Journal of Research in Health Sciences
Volume:25 Issue: 3, Summer 2025

The prevalence of iron-deficiency anemia (IDA) among school-aged children in India varies from 27% to 90%. There is no evidence of the comparative effects of various available interventions. Thus, this study aimed to quantify and rank the effects of different interventions on IDA among school-going children.
Study Design: Systematic review and Meta-analysis.

To this end, PubMed, Scopus, and ScienceDirect databases were searched, and randomized controlled trials (RCTs) evaluating the comparative effects of various interventions on hemoglobin (Hb) and serum ferritin against a control were included in this study. The random-effect model was conducted for Hb, and the fixed-effects model was performed for ferritin to estimate the mean difference (MD) and 95% confidence interval (CI) of the effect of interventions of outcomes based on the heterogeneity (I2 ).

Eight RCTs (including 2534 participants) investigating the effects of 12 interventions for IDA treatment among school-going children in India were obtained. The results of reference-based forest plots and P score indicated that iron-rich fish powder was the most effective intervention for increasing Hb levels (MD: 2.07 g/dL, 95% CI: 0.68–3.47, P score=0.8656), followed by iron and folic acid (IFA) given twice weekly (MD: 1.47 g/dL, 95% CI: -0.31–3.25, P score=0.7209). Additionally, IFA supplementation twice weekly was found to be highly effective in increasing serum ferritin levels among anemic school children (MD: 0.80 ng/mL, 95% CI: 0.33–1.27, P score=0.9148).

It seems that iron-rich fish powder and intermittent IFA supplementation were the most effective interventions, but further research is needed to confirm these results and assess their public health implications.

There is a gap in the literature specifically addressing the relationship between food insecurity and the risk of Alzheimer’s disease (AD).

 A case-control study.

This study aimed to evaluate the association between food insecurity and the risk of AD in 301 participants, including 150 cases and 151 controls. Cases were recruited among people in the early stages of the disease who had been diagnosed with AD within the past six months. Controls were selected from health centers across Tehran. Food security status was assessed using the validated Persian translation of the 18-item United States Department of Agriculture’s household food security questionnaire.

After adjusting for potential cofounders, food insecurity was associated with a higher risk of AD (odds ratio [OR]: 2.80; 95% confidence interval [CI]: 1.59–4.94). Among female participants, food insecurity increased the odds of AD (OR: 3.54; 95% CI: 1.72–7.30). For individuals under 65, food insecurity also increased the likelihood of AD nearly four-fold (OR: 3.94, 95% CI: 1.48–10.47), while for those over 65, the risk was only 2.89 times (OR: 2.89, 95% CI: 1.36–6.14).

Food insecurity might be associated with an increased risk of AD. Further research is required to explore the relationship between food insecurity and other types of neurological disorders or health conditions. More precisely, future studies should aim to investigate the association in a prospective design.

Each year, millions of children under five die globally, with many of these deaths being preventable. The situation is particularly concerning in low sociodemographic index (LSDI) states of India, where the under-five mortality rate is 45 children per 1000 live births. This study aimed to predict under-five mortality and determine related key factors.

 A cross-sectional study.

This study analyzed National Family Health Survey-5 (NFHS-5) data related to 94,202 children from the LSDI states of India. Several survival models were tested, including Cox proportional hazards, random survival forest, and gradient-boosted survival, to identify factors linked to child mortality. Model performance was evaluated using metrics such as the concordance index, integrated Brier score, and time-dependent receiver operating characteristic (ROC) curves.

Among the studied children, 4.5% (4,284) died before their fifth birthday. The risk of death was higher in children born to younger (15–25 years) mothers (hazard ratio [HR] = 1.113, 95% confidence interval (CI): 1.034, 1.198; P < 0.001), uneducated mothers (HR = 1.263, 95% CI: 1.098–1.454; P < 0.0001), mothers with a poorer wealth index (HR = 1.719, 95% CI: 1.475–2.003; P < 0.0001), and children with low birth weight (HR = 2.091, 95% CI: 1.934–2.26; P < 0.001). The random survival forest model outperformed in identifying these risk factors.

This study highlights the importance of empowering women through education, improving family planning, addressing poverty, and providing equitable healthcare to reduce child mortality. These insights can help shape policies and initiatives to improve the survival and health of children in vulnerable communities.

It is widely believed that poverty is a significant factor in causing stunting, and parental habits can also play a role. In this context, households with employed mothers are often suspected of increasing the risk of stunting in children. This study aimed to examine the role of maternal employment status in stunted children among low-income families in Indonesia.

 A cross-sectional analysis.

In general, 47021 children were investigated in this study. The children’s nutritional health and maternal work status were used as the outcome and variables, respectively. Seven control variables were evaluated, including residence type, marital status, mother’s age, education level, child age, antenatal care (ANC), and gender. Finally, a binary logistic regression analysis was employed, ensuring the validity and reliability of the results.

Overall, 19.0% of Indonesian children under two from low-income households experienced stunted growth. Meanwhile, 23.5% of mothers were employed in low-income homes. Regarding nutritional status, the findings revealed that employed mothers had stunted kids, which is slightly higher than that in unemployed mothers. More importantly, it was found that unemployed mothers were 1.022 times more likely to have stunted kids than employed mothers (95% confidence interval: 1.015–1.030), underscoring the crucial role of maternal employment in child nutrition.

Maternal employment status played a role in having stunted children among low-income families, and unemployed mothers were a risk factor for having this type of child. Empowering unemployed mothers through job opportunities, financial support, and access to childcare and nutrition programs can help reduce child stunting in low-income families.

Coronary artery disease (CAD) is a leading cause of death globally, with genetic and lifestyle factors contributing to its development. The first-degree relatives of CAD patients are at increased risk due to shared genetics and environments. This study aimed to perform a comparative analysis of gender-specific patterns of traditional CAD risk factors and QRISK3 scores in the first-degree relatives of CAD patients.

 A cross-sectional study.

This study enrolled 4,485 participants of first-degree relatives of patients who had been admitted to the hospital for CAD. Gender-specific comparisons were conducted in the first-degree relatives of CAD to assess traditional risk factors and QRISK3 scores.

The mean age of patients was 41.8 years, with males comprising 66% of participants in our study. Males exhibited more traditional risk factors, including higher systolic and diastolic blood pressure, dyslipidaemia, smoking, alcohol, junk food consumption, and oral tobacco use. Females had a higher prevalence of obesity, inadequate sleep, depression, and migraines. Males had a significantly higher 10-year CAD risk according to QRISK3 scores, reflecting an increased healthy heart age of 4.20±1.32 years compared to their chronological age (P=0.0004).

The prevalence of coronary risk factors was twice as high in the first-degree male relatives of individuals with known CAD compared to females. Distinct gender-based differences were found in risk factors and QRISK3 scores, highlighting the significance of specific approaches in evaluating and managing the risk of CAD within this high-risk group.

Smoking remains a serious public health issue on a global scale and warrants increased attention. This research aimed to assess the prevalence of smoking and identify key predictors driving the adoption of smoking prevention behaviors among university students in northern Iraq.

 A cross-sectional study.

An online study was conducted among 765 students at Raparin University, Sulaymaniyah, Iraq. The required data were collected using a structured questionnaire distributed through Google Forms. The questionnaire, developed from standardized instruments, assessed sociodemographic factors and determinants of smoking behaviors. Finally, the data were analyzed by SPSS-16 using linear and logistic regressions.

The average age of the students was 21.04 years [95% confidence interval: 20.89, 21.20], with ages ranging from 17 to 29 years. The age group of 21–23 years old increased the chances of cigarette smoking among students (odds ratio [OR]: 2.068). In addition, male students were more likely to have cigarette smoking (OR: 11.675). Father smoking, brother smoking, and friend smoking increased the chances of cigarette smoking by 1.981, 2.687, and 10.426 times among students, respectively. Our study identified key determinants of smoking preventive behaviors, including peer pressure (B=0.507), self-image (B=0.235), belief (B=0.134), value (B=0.184), attitude (B=0.115), and the influence of friends who smoke (B=-1.110).

Our findings emphasize the critical roles of peer pressure and self-image in influencing smoking behaviors among students. To address this issue, targeted educational programs that foster positive self-image and resilience against peer influence are vital for effective smoking prevention strategies.

Fractures constitute a significant concern in low-income and middle-income countries, primarily due to road traffic crashes (RTCs), a leading cause of such injuries. This study aimed to analyze fracture patterns resulting from RTCs in Iran.

 A cross-sectional study.

A registry-based study was conducted using data from the National Trauma Registry of Iran spanning 2016–2023. The study included 10,114 trauma patients involved in RTCs, encompassing car and motorcycle crashes with at least one fracture. International Classification of Diseases (ICD-10) codes were used for data analysis, considering both orthopedic and non-orthopedic admissions related to RTCs. Fracture incidence was compared among pedestrians, drivers/riders, and passengers/pillions.

Males constituted a significant majority of the car (90.1% drivers, 72.1% pedestrians, and 47.0% passengers) and motorcycle (99.6% riders, 77.0% pedestrians, and 65.3% pillions) crashes (P<0.001). Patients under 18 comprised 18.4% of the motorcycle riders and 2.5% of the car drivers. Drivers showed the highest frequency of head injuries (26.9%, P<0.010), while pedestrians had the highest frequency of upper extremity injuries (73.1%, P<0.001). Drivers also demonstrated a higher frequency of vertebral fractures than passengers (C3-C7: 3.2% vs. 1.4%, P=0.006). Riders (33.5%) displayed a higher frequency of head and face fractures compared to pillions (24.8%) and pedestrians (17.4%) (Head: pedestrian vs. rider, P<0.001; pedestrian vs. pillion, P=0.018; rider vs. pillion, P=0.005; Face: pedestrian vs. rider, P<0.001; pedestrian vs. pillion, P<0.001; rider vs. pillion, P=0.033).

The study provided valuable information on the fracture patterns associated with RTCs among road user groups.

Thyroid nodules are common endocrine disorders. Most nodules are benign, with only 5% to 15% being malignant. Fine needle aspiration (FNA) is a primary diagnostic method; however, recent studies have raised concerns about its diagnostic reliability. This study aimed to evaluate performance of FNA in diagnosing thyroid nodules using pathology results as the gold standard.

 A cross-sectional study.

This study analyzed patients who were referred to an endocrine clinic in Hamadan city and underwent thyroidectomy during a 10-year period. The collected data included demographics, clinical symptoms, FNA results, and pathological outcomes. Statistical analysis was conducted using Stata software, with the significance level set at 0.05.

The study included 700 patients, predominantly female (86.2%), with a mean age of 42.5 years. FNA results were as follows: non-diagnostic in 4.8% (n=43), benign in 43.4% (n=304), atypia of undetermined significance or follicular lesion of undetermined significance in 6.1% (n=42), follicular neoplasm in 13.2% (n=92), suspicious for malignancy in 22.8% (n=160), and malignant nodules in 9.7% (n=68) of the cases. Pathology revealed malignant nodules in 56.9% (n=398) of the cases, predominantly papillary carcinoma. Significant factors associated with malignancy included younger age, male gender, history of thyroid cancer in a first-degree relative, and the presence of cervical adenopathy. FNA showed a sensitivity of 72.43% (95% CI 67.58%, 76.93%) and a specificity of 89.64% (95% CI 85.46%, 92.95%), with an accuracy of 79.85% (95% CI 76.55%, 82.87%).

While FNA is a valuable diagnostic tool for thyroid nodules, its sensitivity varies, necessitating close follow-up of patients with negative results.