Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 236 239 Dariush D Farhud Editor-in-Chief 2025 02 08 No Abstract. Not abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38091 https://ijph.tums.ac.ir/index.php/ijph/article/download/38091/8459

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 240 251 Qin Peng Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Lin Li Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Jing Yang Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Kaishan Tao Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Xian Zhao Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Lin Wang Department of Hepatobiliary Pancreatic Splenic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi Province, China Xiaosong Jiang Department of Oncology, the First Affiliated Hospital of Harbin Medical University, Harbin, China 2024 01 09 2024 06 30 Background: Liver cancer and cirrhosis are significant public health challenges with a high global burden. Multidisciplinary Team (MDT) care has gained recognition as a promising approach to improve the management and outcomes of patients with liver cancer and cirrhosis. We aimed to evaluate the effectiveness of MDT care in improving the clinical outcomes, including survival rates, quality of life, and disease progression, in patients with liver cancer and cirrhosis. Methods: The search was performed using the keywords of liver cancer and MDT and their combinations in international databases with a time limit for publishing articles from 2010 and 2023. The data were evaluated using a technique of meta-analysis as well as a model called random effects. The I2 test was used to examine the degree of heterogeneity between the studies. STATA was used to analyze the data. Results: The analysis of 13 different papers with a total sample size of 8641 individuals revealed that the average scores of the MDT and liver cancer were identical to (0.64), with a confidence interval ranging from (95% 48.5-81.7). Conclusion: MDT is effective in the length of treatment and reduction of risk and mortality rates. The negative prognostic factors of not following the MDT decision were not observed. https://ijph.tums.ac.ir/index.php/ijph/article/view/34237 https://ijph.tums.ac.ir/index.php/ijph/article/download/34237/8460

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 252 264 Yujie Gao School of Physical Education, Xi'an Shiyou University, Xi’an 710065, China Zhengfa Han School of Physical Education, Guangdong University of Education, Guangzhou 510800, China Bo Dai School of Physical Education, Shangrao Normal University, Shangrao 334001, China 2024 02 08 2024 08 07 Background: Depression is a prevalent mental health disorder with adverse effects on both physical and psychological health. Taekwondo is posited to exert a positive influence on depression, yet its efficacy warrants further verification. Methods: This study employed meta-analysis to quantify the intervention effect of Taekwondo on depression. Concurrently, based on subgroup analysis results, an optimal intervention program was suggested. Multiple databases were searched, including English (Web of Science, PubMed), Chinese (CNKI, WANFANG DATA), and Korean (RISS, KISS, DBPIA), to retrieve randomized controlled trials (RCTs) studying Taekwondo's impact on depression, published up to Jan 2024. The Cochrane bias risk tool version 2 (RoB 2.0) was utilized for literature bias risk assessment. Comprehensive Meta-Analysis software facilitated the meta-analysis, subgroup analysis, and publication bias evaluation. Results: Fifteen articles, encompassing 1945 participants, were included in the study. The primary findings indicated a significant reduction in depression risk due to Taekwondo intervention (Effect Size [ES]=-0.635, P<0.001). Subgroup analysis revealed the most substantial intervention effects in elderly individuals (ES=-1.025, P=0.004) and women (ES=-1.114, P=0.009). Taekwondo exercises, when conducted over 12 wk (ES=-0.922, P<0.001), three times per week (ES=-0.729, P<0.001), for 60 min per session (ES=-0.980, P=0.003), and at low intensity (ES= -1.777, P=0.024), yielded the greatest depression mitigation effects. Conclusion: Taekwondo is an effective means to alleviate depression, particularly in older women. The study recommends a low-intensity Taekwondo exercise regimen, consisting of 60-minute sessions, three times weekly for 12 wk, as an optimal exercise prescription for best outcomes. https://ijph.tums.ac.ir/index.php/ijph/article/view/34576 https://ijph.tums.ac.ir/index.php/ijph/article/download/34576/8461

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 265 272 EN Darmawan Setijanto Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia Abdullah Hemadi Pediatric Dentistry, Taiz University, Taiz, Yemen Iwan Dewanto Department of Dental Public Health, Faculty of Dentistry, University of Muhammadiyah Yogyakarta, Yogyakarta, Indonesia Melissa Adiatman Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia Kartika Wulan Department of Prosthodontics, Faculty of Dentistry, Universitas Brawijaya, Malang, Indonesia Valendriyani Ningrum Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Baiturrahmah, West Sumatra, Indonesia Armelia Widyarman Department of Microbiology, Faculty of Dentistry, Trisakti University, West Jakarta, Indonesia Tince Jovina Health Policy Agency, Ministry of Health, Jakarta, Indonesia Naneu Arfani Directorate of Primary Health Services, Ministry of Health, Jakarta, Indonesia Indra Dharmawan Directorate General of Health Services, Ministry of Health, Jakarta, Indonesia Sri Nuraini Directorate of Primary Health Services, Ministry of Health, Jakarta, Indonesia Ammara Mahrunisa Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia Marvin Hidayat Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia 2023 09 28 2024 10 06 Background: Stunting has a negative impact on the growth and development of children, which include their susceptibility to dental caries. Caries in primary teeth have been consistently related to malnutrition. Having a history of severe caries was connected with slower childhood growth. We aimed to explain the updated trend of association between stunting and dental caries among all age groups. Methods: A review was done using PRISMA. PubMed and Science Direct was used as database from Jan 2022 to Jan 2023. Studies obtained using specific keywords was 1.748 then filtered. All of the studies that were obtained using specific keywords about stunting and DMFT and or PUFA index. There is no limited year in this systematic search. Endnote software was used to help with the inclusion process; data was extracted into a table that had been prepared. Results: There were 10 included studies in this systematic review. Eight studies that reported higher dental caries in stunting children than the normal children. Two studies showed a connection between developing stunting malnutrition and severe dental caries. Early childhood caries may increase vulnerability to dental caries by causing odontogenesis to fail, delayed tooth eruption and changes in the salivary glands. Children's ability to eat and sleep may be negatively impacted by untreated caries pain. It might result in decreased nutrient intake and poor appetite, while sleep disturbances might prevent growth hormones from being secreted. Conclusion: There was a correlation between dental caries and growth stunting because of a decrease in the composition of saliva and defects in tooth formation in children suffered stunting. Thus, there were oral functional limitations and a decrease in food intake since severe dental caries. https://ijph.tums.ac.ir/index.php/ijph/article/view/33310 https://ijph.tums.ac.ir/index.php/ijph/article/download/33310/8462

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 273 284 EN Dharina Baharuddin 1. Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia 2. Faculty of Public Health, University of Muhammadiyah Aceh, Aceh 23245, Indonesia Mas Ayu Said Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia Hazreen Abdul Majid 1. Centre of Population and Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia 2. AECC University College, Parkwood Campus, Bournemouth, BH5 2DF, United Kingdom 2024 01 21 2024 08 07 Background: Diets utilizing intermittent fasting as an alternative method to promote weight loss have grown in popularity. However, the efficacy of intermittent among elevated blood pressure remains unclear. This review systematically analyses studies investigating the effects of intermittent variations among elevated blood pressure on changes in systolic blood pressure and diastolic blood pressure. Changes in body weight, body mass index, waist circumference, and energy intake were assessed as a secondary objective. Methods: The American Search Elite, CINAHL, Cochrane, MEDLINE, ProQuest, PubMed, Scopus, and grey literature databases were searched for articles investigating intermittent fasting with ad libitum among adults with elevated blood pressure from Jan 2010 to Jun 2022. Results: Twelve studies met the eligibility criteria. Systolic and diastolic blood pressure generally decreased, between -2.0 to -0.04 mmHg and -3 to -0.01 mmHg, respectively. The body weight and body mass index reduced significantly (-2.85 to -0.09 kg and -1.05 to -0.03 kg/m2, respectively). The review found a waist circumference reduction of -0.67 to -0.21 cm and an energy intake reduction of -263.89 to -2.58 kcal. Conclusion: Intermittent fasting reduces systolic and diastolic blood pressure in 2-24 wk while decreasing body weight, body mass index, and energy intake. However, needs 48 wk to reduce waist circumference. This implies that it is critical to perform intermittent fasting on elevated blood pressure before the development of high blood pressure as part of a program to prevent hypertension in adults. https://ijph.tums.ac.ir/index.php/ijph/article/view/34380 https://ijph.tums.ac.ir/index.php/ijph/article/download/34380/8463

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 285 296 Baolian Guo Department of Urology, Zhuji People’s Hospital of Zhejiang Province, Zhuji, 311800, Zhejiang Province, China 2024 08 18 2024 10 30 Background: To study the clinical effect of postoperative nursing on patients undergoing transurethral resection of the prostate (TURP). Methods: The relevant researches about nursing intervention effect evaluation after TURP during January 2000 to May 2024 were selected from databases. These were sorted into an intervention group (Int group) and a control group (Ctrl group) with different nursing methods. Theemotional status, length of hospital stays (LOHS), nursing satisfaction, the incidence, volume, and frequency of urinary incontinence (UI), and the incidences of urinary hemorrhage (UH), bladder spasm (BS), and catheter occlusion (CO) were compared after intervention. Results: Eleven articles and 1,020 cases were included. The LOHS in the Int group was much shorter (mean difference (MD)=-2.91, 95% confidence interval (CI): -4.47~-1.35, Z=3.66, P=0.0002). The nursing satisfaction was significantly improved (odds ratio (OR)=5.70, 95% CI: 3.65-8.90, Z=7.64, P<0.00001). For complications, incidence of UI (OR=0.41, 95% CI: 0.26-0.66, Z=3.72, P=0.0002), the volume of UI (MD=-66.17, 95% CI: -124.74~-11.60, Z=2.36, P=0.02), and the frequency of UI (MD=-1.18, 95% CI: -1.69~-0.67, Z=4.55, P<0.00001) greatly reduced. The incidences of UH (OR=0.43, 95% CI: 0.21-0.87, Z=2.35, P=0.02), BS (OR=0.24, 95% CI: 0.14-0.42, Z=4.97, P<0.00001), and CO (OR=0.20, 95% CI: 0.11-0.36, Z=5.21, P<0.00001) were also highly reduced. Conclusion: Postoperative nursing intervention could effectively shorten LOHS after TURP in patients with benign prostatic hyperplasia (BPH), improving the nursing satisfaction and reducing the incidence of postoperative complications. https://ijph.tums.ac.ir/index.php/ijph/article/view/36419 https://ijph.tums.ac.ir/index.php/ijph/article/download/36419/8464

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 297 308 Lingfei Ma Department of Nursing, Jiaozhou Central Hospital of Qingdao, Qingdao, 266300, China Fuping Ye Department of Gastrointestinal Surgery, Jiaozhou Central Hospital of Qingdao, Qingdao, China 2024 07 27 2024 10 21 Background: Nosocomial infections represent a critical challenge in nursing practice, particularly during the COVID-19 pandemic. Isolation measures have been implemented widely to curb the spread of infections within healthcare settings. We aimed to evaluate the effectiveness of isolation measures in reducing nosocomial infection rates in nursing practice during the COVID-19 pandemic. Methods: A systematic search was conducted using keywords such as "isolatModel Grounded on Character Strengths Theory on Inferiority Complex in Adolescents 1233 1242 Qinjuan Wang School of Economics and Management, Wuchang Institute of Technology, Wuhan, China Li Zhang School of Economics and Management, Wuchang Institute of Technology, Wuhan, China Jing Zhu School of Economics and Management, Wuchang Institute of Technology, Wuhan, China Xu Chen School of Economics and Management, Wuchang Institute of Technology, Wuhan, China 2025 05 05 2025 06 02 Background: Inferiority complex is a common psychological disorder occurring in adolescents during their psychological development and the root cause of most psychological problems. However, inferiority complex in adolescents has rarely been examined in previous intervention studies. This practice-oriented study combined character strengths theory with group psychological counseling to examine adolescents with high inferiority complex scores. Methods: A survey was conducted on 512 adolescents selected using convenience sampling from three middle schools in Wuhan, Hubei Province, China, to collect information regarding the degree and characteristics of their inferiority complex. Those with a high inferiority complex score were recruited for a grouped experiment, where the experiment group received group counseling grounded on character strengths theory. Results: The participants had a moderately high degree of inferiority complex (mean = 2.92). Significant differences were observed in the total inferiority complex score across gender, left-behind experience, and academic performance (P < 0.05). After the intervention, the inferiority complex score of the experiment group was significantly lower than that of the control group, and the difference was statistically significant (P< 0.05). Conclusion: The intervention model constructed in this study effectively reduces inferiority complex in adolescents, providing a reference for exploring an effective approach to adolescent-targeted mental health education. https://ijph.tums.ac.ir/index.php/ijph/article/view/39009 https://ijph.tums.ac.ir/index.php/ijph/article/download/39009/8575

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1142 1152 Laiqing Luo Rehabilitation Department, Sandun district of Zhejiang Hospital, Hangzhou, 310030, China Rongliu Cen Emergency Department, Sandun district of Zhejiang Hospital, Hangzhou, 310030, China 2024 08 15 2024 12 11 Background: This article aimed to compare the value of infection related critical illness scores in predicting the risk of death in infected patients, and evaluate the predictive accuracy of three scoring indicators: SOFA score, APACHE II score, and NEWS score. Methods: Through the established retrieval strategy, the relevant literature from January 2013 to December 2023 were searched on platforms such as CNKI, Wanfang, PubMed, Embase, and Cochrane Library, eight relevant literature were included for meta-analysis. Literature screening and data extraction were conducted according to predetermined standards, using a fixed effects model for data analysis. Results: Among the 8 included literature (References (5-12)), the ratio of mortality to survival and 95% confidence interval for SOFA scores were 1.33 and (0.98, 1.75), respectively; The APACHE II score is 2.24 and (1.58, 2.97); The NEWS score is 1.64 and (1.45, 1.85). All three scoring indicators had significant value in predicting the risk of death in infected patients. In addition, comparing the AUC of the three scoring indicators, the SOFA score had the highest AUC, followed by the APACHE II score, and showed significant differences compared to the NEWS score, with P<0.001 and P<0.05 respectively. Conclusion: The SOFA score has higher accuracy and predictive value in predicting the condition and risk of death of infected patients. However, further attention needs to be paid to the selection of scoring methods to comprehensively consider the clinical situation and research objectives. The results of this study are helpful in guiding the evaluation and prediction of infected patients in clinical practice, and providing a basis for optimizing treatment strategies.  https://ijph.tums.ac.ir/index.php/ijph/article/view/36387 https://ijph.tums.ac.ir/index.php/ijph/article/download/36387/8566

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1325 1326 Ahmad Shamabadi Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran 2024 08 31 2024 10 29 No Abstract. Not Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/36522 https://ijph.tums.ac.ir/index.php/ijph/article/download/36522/8586

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1243 1251 Emre Kenger Istanbul Bilgi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Istanbul, Turkey Tugce Ozlu Karahan Istanbul Bilgi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Istanbul, Turkey 2024 12 03 2025 05 09 Background: We evaluated diet plans generated by ChatGPT for hypertension and dyslipidaemia. Methods: In October 2024, ChatGPT was used to generate meal plans for 24 simulated patients with different cardiovascular health problems. Data were used from men (n=12) and women (n=12), aged 56 yr, with mean heights of 176 cm and 161 cm respectively. Weight categories were based on BMI: normal, overweight, and obese, using weights of 56, 71, and 84 kg for women and 67, 85, and 101 kg for men. Four health conditions were assessed: hypertension stages 1 and 2 (systolic BP 130-139 mm Hg and ≥140 mm Hg; diastolic BP 80-89 mm Hg and ≥90 mm Hg), and elevated LDL levels (≥130 mg/dL and ≥160 mg/dL). Menus were evaluated for adherence to Mediterranean and DASH diets, including recommendations. Results: Adherence to the Mediterranean and DASH diets was low across all groups, with median scores below 9 and 4.5, respectively. Common recommendations included weight loss, physical activity, reduced salt intake, stress management, and omega-3s for both hypertension and LDL reduction. Plant sterols/stanols were suggested only for LDL. No advice was given on smoking or alcohol use. Nutrient content did not differ significantly between hypertension and LDL menus (P>0.05). Conclusion: This pioneering study found that AI-generated dietary models had low adherence to DASH and Mediterranean diets, though most recommendations were generally appropriate. Since the prompts only requested basic nutrition plans, future research should use more specific, personalized prompts to better assess AI's role in managing chronic diseases. https://ijph.tums.ac.ir/index.php/ijph/article/view/37402 https://ijph.tums.ac.ir/index.php/ijph/article/download/37402/8576

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1153 1159 Darko Radulović Faculty of Law in Podgorica, University of Montenegro, Podgorica, Montenegro 2023 12 19 2025 01 21 Euthanasia is a highly controversial issue which keeps the scientific community and the general public divided into those in favour and those opposed to this manner of terminating a person’s life. Ethical, medical, legal, religious and other reasons are used both to justify its legalisation and to argue against it. The main question which attracts differing opinions is whether—beside the right to life as the universal and most important right recognised by the European Convention for the Protection of Human Rights and Fundamental Freedoms—there is the right to die, implying that a person could choose how and when to end their life. The author of the paper analyses several issues. In addition to the introduction which considers the right to life in general, and in the light of international documents, the paper deals with the concept of euthanasia and its historical development, as well as the types of euthanasia. This is followed by an overview of the positions of the proponents and the opponents of the legalisation of euthanasia. Finally, the paper discusses the various ways in which euthanasia is regulated in contemporary criminal legislation. https://ijph.tums.ac.ir/index.php/ijph/article/view/34054 https://ijph.tums.ac.ir/index.php/ijph/article/download/34054/8567

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1327 1328 Zahra Sadeqi-Arani Department of Business Management, Faculty of Financial Science, Management and Entrepreneurship, University of Kashan, Kashan, Iran Reza Vahidnia Faculty of Electrical Engineering, British Columbia Institute of Technology, Vancouver, Canada 2024 08 13 2024 11 10 Letter to the Editor has no Abstract. No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/36361 https://ijph.tums.ac.ir/index.php/ijph/article/download/36361/8587

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1252 1262 EN Puerkaiti Paierhati 1. Department of Breast and Thyroid Surgery, the Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, 830011, China 2. The Clinical Medical Research Center of Breast and Thyroid Tumor in Xinjiang, Urumqi, 830011, China Binlin Ma 1. Department of Breast and Thyroid Surgery, the Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, 830011, China 2. The Clinical Medical Research Center of Breast and Thyroid Tumor in Xinjiang, Urumqi, 830011, China Muzhapaer Abudukeremu 1. Department of Breast and Thyroid Surgery, the Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, 830011, China 2. The Clinical Medical Research Center of Breast and Thyroid Tumor in Xinjiang, Urumqi, 830011, China 2024 09 13 2025 02 06 Background: This study investigates the role of exosomal integrin beta-2 (ITGB2) from triple-negative breast cancer (TNBC) cells in modulating immune responses, with a focus on its interaction with Toll-like receptor 4 (TLR4) in dendritic cells (DCs). This study aimed to understand how ITGB2 contributes to the immunosuppressive tumor microenvironment in TNBC. Methods: ITGB2 expression in TNBC tissues and cell lines was analyzed using qPCR and Western blot at the Affiliated Cancer Hospital of Xinjiang Medical University between 2013 and 2015. Knockdown and overexpression models of ITGB2 were established in MDA-MB-231 cells to explore their effects on TLR4 expression in DCs. Exosomes were isolated from these cells, and DCs were co-cultured with exosomes to measure TLR4 expression and cytokine secretion using flow cytometry and ELISA. Results: ITGB2 was overexpressed in TNBC tissues, correlating with poor prognosis. Exosomal ITGB2 from TNBC cells suppressed TLR4 expression in DCs, leading to impaired DC maturation and reduced cytokine secretion, thus promoting an immunosuppressive microenvironment. Conclusion: Targeting the ITGB2-TLR4 axis could enhance anti-tumor immunity in TNBC. ITGB2 holds potential as a biomarker and therapeutic target, suggesting that inhibition of exosomal ITGB2 or restoration of DC function may improve therapeutic outcomes in TNBC. https://ijph.tums.ac.ir/index.php/ijph/article/view/36637 https://ijph.tums.ac.ir/index.php/ijph/article/download/36637/8577

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1160 1170 Husain Nadaf Symbiosis College of Nursing, Symbiosis International (Deemed University), Pune, India Mangesh Jabade Symbiosis College of Nursing, Symbiosis International (Deemed University), Pune, India Amey Khande KLE Academy of Higher Education and Research, Institute of Nursing Sciences, Belagavi, India Gururaj Udapi KLE Academy of Higher Education and Research, Institute of Nursing Sciences, Belagavi, India Vijayalaxmi Chidanand Patil Siddhagiri Nursing Institute, Kolhapur, India 2024 09 18 2025 01 25 Background: This scoping review explores the key demographic and psychosocial factors impacting organ donation, with a focus on studies utilizing online or digital platforms. We aimed to understand the existing facts that influence to effects of the organ donation decision. Methods: This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of PubMed, CINAHL, and Medline was conducted using MeSH terms and logical operators to identify relevant studies published in English 2018 to 2023. Studies focusing on the demographics and influencing factors for organ donors of any age were included. Abstract concepts, conference proceedings, and non-English studies were excluded. Data extraction and quality assessment were independently conducted by two reviewers using standardized tools, including the Newcastle-Ottawa Scale, Cochrane Risk of Bias tool, and Joanna Briggs Institute checklist. Results: Out of 270 records identified, 9 studies met the inclusion criteria. The synthesis of results revealed three major themes: 1) demographic characteristics of organ donors, 2) psychosocial and digital factors influencing organ donation, and 3) interventions promoting awareness and engagement in organ donation. Online and digital platforms play a significant role in shaping attitudes, intentions, and awareness of organ donation. Quality assessment indicated a moderate-to-high level of methodological rigor across the included studies. Conclusion: This review highlights the key factors influencing organ donation, particularly the role of digital platforms in enhancing awareness and engagement. Future research should focus on leveraging these insights to develop targeted interventions aimed at increasing organ donation rates globally. https://ijph.tums.ac.ir/index.php/ijph/article/view/36665 https://ijph.tums.ac.ir/index.php/ijph/article/download/36665/8568

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1329 1330 Dong-Il Kim 1. Division of Health and Kinesiology, Incheon National University, Incheon, Republic of Korea 2. Sport Science Institute, Incheon National University, Incheon, Republic of Korea 3. Sports Functional Disability Institute, Incheon National University, Incheon, Republic of Korea 2025 04 02 2025 05 09 No Abstract. Not Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38690 https://ijph.tums.ac.ir/index.php/ijph/article/download/38690/8588

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1263 1271 EN Li Zheng 1. College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2. Department of Pharmacy, Xingtai Medical College, Hebei, People’s Republic of China Yiheng Ding Hebei Key Lab of Laboratory Animal Science, Hebei Medical University, Hebei, People’s Republic of China Xinhao Li College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China Jingxuan Jia College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China Yanning Li College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2. Hebei Key Lab of Laboratory Animal Science, Hebei Medical University, Hebei, People’s Republic of China Jinsheng Qi College of Integrated Chinese and Western Medicine, Hebei Medical University, Hebei, People’s Republic of China 2024 03 16 2025 06 02 Background: We aimed to investigate whether 20(S)-ginsenoside Rg3 (Rg3) reduced heterogeneity by inducing the maturation of HepG2 cells via the AMP-activated protein kinase (AMPK)/hepatocyte nuclear factor 4A (HNF4A) pathway. Methods: This in vitro cell research study was conducted under the guidance of Hebei Medical University, Hebei, China, from Sep 2022 to Dec 2023. HepG2 cells were treated with varying concentrations of Rg3 in a low glucose microenvironment. The mRNA expression of ALBUMIN (ALB, a marker for hepatocyte function) and HNF4A (a marker for differentiation of HCC cell), and AMPK protein levels were measured after significant changes in cell morphology were observed. Additionally, 5-Aminoimidazole-4-carboxamide1-β-D-ribofuranoside (AICAR) (an AMPK agonist) and Compound C (an AMPK inhibitor) were used to explore further the underlying mechanism. Results: Under treatment of 5 μM, 10 μM, and 20 μM Rg3, some cells became flattened and larger, and there was an increase in the mRNA expression of ALB and HNF4A (P<0.05). However, there was a decreasing trend in AMPK protein content with 8 μM Rg3 (P<0.05). Compared to the control group, some cells exposed to 8 μM Rg3 exhibited pronounced morphological changes, along with upregulated expression of ALB and HNF4A mRNA. However, no such changes were observed when 8 μM Rg3 was combined with 1.6 mM AICAR. Compared to the control group, 10 μM Compound C or 8 μM Rg3 treatments led to similar changes in cell morphology and showed an increasing trend in HNF4A mRNA expression. Additionally, after treatment with Compound C, pHNF4A was mainly in the nucleus, while after Rg3 treatment, it was mostly in the cytoplasm. Conclusion: Rg3 partially induced the maturation of HepG2 cells through the AMPK/HNF4A pathway.     Keywords: 20(S)-ginsenoside Rg3; HepG2; Maturation, Genetics https://ijph.tums.ac.ir/index.php/ijph/article/view/34913 https://ijph.tums.ac.ir/index.php/ijph/article/download/34913/8578

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1171 1178 Haiyan Cai Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China Liwen Pan Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China Pei Zhang Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, 310009, China 2024 05 14 2024 12 22 Background: Perioperative care plays an unparalleled role in the management of strabismus. However, there is still a lack of adequate understanding of the perioperative care and guidelines on nursing measures for strabismus surgery. This article provides a comprehensive review of perioperative care for strabismus, focusing on psychological intervention and rehabilitative nursing. Methods: To comprehensively collect research related to perioperative nursing, we employed a systematic literature retrieval strategy. The databases searched included PubMed, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), WanFang, and VIP (Weipu). We read, summarized and review the literatures obtained from databases. Results: We summarized the conc (MR) study was designed to evaluate the causal effects of LDL-C levels on IS. Methods: Datasets of LDL-C levels and ischemic stroke were acquired from genome-wide association studies (GWAS). Weighted median method was conducted for main analysis, and MR-Egger and inverse-variance weighted (IVW) methods were performed for auxiliary analyses. Heterogeneity and pleiotropic tests were utilized to confirm the reliability of this study. Results: A total of 359 single nucleotide polymorphisms (SNPs) were associated with LDL-C levels (P < 5 × 10−8) and 337 SNPs were available in ischemic stroke with eliminating outliers. LDL-C levels were significantly associated with ischemic stroke (OR = 1.104, 95%CI = 1.019 - 1.195, P = 1.52 × 10-2). MR-Egger and IVW showed directionally similar estimates (MR-Egger: OR = 1.120, 95%CI = 1.040 - 1.207, P = 3.12 × 10-3; IVW: OR = 1.120, 95%CI = 1.064 - 1.178, P = 1.17 × 10-5). Conclusion: LDL-C levels had causal effects on IS, providing insights into the design of future interventions to reduce the burden of ischemic stroke. https://ijph.tums.ac.ir/index.php/ijph/article/view/31975 https://ijph.tums.ac.ir/index.php/ijph/article/download/31975/8165

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 313 322 EN Yan-Li Niu Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Ye Zhang Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Zhi-Yong Song Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Chuan-Zhi Zhao Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Yun Luo Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Yan Wang Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Jing Yuan Emergency Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China 2023 06 03 2023 08 14 Background: We systematically reviewed and analyzed the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) versus biphasic insulin aspart 30 (BIAsp 30) in patients with type 2 diabetes (T2D). Methods: We used computers to search the Embase, PubMed, Clinical Trials, and the Cochrane Library database, and collected randomized controlled trials (RCTs) on the treatment of IDegAsp versus BIAsp 30 in T2D patients. The research period was from the establishment of the database to May 19, 2023. We used Review Manager 5.20 statistical software for systematic meta-analysis. Results: We included 8 RCTs with 2281 participants. IDegAsp was better to BIAsp30 in improving fasting plasma glucose (FPG) levels (P<0.001) and reducing the endpoint daily average insulin dose (P<0.01). Furthermore, compared with BIAsp30, IDegAsp significantly reduced the risk of nocturnal hypoglycemic events (P<0.001). However, there was no significant difference in the improvement of body weight change (P=0.99), glycosylated hemoglobin (P=0.50), the overall risk of hypoglycemic events (P=0.57) and adverse events (P=0.89) between the two groups. Conclusion: Compared with BIAsp30, IDegAsp could significantly reduce FPG levels, insulin dosage, and the risk of nocturnal hypoglycemic events in T2D patients, without increasing the overall risk of adverse events. https://ijph.tums.ac.ir/index.php/ijph/article/view/32189 https://ijph.tums.ac.ir/index.php/ijph/article/download/32189/8157

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 404 413 Qiong Jia School of Design and Art, Shenyang Jianzhu University, Shenyang, China Heyao Wang School of Design and Art, Shenyang Jianzhu University, Shenyang, China Dalin Sun School of Design and Art, Shenyang Jianzhu University, Shenyang, China 2023 12 19 2024 01 30 Background: Anxiety is a common mental health problem among adolescents that substantially increases the risk of anxiety disorder. Depression in adulthood and is a high-risk factor leading to suicide. We aimed to explore effective anxiety intervention methods in view of the annual rising detection rate of anxiety in adolescents. Methods: We enrolled 150 volunteers with mild anxiety or above (anxiety scale≥50 points) from 1015 adolescents between March and May 2023 in four communities in Shenyang, Liaoning Province and Nantong, Jiangsu Province in China. The participants were randomly divided into the experimental and control groups, comprising 73 and 74, respectively. The experimental group was given 2-month psychological intervention based on behavior change wheel (BCW) theory, whereas the control group was given no intervention. Results: The average anxiety score of the participants 46.57 ± 14.19, with 40.4% having anxiety symptoms. Anxiety was statistically correlated with self-evaluation of physical condition, family relationship, and grades (P < 0.05). The depression and anxiety score of the experimental group was significantly lower than that of the control group (P < 0.001). Conclusion: Anxiety has become a common phenomenon among adolescents. Self-evaluation of physical condition, family relationship, and grades are the focus of intervention for individuals with anxiety. The intervention method proposed in this study can effectively reduce the level of anxiety and depression in adolescents, providing a new perspective for formulating anxiety intervention strategies for adolescents. https://ijph.tums.ac.ir/index.php/ijph/article/view/34058 https://ijph.tums.ac.ir/index.php/ijph/article/download/34058/8166

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 323 334 EN Maliheh Ghobadi Department of Health Management, Policy, and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran Anahita Behzadi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Asma Sabermahani Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2022 10 22 2023 06 15 Background: Clinical practice guideline (CPGs) are highly valuable in enhancing healthcare efficiency as they lead to the selection of the best medical methods and reduction of their costs. Nevertheless, implementing CPGs in practice can be quite challenging, as they require alterations at individual, organizational, and health system levels. Therefore, we aimed to identify the outcomes, barriers, and facilitators associated with CPG implementation. Methods: We conducted an extensive search using Web of Science, PubMed, Scopus, Embase, and various non-English databases to gather quantitative, qualitative, and review studies on the implementation of CPGs from Jan 1, 1990, to Dec 26, 2022. Our analysis focused on the outcomes, barriers, and facilitators of CPG implementation, which categorized into four groups: policy-making, health system and hospitals, professional experts, and clinical guidelines. Results: After conducting a thorough review of 37 studies, the most significant outcomes were found to be reduced costs and enhanced quality of care. However, certain challenges, such as inadequate support, insufficient education, high work pressure, tight schedules, and a lack of unified and clear guidelines, hindered these improvements. To overcome these barriers, it is essential to prioritize effective leadership, improve work conditions, allocate necessary resources, create a structured framework for the guidelines, and simplify their content to fit the clinical circumstances. Conclusion: It is crucial to identify the outcomes and barriers associated with implementing CPGs to enhance professional performance, elevate the quality of care, and foster patient satisfaction. Developing effective strategies hinges on this awareness.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30173 https://ijph.tums.ac.ir/index.php/ijph/article/download/30173/8158

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 414 424 Maja Milosevic Markovic Department of Public Health, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Milan Petrovic Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Milan Latas Clinic for Psychiatry, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia Igor Djordjevic Clinic for Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Srdjan Milovanovic Clinic for Psychiatry, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia Svetlana Jovanovic Department of Public Health, School of Dental Medicine, University of Belgrade, Belgrade, Serbia 2022 08 03 2023 04 07 Background: Oral squamous cell carcinoma (OSCC) has numerous physical, psychosocial and financial implications, which significantly affect patients' quality of life. We aimed to determine the health-related quality of life (HRQoL) and identify quality of life (QoL) predictors in patients with OSCC. Methods: We included 64 consecutive patients aged 40 to 80 yr treated for OSCC from Jan to Dec 2021. Health-related QoL was evaluated using the 30-item Cancer Quality of Life Questionnaire (QLQ-C30) and the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-H&N35). The demographic questionnaire and clinical parameters were also presented. Results: The functioning scale in the QLQ-C30 questionnaire with the lowest average score was Global health status. The mean QLQ-C30 summary score (80.92 ± 10.4) was higher than the Global health status score (50.5 ± 22.2). In the QLQ-H&N35 questionnaire, the symptoms with highest scores were weight loss, dry mouth, and social eating. Linear regression analysis demonstrated that Global health status score was associated with education level [β-coefficient = 19.33 (95% CI: 10.7-24.9, P=0.004], alcohol consumption [β-coefficient=10.04 (95% CI: 4.5-14.8), P=0.023] and invasive surgical procedure [β-coefficient=22.75 (95% CI: 15.0-30.5), P=0.002]. The QLQ-C30 summary score was associated with living alone [β-coefficient= -20.05 (95% CI: −29.91-(−10.21), P=0.018], smoking status [β-coefficient=4.35 (95% CI: 1.8-6.91), P=0.043] and alcohol consumption [β-coefficient =4.59 (95% CI: 1.99-7.19), P=0.037]. Conclusion: We found several significant predictors of worse perception of HRQoL among patients with OSCC, which may be useful for specific prevention and treatment in order to achieve better QoL.   https://ijph.tums.ac.ir/index.php/ijph/article/view/29466 https://ijph.tums.ac.ir/index.php/ijph/article/download/29466/8167

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 335 347 Mohammed Muneer Alareqi School of Public Health, Lanzhou University, Lanzhou, China Lina Alshoaibi School of Stomatology, Lanzhou University, Lanzhou, China Yanli Liu School of Public Health, Lanzhou University, Lanzhou, China Sushma Dhital School of Public Health, Lanzhou University, Lanzhou, China Benzhong Zhang School of Public Health, Lanzhou University, Lanzhou, China 2022 05 14 2023 01 31 Background: In humanitarian crises, water, sanitation and hygiene interventions are critical for the survival of people. However, strong evidence-based information is still limited. In order to describe the quantity and quality of current evidence, we conducted an evidence gap map provides a visual overview, highlighting areas lacking evidence. Methods: According to developed inclusion and exclusion criteria, a systematic literature search was conducted to find related systematic reviews and meta-analyses. The databases, including PubMed, Web of Science, SCOPUS and Cochrane were searched using search strings from 2000 until 2021. Characteristics of the included reviews were extracted and summarized. Two persons evaluated methodological quality independently using the AMSTAR tool. Invite a third person to solve any discrepancies. Results: This study revealed seven systematic reviews, including one meta-analysis. One study was of high quality, four of medium, and two of low quality. A total of 272 primary studies were included with a median value of 38.8 (range, 6-106) which deeply analyzed for data extraction. Cross-sectional, case-control, and qualitative case studies were the most used study designs. Diarrheal diseases were the most reported outcomes representing 46% of the impact evaluations. Cholera outbreaks account for 43% of a crisis context. The research gaps were insufficient reporting of some interventions with related outcomes and the geographical distribution of current evidence. Conclusion: There is a limitation in current evidence represented by a lack of high-quality and experimental studies investigate the impact of water, sanitation and hygiene (WaSH) interventions on health and behavioral outcomes in humanitarian sittings.   https://ijph.tums.ac.ir/index.php/ijph/article/view/28742 https://ijph.tums.ac.ir/index.php/ijph/article/download/28742/8159

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 425 432 Gulshara Berdeshova Department of General Hygiene, West Kazakhstan Medical University named after M. Ospanov, Aktobe, Kazakhstan Aiman Mussina Department of Public Health and Epidemiology, Astana Medical University, Nur-Sultan, Kazakhstan Lyazat Orakbay Department of Public Health, Kazakh-Russian Medical University, Almaty, Kazakhstan Aidana Tolegenova Department of Health Policy and Management, Kazakh National Medical University named after S.D. Asfendiyarov, Al-maty, Kazakhstan Saya Zhorabek Department of Health Policy and Management, Kazakh National Medical University named after S.D. Asfendiyarov, Al-maty, Kazakhstan Assel Amanova Department of Public Health and Hygiene, Astana Medical University, Nur-Sultan, Kazakhstan Shynar Kulbayeva Department of Clinical Disciplines, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan 2022 10 31 2023 04 26 Background: We aimed to study the rate and trends of the incidence of chronic cardiovascular diseases in urban and rural areas of the northern regions of the Republic of Kazakhstan (RK) from 2015 to 2020. Methods: The retrospective data were analyzed using modern methods of biomedical statistics. We used the Electronic Register of Dispensary Patients (2015-2020), where we conducted a retrospective study and trend calculations. The study included patients with chronic cardiovascular diseases (CVD) (according to the International Classifier of Diseases-10, the following nosologies were identified: I25 chronic coronary heart disease and its nosological forms (I25.0-I25.9), and patients by age categories, consisting of dispensary registration in polyclinics of the northern region of the RK. Results: For 2015 - 2020 in the northern region (urban and rural) of RK, 12,315 patients were registered, who were on dispensary records for the chronic CVD. This amounted to 87.3% of urban residents, and 12.7% of rural residents. The share of patients with chronic CVD in the northern region of the republic by age groups had a bimodal growth pattern with the first peak at the age of 60-74 (40.4%) and the second - at the age of 45-59 (37.7%). Conclusion: This study notes an increase in chronic CVD, both in urban and rural areas of the northern region of the RK. This once again proves the need for the development, implementation and use of modern tools in the provision of medical services to cardiological patients at the outpatient level, taking into account the characteristics of the northern regions of our country. https://ijph.tums.ac.ir/index.php/ijph/article/view/30270 https://ijph.tums.ac.ir/index.php/ijph/article/download/30270/8168

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 433 442 Mohammad-Reza Mohajeri-Tehrani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Seyyed Amirsina Alemzadeh Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Abbaszadeh Marzbali Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Sadaf Nasserisina Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Hosnan Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Ameneh Naghghash Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran Amir Ali Hamidieh Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Behfar Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Fariba Mohseni Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Hoda Rashidian Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Sara Shirazi Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Maryam Aboee-Rad Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Mostafa Qorbani Non-Communicable Diseases Research Center, Alborz University of Medical Science, Karaj, Iran Bagher Larijani Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran Zohreh Hamidi Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 2022 12 06 2023 03 29 Background: Beta-thalassemia major patients frequently have endocrinopathies. We tried to determine relation between demographic and transfusion factor and endocrinopathies. Methods: Major beta-thalassemia patients (n=114 cases), 3–38 yr of age, entered this study. Female to male ratio was 51/63. Children (less than 20 yr) formed 57% of participants. Information about bone mineral density (BMD) and hormonal and biochemistry blood evaluation including fasting blood sugar (FBS), ferritin, triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testosterone (males), and estradiol (females) entered data sheet. Results: Sex and ferritin level showed no significant correlation with above disorders. Age significantly correlated to short stature, diabetes, low BMD at femur and neck (P, 0.031, 0.008, 0.009 and <0.001, respectively). The risk of short stature had increased in 12 yr and older patients 7.71 times than younger patients (P= 0.008). The risk of diabetes had increased in 35 yr and older patients 26.25 times than younger patients (P= 0.03).  The risk of Z-score ≤ -2 in femoral region has increased in 19 yr and older patients 5.84 times than younger patients (P= 0.002). The risk of Z-score ≤ -2 in spinal region has increased in 14 yr and older patients 17 times than younger patients (P= 0.007). Conclusion: The main factor related with endocrinopathies was age. The correlation between age and short stature, diabetes and low BMD was positive. Therefore, we recommend early monitoring of thalassemia patients (in their late childhood and early teenage) for these complications.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30593 https://ijph.tums.ac.ir/index.php/ijph/article/download/30593/8169

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 443 452 EN Morvarid Zarif-Yeganeh Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mahboobeh Khabaz Mafinejad Health Professions Education Research Center, Education Development Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran Niayesh