International Journal of Preventive Medicine (Int J Prev Med)2008-78021662025090718EN20250907Background: This study’s objective was to assess the adverse events (AEs) of rituximab (RTX) therapy in people with multiple sclerosis (pwMS). Methods: This observational study was conducted on clinical data of pwMS who visited an MS center in Iran from January 2015 to January 2018 and underwent RTX therapy. The primary efficacy outcomes assessed were disability progression and the annual relapse rate. Initially the patients received 2 g of RTX (Zytux AryoGen Pharmed Company Iran) delivered in four 500‑mg doses via an intravenous line each of which took 6 hours to avoid unwanted reactions. Afterward two 500‑mg doses of RTX were administered every 6 months. we administered each dose within 4–6 hours to minimize unwanted reactions. Results: A total of 307 RTX‑treated patients were included in the study. Around 75.2% of patients were female. The mean (standard deviation (SD)) age was 37.9 (9) years, and the mean (interquartile range (IQR)) disease duration was 7 (7) years. During treatment, the Expanded Disability Status Scale (EDSS) remained unchanged for patients with shorter disease duration (<3 years), and it was significantly improved for patients with longer disease duration (>3 years, P value = 0.015). Around 39.4% of the patients had at least one side effect, most of which were minor infections of the urinary and respiratory tract, all mild in nature. Conclusions: RTX treatment is well‑tolerated and safe, with a minor risk of mild infusion reactions and minor side effects for MS patients.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/3005http://ijpm.mui.ac.ir/index.php/ijpm/article/download/3005/717718846

International Journal of Preventive Medicine (Int J Prev Med)2008-780216620250907916EN20250907Background: Opium users are at risk of lead poisoning. Therefore, this study aimed to compare opium users with healthy controls in terms of blood lead levels (BLLs), blood biochemistry, and liver function tests. Methods: A total of 100 people participated in the study. Biological samples (blood and urine) obtained from participants were prepared before analysis for the detection of opium alkaloids (morphine, codeine, papaverine, noscapine,…), amphetamine‑type stimulants, and other licit and illicit drugs. Atomic absorption spectroscopy was used to calculate BLLs. We evaluated biochemical parameters and function tests. All statistical analysis was performed by using SPSS. In addition, biochemical parameters and liver function tests were evaluated. Results: The BLLs of opium addicts living in Tehran and healthy controls were 18.8 and 7.1 g/dL, respectively. A strong correlation was observed between the route of opium consumption and the average amount of BLL ± SEM (P = 0.037). As compared with the control group, opium users showed a statistically significant (p 0.001) association between the serum levels of the enzyme’s aspartate aminotransferase, gamma‑glutamyl transferase, lactate dehydrogenase, alanine aminotransferase, alkaline phosphatase, and total bilirubin and an increase in white blood cell and hematocrit levels. Conclusions: Results of the present study showed that opium users had elevated BLLs in comparison to the control group, which profoundly affected biochemical parameters and liver enzymes.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/3006http://ijpm.mui.ac.ir/index.php/ijpm/article/download/3006/717718847

International Journal of Preventive Medicine (Int J Prev Med)2008-7802166202509071724EN20250907Background: Obesity and its complications are becoming a global concern. Assessing hemoglobin (Hb), vitamin B12, and ferritin deficiencies is crucial for morbidly obese patients due to the significant implications these deficiencies can have on their overall health and well‑being. Studies indicate that individuals undergoing bariatric surgery are at a high risk of developing deficiencies in essential nutrients such as vitamin B12, iron, and folate, which can have profound health implications. One of the most effective treatments for morbidly obese patients is bariatric surgery. By understanding the process of these surgeries, several micronutrient deficiencies are anticipated. The lack of data about how bariatric strategies may affect these micronutrient levels provoked us to examine these changes closely. Methods: In the current retrospective cohort study, we submitted 224 morbidly obese patients (body mass index (BMI) ≥ 40 kg/m2 or BMI = 35‑39.9 kg/m2 with a risk factor, e.g. diabetes mellitus) who were candidates to bariatric surgeries at the obesity center of Rasoul‑e‑Akram Hospital from December 2018 to December 2019. Participants were divided into three groups of bariatric surgeries: sleeve gastrectomy (SG), mini‑gastric bypass, and Roux‑en‑Y gastric bypass (RYGB). Demographics and clinical features and hemoglobin, ferritin, and vitamin B12 were recorded preoperatively and compared with postoperative follow‑up periods at three, six, and 12 months after the operation. Results: The mean age was 39.17 ± 10.60 years, and preoperative BMI was 46.13 ± 5.83 kg/m2. The prevalence of anemia was 7.1% before the surgery and 28.1% one year after. The results showed that hemoglobin level had been reduced within 12 months postoperatively, and the changes were statistically significant (P < 0.001). We were unable to find significant differences in the preoperative and postoperative proportions of anemia among different types of surgeries. Ferritin levels increased in the first three months after the operation and reduced as time went on. Preoperatively, 32.6% of the cases were ferritin deficient, which rose to 44.6% at the end of the 12‑month follow‑up. Vitamin B12 level was corrected by supplement therapy, and it did not reduce over follow‑up periods (25% preoperatively vs. 21.9% at the end of the 12th month). We found no meaningful differences among various types of surgery in examining vitamin B12 deficiency. Conclusions: Bariatric surgery probably can increase the prevalence of anemia and ferritin deficiency. Vitamin B12 deficiency is expected after the surgery; however, it can be prevented by encouraging patients to use intramuscular or oral supplements during postoperative periods. Although micronutrient deficiencies can develop years after the surgery, a more significant study population must be designed with extended follow‑up periods to determine more specific changes.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/3008http://ijpm.mui.ac.ir/index.php/ijpm/article/download/3008/717718849

International Journal of Preventive Medicine (Int J Prev Med)2008-7802166202509072529EN20250907Background: Family‑based digital interventions have been shown to be effective in helping children and families adopt healthier lifestyles. This study aims to assess the efficacy of virtual educational programs in promoting lifestyle modification, with a focus on improving dietary habits, increasing physical activity, and reducing tobacco use among families in Isfahan, Iran. Methods: This study was carried out in two stages from 2023 to 2024. The initial phase involved a comprehensive review of the existing literature, alongside consultations with health experts, to standardize and develop intervention programs tailored to the cultural context of Iranian society. The second phase was a randomized intervention survey conducted in parallel and double‑blind (participants and statistics specialist) manner in two groups. Eligible participants included families registered at health centers, with at least one child aged 6–15 years and access to the internet and electronic devices. Participants were randomly assigned to either the intervention or control group. In the intervention group, each family member received virtual educational content via a website or mobile app. The program was delivered weekly for the first 8 weeks, followed by biweekly sessions for the next 8 weeks. The content focused on improving dietary habits, increasing physical activity, and reducing tobacco use and smoking exposure. The control group received no educational interventions but was given access to the recorded sessions after the study concluded. Participants were followed up at 2‑ and 6‑month post‑intervention. Results: The primary outcomes include changes in body mass index (BMI), physical activity levels in both children and parents, dietary habits, smoking status, and exposure to indoor air pollutants. Conclusions: The rigorous design, incorporating cultural adaptation and a double-blind randomized controlled trial with follow-up assessments, provides a strong methodological framework for evaluating the effectiveness of virtual health interventions in a specific cultural context.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/3009http://ijpm.mui.ac.ir/index.php/ijpm/article/download/3009/717718850

International Journal of Preventive Medicine (Int J Prev Med)2008-7802166202509073031EN20250907Dear Editor, I am writing to express my strong endorsement of the “One Nation One Health System” initiative proposed by the Indian government. This innovative approach seeks to merge traditional and modern healthcare systems, creating a more inclusive and holistic model of care.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/3007http://ijpm.mui.ac.ir/index.php/ijpm/article/download/3007/717718848