Iranian Journal of Public Health
Volume:52 Issue: 5, May 2023

Three selective and most used inhibitors of PDE-5- sildenafil, vardenafil and tadalafil- have been successfully used for the treatment of erectile dysfunction. Erectile dysfunction and cardiovascular diseases might be considered as two dissimilar clinical signs of the identical systemic disease. PDE-5 inhibitors can through different models and mechanisms induce vasodilation, decrease apoptosis and cell proliferation, and they are widely present in various tissues that make them promising targets in a range of cardiovascular diseases.

PubMed was explored to identify papers published from 1990-2019, presenting data for the most used PDE-5 inhibitors (sildenafil, tadalafil or vardenafil) in treatment of cardiovascular diseases.

This article analyses the therapeutic potentials of PDE-5 inhibitors in cardiovascular diseases and discusses mechanisms, possible risks and limitations. Comparable to earlier studies, newer studies suggest cardioprotective effects of PDE-5 inhibitors, which include different models and mechanisms and do not indicate an increased rate of significant cardiovascular adverse reactions. Dissimilarity in the pharmacokinetics and pharmacodynamics of PDE-5 inhibitors are significant to their risk- benefit profile and clinical use. Some of the studies suggesting infarct size reduction after PDE-5 inhibition described the especially close dose-effect relation, other studies dosage adaptation in drug- drug interactions.

 PDE-5 inhibitors indicate the encouraging useful effects by ischemia/reperfusion injury, myocardial infarction, cardiac hypertrophy, cardiomyopathy and systolic and diastolic congestive heart failure. Therefore, this and similar reviews can help for additional clinical targeting in the therapy of cardiovascular diseases.

While people’s living standards are improving, the incidence of chronic diseases due to a lack of exercise is increasing. Complex health conditions (e.g., metabolic syndrome) are becoming common, and means to lower their incidence are essential.

This study systematically reviewed the literature and performed a meta-analysis on the effects of Baduanjin exercise on metabolic syndrome-related factors. Using four English databases and three Chinese databases, randomized controlled trials on the effects of Baduanjin exercise on metabolic syndrome were identified. We analyzed whether Baduanjin could alleviate various metabolic syndrome indicators according to our selection guidelines.

We found that Baduanjin exercise had positive effects on blood pressure (systolic blood pressure: mean difference (MD)=-6.39; 95% confidence interval (CI): -9.86 to -2.92; I2=12%; diastolic blood pressure: MD=-2.86; 95% CI: -5.96 to -0.23; I2=35%; P=0.07) and total cholesterol (standardized mean (SMD)=-0.55; 95% CI: -1.11 to 0.02; I2=86%; P=0.06), triglyceride (SMD=-0.29; 95% CI: -1.13 to - 0.56; I2=94%; P<0.51), and low-density cholesterol (SMD =-0.33; 95% CI: -0.52 to -0.14; I2=0%; P<0.0007) levels.

This evidence shows that Baduanjin exercise provides beneficial effects by improving metabolic syndrome and cardiovascular disease in adults. This suggests that Baduanjin exercise could be an effective alternative or complementary approach to conventional treatments for adults with metabolic problems. Additionally, these findings suggest that more rigorous randomized control trials are needed in the future.

 Previous research dealt with the concept of ‘hygiene’ in Korea, mainly regarding the modern transition summarized as ‘from regimen to hygiene’, has been based on qualitative research methods. However, because modern Korean language material had been constructed as a corpus with a considerable size, a quantitative approach based on language material has become possible. Through this, the provision of a new implication point can be received.

 The Corpus of Modern Korean Magazines, which is a morph-tagged corpus constructed based on 20 kinds of original texts of modern magazines in Korea, was utilized. In this corpus, a list of the co-occurred words of ‘wisaeng [hygiene], yangsaeang [regimen], geongang [health], and cheonggyeol [cleanliness]’, importantly related to the concept of ‘modern hygiene’ and the strength of co-occurrence that was calculated with the t-score, were extracted and analyzed. 

 Through a quantitative analysis of the corpus base, it was confirmed that the number of the co-occurred words of ‘wisaeng [hygiene]’ decreases and the strength of the co-occurrence gets low.  In contrast, the number of the co-occurred words of ‘geongang [health]’ increases and the strength of the co-occurred words becomes heightened. 

 Regarding the change after ‘from regimen to hygiene’, an analysis based on the corpus has been attempted. Through the quantitative data, the conversion into ‘from hygiene to health’ was confirmed. Research with such a method proves the need and the feasibility of quantitative research that supplements the previous qualitative analysis.

Proprotein convertase subtilisin / Kexin type 9 (PCSK9) inhibitors are efficacious lipid-lowering agents. This drug is related to improving the prognosis of patients with cardiovascular disease (CVD). The pur-pose of this meta-analysis was to systematically analyze the safety and efficacy of PCSK9 inhibitors in all pub-lished randomized controlled trials (RCTs).

As of October 25, 2021, we searched PubMed, EMBASE, MEDLINE, Cochrane Library and web of science.

From 684 articles, we included 11 trials for meta-analysis, including 52511 participants (26938 in the PCSK9 inhibitor group and 25573 in the control group). In terms of effectiveness, PCSK9 inhibitors reduced the risk of major adverse cardiovascular events(MACE) (OR=0.89, 95% Cl: 0.83-0.95, P=0.0009), but did not significantly reduce the risk of cardiovascular death (OR=0.95, 95% Cl: 0.84-1.07, P=0.38) or all-cause death (OR=0.93, 95% Cl: 0.85-1.03, P=0.18); In terms of safety, PCSK9 did not increase the risk of treatment-emergent adverse events (TEAE)(OR=0.98, 95% Cl: 0.94-1.02, P=0.28).

PCSK9 inhibitors can significantly reduce the risk of MACE in patients with high cardiovascular risk, which is well tolerated, but the impact on the risk of death is unclear.

This study was conducted to classify the types of evaluation methods in clinical health technolo-gies based on a systematic review method.

An electronic search was conducted in three scientific databases including Scopus, PubMed and ISI. The search strategy was performed in Jul to Nov 2021 and based on the three main concepts of "evaluation", "technology", "health. This search has been restricted to 10 years (2011-2021). Moreover, it only was limited to English and papers published in journals and conferences proceeding.

Overall, 8149 references were identified for title and abstract screening. Full text screening was per-formed for 2674 articles, with 174 meeting the criteria for study inclusion.

Most of the technologies evaluated in these articles were associated with PC-based systems (N=107), and there have been fewer mobile apps (N=67). Most of used technologies were with goals of treat-ment (43%, N=74) and education (26%, N=45). Among all the methods, the most and the least used methods were usability (66%, N=115) and qualitative (1%, N=2) method, respectively. The most method for health clini-cal technologies is usability method especially in telemedicine field.

In recent years, various studies have been conducted to investigate the role of the influenza vaccine in reducing the risk of hospitalization and mortality; however, the results of these studies are clearly contradictory. Accordingly, we aimed to investigate the effect of monovalent flu vaccines on the risk of hospitalization and all-cause mortality.

This study was a systematic review and meta-analysis of Randomized Clinical Trial (RCT) studies published in databases (Web of Science (ISI), Scopus, PubMed, Cochrane, Science Direct, Google Scholar) from 1980 to Dec 2022. All analyzes were performed by Stata15 statistical software and the significance level in this study was considered 0.05.

In the initial search, 375 articles were retrieved which, considering the study criteria, finally 8 RCT were included in the meta-analysis of the effects of monovalent Flu vaccine on the risk of hospitalization, and 10 RCT on the risk of all-cause mortality. Based on the results of meta-analysis, the overall Odds Ratio (OR) of hospital-ization is equal to 0.71 (95% CI: 0.56-0.90; P <0.001) and the overall OR of all-cause mortality is equal to 0.82 (95% CI: 0.68-0.98; P=0.033). There was no publication bias in the study of the effect of monovalent flu vaccine on the risk of hospitalization and all-cause mortality

Getting the flu vaccine can reduce the risk of hospitalization by 29% and the risk of overall death by 18%. Therefore, it may be promising to receive this vaccine as a preventive intervention for deaths and hos-pitalizations.

Maternal anxiety has been accompanied by many unfavorable effects on breastfeeding in the postpartum period. We aimed to provide scientific evidence in identifying effective interventions for anxiety and breastfeeding self-efficacy (BSE) in a systematic review and meta-analysis.

All published studies with inclusion criteria by 2022 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, PubMed, Scopus, SID and Magiran. The literature search was performed using PRISMA instructions. Further, 20 eligible interventional studies (RCT and pre-posttest) and one case study were included in this systematic review and meta-analysis. Publication bias was checked with Eggers test and funnel plot methods. The collected data were analyzed using stata version16.

It is not possible to provide an explicit and accurate conclusion about the effective intervention method in reducing anxiety and increasing BSE among lactating women during the covid19 pandemic. The results indicated a significant increase in BSE among lactating women after educational and psychological inter-ventions (4.20, 95% CI: 3.61 to 4.80, I2 = 26.38%).

It is recommended to conduct further studies with a strong methodology and based on interven-tion methods during the postpartum period, especially in the first month of birth to reduce the symptoms of stress and anxiety in the mother, establish better mother-child attachment, and improve BSE and maternal per-formance during the Covid-19 pandemic.

Autism Spectrum Disorders (ASDs) are common behavioral syndromes but limited critical evi-dence in Vietnam. This study aimed to identify ante-, peri- and neonatal factors for ASDs amongst children in Vietnam.

This population-based study applied the cross-sectional design with a multistage sampling in 21 urban and rural districts in seven cities/provinces in Vietnam during 2017-2018. Overall, 42,551 children age 18 to 30 months were enrolled in the study. Two phases of assessment using Modified Checklist for Autism in Toddlers (M-CHAT) for screening and diagnostic assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for confirmation. We employed univariate and binary logistic regression to identify.

Our study showed a fast-growing trend of ASDs amongst children age 18 and 30 months (75.8 per 10,000 individuals). Nine ante-, peri-, and neonatal factors were associated with ASDs: five factors of antenatal period (history of miscarriage/abortion or stillbirth, children conceived by assisted reproduction technologies, having cold, flu or acquiring virus during pregnancy, having gestational diabetes, toxemia, high blood pressure or pre-eclampsia during pregnancy, and having stress or mental disorders during pregnancy); one factors of perinatal period (mode of delivery); and three factors of neonatal period (jaundice, respiratory distress, and new-born seizures)

This first large-scale survey in Vietnam confirms some prenatal, perinatal, and postnatal factors with ASDs amongst children age 18 and 30 months. Future interventions should focus on these factors to early diagnosis and intervention to improve functional outcomes for risky children.

Middle and primary school teachers are experiencing considerable stress from their careers. However, previous studies on work stress among teachers focused on the influence of various types of stress on individuals but failed to explore the relationship among middle and primary school teachers’ work stress, psychache. We aimed to examine the basic conditions of the challenge-hindrance stress of middle and primary school teachers as well as its relationship with psychache and psychological resilience.

A total of 512 middle and primary school teachers from Zhejiang and Anhui in China were enrolled from May to October 2021. The subjects were evaluated with the challenge–hindrance stress questionnaire, psychache scale, and psychological resilience scale. t-test, ANOVA analysis, correlation analysis, and multivari-ate regression analysis were used to explore the relationship between challenge-hindrance stress and psychache

Middle and primary school teachers generally experience high challenge–hindrance stress and psy-chache. The challenge-hindrance stress had a significantly positive correlation with psychache (r=0.295, 0.439, P<0.01) and a significantly negative correlation with psychological resilience (r＝−0.320, −0.494, P<0.01). Challenge–hindrance stress could be used to significantly predict the psychache. Specifically, challenge stress and hindrance stress could significantly positively predicted the psychache (β=0.295 and β=0.439, respectively). In addition, psychological resilience exerted a partial mediating effect on the relationship between challenge–hindrance stress and psychache.

The challenge–hindrance stress of middle and primary school teachers influences their psychache directly as well as indirectly through the mediating effect of psychological resilience.

Dynamic balance monitoring involves the assessment of the muscular control during changes of the centre of gravity location in space above the supporting plane. We aimed to determine the structure of the Y-Balance Test and its accuracy based on measurements of strength and resistance to fatigue of muscles acting on the knee joint under static conditions, as well as joint motion ranges and static balance in girls aged 14 years.

The study included 40 girls aged 14, who attended Gymnasium No. 2 in Cracow (Poland). The re-search was conducted in October 2020. Postural stability was examined with the use of the YBT. The measure-ments of muscle strength and knee joint extensor and flexor resistance to fatigue during an isometric contrac-tion were performed in a standard position on the test bench. The measurements of lower extremity joint range of motion were performed in accordance with the SFTR methodology. Static balance was assessed with the use of the modified FBT.

The factor structure obtained for both lower extremities has satisfactorily explained the common vari-ance (about 70%) and showed slight differences between the left and right extremities.

The factor structure in the group of examined girls suggests a highly hybrid nature of the Y-Balance Test with a wide spectrum of biomechanical variables that have little influence on the measurement results.

Poisonings is a preventable public health problem that globally affects the population. We aimed to characterize drug-related acute poisonings occurred in Chile between the years of 2016 and 2020.

A retrospective study of poisonings among hospitalized patients was carried out. Data were ob-tained from the Medical Outcome Statistical Report database. Inclusion criteria were cases of patients admitted into either public or private healthcare settings with diagnosis of drug-related poisoning according to the WHO ICD-10 codes T30-T50. Statistical analyses were run to establish either significant associations or differences between variables selected in the study.

Overall, 12,975 poisonings were identified during the 2016-2020 period. These events corresponded to 0.16% of all national hospital admissions in the study period. Women represented 71.1% of the cases. 76.7% of events were related to intentional poisonings while 7.3% and 16% were accidental and undetermined poi-sonings respectively. 44.6% of accidental and intentional poisonings occurred at the age of 18-29 yr old. Ben-zodiazepines (22.8%), antidepressants (11.2%), and acetaminophen (5.1) were the most common drugs associ-ated with poisonings. Average length of hospitalization was between 3.3 and 8.2 days. 0.6% of poisonings resulted in deaths.

Poisonings were characterized by patients’ sex and age, circumstance of exposure, length of hos-pitalization, and outcome. Poisoning rates were stable along the years with a slight decrease in 2020. Intentional poisonings among young women and men were more common. Most of the cases had favorable outcome for patients.

We aimed to analyze the differences and changing trends of mortality of Injury and Poisoning (IP) between urban and rural areas and gender in China to find out the influencing factors and to propose im-provement measures.

IP mortality, population, economy, medical and health information data came from the official web-site of the National Bureau of Statistics, and basic data on education level came from the Chinese Ministry of Education. Then the differences of the mortality of IP were compared between different areas and gender in China from 2009 to 2019, and the relationships between the mortality changes of IP and education level, GDP per capita, the numbers of practicing physicians, health institutions and urbanization rate were also explored by establishing a ridge regression model.

The mortality of IP in rural areas was significantly higher than that of urban areas, and in male was higher than that of female (both P<0.001). Primary school graduates, GDP per capita, the number of practic-ing physicians, health institutions and urbanization rate had strong correlations (rmin=-0.622) with the mortality of IP. Ridge regression model showed that there was a quantitative relationship between primary school gradu-ates, GDP per capita, the number of practising physicians, health institutions, urbanization rate and the mortal-ity of IP in China.

As the difference of working nature, economic development imbalance, psychological and gen-der, the mortality of IP was significantly different, so the state should take more effective measures to develop the urban and rural areas balanced, and reduce the IP risk in some particular occupations.

Cuproptosis-related long non-coding RNA (lncRNA) disease is associated with the development and progression of tumors. We aimed to investigate the prediction of cuproptosis-related lncRNA on the prog-nosis and immunotherapy of patients with thyroid carcinoma (THCA).

The thyroid cancer-associated expression data and lnc RNAs data were downloaded from The Can-cer Genome Atlas (TCGA) and Ensembl database. The prognostic model of cuproptosis-related lncRNAs was successfully constructed through Lasso regression analysis and Cox regression analysis. Then, the prognostic value of prognostic model of cuproptosis-related lncRNAs was tested through the survival analysis, ROC curves and nomographic charts. Finally, the prognostic model of cuproptosis-related lncRNAs associated with immunity and mutational load of tumors was analyzed, and potential targeted drugs for THCA were predicted.

A cuproptosis-related lncRNA model of THCA (AC026100.1, AF235103.3, LNCSRLR) was success-fully constructed, which has an independent prognostic value. Moreover, the cuproptosis-related lncRNA mod-el was associated with immune signatures and mutational load in most tumors, showing its high correlation with the sensitivity of targeted drugs such as 5-Fluorouracil, Bleomycin, Rapamycin and Sunitinib.

The cuproptosis-related lncRNA model of THCA has promising applications in the treatment and prognosis of THCA.

The coronavirus disease pandemic has caused significant disruption in the field of education, resulting in the need for more online classes and a blended offline and online teaching model. Therefore, un-derstanding what makes this model effective is important. Accordingly, this study explored the structural rela-tionships among academic pressure, independent learning ability, and academic self-efficacy in a blended teaching environment during the pandemic and independent learning ability’s mediating effect on the relation-ship between academic pressure and academic self-efficacy.

Adopting a random sampling method, this study surveyed 761 Chinese college, Shaanxi Province, China in 2022 and university students. Factor analysis, correlation analysis, structural equation modeling, and path analysis were used to analyze the data.

The results show that the academic pressure faced by Chinese English majors had a significant nega-tive impact on academic self-efficacy (P<0.001). However, academic pressure had no statistical effect on stu-dents’ independent learning ability (P=0.317). Moreover, independent learning ability had a significant positive effect on academic self-efficacy (P<0.001) and a mediating effect on the relationship between academic pres-sure and academic self-efficacy (P=0.032).

Independent learning ability can directly and indirectly affect academic self-efficacy. Thus, in an online and offline blended teaching model, teachers should guide students regarding self-exploration, com-munication, and cooperation based on existing knowledge and experience. They should also enable students to improve their learning process and independent learning ability. Various language learning situations should be established for learning English so that by experiencing success and failure, students can ultimately im-prove their academic self-efficacy.

Hepatolenticular degeneration (HLD) is an inherited disorder caused by the mutation in the adenosine triphosphatase copper transporting β gene (ATP7B). W aimed to explore the genetic changes in HLD using bioinformatics analysis.

The study was conducted in Nepal, in 2019. The GSE107323 dataset was downloaded and the dif-ferentially expressed lncRNAs (DElncRNAs) as well as differentially expressed genes (DEGs) induced by ATP7B knockout (KO) and copper toxicity were clustered using Mfuzz clustering analysis. LncRNAs and genes with high coexpression (correlation coefficient > 0.9) and pathways involving the DEGs were used to construct the lncRNA-gene-pathway network.

ATP7B KO and ATP7B KO + copper induced 51 overlapping DEGs and 687 overlapping DElncRNAs, respectively. Mfuzz analysis identified four clusters, including two clusters of consistently upreg-ulated and downregulated DEGs/DElncRNAs. The lncRNA-gene-pathway network consisted of 13 DElncRNAs, 10 DEGs, and two pathways, including “hsa04630: Jak-STAT signaling pathway” and “hsa04920: Adipocytokine signaling pathway”. Eight downregulated genes, including erythropoietin (EPO), insulin receptor substrate 1 (IRS1), and PPARG coactivator 1 alpha (PPARGC1A), and two upregulated genes (cardiotrophin-like cytokine factor 1 and cyclin D3) were involved in the two pathways. These genes were tar-geted by multiple lncRNAs, including PCAT6 and MALAT1.

Collectively, the differentially expressed lncRNA-mRNA axes play crucial roles in HLD patho-genesis through mediating cell proliferation and inflammation. Moreover, the EPO, IRS1, or PPARGC1A genes were potent therapeutic targets for HLD.

Thalassemia is the most common inherited anemia in worldwide. Heart failure is the most common cause of mortality and morbidity in patients with major and intermedia β-thalassemia. This study aimed to evaluate the effect of oral administration of L-arginine on the improvement of systolic Pulmonary Artery Pressure (PAP) and cardiac function in patients with major and intermedia β-thalassemia.

This randomized clinical trial was done on 88 patients with β-thalassemia admitted to Ali Asghar Hospital, Tehran, Iran between 2020 and 2021. Echocardiography was performed for all the patients before the intervention. Afterwards, the patients were randomly divided into two groups of placebo and L-arginine. The patients underwent echocardiography after eight weeks and were compared with respect to the results.

The mean blood transfusion interval was 20.21 d in the placebo group and 17.14 d in the L-arginine group (P=0.082). The results revealed no significant difference between the two groups regarding the mean levels of Hemoglobin (Hb) and ferritin, frequency of splenectomy. However, the mean PAP significantly de-creased from 32.88 to 26.02 in the L-arginine group (P=0.009), but did not change in the placebo group. Nonetheless, no significant change was observed in the mean Ejection Fraction (EF) before and after L-arginine administration.

L-arginine administration prevented the increase of PAP and was effective in preventing cardio-vascular disorders including increased systolic PAP in patients with major and intermedia B-thalassemia. How-ever, the results have to be confirmed in further studies with larger sample sizes.

Calculating the fat content per 100 g or 100 mL, 50 g, or the reference amount customarily con-sumed (RACC) shows the fat content of some foods inappropriately. Therefore, making some food choices based on them to limit fat intake may increase the risks of some chronic diseases.

We calculated the fat content and determining appropriate fat levels (to limit fat intake) based on U.S. Food and Drug Administration (FDA), Codex Alimentarius Commission (CAC), and the proposed method were performed on 8,596 food items during July 2018 to June 2020 in Tehran, Iran. Information on food and fat profiles was provided from the USDA National Nutrient Database for Standard Reference, released in 2016.

Making some food choices based on the CAC per 100 g or 100 mL or FDA per serving (the serving is derived from the RACC, 100 g, or 50 g) to limit fat intake exceeded fat needs, which may increase the risks of some chronic diseases. Some foods that did not exceed fat needs were not appropriate food choices based on the CAC per 100 g or 100 mL or FDA per serving to limit fat intake. Some foods were free of, but not low in, fat, based on the FDA per serving.

Making food choices based on the proposed method to limit fat intake did not exceed fat needs and the appropriate percentage of energy from fat. Also, foods that did not exceed fat needs were appropriate food choices based on the proposed method to limit fat intake.

miRNAs are small non-coding RNAs; regulate gene expression using RNA degradation or translation repression. Dysregulation of miRNAs is involved in the initiation and progression of many cancers. We aimed to determine the relationship between miR-5571-5p expression and clinical factors and regulatory mechanisms in breast cancer.

Histopathologic sections approximately with 25 microns thick from FFPE tissues were achievement of Al-Zahra Hospital (Isfahan, Iran) in 2020-2021 years by Pathologist. miR-5571-5p expression, determined using real-time PCR. For miRNA target genes prediction, integrated miRNA target prediction tools, were used. Gene ontology and KEGG pathway analysis were accomplished to identify the biological function. A PPI network was constructed to display key target genes. For hub genes validation, GEPIA databases were used.

miR-5571-5p was upregulated in breast tumor tissues, and its increase was significantly related to a poor prognosis in breast cancer (P<0.0001). At first, 324 target genes were predicted, and then 110 genes with a decrease in expression were selected. GO analysis showed that genes were mainly enriched in the regulation of the ERBB2 and EGFR signaling pathway. KEGG pathway analysis suggested that downregulated genes were enriched in glioma, the ErbB signaling pathway, and breast cancer. Finally, the ten hub genes (EGF, PIK3R1, SOS1, PTEN, SHC1, CBLB, LIFR, LEP, PDE1C, and NT5C2) were detected from the PPI network.

miR-5571-5p up-regulation is associated with breast cancer progression and worse survival. The current study identified ten genes associated with breast cancer, which might help to provide candidate targets for the treatment.

Although malaria is endemic in some areas of southeastern Iran, following the successful national malaria elimination plan (NMEP), the local transmission area has been shrunk. This study was aimed to evaluate the effect of climate change on the distribution of main vectors.

All documents related to research investigations conducted in Kerman Province on malaria vectors published during 2000–2019 were retrieved from scientific databases. Spatial distributions of the main vectors were mapped and modeled using MaxEnt ecological model. The future environmental suitability for main vec-tors was determined under three climate changes scenarios in the 2030s.

Five malaria vectors are present in Kerman Province. The best ecological niches for these vectors are located in the southern regions of the province under the current climatic condition as well as different climate change scenarios in the 2030s.

Climate change in 2030 will not have a significant impact on the distribution of malaria vectors in the region. Entomological monitoring is advised to update the spatial database of Anopheles vectors of malaria in this malaria receptive region.

Exploring and analyzing the cost of medicines is an important tool for their management and planning. This study aims to analyze the utilization and costs of parenteral anti-diabetic medications during the past decade and predict the future trend of these medications from 2021 to 2031 in people that are covered by Iran Health Insurance Organization (IHIO).

This study was based on secondary analysis of data routinely reported to IHIO from 2011 to 2019. For each drug, the Defined Daily Dose (DDDs) and DDDs per 1000 inhabitants per day were calculated for the last 9 years according to the WHO protocol. Then a regression analysis was used to predict the utilization trend of each drug for the following 10 years.

The overall utilization of injectable antidiabetic drugs has constantly increased during the last nine years. This increasing trend is estimated to continue during the next decade.

In Iran, the increase in the diabetic population and better access in the future will be the main reasons for the increase in the utilization of various insulins. The increasing trend of utilizing injectable antidiabetic drugs in Iran might be partly due to new patients and partly because of improvement in patient access to new treatments. This also suggests that, compared to the average in the commonwealth countries, Iranian diabetic patients has faced lack of drug utilization in the past decade that is gradually reducing.

Obesity has increasingly become a health threat in the Middle East and North Africa (MENA) countries. This study aimed to investigate the scientific publications on obesity in the MENA countries during 2008-2020.

A longitudinal analysis of 13 years (2008-2020) of bibliographic data from obesity-related articles was performed. Web of Science core collection (WoS) was searched for bibliographic data. The bibliometric indicators including overall productivity and collaboration along with the prevalence of obesity and socioeco-nomic status were used to assess and compare the context of obesity research efforts in the MENA region.

The overall obesity-related articles of the MENA countries cumulated to 23680 publications. The MENA region accounted for a 6.5% global publication share in obesity research. Turkey contributed the high-est rate of total publications (n=6162) followed by Iran (n=5302) and Israel (n=2847). Iran and Turkey had the lowest rates of international collaborations. The overall obesity research was not significantly associated with socio-demographic index (SDI) measure (r=-0.26, P=0.27). No significant association was found between Gross National Income (GNI) per capita and the overall production of obesity research (r=0.41, P=0.08). Ad-ditionally, obesity research was not significantly associated with the prevalence of obesity in the countries (r=0.24, P=0.30).

This study observed an increased share of scientific productivity in the field of obesity from the MENA countries. Neither SDI, GNI per capita, nor obesity prevalence was not significantly associated with the overall productivity of the region.