Antibody titers of the subjects in the intervention and control groups increased from 5.07 ± 2.9 IU/L to 744.45 ± 353.07 IU/L and from 4.45 ± 3.4 IU/L to 589.94 ± 353 IU/L, respectively (both P < 0.001). Also, the mean difference of antibody titer was significantly different between the two groups (P = 0.011). Td vaccination can be applied as a feasible approach to promote efficient and persistent immunity in healthy individuals with insufficient HBsAb titers.

Thyroid absorption of iodine could be encumbered by nitrate drinking water when it is transported to the fetal thyroid gland. Therefore, nitrate potentially causes congenital hypothyroidism (CH) due to thyroid dysfunction. In this study, we have not only aimed at spatial determination of CH distribution and nitrate concentration (NC) existing in drinking water, but also we intended to evaluate the probable impact of nitrate on CH incidence. Annual average of nitrate in drinking‑water as well as number of CH infants diagnosed through the screening program were applied to determine the incidence ratio of the disease for each town (from 2010 to 2013). Afterward, Arc GIS 9.3 was used to draw choropleth maps with quantile classification. Data were entered into SPSS 16.0 and Excel 2010 software. Finally, linear regression was applied for data analysis. The incidence rate of CH (considering transient and permanent cases) was about one in every 413 births. Khansar, Golpaygan, Naein, and Ardestan had the highest incidence rate of CH respectively. On the other hand, Tiran, Dehaghan, Khansar, and Fereydan had the highest level of nitrate drinking water. There was a strong relationship between the NC and incidence of CH in Khansar; however, this relationship was not significant (P = 0.392) in Isfahan province. Since there was not a significant relationship between NC in drinking‑water and incidence of CH through linear regression analysis, more studies should be implemented to confirm or refute our observations.

This study aimed to determine the association of serum 25-hydroxy Vitamin D (25(OH)D) levels with measures of general and abdominal obesity in Iranian adolescents. This nationwide cross-sectional study was conducted among 1090 students, aged 10-18 years, living in 27 provinces in Iran. Serum concentration of 25(OH)D was analyzed quantitatively by direct competitive immunoassay chemiluminescence method. Body mass index (BMI) and waist-to-height ratio (WHtR) were considered as measures of generalized and abdominal obesity, respectively. Study participants consisted of 1090 adolescents (51.9% boy and 67.1% urban residents) with mean age, BMI, and waist circumference of 14.7 (2.6) years, 19.3 (4.2) kg/m2, and 67.82 (12.23) cm, respectively. The median serum 25(OH)D was 13.0 ng/mL (interquartile range: 20.6). Overall, 40% of participants were Vitamin D deficient, and 39% were Vitamin D insufficient. Serum 25(OH)D level was not associated with BMI and WHtR. We did not document any significant association between serum 25(OH)D level and anthropometric measures in adolescents. This finding may be because of considerably high prevalence of hypovitaminosis D in the study population.

Leishmaniasis is one of the major health problems and categorized as a class I disease (emerging and uncontrolled) by World Health Organization (WHO), causing highly significant morbidity and mortality. Indeed, more than 350 million individuals are at risk of Leishmania infection, and about 1.6 million new cases occur causing more than 50 thousands death annually. Because of the severe toxicity and drug resistance, present chemotherapy regimen against diverse forms of Leishmania infections is not totally worthwhile. However, sound immunity due to natural infection, implies that vigor cellular immunity against Leishmania parasites, via their live, attenuated or killed forms, can be developed in dogs and humans. Moreover, genetically conserved antigens (in most of Leishmania species), and components of sand fly saliva confer potential immunogenic molecules for Leishmania vaccination. Vaccines successes in animal studies and some clinical trials clearly justify more researches and investments illuminating opportunities in suitable vaccine designation.

ackground: This study aims to assess the frequency, causes, and places of injuries in a nationally representative sample of Iranian children and adolescents, as well as the referral, places allocated for injured individuals. This nationwide study was conducted in 2011-2012 among 13486 elementary, secondary and high‑school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. The Global School‑based Health Survey questionnaire of the World Health Organization was used. The study participants consisted of 50.8% boys, 75.6% urban resident with a mean age of 12.5 years. Overall, 20.25% of participants reported that they were minimally injured once in the last 12 months; this prevalence was higher in boys than in girls (25.74% vs. 14.58%, respectively, P < 0.001), without significant difference in urban (20.11%) and rural (20.69%) areas. Most of them (39.92%) were injured at homes or house yards with higher prevalence in girls than in boys (48.61% vs. 35.17%, respectively, P < 0.001) and in rural than in urban areas (27.30% vs. 20.89%, respectively, P < 0.001). Schools were reported as the second prevalent site of injury occurrence (22.50%). Emergency departments and physician offices were the most prevalent referral places for injured individuals (32.31% and 22.38%, respectively). Most of the school injuries occurred during play or sport activities (45.92%). Prevention of unintentional injuries should be considered as a health priority. Appropriate preventive strategies should be enhanced at homes and schools.

Idiopathic granulomatous mastitis (IGM) is defi ned as a rare, infl ammatory, chronic and benign disease mimicking malignant hyperplasia of mammary glands. Th ere is no defi nitive therapeutic strategy for IGM; nevertheless, some approaches can be exploited as benefi cial strategies. In this study, the surgery strategy was compared with coincident treatment with azithromycin and corticosteroid in IGM patients.

Th is study was implemented as clinical trial during 2011-2013 in Isfahan, Iran. Th e target population comprised women whose IGM was substantiated. Th e medical group consisted of 20 patients, which were compared with a historical control group treated through surgical approach. Surgical group comprised 39 patients. Partial mastectomy was implemented in the surgical group whereas treatment protocol comprising azithromycin and prednisolone administered in medical group. Recurrence of mass was followed for 12 months. Fischer exact test, Chi-square test, Mann-Whitney and regression tests were applied for statistical analysis. Th is study was registered in Iranian Registry of clinical trial (IRCT number: IRCT 2013123015999N1).

No signifi cant diff erences were recognized in side of lesions, lymphadenopathy, fever and pain; however, number of abscesses, number of lesions and size of lesions were signifi cantly higher in the surgical group (P < 0.0001). Furthermore, probability of relapse correlated with the number of lesions, (odds ratio = 24.67 confi dence interval [CI] = 2.2-269.3), whereas methods of IGM treatment did not contribute to the likelihood of relapse (odds ratio = 12.5 CI = 0.52-299).

Th is clinical trial demonstrated that pharmaceutical treatment has appropriate effi cacy, in treatment and prevention of IGM relapse. Moreover, this study presented hazf gardad number of the lesions as the most appropriate criteria for IGM prognosis, thus the probability of relapse decreases whether earlier IGM recognizing could be implemented.