International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Oncogenic Viral Infections Among Iranian Hemodialysis Patients: A Systematic Review22072207ENDeputy of Research and Technology, Ministry of Health and Medical Education, TehranNon-Communicable Diseases Research Center, Alborz University of Medical Science, KarajDeputy of Research and Technology, Ministry of Health and Medical Education, Tehran & NonCommunicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, TehranSpiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, TehranNon-Communicable Diseases Research Center, Alborz University of Medical Science, KarajHealth Management and Economics Research Center, Iran University of Medical Sciences, TehranDepartment of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, TehranDepartment of Medical Emergencies, Qom University of Medical Sciences, QomDepartment of Public Health, Maragheh University of Medical Sciences, MaraghehSubstance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran20200315<p><span class="fontstyle2">Chronic hemodialysis is a lifesaving procedure for end‑stage renal failure patients<br />who may lead to the transmission of oncogenic viral infections discussed as a major cause of liver disease and a potential cause of substantial morbidity and mortality. In this regard, the hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common infections that studied recently. This study aimed to review systematically all available documents on the prevalence of hepatitis D virus (HED), hepatitis E virus (HEV), hepatitis G virus (HGV), human T‑lymphotropic virus (HTLV),<br />human immunodeficiency virus (HIV), and Kaposi’s sarcoma‑associated herpes virus (KSHV) in Iranian hemodialysis patients. </span><span class="fontstyle2">We conducted a comprehensive systematic review of literature on the prevalence and factors associated with HED, HEV, HGV, HTLV, HIV, and KSHV in Iranian hemodialysis patients. Using Medical Subject Headings (MeSH) terms, Emtree, and related<br />equal Persian key words, irrespective of age, date, and language, the main domestic databanks of Barekat, Scientific Information Database (SID), Iran‑doc, and also international databases of PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS searched. Interest outcome of infection prevalence was confirmed based on reported positive tests of blood samples. Since the studied factors are very numerous and there is even a high heterogeneity in each factor, so the meta‑analysis was not performed. </span><span class="fontstyle2">Based on our search strategy through comprehensive searching, 509 studies were found. From them, 314 articles were from international data bases and others from Iranian data banks. After excluding duplicates and overlapping studies, 41 studies were included in the analysis; 11 studies were relevant to HIV, 10 studies assigned to HEV, and 7 studies belonged to HGV field. The HDV, HTLV1,2, and KSHV were the other research subject areas. The prevalence of HIV, HGV, and HTLV1,2 ranged from 0% to 1.5%, 0% to 24.19%, and 0.6% to 70.4%, respectively, in different provinces. </span><span class="fontstyle2">This is the comprehensive systematic review on oncogenic viral infections prevalence in the Iranian hemodialysis patients. Present findings emphasize on requirement to evidence‑based practical intervention for better<br />prevention and control of problem. The findings could be used as a scientific evidence for developing related policies and highlighting the future plan of complementary researches.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Hemodialysis, infections, Iran, oncogenic viral, systematic review</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2207http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2207/717718006International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Effects of Selenium Supplementation on Cardiometabolic Risk Factors, Inflammatory, and Antioxidant Markers: A Systematic Review and Meta‑analysis Protocol22042204ENDeputy of Research and Technology, Ministry of Health and Medical Education, Tehran & Noncommunicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDeputy of Research and Technology, Ministry of Health and Medical Education, TehranDepartment of Nutrition, School of Public Health, Iran University of Medical Sciences, TehranNoncommunicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences & Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, TehranSpiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, TehranDepartment of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, TehranSocial Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, TehranNon-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, & Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDepartment of Medical Emergencies, Qom University of Medical Sciences, QomDepartment of Public Health, Maragheh University of medical Sciences, Maragheh20200315<p><span class="fontstyle2">Selenium (Se) is considered as an antioxidant trace element involved in key activities in human metabolism. Recent investigations indicate that Se plays a pivotal role in human health. Se supplementation considered as an intervention is both cost‑effective and simple‑to‑use that may play an important role in the prevention of cardiometabolic risk factors (CRFs), inflammatory, and<br />antioxidant markers. </span><span class="fontstyle2">This paper is a protocol study on systematic review of probable effects of Se supplementation on CRFs, inflammatory, and antioxidant markers. The aim was to achieve three international databases available related to the current publications including, PubMed, ISI/WOS, and Scopus. We attempted to search for randomized clinical trials (RCT) and cross‑over trials pertaining to human subjects without any restriction on language and time. In addition, there<br />was no limitation on the age of participants. For RCTs were included all studies in different target groups comprising diabetic patients, patients with polycystic ovarian syndrome, obese subjects, or even healthy controls. To investigate the effect of Se, we included all studies which Se is used either as single therapy or as combination therapy. All studies associated with articles and meta‑analyses<br />would be evaluated to review their references. </span><span class="fontstyle2">The current study contained numerous outcomes. The result of this study can be led to make reliable scientific evidence on the probable effects of Se supplementation on CRFs, inflammatory factors, and antioxidant factors. In addition to these findings, other technical documents developed for a systematic review can be used for future<br />studies.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Antioxidant markers, cardiometabolic risk factors, inflammatory markers, selenium,<br />supplementation, systematic review</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2204http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2204/717718003International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Stromal Cell‑derived Factor‑1 and CXC Chemokine Receptor Type‑4 are Associated with Cardiovascular Disease in Patients under Hemodialysis22102210ENDepartments of Cardiology, AJA University of Medical Sciences, TehranDepartments of Pediatric Nephrology, AJA University of Medical Sciences, TehranDepartment of Internal Medicine & Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, IsfahanDepartments of Cardiology, AJA University of Medical Sciences, TehranDepartment of Genetics and Molecular Biology, School of Medicine, Isfahan University of Sciences, IsfahanDepartments of Pediatric Nephrology, AJA University of Medical Sciences, Tehran20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Cardiovascular disease (CVD) is the most common cause of death among patients<br />with end‑stage renal disease especially whom under hemodialysis (HD). Stromal cell‑derived<br />factor‑1 (SDF‑1) and its receptor CXC chemokine receptor type‑4 (CXCR4) could contribute to<br />CVD. The main aim of this study was to evaluate the association between SDF‑1 and CXCR4 with<br />CVD and its related risk factors in patients under HD. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">Sixty patients under HD and 29<br />healthy subjects were recruited in the study. The serum levels and relative messenger RNA (mRNA)<br />expressions of SDF‑1 and CXCR4 were measured using enzyme‑linked immunosorbent assay and<br />real‑time polymerase chain reaction in patients and controls, respectively. CVD history of the patients<br />was obtained. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">Twenty patients (33.3%) had a history of CVD. The mean levels of serum and<br />relative mRNA expressions of SDF‑1 and CXCR4 were higher in patients than controls and also in<br />patients with a history of CVD than patients without it. The serum levels and relative expressions of<br />SDF‑1 and CXCR4 were positively correlated with blood urea nitrogen, parathyroid hormone, and<br />high‑sensitivity C‑reactive protein and inversely correlated with hemoglobin. The history of CVD was<br />the independent predictor of serum levels of SDF‑1 and CXCR4 and also relative mRNA expression<br />of CXCR4. </span></p><p><strong></strong><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">The higher levels of serum and relative mRNA expressions of SDF‑1 and<br />CXCR4 were associated with CVD in patients under HD. Furthermore, SDF‑1 and CXCR4 were<br />associated with several traditional and uremia‑related CVD risk factors in such patients.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Cardiovascular disease, CXC chemokine receptor type 4, end‑stage renal disease, hemodialysis, stromal cell‑derived factor‑1</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2210http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2210/717718009International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Proportion and Determinants of Adherence to Antiretroviral Therapy among HIV Positive People Registered Under ART Center in South India21972197ENDepartment of Community Medicine, SDMCMS&H, Sattur, Dharwad, KarnatakaDepartment of Community Medicine, SDMCMS&H, Sattur, Dharwad, KarnatakaDepartment of Community Medicine, SDMCMS&H, Sattur, Dharwad, Karnataka20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Antiretroviral therapy (ART) significantly delays the progression from HIV to AIDS. Adherence to ART is the second strongest predictor of progression to AIDS and death, after CD4<br />count. A very high level of adherence (≥95%) is required for ART to be effective on a long term and<br />to prevent the emergence of resistant viral strains and prevent comorbidities. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">A case series<br />study was undertaken at an ART center for a period of 6 months. Non‑probability purposive sampling<br />was adapted to select HIV‑positive subjects aged >15 years on ART for more than 6 months.<br />A predesigned semi‑structured questionnaire was used to obtain the data. Treatment compliance<br />was assessed by self‑reported 1‑week recall method. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">A total of 536 HIV‑positive people<br />were interviewed, among which 315 (58.8%) of them were males and 214 (39.9%) were females.<br />Nearly two third of the participants (359, 67.0%) reported ≥95% adherence to treatment. Personal<br />commitments (51, 28.8%) and working time inconvenience (42, 23.7%) were the common reasons<br />for less adherence. On bivariate analysis, married people (OR: 1.586, CI: 1.097‑2.292), participants<br />residing in rural area (OR: 1.628, CI: 1.130‑2.345), participants not having side effects of drugs (OR:<br />5.324, CI: 3.491‑8.181), participants equipped with better knowledge about ART (OR: 2.019, CI:<br />1.377‑2.961), and participants having support of friends and family members (OR: 1.612, CI:<br />1.019‑2.540) showed a higher level of adherence to ART. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Demographic factors such<br />as marital status, residing in rural area, and other personal factors like having good knowledge about<br />ART, without side effects to drugs, and having support of friends and family members were found to<br />show a high level of adherence to ART.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Acquired immunodeficiency syndrome, adherence, antiretroviral therapy, human immunodeficiency virus</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2197http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2197/717717996International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Effect of Flaxseed Powder on Cardiovascular Risk Factor in Dyslipidemic and Hypertensive Patients22092209ENDepartment of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, IsfahanDepartment of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, IsfahanDepartment of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, IsfahanDepartment of Epidemiology and Biostatistics, Isfahan Endocrine and Metabolism Research Center, School of Public Health, Isfahan University of Medical Sciences, IsfahanUniversity of Medical Sciences, Shiraz20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Hyperlipidemia and hypertension are the most important causes of ischemic<br />heart disease. There is evidence that flaxseed powder can improve lipid profile and blood<br />pressure. In this study, we want to investigate the effects of flaxseed powder consumption<br />on patients with hyperlipidemia and hypertension. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">This randomized double‑blind<br />placebo‑controlled clinical trial was performed on 80 hyperlipidemic and hypertensive patients<br />(men and women between 20 and 60 years old). In this study, participants were recruited from Imam<br />Khomeini hospital clinics of Shiraz University of Medical Sciences in 2017 randomly allocated<br />to flaxseed powder group and placebo group. The intervention group received 36 g of flaxseed<br />sachet (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 40), and control group received 12 g placebo sachet (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 40) for 8 weeks. Serum lipid<br />profiles, blood pressure, fasting blood sugar, and anthropometric indices were measured. Data were<br />analyzed by using SPSS.</span></p><p><strong></strong><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">We found significant reduction (</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.001) in anthropometric<br />indices (waist circumference and waist‑to‑hip ratio) and lipid profiles (triglycerides [</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.015], total<br />cholesterol [</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.018], and low‑density lipoprotein [</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.001]) within flaxseed group in comparison<br />with placebo group. </span></p><p><strong></strong><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Based on beneficial effects of flaxseed on cardiovascular risk<br />factors, it seems that flaxseed consumption can be considered as a useful therapeutic approach for<br />reducing lipid profile and anthropometric indices.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Cardiovascular diseases, flax, hyperlipidemias, hypertension</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2209http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2209/717718008International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Descriptive Study of Economic Behavior of General Practitioners in Iran: Practice Income, Hours of Work, and Patient Visits22082208ENHealth Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, ShirazDepartment of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran & Information, Evidence and Research, World Health Organization Regional Office for the Eastern Mediterranean, Cairo20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Although there is a critical need for information on economic performance of<br />Iranian general practitioners (GPs) in health policymaking, there is not any scientific evidence<br />in this area. Therefore, in the present report, the characteristics of economic behaviors of Iranian<br />GPs were described. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">This was a cross‑sectional study in 2015, in which the data were<br />collected from 666 GPs. The variables including monthly gross income, hours of work, and patient<br />visits were studied as the measures of economic behavior of GPs. Descriptive statistics, </span><span class="fontstyle3">t</span><span class="fontstyle2">‑test,<br />and Analysis of Variance were used for analyzing the data. The statistical analysis was performed<br />by STATA12.</span></p><p><strong></strong><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The annual income of the GPs understudy was 26,000 US dollar (USD)<br />(82,680 purchasing power parity [PPP]). The ratio of this value to gross domestic product per capita<br />and minimum wage of Iran in 2015 was 4.8 and 9.2, respectively. On average, every GP in Iran has<br />an income of 2188.1 USD (6958.16 PPP), works 142 h, and visits an average of 494 patients/month.<br />The results showed that the economic behavior of Iranian GPs has a significant difference in<br />terms of gender, age, marital status, practice experience, practice location, type of practice, being<br />a family physicians, and working in different settings (</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.05). </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">The Iranian GPs<br />understudy work less than their counterparts in other (compared) countries. The studied GPs had a<br />higher income (adjusted by hours of work and countries’ per capita income) than their counterparts<br />in other (studied) countries. Moreover, there are inequalities between GPs in terms of income, the<br />volume of services provided and the work hours.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Family practice, general practitioners, health‑care economics and organizations, office<br />visits, private practice</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2208http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2208/717718007International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Evaluation the effect of testosterone on the number of endothelial progenitor cells and amount of SDF-1α, PDGF, bFGF, and NO22052205ENDepartment of Physiology, Physiology Research Center & Medical Student Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Physiology, Physiology Research Center & Medical Student Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Physiology, Physiology Research Center & Medical Student Research Center, Isfahan University of Medical Sciences, Isfahan20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Recent therapeutic advances in cardiovascular disease, thanks to the discovery of<br />endothelial progenitor cells (EPCs). Stromal cell‑derived factor‑1</span><span class="fontstyle3">α </span><span class="fontstyle2">(SDF‑1</span><span class="fontstyle3">α</span><span class="fontstyle2">), platelet‑derived<br />growth factor (PDGF), basic fibroblast growth factor (bFGF), and nitric oxide (NO) play a role<br />in migration, homing, and differentiation of EPCs into mature endothelial cells. The incidence of<br />cardiovascular disease is higher in men than in women. This fact suggests the influence of sex<br />hormones on incidence of cardiovascular disease. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">Twenty‑four female wistar rats weighing<br />160–180 g were randomly divided into four groups (</span><span class="fontstyle4">N </span><span class="fontstyle2">= 6): 1. sham‑treated by sesame oil, 2.<br />ovariectomized (OVX)‑treated by sesame oil, 3. OVX‑treated by 10 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone, and 4.<br />OVX‑treated by 100 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone. After 21 days, the animals were euthanized and blood<br />samples were saved for determination of EPC count and serum levels of SDF‑1</span><span class="fontstyle3">α</span><span class="fontstyle2">, PDGF, bFGF,<br />and NO production. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">High‑dose testosterone induced significant increase in EPC count in<br />OVX rats (</span><span class="fontstyle4">P </span><span class="fontstyle2">˂ 0.05). Also 100 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone increased serum level of SDF‑1</span><span class="fontstyle3">α </span><span class="fontstyle2">more than<br />OVX‑treated by 10 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone (</span><span class="fontstyle4">P </span><span class="fontstyle2">˂ 0.05). But 10 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone increased<br />significantly the serum level of PDGF >100 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone‑treated group (</span><span class="fontstyle4">P </span><span class="fontstyle2">˂ 0.05). The<br />serum level of bFGF in sham‑treated by sesame oil was equal with its concentration in OVX‑treated<br />by 100 </span><span class="fontstyle3">µ</span><span class="fontstyle2">g/kg/day testosterone. And the serum concentration of NO production in testosterone‑treated<br />groups were significantly less than other groups (</span><span class="fontstyle4">P </span><span class="fontstyle2">< 0.05). </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">This study suggests that<br />testosterone might be effective on cardiovascular disease in females by increasing EPC count through<br />SDF‑1</span><span class="fontstyle3">α </span><span class="fontstyle2">and PDGF mechanisms which are some of the vascular healing factors.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle4">Basic fibroblast growth factor, endothelial progenitor cell, nitric oxide, platelet‑derived growth factor, stromal cell‑derived factor‑1</span><span class="fontstyle3">α</span><span class="fontstyle4">, testosterone</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2205http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2205/717718004International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Association Between BMI and Inflammation Among Diabetic Polyneuropathy Patients22032203ENFood Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Neurology, Isfahan University of Medical Sciences, IsfahanDepartment of Infectious Diseases, Isfahan University of Medical Sciences, IsfahanDepartment of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, IsfahanPediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non‑ communicable Disease and Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Inflammation is defined as body tissues response to harmful stimuli. Obesity‑related<br />inflammation leads to increased risk chronic diseases including diabetic polyneuropathy (DPN).<br />The present study was performed to determine association between body mass index (BMI) and<br />inflammatory markers including erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP)<br />in DPN patients. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">In this cross‑sectional study, 200 DPN patients with a mean (SD) of age<br />58.76 (9.53) years were selected. All patients completed the questionnaire including demographic<br />data and chronic disease history. In addition, anthropometric measures and clinical laboratory tests<br />were taken. Multivariate linear regression was used to detect the association between BMI, CRP,<br />and ESR levels. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">BMI was associated with increase in ESR and CRP levels (</span><span class="fontstyle3">β</span><span class="fontstyle2">‑ESR = 4.67,<br /></span><span class="fontstyle4">P </span><span class="fontstyle2">< 0.001 and </span><span class="fontstyle3">β</span><span class="fontstyle2">‑CRP = 0.71, </span><span class="fontstyle4">P </span><span class="fontstyle2">< 0.001). Also, this association remained after adjustment for other<br />different variables. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">These findings indicate that higher BMI is related to increase<br />inflammatory markers including CRP and ESR in DPN patients. Therapies for DPN and reducing<br />inflammation should target the weight loss among obese patients.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle4">Body mass index, C‑reactive protein, diabetes, erythrocyte sedimentation rate,<br />polyneuropathy</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2203http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2203/717718002International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Late Cardiotoxicity in MS Patients Treated with Mitoxantrone22022202ENHypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanCardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanInterventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanDepartment of Neurology, Medical School, Isfahan University of Medical Sciences, Isfahan20200315<p><span class="fontstyle0"><strong>Context</strong>: </span><span class="fontstyle2">Mitoxantrone (MTX) is an antracyclin drug that is used for treatment of patients with<br />chronic refractory multiple sclerosis (MS). Congestive heart failure (CHF) is a rare complication of<br />this drug that may occur early, during therapy, or late, months or years after termination of therapy.<br /></span></p><p><span class="fontstyle0"><strong>Aims</strong>: </span><span class="fontstyle2">The aim of this study is to evaluate the long‑term adverse effect of MTX on cardiac function.<br /></span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">The study involved 49 MS patients on MTX therapy because of their disease was refractory<br />to other treatments (18 men and 31 women). They were treated in two canters related to Esfahan<br />University of Medical Sciences. The mean age was 34.65 ± 9.56 years. Systolic and diastolic left<br />ventricular (LV) functions were measured by echocardiography. The baseline echocardiographic data<br />were collected from patients’ file. Echocardiography was repeated by a single cardiologist in 2016.<br /></span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">After MTX therapy, one patient’s ejection fraction (EF) reduced below 50% (2%). In spite<br />of their normal diastolic function before therapy, two patients developed diastolic dysfunction (4%).<br />Nonparametric binominal analysis reveals that MTX therapy increased the probability of developing<br />systolic dysfunction, early or late </span><span class="fontstyle3">P </span><span class="fontstyle2">< 001.</span></p><p><strong></strong><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">MS patients treated with MTX are at<br />increased risk of developing early and late‑LV dysfunction, so all patients on MTX therapy must be<br />periodically evaluated for these late complications.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Heart failure, mitoxantrone, multiple sclerosis</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2202http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2202/717718001International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Selenium Level in Patients with Heart Failure versus Normal Individuals22012201ENDepartment of Cardiology, Najafabad Branch, Islamic Azad University, NajafabadDepartment of Internal Medicine, Islamic Azad University, NajafabadDepartment of Cardiology, Najafabad Branch, Islamic Azad University, NajafabadClinical Anatomical Pathology, Dr. Fouladi Laboratory, Isfahan20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Despite many attempts to discover pathophysiologic mechanisms to explain chronic<br />heart failure (CHF), no conceptual paradigms have been proved yet. Various studies have shown<br />the role of trace elements on heart failure (HF). Among all trace elements, selenium deficiency<br />is regarded as important risk factors for HF. Considering selenium deficiency in our society and<br />high prevalence of HF, we compared selenium level in patients with HF with healthy individuals.<br /></span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">In all, 32 hospitalized patients with HF and 32 healthy controls were enrolled in a<br />case–control study. Demographic characteristics as well as functional class and risk factors were<br />recorded for all two groups. Echocardiography was conducted for patients and all provided data<br />were registered. Then serum selenium levels were compared in case and control groups. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The mean (±standard deviation) serum selenium was 92.5 ± 22.44 mg/dL in patients with HF and<br />109.3 ± 29.62 mg/dL in controls. The level of selenium was significantly lower and the frequency<br />of risk factors was significantly higher in case group. Selenium level did not differ significantly in<br />patients with different HF causes. There were a nonsignificant relationship between selenium level<br />and left ventricular ejection fraction and a significant reverse relationship between selenium level and<br />left ventricular volume and pulmonary artery pressure. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Our results showed statistically<br />significant lower level of serum selenium in patients with CHF in comparison to normal individuals.<br />Moreover, selenium level had significant reverse relationship with left ventricular volume and<br />pulmonary artery pressure.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Heart failure, left ventricular volume, selenium</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2201http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2201/717718000International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Association of Maternal Serum Vitamin D Level with Risk of Pregnancy‑Related Complications and Neonatal Anthropometric Measures: A Prospective Observational Study21992199ENFood Security Research Center, Isfahan University of Medical Sciences, Isfahan & Food Safety Research Center (salt), Semnan University of Medical Sciences, SemnanFood Security Research Center, Isfahan University of Medical Sciences, Isfahan & Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, TehranDepartment of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, IsfahanDepartment of Gynecology, School of Medicine Science, Isfahan University of Medical Sciences, IsfahanFood Security Research Center, Isfahan University of Medical Sciences, Isfahan & Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Body of evidence is increasing about the importance of Vitamin D (VD) for<br />normal development of the fetus and for maternal health. As limited data are available regarding<br />the association between maternal VD level and pregnancy‑related complications and neonatal<br />anthropometric measures, the present study aimed to evaluate the neonatal anthropometric measures<br />including weight, high, and head circumference and pregnancy‑related complications such as<br />preeclampsia, blood pressure, gestational diabetes mellitus, and nausea and vomiting in pregnancy with<br />25(OH)VD level. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">The current prospective observational study was conducted among 812<br />Iranian pregnant women during the first trimester in Isfahan, Iran. Needed data were collected using<br />validated questionnaires and biochemical examinations. </span></p><p><strong></strong><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">Overall, this study demonstrated<br />an inverse significant association between VD level and chance of having low‑weight infant in the<br />adjusted model (odds ratio [OR]: 0.03, 95% confidence interval [CI]: 0.004–0.26, </span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.001) in<br />the first VD assessment. The same results were obtained in the second VD assessment (OR: 0.08,<br />95% CI: 0.01–0.40, </span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.01). However, such associations were not seen about other neonatal<br />measures and pregnancy‑related complications. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">We found that low maternal VD level<br />might be associated with risk of low‑weight infant. Such findings could be considered to implement<br />informative interventional programs to control newborn adverse outcomes. Further studies are<br />required to confirm these findings.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Maternal Vitamin D, neonatal anthropometric measures, pregnancy complications</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2199http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2199/717717998International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Growth Indices of Exclusively Breastfed Until 6 Months Age and Formula‑Fed Infants in Southwest of Iran21982198ENDepartment of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, YasujDepartment of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, YasujDepartment of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, YasujDepartment of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, YasujDepartment of Nutrition, Arak University of Medical Sciences, Arak20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Formula milk is prepared as a nutritional substitution for human breast milk, but<br />because of biologic and constituent differences, it might cause obesity and growth disorders in<br />infants. In this study, we compared the growth pattern of formula‑fed and breastfed infants living in<br />Yasuj, southwest of Iran. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">Infants 7–14 months of age in southwest of Iran were classified<br />as exclusively breastfed (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 200) and formula‑fed (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 200) in their first 6 months of life. Growth<br />velocity and </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑scores of weight for age, length for age, weight for length, and head circumference<br />were estimated using WHO Anthro Plus software (2010) and SPSS Version 19 (SPSS Inc., Chicago,<br />IL, USA) using World Health Organization reference for growth data. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The study showed<br />that </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑score of length for age and head circumference for age at the birth were significantly lower in<br />formula‑fed group than exclusively breastfed group (</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.05), but the </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑score of weight for length<br />did not differ significantly. At the sixth month of age, </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑score of weight for length was significantly<br />higher in formula‑fed group (</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.05), but </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑score of length for age had no significant difference<br />and </span><span class="fontstyle3">Z</span><span class="fontstyle2">‑score of head circumference was higher in exclusively breastfed group yet (</span><span class="fontstyle3">P </span><span class="fontstyle2">< 0.05). Growth<br />velocity, prevalence of obesity, wasting, underweight, and stunting did not differ between two groups.<br /></span><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Our findings suggest that formula feeding can lead to greater weight gain and may<br />help the catch up of length, but evidences are not convincing enough to suggest the formula as an<br />obesogenic feeding in the studied area. To make a conclusion, we suggest comparing the privileged<br />and unprivileged areas and controlling for confounding variables including family hygiene and infant<br />feeding practices between formula‑fed and breastfed infants.<br /></span><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Breastfeeding, formula feeding, growth velocity</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2198http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2198/717717997International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Obesity is the Most Important Factor for Gender Inequality in Type 2 Diabetes Incidence in an Iranian Population22062206ENDepartment of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, ShahroudCenter for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, ShahroudNoor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, TehranDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran20200315<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">The results of Shahroud Eye Cohort Study (ShECS) showed a high 5‑year incidence<br />of diabetes mellitus with female predominance in 40–64 years old Iranian population. The<br />aim of this report was to decompose the observed sex differences in the incidence of diabetes.<br /></span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">Sex‑specific incidence rate of diabetes was calculated between the two phases of ShECS<br />(2009–2014). The gap decomposition was done by the twofold Blinder–Oaxaca decomposition<br />model. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The results showed that from the total gap (11.19%–15.55% = -4.36%) between<br />the two sexes, 3.46% which forms 79.4% of the total gap is related to the difference in obesity in<br />both genders. In contrast to obesity, age and overweigh status had a decreasing influence on gender<br />inequality. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Obesity of Iranian women compared with men is the most important reason<br />for an increase in the incidence of diabetes in women.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Diabetes mellitus, incidence rate, Iran, Blinder–Oaxaca decomposition, Obesity</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2206http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2206/717718005International Journal of Preventive Medicine (Int J Prev Med)2008-7802101220200315Nutritional and Social Consequences of Cheating Trout Distribution Instead of Salmon Fish22002200EN20200315---http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2200http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2200/717717999