Background: In Iranian women, the use of hookah is the most common method of tobacco smoking. This study aimed to find the role of psycho-social needs and gaps as a possible risk factor for hookah smoking initiation in women. Methods: This qualitative study was conducted during 2012-2013 in Tehran, Iran. Thirty-six women participated in the study. They were current or former users of hookah. Data were collected through in-depth individual interviews and was analyzed through content analysis. Results: Four main categories were identified from the data. This study focused on the category: Psycho-social needs and gaps. This category has five sub-categories which explain why women begin to smoke hookah including curiosity; desire for non-feminine, forbidden, and negative activities; need for amusement and recreation; for others: To show off; attract attention; satisfy and join others and protection. Conclusions: From this study, a variety of factors which contribute to the initiation of hookah smoking among women have been identified. Keeping young girls and women away from seemingly happy gatherings of hookah smokers; Providing appropriate recreational facilities for young women and training families on how to help their children in the event of a crisis-like intention to take up smoking behavior, can be some effective ways for reducing hookah smoking initiation among women.

Background: The incidence of heat stress is one of the most common problems in workplaces and industries. Many heat stress indices have been developed, and these indices have some disadvantages. The purpose of this study is to validate the perceptual strain index (PeSI) in experimental hot conditions. Methods: This study is of cross-sectional carried out on 15 men at five different thermal conditions (35°C, 30°C, 27°C, 24°C, and 21°C) in a climate chamber and on a treadmill at three levels of light (2.4 kph), medium (4.8 kph) and heavy activity (6.3 kph). Heart rate and oral temperature were respectively measured to calculate the physiological strain index. Also, thermal sensation and rate perceive exertion were respectively measured to calculate the PeSI. Finally, the correlation between the indices was analyzed using Pearson correlation test and regression analysis. Results: Pearson correlation test showed a high correlation (r = 0.94) between the PeSI and physiological strain index (P = 0/001). It was also observed a high correlation between the PeSI and the oral temperature (r = 0.78, P = 0/001) and the heart rate (r = 0.90, P = 0/001). In addition, there was found a moderate correlation (r = 0.71) between the PeSI and the wet bulb glob temperature (P = 0/001). However, there was no correlation between the PeSI and the body mass index (r = 0.0009, P = 0.79). Conclusions: The research findings showed when there is no access to other forms of methods to evaluate the heat stress, it can be used the PeSI in evaluating the strain because of its favorable correlation with the thermal strain.

Background: This paper presents the methodology and primary findings of a national project on determinants of weight disorders among Iranian children and adolescents at national and sub-national levels. Methods: This nationwide study was conducted in 2011-2012 in Iran as part of the fourth phase of a national surveillance program entitled Childhood and Adolescence Surveillance and PreventIon of Adult Noncommunicable disease-IV study. It had two phases of qualitative and quantitative study. This multicentric study was conducted among 25,000 students aged 6-18 years, living in urban and rural areas of 30 provinces of Iran. Students were selected by multistage cluster sampling method. Data regarding weight disorders including sociodemographic variables, perinatal factors, lifestyle factors, family and student dietary habits, quality of life, and family history of chronic diseases as well as body image were gathered via validated questionnaires. Results: Overall, 23043 students completed the survey (participation rate: 92.17%). The mean age of participants was 12.55 ± 3.31 years; 50.8% were boys, and 73.4% were from urban areas. Underweight was found in 10.4% of boys and 9.2% of girls, the corresponding figure for overweight and obesity was 21% and 18.3%. Abdominal obesity was found in 17.6% of students. Among parents, obesity was more frequent than other weight disorders, with higher prevalence in parents of girls than boys (24.5% vs. 21.5%, respectively, P < 0.001). Overweight and obesity were more prevalent in urban than in rural parents (66.7% vs. 59.7%, respectively, P < 0.001). Conclusions: This survey serves as confirmatory evidence on the prevalence of dual burden of weight disorders in Iran. Its findings on determinants of weight disorders would help policymakers to implement relevant programs at national and sub-national levels.

Background: Thyroid absorption of iodine could be encumbered by nitrate drinking water when it is transported to the fetal thyroid gland. Therefore, nitrate potentially causes congenital hypothyroidism (CH) due to thyroid dysfunction. In this study, we have not only aimed at spatial determination of CH distribution and nitrate concentration (NC) existing in drinking water, but also we intended to evaluate the probable impact of nitrate on CH incidence. Methods: Annual average of nitrate in drinking-water as well as number of CH infants diagnosed through the screening program were applied to determine the incidence ratio of the disease for each town (from 2010 to 2013). Afterward, Arc GIS 9.3 was used to draw choropleth maps with quantile classification. Data were entered into SPSS 16.0 and Excel 2010 software. Finally, linear regression was applied for data analysis. Results: The incidence rate of CH (considering transient and permanent cases) was about one in every 413 births. Khansar, Golpaygan, Naein, and Ardestan had the highest incidence rate of CH respectively. On the other hand, Tiran, Dehaghan, Khansar, and Fereydan had the highest level of nitrate drinking water. There was a strong relationship between the NC and incidence of CH in Khansar; however, this relationship was not significant (P = 0.392) in Isfahan province. Conclusions: Since there was not a significant relationship between NC in drinking-water and incidence of CH through linear regression analysis, more studies should be implemented to confirm or refute our observations.

Background: One of the core responsibilities of health system is to treat tobacco dependence. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess physicians' opinions towards quality and result of different quit smoking methods provided in tobacco cessation services centers in Iran. Methods: In this cross-sectional and descriptive study, random sampling of all quit centers at country level was used to obtain a representative sample size of 100 physicians. Physicians completed a self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects, and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: Most experts preferred to use combination quit smoking methods and then Nicotine Replacement Therapy (NRT) with 26 and 23, respectively. The least used methods were quit line and some methods without medication with 3 cases. The method which gained the maximum scores were telephone consultation, acupuncture, Willpower, Champix, combined method, and Interactive Voice Response (IVR) with the mean of 23.3, 23, 22.5, 22, 21.7 and 21.3, respectively. The minimum scores were related to e-cigarette, some methods without medication, and non-NRT medication with the mean of 12.3, 15.8 and 16.2, respectively. There were no significant differences in the mean of scores based on different cities (P = 0.256). Analysis of variance in mean scores showed significant differences in the means scores of different methods (P < 0.000). Conclusions: According to physicians acupuncture, personal methods and Champix are the most effective methods and these methods could be much more feasible and cost effective than other methods.

Background: The present investigation was aimed to improve the inflammatory factors and lipoproteins concentration in patients with myocardial infarction (MI) by supplementation with coenzyme Q10 (CoQ10). Methods: In a double-blind, placebo-controlled study, we measured serum concentrations of one soluble cell adhesion molecules (intercellular adhesion molecule-1 [ICAM-1]), serum concentration of intereukin-6 (IL-6) and lipid profiles (high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], total cholesterol and triglyceride [TG]) in CoQ10 supplementation group (n = 26) compared with placebo group (n = 26) in hyperlipidemic patients with MI. Fifty-two patients were randomized to receive 200 mg/day of CoQ10 or placebo for 12 weeks. Results: There were no significant differences for serum LDL-C, total cholesterol, and TG between two mentioned groups after the intervention. A significant enhancement in serum HDL-C level was observed between groups after the intervention (55.46 ± 6.87 and 44.07 ± 6.99 mg/dl in CoQ10 and placebo groups, respectively P < 0.001). Concentrations of ICAM-1 (415.03 ± 96.89 and 453.38 ± 0.7 ng/dl CoQ10 and placebo groups, respectively, P = 0.001) and IL-6 (11 ± 9.57 and 12.55 ± 8.76 pg/ml CoQ10 and placebo groups, respectively P = 0.001) in serum were significantly decreased in CoQ10 group. Conclusions: Supplementation with CoQ10 in hyperlipidemic patients with MI that have statin therapy has beneficial effects on their aspects of health.

Background: Under nutrition is a health problem in developing countries and the main aim of this study was determine of the nutritional status and some sociodemographic factors among rural under-5-year children in the North of Iran in 2013. Methods: This was a descriptive, cross-sectional study, which carried out on 2530 children (637 = Fars-native, 1002 = Turkman and 891 = Sistani) from 21 villages in the North of Iran. Villages were chosen by random sampling among 118, and all of under-five children were chosen by simple sampling. For all of cases, a questionnaire with contain questions on the socialdemographic condition was completed and anthropometric indexes were measured by a learned team. Anthropometric data were compared with those in Centers for Disease Control and Prevention reference population. SPSS 18.0 software was used for statistical data analysis and P value under 0.05 included significations. Results: Generally, under nutrition (Z-score ≤ −2) was observed in 6.6%, 18.5% and 3.3% based on underweight, stunting and wasting, respectively and there were in boys more than girls and in Sistani more than other ethnic groups. Based on underweight and stunting, under nutrition was seen in Sistani more than other ethnic groups. Among three ethnic groups, stunting was significant both in boys (P = 0.013) and in girls (P = 0.004), but wasting was significant only in girls (P = 0.001). The estimated odds ratio (OR) with 95% confidence interval of under nutrition was obtained from logistic regression. Compared with good economic group, the OR was 1.831 in poor economic groups (P = 0.001). The risk of under nutrition in Sistanish ethnic group was 1.754 times more than Fars-native group (P = 0.001). Conclusions: Under nutrition is a health problem among under-5-year children in rural area in the North of Iran and stunting was seen in an alarming rate among them. Among ethnic groups, Sistanish children more than others were under nourished. Poor economic status is a risk factor for under nutrition in this area.