Background: Iron deficiency is the most common and widespread nutritional disorder in the world, affecting a large number of children and women in developing countries and constituting a public health condition of epidemic proportions. Weekly iron and folic acid supplementation (WIFS) with health education has been demonstrated to be effective in reducing anemia in adolescent school going girls. We assessed the impact of WIFS with and without health education on anemia in adolescent school girls of Delhi. Methods: This is a school-based intervention study conducted in two government senior secondary schools of Delhi. A total of 210 adolescent school girls from two schools were included in the study. In one school (intervention group), weekly ironfolic acid with health education once a month was given, and in the second school (control group), only WIFS was given for 6 months. Iron–folic acid supplementation containing 100 mg of elemental iron and 0.5 mg of folic acid was given on a weekly basis, and health education was provided once a month for 6 consecutive months. Hemoglobin (Hb) estimation was done at the beginning and the end of the study using the Hemocue method. Mean Hb change after intervention between the control and experimental groups was compared using a t test. Pre and post differences within the control and experimental groups were assessed using a paired-t test. Results: After intervention, there was a significant decline in prevalence of anemia in both the intervention (54.7 percentage points decline) and the control (26 percentage points decline) groups (P < 0.001). Conclusions: WIFS with once a month health education can be effective in reducing the prevalence of anemia in adolescent school girls.

Background: The purpose of this study was to investigate the relationship between cardiorespiratory fitness, muscle endurance, and test anxiety levels with academic performance in both genders of high school students. Methods: A total of 545 grade nine students (mean age: 14.1 ± 0.4 years old) participated in this study. Final grades in language, mathematics, and science and the overall mean average of all courses were used to assess academic performance. Cardiorespiratory fitness levels were estimated using the 20 meter shuttle run test and muscle endurance was measured using push-up and curl-up tests. Participants also completed a questionnaire for the assessment of test anxiety. Independent t-tests, correlations, and linear regression analysis were performed. Results: Results show that female students (n = 292) had significantly higher grades in language and science as well as a higher overall mean average than male students (P < 0.001). Moreover, we observed that female students had significant greater correlation coefficient values than male students for cardiorespiratory fitness levels and muscle endurance with academic performance (P < 0.05). Finally, linear regression analysis showed multiple differences between male and female students regarding independent predictors of academic performance (P < 0.01). Conclusions: Results of the present study indicate that the academic performances of male and female students are different in high school and that these distinct academic performances appear to be explained by different variables.

Background: Noncommunicable disease (NCD) screening provides a means for early detection of chronic diseases, thereby reducing the risks posed by NCDs. In 2012, 56 million deaths were reported globally, 38 million of which were attributed to NCDs. In Indonesia, NCDs are a major cause of mortality. In Depok City, an NCD screening program among white collar employees has been in place since 2016. This study aimed to establish the determinants of NCD screening among workers at the Depok City Hall. Methods: The study used quantitative methods and a cross-sectional study design. It was conducted at Depok City Hall, Depok City, West Java, Indonesia. Data were collected using a self-reported questionnaire, which was pretested for validity and reliability. Data were analyzed using multiple logistic regressions. Results: Only 45.7% of workers had used the NCD screening service. Peer support (P < 0.01) and having pre-existing NCDs (P < 0.05) were the determinants of NCD screening among respondents. Peer support was the dominant factor associated with the utilization of NCD screening. After controlling for having NCDs, workers with adequate peer support had increased odds of uptake of NCD screening by more than two times (OR: 2.37, 95% CI: 1.29–4.37). Conclusions: Peer support is important in persuading workers to utilize NCD screening. Therefore, it is necessary to develop health promotion programs in the workplace and to empower peer educators to encourage their colleagues to undertake regular health screening.

Background: Many studies who evaluated the outcome of the congenital hypothyroidism (CH) screening reported some intellectual and behavioral deficit despite early diagnose and treatment. The aim of the present study was to compare the intellectual and behavioral adjustment of CH children with controls. Methods: This study was conducted among a group of 135 children aged 8--12 years in Isfahan, including transient and permanent congenital hypothyroidism (TCH and PCH) and a matched group of their classmate. Demographic characteristics collected using a designed data collecting form completed by parents. Intellectual quotient (IQ) was evaluated using Wechsler Intelligence Scale for Children aged 6--16 years (WISC-III). Depression and anxiety were evaluated using The Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC), respectively. The SPSS software version 20.0 was used for data analysis. Nonparametric tests (Mann--Whitney) were used to investigate the association between variables. A significant level of less than 0.05 was considered in all analyzes. Results: There was no significant difference in the IQ scores between PCH and TCH groups (P = NS). However, neither of them had intellectual disability (defined as IQ <70). IQ scores were significantly lower in PCH comparing to controls (P < 0.001). Total IQ and verbal IQ were significantly differenct between TCH and control group (P = 0.007 and P = 0.001). No significant difference was found in anxiety and depression scores between CH children and controls. Conclusions: There is no significant difference in anxiety and depression scores between congenital hypothyroidism children and controls, although IQ scores in children with congenital hypothyroidism is lower than controls.

Background: Water-pipe smoking is increasing around the world. However, there is no comprehensive information on nicotine addiction in water-pipe smokers. This study was carried out to translate and validate the Lebanon Water-pipe Dependence Scale- into Persian language; besides, tobacco dependence was evaluated in Iranian water-pipe smokers. Methods: A forward-backward translation procedure was done to provide the Iranian version of the questionnaire. Our subjects were current water-pipe smokers who were known in prevalence study that conducted in Tehran. Psychometric properties of the instrument including validity (content, face and construct validity) and reliability (internal consistency and test-retest analysis), were evaluated. Results: A total of 465 participants took part in this study, of whom 298 (64%) were male. The mean age was 30 (standard deviation 10.2). Fifty three percent of subjects got score more than 10 on LWDS questionnaire that indicating dependence. The internal consistency of the LWDS (Persian Version) was 0.85. The physiologic dependence, psychological craving, and negative reinforcement domains had acceptable reliability (Cronbach's alpha was 0.94, 0.81, 0.77 respectively), but reliability was low (alpha = 0.45) in the positive reinforcement domain. External consistency of the LWDS was assessed by test retest. Intra class correlation (ICC) was calculated for all items (n = 20) and ICC for all of them was >0.7 and the mean ICC was 0.9. Content validity was acceptable; all of obtained content validity indexes (CVIs) were above 80%. The result of goodness of fit shows an adequate model (Comparative Fit Index (CFI = 0.94), Root Mean Square Error of approximation (RMSE) = 0.08). Conclusions: The study revealed strong documents for the reliability and validity of the LWDS for use in Iran. However, further study may be required to improve the reliability results in the positive reinforcement domain.

Background: Anti-oxidants were investigated in several studies as a preventive strategy for prevention of contrast-induced nephropathy (CIN). Omega-3 polyunsaturated fatty acids have antioxidant properties; however, their role in the prevention of CIN is still unknown. Therefore, in this study, we aimed to evaluate the efficacy of omega-3 supplementation in the prevention of contrast-induced nephropathy following elective percutaneous coronary intervention in patients with chronic kidney disease. Methods: This is a double-blinded and randomized clinical trial. Eighty eligible patients with glomerular filtration rate of 30-60 mL/min/1.73 m², scheduled to undergo elective PCI, were randomly divided into omega-3 (a single dose of 2500 mg omega-3 12 hours before PCI plus hydration therapy) or control (placebo plus hydration therapy) groups. Blood specimens for measuring serum creatinine and cystatin C were collected from each patient at baseline and 24 h after PCI. Results: Omega-3 did not show any significant effect on post-PCI serum creatinine and cystatin C compared to the controls. In addition, serum creatinine analysis showed that CIN occurred in 6 (16.2%) patients of the omega-3 and 4 (9.3%) patients of the control group (P = 0.50). Conclusions: Our results could not support the protective effect of a single dose of omega-3 in decreasing serum creatinine, serum cystatin C, and the incidence of CIN in patients with CKD undergoing PCI. To better evaluate the effect of omega-3, future studies with higher and/or multiple doses of omega-3 are highly recommended.

Background: Vitamin D deficiency has a far-reaching impact on several metabolic functions including cardiovascular health. This study aimed to test the association of serum 25 [OH]-vitamin D3 levels among cardiovascular disease (i.e., hypertension and ischemic heart disease) patients. Methods: A cross-sectional study was conducted among 360 participants from the tertiary care hospital. The simple random technique was used to select the participants. Only Saudi nationals were included in the study. Sociodemographic information, nutritional status, biochemical parameter (lipid profile, blood glucose level), and questions relating to cardiovascular disease were collected from the hospital record through data collection sheet. Serum Vit D level was determined by serum 25 (OH) blood test. Statistical package for social science (SPSS) software version 24 was used for data analysis. Binary logistic regression model was fitted to indentify the associated factors of vitamin D deficiency among cardiovascular disease patients. Results: Approximately 40.6% and 27.8% of study participants had vitamin D deficiency and insufficiency, respectively. After adjustment of covariates, among cardiac patients, vitamin D deficiency was associated with ischemic heart disease (OR 2.24, 95% CI 1.11–4.52), and blood triglyceride level (OR 2.27, 95% CI 1.22–4.22). Conclusions: Vitamin D deficiency and insufficiency are associated with ischemic heart disease, hyperglycemia, and hypertriglyceridemia. There is a need for the screening of cardiovascular disease patients for vitamin D levels.

Background: To determine socioeconomic inequalities in cardiovascular health (CVH) metrics among Peruvian adults as well as differences according to sex. Methods: An observational, cross-sectional study was conducted in 26,175 individuals aged 18–65 years using the 2017 Peruvian Demographic and Health Survey. According to the American Heart Association, 5 CVH metrics which comprised three ideal health behaviors (diet, non smoking, ideal body mass index [BMI]), and two ideal health factors (ideal blood pressure and no history of diabetes) were evaluated. The concentration curves (CC) methodology was used to analyze whether CVH metrics vary between socioeconomic status and sex. The concentration index (CI) was used to quantify socioeconomic-related inequality in health variables. Results: Overall, the mean age was 36.5 years (SD = 11.9) and 51.2% were women. Only 2.4% had 5 ideal CVH metrics (women 3.7%, men 1.0%) with a CI very close to the equality line (0.0135). (0.0135; higher in women [0.0262], compared to men [0,0002]). A greater prevalence of ideal CHV metrics (3 or more) was found in women (P < 0.001). Ideal health factors were more prevalent (52.1%) than ideal health behaviors (13.8%). Regarding inequality measures, CCs for most CVH metrics had a higher concentration in the lowest wealth population, except for ideal diet, which was more frequent among higher levels of wealth. An ideal BMI was the CVH metric with the lowest CI (overall: −0.0817; men: −0.2699). Conclusions: Peruvian women presented a higher prevalence of ideal CVH metrics and fewer inequalities. Ideal CVH metrics tend to be concentrated in the wealthiest women. Low- and middle-income countries should consider socioeconomic inequalities in cardiovascular disease prevention programs.

Background: Hydatid cysts are the larval stage of Echinococcus granulosus, which lead to humoral and cellular immune responses in hosts. Such immune responses play a key role in the inhibition of tumor growth and cancers. To test this hypothesis, it was attempted not only to examine the changes in serum level of some Th1 and Th2 cytokines but also to find relationships between the cytokines and cancer in 4T1 breast cancer-bearing mice immunized with hydatid cyst wall (HCW) antigens. Methods: Six to eight-week-old Balb/c female mice were immunized with alum, PBS and HCW antigens, including crude extract of HCW (laminated layer) 28 and 27 kDa protein bands (upper and lower bands) and then challenged with 4T1 breast cancer cells. The amounts of IL2, TNF-α, IFN-γ (Th1 cytokines), and IL4 (Th2 cytokine) were estimated using ELISA. Correlations between these cytokines and cancer parameters (tumor growth, metastasis, and survival) were determined by Pearson's correlation coefficients. Results: Overall, HCW antigens increased the amounts of IL2, TNF-α, IFN-γ, and IL4. Pearson's correlation coefficients indicated reverse relationships between changes in amounts of these cytokines and tumor growth/metastasis. However, except for IL-4, all cytokines had a direct relationship with mouse survival. Conclusions: The results of this study indicated that the inhibition of breast tumor growth and metastasis and improvement of survival in 4T1 mice immunized with HCW antigens, especially laminated layer and 27 kDa protein band can occur through a rise in the levels of cytokines.

Background: The combination of dyslipidemia, obesity, and hyperglycemia can accelerate the progression to cardiovascular disease. Therefore, this study aimed to investigate dyslipidemia and its components across body mass index (BMI) levels among type II diabetic patients. Methods: The data for this cross-sectional study were extracted from the records of diabetic patients during 2014 to 2015. About 2,300 diabetic patients had been registered, and finally, the records of 2,110 patients which were fully completed were investigated. Dyslipidemia was defined based on the NCEP/ATP III classification of lipid profile. In order to investigate about nonlinear relationship between BMI and dyslipidemia, and its components, restricted cubic spline method was used. Results: The median age of patients was 55 (IQR = 14) years. 61.11% was females. The median of BMI, triglyceride, cholesterol, HDL-Chol, and LDL-Chol were 28.3 kg/m², 167, 193, 41, and 110 mg/dL in patients, respectively. The prevalence of dyslipidemia was 91.29% (95% CI: 90.05–92.54). Being overweight, diabetic patients were associated with an increased risk of dyslipidemia (OR = 1.87–2.78), hypertriglyceridemia (OR = 1.64; 95% CI: 1.29–2.09), and hypo-HDL (OR = 1.55; 95% CI: 1.20–2.01). Similarly, obesity also increased the risk of dyslipidemia (OR = 1.94; 95% CI: 1.28–2.95), hypertriglyceridemia (OR = 1.66; 95% CI: 1.29–2.12), and hypo-HDL (OR = 1.86; 95% CI: 1.41–2.43). The nonlinear dose–response relationship was associated with a significant increase then decrease in the risk of dyslipidemia, hypertriglyceridemia, and hypo-HDL in men and women as per 1 kg/m² increase in BMI. Conclusions: With regards to the result, we know that there is no linear relationship between lipid profiles and BMI, the bell-shape association between dyslipidemia, hypertriglyceridemia, and hypo-HDL needs to be further investigated in both diabetic and general population in men and women separately. In addition, for public health section, an appropriate intervention is of most important priorities.

Background: The majority of studies which investigate the predicted power of Human chorionic gonadotropin (hCG) levels to the occurrence of Gestational trophoblastic neoplasia (GTN) considered the effect of a single measurement of hCG or used classical statistical methods without considering the endogenous marker. The aim of this study is to investigate the association between weekly measurements of β-hCG with time to GTN occurring, using a robust Bayesian joint modeling. Methods: Data of 201 women with a molar pregnancy were considered for this retrospective cohort study. After the first measurement of β-hCG in 48 hours post evacuation of mole, the other titration was performed on a weekly basis until three consecutive normal titers. The association between serial measurements of β-hCG and risk of GTN occurring were assessed by the classic and Bayesian joint modeling and in separate analysis the mixed linear effect and Cox-PH model were used. Results: The mean age (SD) of participants was 26.6 (6.55) year. The GTN was occurred among 14.9% of patients. The association parameter using Bayesian approach was estimated as 1.30 (95% CI: 0.44 to 2.20) which showed one unit increase in the log β-hCG corresponds to the 2.80-times increase in the hazard for the occurrence of GTN (Hazard Ratio: 2.80, 95% CI: 1.55 to 8.98). Conclusions: Findings of this study revealed that weekly measurements of β-hCG are an important and reliable biomarker to early detection of developing of molar pregnancy to persistent GTN.