Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 495 507 Jin Wang Department of Urology, The First Hospital of Xuzhou Mining Group, Xuzhou, 221131, China Shikui Wu Department of Urology, The First Hospital of Xuzhou Mining Group, Xuzhou, 221131, China Mingsheng Wang Department of Urology, The First Hospital of Xuzhou Mining Group, Xuzhou, 221131, China 2023 09 25 2023 12 19 Background: Patients with benign prostatic hyperplasia are generally treated holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP). Therefore, it is important to analyze the several surgical procedures used for benign prostatic hyperplasia in terms of their role, effectiveness and safety. Methods: We conducted a meta-analysis by searching databases of PubMed, Google Scholar, and Web of Science. Finally, we selected 10 papers including 2,456 patients treated with of thulium laser and holmium laser in the surgical treatment of benign prostatic hyperplasia. We did the analysis using RevMan 5.0 with the selected studies until 26 October 2023. Results: ThuLEP resulted in a smaller reduction in haemoglobin (MD: -0.22, 95%CI -0.32 to -0.13, P<0.001) and a shorter hospital stay (MD: -0.29, 95%CI -0.38 to -0.20, P <0.001). During the postoperative follow-ups, only the IPSS (MD: -0.03; 95%CI -0.11 to -0.06; P 0.58) at the six-month showed statistically significant differences. Conclusion: ThuLEP has greater security and faster growth than HoLEP. https://ijph.tums.ac.ir/index.php/ijph/article/view/33292 https://ijph.tums.ac.ir/index.php/ijph/article/download/33292/8178

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 508 523 EN Aliasghar Fakhri-Demeshghieh Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran Abolghasem Shokri Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran Saied Bokaie Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran 2022 12 23 2023 07 15 Background: Uropathogenic Escherichia coli is a major cause of urinary tract infections (UTIs). This systematic review and meta-analysis was conducted to determine the prevalence of antibiotic-resistant uropathogenic E. coli among Iranian children with confirmed bacterial UTIs from 2012 to 2022. Methods: A systematic review was performed by searching PubMed, Scopus, Google Scholar, Web of Science, MagIran, Iranian Scientific Information Database, IranMedex, and Iranian Research Institute for Information Science and Technology. The antibiotic-specific pooled prevalence estimates were calculated by applying a random-effects model. Freeman-Tukey Double Arcsine transformation was applied. I-squared statistic, and Cochran’s Q test were computed and meta-regression was conducted on latitude of sampling location. Results: The literature search retrieved 2159 articles, among which 19 articles were included. The highest antibiotic resistance was related to doxycycline, ticarcillin-clavulanic acid, cefazolin, cefuroxime, and amoxycillin-clavulanic acid, 59%, 57%, 54%, 53%, and 52%, respectively. Meta-regression on the latitude was statistically significant for nitrofurantoin (P=0.05). Conclusion: Resistant uropathogenic Escherichia coli strains were observed in the majority of confirmed bacterial UTIs among Iranian children. The most effective antibiotics for uropathogens were colistin, meropenem, and imipenem. https://ijph.tums.ac.ir/index.php/ijph/article/view/30717 https://ijph.tums.ac.ir/index.php/ijph/article/download/30717/8179

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 524 538 Zahra Hadizadeh-Talasaz Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Talaat Khadivzadeh Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Taraneh Mohajeri Department of Obstetrics & Gynecology, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran Masoumeh Sadeghi Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2023 04 06 2023 08 24 Background: The prevalence of pelvic organ prolapse is varied in different countries. For validating the results of numerous studies on the prevalence of Pelvic organ prolapse in the world, a meta-analysis study seems necessary to provide an accurate and valid prevalence for planners and researchers in this field. Therefore, we aimed to investigate the worldwide prevalence of pelvic organ prolapse using the meta-analysis method. Methods: By using valid keywords, searching was done in ISI Web of Science, PubMed, Scopus, and Medline databases, and 22 articles were selected based on inclusion criteria between 2009 and 2021. The quality of articles was checked using The Joanna Briggs Institute (JBI) checklist. Meta-analysis was performed on collected data using Comprehensive Meta-Analysis Software (CMA, Version 2). Meta-analysis of data was done with a random-effects model. The heterogeneity of the study was checked using the I2 index. Publication bias was assessed by the Egger test and funnel graph. Results: The overall prevalence of included studies was 30.9% (95% confidence interval: 24.4-38.2%), (P<0.001, heterogeneity I2=99.8%). Meta-analysis of subgroups in studies that used a questionnaire to estimate the prevalence rate showed the prevalence was 25.0% and in the studies used the physical examination was 41.8%. Conclusion: Studies carried out in different parts of the world have examined the prevalence of pelvic organ prolapse using different tools. Since some cases are asymptomatic, especially in the low stage of prolapse, physical examination of pelvic organ prolapse should be considered an essential tool in evaluating pelvic organ prolapse. https://ijph.tums.ac.ir/index.php/ijph/article/view/31666 https://ijph.tums.ac.ir/index.php/ijph/article/download/31666/8180

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 539 552 EN Mahbobeh Firooz School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran Gholam Reza Mahmoodi shan Nursing Research Center, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran Leila Jouybari Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran Khadijeh Yazdi Department of Medical Surgical Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran Joseph Osuji School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada 2023 06 03 2023 09 27 Background: Several studies have evaluated the effects of lavender essential oil on the anxiety of hemodialysis (HD) patients, but most of them did not estimate the pooled effect size. The current systematic review and meta-analysis was conducted to evaluate the effects of lavender on anxiety and fatigue among HD patients. Methods: Eligible studies were selected based on the PRISMA steps and protocol. Literature was retrieved from PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engines until Sep 2022. The risk of bias and analysis were evaluated using version 2 of the Cochrane risk-of-bias tool and STATA v.14 software, respectively. Effect sizes were pooled using random effect models. Results: Nine studies were included. Lavender oil significantly reduced the average anxiety of HD patients compared to the control group (SMD: -2.51, 95% CI: [-3.56, -1.45], Z=4.67, P<0.001, I2 :89.9%). Also, it significantly reduced the average fatigue compared to the control group (SMD: -1.56, 95% CI: [-2.49, -0.63], Z=3.29, P=0.001, I2:92.2%). Subgroup analysis indicated controversial results regarding session frequency and drop number of lavender oil. Conclusion: Using Lavender oil significantly reduced fatigue and anxiety in HD patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/32197 https://ijph.tums.ac.ir/index.php/ijph/article/download/32197/8181

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 553 567 Abdollah Mohammadian-Hafshejani Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran Parisa Farahmandian Student Research Committee, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran Abdolmajid Fadaei Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran Ramezan Sadeghi Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran 2022 11 01 2023 08 12 Background: Cadmium, a toxic heavy metal, experienced a surge in production during the 20th century due to the rise of nickel-cadmium batteries, metal plating, and plastic stabilizers. Exposure to cadmium primarily occurs through the consumption of contaminated food, such as vegetables and grains, as well as drinking water or inhaling polluted air. The objective of this study was to investigate the relationship between cadmium exposure and the incidence of prostate cancer using a systematic review and meta-analysis approach. Methods: This research involved searching and retrieving observational and experimental studies conducted until May 2022 from various databases, including ISI Web of Science, Cochrane, Science Direct, Scopus, PubMed, and Google Scholar. Data analysis was performed using Stata 15 statistical software. Results: The initial search yielded 794 articles, which were subsequently reduced to 427 articles after eliminating duplicates. Following the application of inclusion and exclusion criteria, a total of 16 studies were included in the meta-analysis. The odds ratio of prostate cancer compared to the first quartile of exposure in the second quartile was 1.03 (0.95-1.12), in the third quartile it was 1.12 (0.99-1.26) and in the fourth quartile of exposure was equal to 1.16 (0.79-1.70). Regarding the investigation of the probability of the occurrence of publication bias, the results of Begg's and Egger's tests were not statistically significant. Conclusion: Although exposure to cadmium leads to an increase in the chance of prostate cancer, this chance increase was not statistically significant. https://ijph.tums.ac.ir/index.php/ijph/article/view/30279 https://ijph.tums.ac.ir/index.php/ijph/article/download/30279/8182

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 568 576 Alireza Hejrati Department of Internal Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran Sadaf Parvin School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mehrnia Omidali School of Medicine, Iran University of Medical Sciences, Tehran, Iran Lina Hejrati School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran Bahareh Shateri Amiri Department of Internal Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran 2023 03 05 2023 09 18 Multiple Myeloma (MM) is a neoplastic hematologic disorder caused by the excessive proliferation of plasma cells and leads to bone lesions, anemia, and kidney failure. No definite etiology has been proposed for MM, but several environmental and genetic risk factors have been implicated so far. Exposure to pesticides, benzene, and organic solvents like methyl chloride have been considered a potential risk factor. Asbestos, ionizing radiation, and wood dust exposure have also been associated with MM. As MM is a relatively rare condition, the number of studies is insufficient, and in many studies, only a few study participants recall exposure to any agents. Therefore, establishing a definite risk factor is cumbersome and further studies with large study samples are needed. By recognizing these occupational risk factors, clinicians can encourage employees to reduce their exposure as more as possible and implement precautionary measures. In this review, we highlighted the current research on the potential association between occupational exposures and MM. Because of these studies, new regulations with the goal of occupational exposure reduction are anticipated in the future. https://ijph.tums.ac.ir/index.php/ijph/article/view/31395 https://ijph.tums.ac.ir/index.php/ijph/article/download/31395/8183

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 577 585 Myoungjin Kwon Daejeon University Department of Nursing, 62 Daehak-ro, Dong-gu, Daejeon, South Korea Na An Department of Nursing, Woosong College, 59, Baengnyong-ro, Dong-gu, Daejeon, South Korea Kawoun Seo Department of Nursing, Joongbu University, 201 Daehak-ro, Chubu-myeon, Geumsan-gun, Chungnam, South Korea 2022 07 10 2023 01 09 Background: As Korea rapidly enters a super-aged society, interest in depression, a change in psychological function that occurs with aging, is increasing. Although previous studies have suggested a relationship between depression and cognitive decline in older adults, they have not clarified how cognitive decline leads to depression. We aimed to examine the mediating effects of digital information utilization ability (DIUA) and interpersonal contact (IC) in the relationship between cognitive function and depression in older adults. Methods: This descriptive cross-sectional study used data from the 2020 Korean Elderly Survey. The participants were 9,920 seniors aged 65 years and older. Descriptive statistics, t-test, and one-way ANOVA correlation analysis were performed using SPSS 24.0 and the dual mediation effect was analyzed using PROCESS Macro for SPSS v.3.5 model 6. Results: Depression had a negative correlation with cognitive function (r=-.26, P<.001), DIUA (r=-.20, P<.001), and IC (r=-.13, P<.001). Cognitive function was positively correlated with DIUA (r=.40, P<.001) and IC (r=.08, P<.001). There was a positive correlation between DIUA and IC (r=.10, P<.001). Finally, the mediating effect of cognitive function on depression through the dual parameters of DIUA and IC was also statistically significant (B=.-001, 95% CI [-.002, -.001). Conclusion: The depression caused by cognitive decline can be reduced by improving older adults’ ability to use digital information and interact with others. Therefore, social interventions to increase the interpersonal contact of older adults is required, and education programs for improving older adults’ ability to utilize digital information may be developed to increase indirect contact using digital devices as well as direct contact. https://ijph.tums.ac.ir/index.php/ijph/article/view/29260 https://ijph.tums.ac.ir/index.php/ijph/article/download/29260/8184

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 586 591 Besir Shaqiri Department of Sport and Movement Science, University for Businnes and Technology, Kosovo, Prishtina, Kosovo Abedin Bahtiri Department of Sport and Movement Science, University for Businnes and Technology, Kosovo, Prishtina, Kosovo 2022 06 30 2023 02 02 Background: Most of the people with Down syndrome have short stature compared to general population. There is also a high prevalence of overweight and obesity, mainly in the adolescence and in the adult life. The aim of this study was to compare some anthropometric parameters, heart rate and blood pressure of children with Down syndrome and those with normal development. Down syndrome is among the most commonly classified categories of mental sub normality, with the incidence at birth being around 1: 700 and 1: 750 in live births in most countries worldwide, with the risk of increasing with mother’s age. Methods: The sample consisted of 82 children, 32 with Down syndrome and 50 healthy children, male, aged 14-15 yr from the population of Kosovo in 2022. There were no health problems present in the healthy children. Results: About 53% of children with Down syndrome have normal body mass, 15.62% are overweight, and 21.8 are obese. In terms of blood pressure, Down syndrome children have higher systolic pressure (121.94mm/hg), sd ±21.69 than healthy children (111.18mm/hg, sd ±10.88). Conclusion: Children with Down syndrome had significantly higher body mass index, heart rate, and systolic pressure at rest compared to healthy children. However, after short physical activity, healthy children exhibited greater diastolic pressure than children with Down syndrome. https://ijph.tums.ac.ir/index.php/ijph/article/view/29147 https://ijph.tums.ac.ir/index.php/ijph/article/download/29147/8185

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 592 604 Changping Yun Department of Respiration, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Yuguang Wang CT Room, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Dongxu Wang CT Room, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Jialin Zang CT Room, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Zhen Lv School of Pharmacy, Qiqihar Medical University, Qiqihar 161000, China Ruinan Liu CT Room, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Houyi Cong CT Room, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China 2023 05 19 2023 09 18 Background: Chronic obstructive pulmonary disease (COPD) has become a global public health problem due to its high mortality. So there is an urgent need to find an effective treatment Methods: The targeting relationship among circABCB10, miR-130a and PTEN was predicted by  the targetscan database. The lung condition was detected by CT(Computed Tomograph). The expression levels of circABCB10, miR-130a and PTEN in lung tissues were determined by qRT-PCR. The COPD model was established by stimulating normal and silenced 16HBE cells in circABCB10 genes with cigarette smoke extract (CSE) at different concentrations. qRT-PCR was conducted for the expression levels of circABCB10, miR-130a and PTEN, WB for the expression levels of apoptotic proteins,ELISA for the content of inflammatory factors,and CCK8 for the effect of CSE on the proliferation of cells. Results: CircABCB10 expression increased in lung tissues from patients with COPD and in 16HBE cells treated with CSE. The stimulation on cells with CSE increased the expression of inflammatory factors, while knocking down circABCB10 could reverse this response. The inflammatory response to the knockdown of circABCB10 was reversed by miR-130a inhibitor, which increased the expression of c-caspase 3. The targetscan database predicted the target factor downstream miR-130a was PTEN. Transfecting OE-PTEN reversed the inflammation of knocking down circABCB10, and increased the apoptosis and inflammation. Conclusion: CircABCB10 can cause the inflammatory response by targeting miR-130a/PTEN axis, which is a mechanism that may lead to the occurrence and development of COPD. https://ijph.tums.ac.ir/index.php/ijph/article/view/32079 https://ijph.tums.ac.ir/index.php/ijph/article/download/32079/8186

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 605 613 Seung-Yong Kim Department of Leisure Sports, Dong Seoul University, Gyeonggi-do, Republic of Korea 2023 12 18 2024 02 28 Background: Physical education in schools improves students’ health, physical strength, and lifelong physical engagement. Therefore, participation must be encouraged. This study aimed to investigate the relationship between emotional responses and participation satisfaction, word-of-mouth (WOM) praise, and WOM activity in students participating in school sports. Few studies have considered WOM praise and activity separately. This study addresses this gap in the literature. Methods: In 2023, a survey of total of 345 students in Gyeonggi-do, Korea, was conducted using convenience sampling. Data processing included factor analysis to verify validity and reliability, correlation analysis, confirmatory factor analysis, and structural equation modeling to test the hypotheses. Results: The results confirmed a relationship between the emotional responses of students and satisfaction with participation. The emotional responses (ventilation [P<0.001], sense of dominance [P<0.001]) significantly affected participation satisfaction, and the latter had a possible causal relationship with WOM praise (P<0.001) and activity (P<0.001). Conclusion: The emotional responses of school sports participants were related to participation satisfaction, WOM praise, and WOM activity. Participation satisfaction significantly affected WOM praise and WOM activity. Therefore, to contribute to students’ lifelong health, school sports programs should be developed and implemented to induce positive emotional responses, ensure students’ participation in school sports, and improve their future quality of life. https://ijph.tums.ac.ir/index.php/ijph/article/view/34040 https://ijph.tums.ac.ir/index.php/ijph/article/download/34040/8187

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 614 624 Ai-Bin Weng Department of Pharmacy, The Affiliated Hospital of Putian University, Fujian Province, China Meng-Meng Deng Pharmaceutical and Medical Technology College, Putian University, Fujian Province, China Xiao-Dan Liu Pharmaceutical and Medical Technology College, Putian University, Fujian Province, China Hai-Bin Wang Pharmaceutical and Medical Technology College, Putian University, Fujian Province, China Qi Lin Key Laboratory for Translational Oncology of Fujian Province, Putian University, Fujian Province, China 2023 04 18 2023 09 18 Background: Fine particulate matter (PM2.5), an important component of ambient air pollution, induces significant adverse health effects. MitoQuinone (MitoQ), a mitochondria-targeted antioxidant, has been reported to play a protective role in various diseases. However, the roles of MitoQ in PM2.5 induced pulmonary toxicity remains to be elucidated. Methods: All the experiments were performed at Higher Educational Key Laboratory for Translational Oncology of Fujian Province, Putian City, China in 2023. Pulmonary epithelial cells (A549) were pretreated with 4 µM MitoQ for 2 h and exposed to PM2.5 for 24 h. Cell viability was tested through CCK8 assay. Oxidative stress state and active mitochondria was used to study MitoQ’s effect on PM2.5 induced injury, and cell apoptosis was measured using a flow cytometer and analyzed by Bcl-2 family. Results: MitoQ pretreatment significantly relieved a decreased cell viability, subsequently, MitoQ alleviated ROS production and prevented the reduction of T-AOC and GSH and increased the expression of NF-E2-related factor 2 (Nrf2) and p62 in A549 cells exposed to PM2.5. MitoQ restored the decreased mitochondrial dysfunction and dynamics disorder and inhibited activated mitochondrial-mediated apoptosis induced by PM2.5. Furthermore, the decreased ratio of Bcl-2/Bax and expression of Mcl-1 and the enhanced expression of Caspase-3 were reversed by MitoQ pretreatment. Conclusion: MitoQ might be regarded as a potential drug to relieve PM2.5 induced pulmonary epithelial cells damage. https://ijph.tums.ac.ir/index.php/ijph/article/view/31789 https://ijph.tums.ac.ir/index.php/ijph/article/download/31789/8188

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 625 633 Milos Stepovic Department of Anatomy, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia Berislav Vekic 1. Clinic for Surgery, University Hospital Center “Dr. Dragisa Misovic”, Belgrade, Serbia 2. Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Sanja Kocic Department of Social medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Svetlana Radevic Department of Social medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Viktorija Dragojevic Simic 1. Centre for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia 2. Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia Snezana Radovanovic Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Radisa Vojinovic Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Nemanja Rancic 1. Centre for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia 2. Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia 2022 03 02 2024 02 28 v https://ijph.tums.ac.ir/index.php/ijph/article/view/28047 https://ijph.tums.ac.ir/index.php/ijph/article/download/28047/8189

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 634 643 Chunjing Tu Taizhou University Xiaolong Chen School of Physical Education, Hangzhou Normal University, Hangzhou, China Yibo Gao China Institute of Sport Science, Beijing, China Qi Pan School of Physical Education, Hangzhou Normal University, Hangzhou, China Lupei Jiang China Institute of Sport Science, Beijing, China Yuyu Li School of Physical Education, Hangzhou Normal University, Hangzhou, China Yanfeng Zhang China Institute of Sport Science, Beijing, China 2023 12 27 2024 02 28 Background: We aimed to explore the epidemiological trends and characteristics of undernutrition among children and adolescents aged 7~18 years in Macao from 2005 to 2020 to provide insights into the improvement of nutritional status among the youth in Macao, China. Methods: Based on the data collected from the Citizen Physical Fitness surveillance sessions in Macao in 2005, 2010, 2015, and 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was calculated. Result: In 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was 12.11%. Among them, the rates of stunting, moderate or severe wasting, and mild wasting were 0.63%, 5.25%, and 6.23%, respectively. The prevalence of undernutrition among boys (13.81%) was higher than that among girls (10.06%). Mild wasting was the main form of undernutrition among students. From 2005 to 2020, the prevalence of malnutrition showed a decreasing trend (P<0.05), but there was a rebound in 2020 from 2015, mainly because it may be caused by the COVID-19 pandemic in 2020. The prevalence of undernutrition among children and adolescents in Macao was lower than that in Mainland China (P<0.01). Conclusion: The detection rates of undernutrition showed a decreasing trend from 2005 to 2020. In the post-pandemic era, Macao should undertake more effective measures in areas such as promoting balanced nutritional intake, increasing physical activity levels, enhancing school physical education, and incorporating mental health education. These efforts are essential for further reducing the prevalence of undernutrition among children and adolescents. https://ijph.tums.ac.ir/index.php/ijph/article/view/34124 https://ijph.tums.ac.ir/index.php/ijph/article/download/34124/8190

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 644 653 Xiao Ouyang Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Xingran Chen Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Feng Xin Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Peng Sha Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Songming Tong Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Meng Liu Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Shimin Li Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China Xinxin Li Department of Orthopedic Surgery, Xuzhou Third People's Hospital, Affiliated Xuzhou Hospital of Jiangsu University, Affiliated Xuzhou Third People's Hospital of Xuzhou Medical University, Xuzhou 221000, China 2023 04 19 2023 09 18 Background: The regulation of p21 in the pyroptosis of cartilage cells still needs to be further clarified. We aimed to explore the regulation of p21 on the pyroptosis of cartilage cells and to reveal the improvement of osteoarthritis. Methods: Chondrocytes were collected and isolated from patients with osteoarthritis (average age 58.64 ± 4.32) in Xuzhou Third People's Hospital, China in 2019, and healthy volunteers (average age 58.23 ± 3.91) were enrolled as the control group. mRNA expression levels of p21 and pyroptosis-related proteins (NLRP3, ASC, total caspase1 and cleaved-Caspase1) were detected by Western blot and real-time PCR. Cell activity, total number of cells and number of dead cells were calculated with CCK-8, MTT. And the regulation of p21 on the pyroptosis of cartilage cells was verified with overexpression and knockdown of p21 in cartilage cells. Results: In cartilage cells of patients with osteoarthritis, the transcription and translation levels of pyrolysis-related genes (NLRP3, cleaved-caspase 1, and ASC) significantly increased (P<0.01). p21 expression was up-regulated and positively correlated with the changing trend of pyrolysis-related proteins (P<0.01). Overexpressing p21 genes in normal cartilage cells significantly increased the expression of pyrolysis-related proteins (P<0.01). Conclusion: The pyroptosis of cartilage cells is causally related to the process of osteoarthritis, and can be regulated by transcription factor p21, which is a potential therapeutic target for osteoarthritis.Osteoarthritis https://ijph.tums.ac.ir/index.php/ijph/article/view/31801 https://ijph.tums.ac.ir/index.php/ijph/article/download/31801/8191

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 3 2024 02 28 654 662 EN Hossien Hassani Lafmejan Pour Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran Mehdi Tavalla Department of Parasitology, School of Medicine Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Hossein Keshavarz Valian Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran Mahdi Mohebali Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran Saeideh Hashemi Hafshejani Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Ali Latifi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran Mahboobeh Salimi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran Aref Teimouri Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Saeedeh Shojaee Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical, Tehran, Iran 2022 07 09 2022 10 23 Background: Soil is an appropriate substrate for the storage and transmission of oocytes of Toxoplasma gondii. Ingestion of soil contaminated with T. gondii oocysts is a major transmission route of human and animal toxoplasmosis. The preName> Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand 2019 01 16 Background: Elderly falls increase dramatically with age and are a leading cause of injury, carrying a risk of loss of independence and death. We studied the effects of a health education program on fall-risk prevention among urban elderly persons in the municipality of Khon Kaen, Thailand. Methods: A quasi-experimental study was conducted in 2 communities. The calculated sample size was 216 individuals: 108 for intervention and 108 for control, all of whom were 60 or older, and registered at the Samlium Primary Care Unit (SPCU). The educational intervention was a fall risk intervention program by an elderly buddy. A structured questionnaire that incorporated questions from the Thai Fall Risk Assessment Tool (Thai-FRAT) was used to collect general and specific information. Data were analyzed using the independent sample t-test and c2, with P<0.05 being statistically significant. Results: The response rate was 94.4%. More than half of the respondents were at risk of a fall. The prevalence of risk of a fall among the intervention group was slightly less than that for those within the control group [Intervention group=52.9% (95%CI: 42.85, 62.81, P<0.001); Control group=60.8% (95%CI: 50.59, 70.15, P=0.016)]. After 6 months of intervention, the balance impairment, medicine usage, and overall proportion with risk of fall were decreased. The difference between the intervention and control groups was statistically significant (P<0.05). Conclusion: The provision of a health education program designed for fall risk prevention among the elderly would be a useful public health initiative.     https://ijph.tums.ac.ir/index.php/ijph/article/view/15944 https://ijph.tums.ac.ir/index.php/ijph/article/download/15944/6259

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 187 188 Fariba KHAYYATI Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Mohammad ASGHARI JAFARABADI Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran AND Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran Masoud LOTFIZADEH Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran Asrin KARIMI Neurosciences Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Khaled RAHMANI Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2019 01 16 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/15959 https://ijph.tums.ac.ir/index.php/ijph/article/download/15959/6274

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 112 119 Sheng-Jun WANG Department of Teaching, School of Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai, China Li-Juan LIU Department of Health Management, Second Military Medical University, Shanghai, 200433, China Guang-Yue JI Department of Logistics Support, Shanghai Tenth People’s Hospital, Shanghai, 200072, China AND Department of Training, Second Military Medical University, Shanghai, 200433, China Xiao-Hua (Andrew) ZHOU Department of Biostatistics, School of Public Health, University of Washington, Washington, America Tian-Jiao JIANG Department of Health Management, Second Military Medical University, Shanghai, 200433, China Mei-Hua LU Department of Teaching, School of Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai, China De-Lin YU Department of Medical Administration, Guilin Sanatorium of Guangzhou Military Command Area, Guilin, Guangxi, 541000, China Qiang GUO Department of Health Management, Second Military Medical University, Shanghai, 200433, China Jin-Hai SUN Department of Health Management, Second Military Medical University, Shanghai, 200433, China 2019 01 16 Background: This study aimed to evaluate the characteristics of faculty and research activities of basic stem cell research groups in China. Methods: A questionnaire was administered to persons who knew the information among 46 basic stem cell research groups in China. Multiple linear regression models and repeated-measures analyses of variance were used. Repeated-measures analyses of variance were used. Results: Of the 46 groups, 39.1% did not have any faculty recruited from abroad from 2009 to 2013, 37.0% did not have any faculty with junior-level title, 34.8% had ≤25.0% faculty with either M.D. or Ph.D. degree. Papers published in SCI journals per faculty and having faculty recruited from abroad were positively associated with research funding per faculty. The groups with faculty recruited from abroad had significantly higher research funding per faculty over time compared with the group without faculty recruited from abroad. Repeated-measures analyses of variance showed the group with faculty recruited from abroad had significantly higher research funding per faculty over time compared with the group without faculty recruited from abroad. Conclusion: To increase the development of basic stem cell research, some characteristics of human resources should be improved, and the groups should recruit more faculty with overseas experience.     https://ijph.tums.ac.ir/index.php/ijph/article/view/15945 https://ijph.tums.ac.ir/index.php/ijph/article/download/15945/6260

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 120 125 Can ONER Department of Family Medicine, Kartal Dr Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey Binali CATAK Department of Public Health, School of Medicine, Kafkas University, Kars, Turkey 2019 01 16 Background: High-quality prenatal care services could decrease maternal-neonatal mortality and morbidities. The aim of this study was to compare institutional and unplanned home deliveries with regard to the use and content of prenatal care services. Methods: The study was conducted in 2011 with two hundred and twenty-nine mothers with unplanned deliveries at home as study group and 458 mothers having institutional deliveries as controls living in Istanbul. The content of prenatal care was evaluated in accordance with the national ministry of health prenatal care management guidelines and the data was collected by a questionnaire with face to face interview. Results: Women with unplanned deliveries at home use prenatal care services less frequently. Percentage of mothers that had home deliveries and did not use prenatal care services was 16.2% while this was only 3.4% in women having institutional deliveries (P=0.001). Moreover, all parameters of prenatal care were poor in content compared to women with institutional deliveries. Conclusion: Adequate prenatal care services in terms of quantity and quality can promote institutional deliveries.   https://ijph.tums.ac.ir/index.php/ijph/article/view/15946 https://ijph.tums.ac.ir/index.php/ijph/article/download/15946/6261

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 126 131 Huafeng LI Genetic Laboratory, Women & Children’s Health Care Hospital of Linyi, Shandong Province, Linyi, 276014, PR China Yongli LI Genetic Laboratory, Women & Children’s Health Care Hospital of Linyi, Shandong Province, Linyi, 276014, PR China Rui ZHAO Genetic Laboratory, Women & Children’s Health Care Hospital of Linyi, Shandong Province, Linyi, 276014, PR China Yanli ZHANG Genetic Laboratory, Women & Children’s Health Care Hospital of Linyi, Shandong Province, Linyi, 276014, PR China 2019 01 16 Background: We aimed to assess the frequency and structure of chromosomal abnormalities as well as the distribution of the indications of prenatal diagnosis in 4206 cases of high-risk pregnant women. Methods: A retrospective analysis of cytogenetic studies of 4206 pregnant women with indications of amniocentesis, referred to Linyi Women and Children’s Hospital, Shandong Province, Linyi, China in 2016-2017, was performed. Among those, 4191 amniotic fluid specimens were successfully extracted and cultured, and received karyotype diagnosis. Results: A total of 358 abnormal karyotypes were detected and the abnormal rate was 8.54%. Among them, autosomal aneuploidy was the most common pattern occupied 64.53% and the detection rate was 5.51%, of which 173 (48.32%) cases were 21-trisomy, which was the main type of abnormal karyotypes, followed by 18-trisomy (14.25%). There were 38 cases with sex chromosome aneuploidy, including 47, XXY, 47, XXX, 47, XYY, 69, XXX and 45, X0, accounting for 10.61% of the total chromosome abnormalities and the detection rate was 0.91%. Chromosome structural disorders occupied 10.61% (38/358) of the chromosome abnormalities, including Robertson translocation (16 cases), balance translocation (14 cases), inversion (3 cases), deletion (3 cases), and so on. Chromosome polymorphism was 10.61% too. Other uncommon abnormal karyotypes included mosaicism (11/358), marker chromosome (1.3%). Advanced age and serological screening for high risk were the major prenatal diagnostic indications for pregnant women with chromosomal abnormalities. Conclusion: The karyotype analysis of amniotic fluid cells in pregnant women with different amniocentisis indications can effectively prevent the birth of fetuses with chromosomal diseases and reduce the risk of fetal malformation.   https://ijph.tums.ac.ir/index.php/ijph/article/view/15947 https://ijph.tums.ac.ir/index.php/ijph/article/download/15947/6262

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 132 138 Siavaah CHALABIANI Department of Molecular Diagnostics, Noor Pathobiology Laboratory, Tehran, Iran Mina KHODADAD NAZARI Department of Molecular Diagnostics, Noor Pathobiology Laboratory, Tehran, Iran Nada RAZAVI DAVOODI Department of Molecular Diagnostics, Noor Pathobiology Laboratory, Tehran, Iran Mahdi SHABANI Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Masoud MARDANI Tropical Infectious Diseases Research Center, Shahid Behshti University of Medical Sciences, Tehran, Iran Abdolfatah SARAFNEJAD Department of Molecular Diagnostics, Noor Pathobiology Laboratory, Tehran, Iran AND Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali AKBAR AMIRZARGAR Department of Molecular Diagnostics, Noor Pathobiology Laboratory, Tehran, Iran AND Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran AND Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran 2019 01 16 Background: Brucellosis as a zoonotic disease is widespread among human and animal that it continues to be a major public health problem. Due to the shortage of recent epidemiologic data regarding the brucellosis distribution in Iran, we convinced to evaluate the prevalence of brucellosis in provinces of Iran. Methods: In this descriptive study, data were collected from brucellosis suspected patients referred to Noor Pathobiology Laboratory, Tehran, Iran from 18 out of 31 provinces of Iran during 2013-2015. Results: Overall, 2635 out of 17103 attending cases (15.4%) were recognized as brucellosis patients. The most prevalent rate was found in patients aged 20-39 yr old (41%) which of them 67% were male. Patients with brucellosis were significantly diagnosed in spring season (Apr to late May). Among included provinces, Hamadan Province had the highest (25%) prevalence followed by Markazi and Mazandaran with 24.7% and 22.5%, respectively. Conclusion: Brucellosis is still considered as an important infectious disease with a high prevalence in many provinces of Iran. It is necessary to implement a national brucellosis control program by increasing medical education, public knowledge and various controlling plans for preventing, controlling and eradicating of brucellosis.   https://ijph.tums.ac.ir/index.php/ijph/article/view/15948 https://ijph.tums.ac.ir/index.php/ijph/article/download/15948/6263

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 139 146 Zeinab EBRAHIMZADEH Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran Mohammad Ali GOODARZI Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran Hassan JOULAEI Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2019 01 16 Background: Antiretroviral therapy has significantly reduced the prevalence of diseases and mortality rate caused by HIV; therefore, recognition of the factors affecting the antiretroviral therapy is of great importance. We aimed to investigate the relationship between antiretroviral medication adherence and CD4 with posttrau-matic stress disorder (PTSD) and depression in patients with HIV. Methods: This was a descriptive, cross-sectional, quantitative, and correlational study. The statistical popula-tion included all of the patients with HIV in Shiraz, Fars Province, southwest of Iran in 2013, of whom 220 were selected from the Behavioral Diseases Consultation Center using the convenience sampling method. The measures included Mississippi Post Traumatic Stress Disorder Questionnaire, Beck-II Depression, and ACTG Adherence (ACTG). The results were analyzed using the Pearson correlation method and stepwise hierarchical multivariate regression. Results: Regression analysis showed that of two mediating variables (age & educational level), only age could predict 5% (P<0.001) and of two predictive variables (depression & PTSD) only PTSD could predict 53% (P<0.001) of medication adherence's variance. Moreover, of two mediating variables (age & disease duration), only age could predict 3% (P<0.004) and of two predictive variables (depression & PTSD) only PTSD could predict 4% (P<0.001) of CD4 variance. Conclusion: The posttraumatic stress disorder symptoms could predict the medication non-adherence and lower CD4 levels. https://ijph.tums.ac.ir/index.php/ijph/article/view/15949 https://ijph.tums.ac.ir/index.php/ijph/article/download/15949/6264

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 147 155 Jafar Sadegh TABRIZI Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Majid KARAMOUZ East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran Homayoun SADEGHI-BAZARGANI Road Traffic Injury Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Alireza NIKNIAZ Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Leila NIKNIAZ Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Roya HASANZADEH Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Jalal HANAEE Department of Medicinal Chemistry, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran Mostafa FARAHBAKHSH Research Center of Psychiatry and Behavioral Sciences, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran 2019 01 16 Background: For overcoming the existing problems and finding a pathway for realization of universal health care, health complexes were implemented in the form of a pilot project in Tabriz suburban area. Methods: Tabriz Health Complex Project was designed in 2013 in the provincial health center of East Azerbaijan. In terms of execution schedule, this intervention had 4 phases including 1) study phase, 2) planning phase, 3) pilot phase, and 4) implementation phase. Each health complex covers a population of 40,000 to 120,000 in a defined geographic area and consists of a Comprehensive Health Center (CHC) including health centers and a management center, which usually located in CHC. The important features of this project are as follows: people-centered primary health care, special attention to health promotion and prevention and establishment of a referral system within the region (organic connection between the first and second levels). Results: An accountable and responsive health care system has been established to deliver integrated care services to people in a defined catchment area against identified per capita payment, under district health centre policies and regulations. Each health team consisted of a general practitioner and a family health nurse who covered around 4000 people to deliver prevention, promotion, and treatment services especially in and NCDs field. Conclusion: Health complex as a model of public-private participation and practical solution to address many of the problems in the primary care system of the country. The project can organize the PHC system and family medicine program.   https://ijph.tums.ac.ir/index.php/ijph/article/view/15950 https://ijph.tums.ac.ir/index.php/ijph/article/download/15950/6265

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 156 161 Afagh FAZELI Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Parivash KORDBACHEH Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali NAZARI Department of Infectious Diseases, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran Roshanak DAIE GHAZVINI Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Hossein MIRHENDI Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mahin SAFARA Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Heidar BAKHSHI Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Razieh YAGHOUBI Department of Parasitology and Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2019 01 16 Background: Candiduria in hospitalized patients may represent contamination, colonization, or urinary tract infections. On the other hand, candidemia and upper urinary tract infection could be the complications of candiduria. The aim of this study was to determine candiduria in hospitalized patients and identify isolated Candida species by conventional and molecular methods. Methods: This cross-sectional study was conducted on hospitalized patients in Imam Khomeini and Mostafa Khomeini hospitals in Ilam, western Iran from Jan to Dec 2016. Urine samples of hospitalized patients were collected during a period of 4 months for diagnosis of candiduria. Primary identification was done by conventional methods. PCR profile was carried out using phenol-chloroform method and confirmed using restriction fragment length polymorphism (PCR-RFLP) technique by MspI restriction enzyme. Results: Candiduria was diagnosed in 18 (9.2%) cases from a total of 195 patients. Isolated yeasts were identified as C. albicans (n: 13), C. glabrata (n: 5), and C. parapsilosis (n: 1) in the one case both C. albicans and C. glabrata were isolated from a urine sample. Conclusion: Candida urinary tract infection is becoming increasingly common in hospitalized patients but, differentiation fungal colonization from infection and identification of etiologic agents for optimal treatment is necessary.   https://ijph.tums.ac.ir/index.php/ijph/article/view/15951 https://ijph.tums.ac.ir/index.php/ijph/article/download/15951/6266

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 1 2019 01 16 162 170 Zahra BAHADORAN Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Asghar GHASEMI Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Parvin MIRMIRAN Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Yadollah MEHRABI Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Scien