[Correlation between menarcheal age and certain demographic characteristics]

The first occurrence of menstruation [or periods] is called menarche and it is a vital event during puberty in girls. Various studies show a downward trend in menarcheal age over the last hundred years. Many factors can influence age at menarche. The aim of this study was to determine the correlation between menarcheal age and certain demographic characteristics, in female residents of district 13, Tehran Lipid and Glucose Study. In this longitudinal descriptive, conducted within the framework of the Tehran lipid and glucose study, subjects were 402 girls, aged 12 and 18 years, whose menarche had not begun at the initiation of the study, but it did during their follow-up. In order to collect data, questionnaires previously completed in the TLGS were used. Validity and reliability of the questionnaire confirmed in previous studies. Various factors including maternal age at menarche, maternal education, maternal occupation, body mass index, physical activity, energy expenditure and exposure to tobacco smoke were examined. Findings showed that the mean age at menarche was 13.06 +/- 1.24 years in this study. There were significant statistical associations between body mass index [P=0.002, r=-0.04], mother's age at menarche [P<0.001, r=0.66] and maternal education [P=0.027, r=0.25] and the subjects age at menarche. However there was no significant association between age at menarche, with mother's occupation, passive smoking, physical activity and energy expenditure. It seems that BMI, mother's menarcheal age and maternal education are factors that influence the age at menarche

[Leisure-time physical activity and its association with metabolic risk factors in Tehranian adults: TLGS]

Leisure-time physical activity [LTPA], as a lifestyle-related behavior, could be a preventive factor for metabolic syndrome [MetS]. We aimed to examine the association between LTPA and MetS among the adults who participated in the Tehran Lipid and Glucose Study [TLGS]. In the present cross-sectional study, 4665 adults [1976 males and 2686 females], aged 20-70 years, were selected by multi-stage random cluster sampling from among TLGS participants. Subjects were classified according to their BMI. LTPA was determined via a validated and Modifiable Activity Questionnaire [MAQ], and MetS, according to the JIS criteria. Prevalence of the MetS was higher in obese groups [58.2%] compared to the overweight [36.6%] and normal weight [6%] ones [p<0.001]. Normal weight subjects [18.1%] were physically more active than other groups. In the normal weight group with light LTPA, the risk of lower levels of HDL-C and elevated levels of TG were higher than in individuals with vigorous LTPA [OR: 1.15; CI95% 1.05, 2.33] [OR: 1.46; CI95% 1.01, 2.14]. In the overweight group, the probability of elevated levels of FBS was higher among individuals with moderate LTPA than in those with vigorous LTPA [OR: 1.65 CI95% 1.37, 3.23], and there was also an inverse association between light LTPA and MetS [OR: 2.08; CI95% 1.03, 4.21]. This study confirmed that increased levels of LTPA are associated with a decreased likelihood of any inappropriate changes in components of Mets and the occurrence of Mets

[Impact of diabetes, hyperlipidemia, smoking and other risk factors on survival time of the elderly participants in the Tehran lipid and glucose study. a 10-year follow-up]

Introduction: In the rapidly increasing elderly population of Iran, no prospective health studies have yet been undertaken. This study was conducted to identify the risk factors of survival time of elderly Tehranians, aged above 60 years

Materials and Methods: Individuals aged above 60 years old [n=929], recruited in the primary phase [1998-2001] of the ongoing Tehran Lipid and Glucose Study [TLGS], were followed up for 10 years and their vital statistics were documented [1998-2008]. Age and sex mortality rates for age groups [60-69, 70-79, 80+] were calculated and the hazard rates were estimated using Cox proportional hazard model

Results: Of 929 males, 154 [17%] and out of 869 women 85[10%] died during the follow-up years. Cox model showed that diabetes, on an average, reduced 2.5 years and 4.4 years, while smoking reduced 6.6 and 5 years of females' and males' survival time, respectively. BMI>33Kg/m2 and dyslipoproteinemia reduced 4.5 years and 4 years of women's life spans, respectively. Native Tehranian males on an average, live 3 years less than other male residents; in addition, hypertension and history of MI, stroke or sudden death of father, brother or son reduced 3.3 years and 4.1 years of men's life time respectivly

Conclusion: Elderly women with BMI>33 Kg/m2 and/or smokers and/or with dyslipoproteinemia are more in need of health care, while among their male countery parts elderly diabetic men and/or smokers and/or those who have history of MI, stroke or sudden death of a father, brother or son also need more attention

Physical inactivity and related factors in an adult Tehranian population [Tehran lipid and glucose study]

Physical activities represent an independent risk factor for a number of chronic diseases. The aim of this study was to assess physical inactivity in a sample of Tehranian adults. We selected 7285 TLGS participants [>/= 20 years], who had completed physical activity questionnaires between 2002-2004. Leisure time physical activity level was assessed using the modifiable Activity Questionnaire [MAQ], with each activity being weighted by its relative intensity, referred to as a Metabolic Equivalent [MET]. Subjects were asked to report the activities they had participated in during past 12 months and to estimate the frequency and duration for each leisure time activity indentified and were categorized into the active and inactive groups. The overall prevalence of inactivity was 69.8% and only 30.2% [95%CI=27.2-33.1%] of males and 30.3% [95%CI=27.7-32.8%] of females were considered active. In males, the prevalence of inactivity increased with age and the highest rate of physical inactivity was observed in the 40-49 year group. There was a statistically significant decrease in leisure time physical activity level [LTPA] with increasing body mass index, and smoking and hours of work. A positive association was observed between LTPA and high educational levels in males. Moreover, a statistically significant difference was found between the physical activity and occupations between men and women [p<0.05]. Findings of the present study showed that a high prevalence of physical inactivity among Tehranian adults, raising concerns about public health, and necessitating health policies encouraging the population to be more active

Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study

This study is the first report on the prevalence of coronary heart disease [CHD] and its associated risk factors in adult residents of Tehran. Standard supine ECG data were collected for 5984 men and women aged > /= 30 years and coded by Minnesota criteria. All major cardiovascular risk factors were also measured. Based on Rose angina, self-reported history of CHD or ECG-defined CHD, the aged-adjusted prevalence of CHD was 21.8% [22.3% in women and 18.8% in men]. Variables independently associated with CHD were female sex, age, systolic blood pressure, 2-hour postprandial glucose, body mass index, waist-to-hip ratio and LDL/HDL cholesterol ratio

knowledge of pediatric intensive care unit staffs regarding pulse oximetry

Pulse Oximeter monitoring technology has become so common in intensive health care settings over the last decade that blood oxygen level is now considered as the fifth vital sign. However, it seems that medical and nursing staffs are not specially educated to operate with the devices. The aim of the study was to investigate the knowledge of medical assistants [residents], nurses and anesthesia technicians of pediatric intensive care units regarding Pulse Oximetery. This is a cross-sectional study. The study population consisted of all nurses, first year to third year medical assistants, and anesthesia technicians who working in intensive care units in Pediatric Center. A questionnaire was used for data gathering that had three sections: the first section as demographic data [occupational condition, record of service in pediatric unit, having the experience of using Pulse Oximetery, having enough knowledge about Pulse Oximetery, and its educational program type]; the second section [eighteen short answer questions] in order to determine the participants knowledge about Pulse Oximetery and the third section [four imaginary clinical scenarios] evaluating the participants interpretation on Pulse Oximetery reports and its changes in patients. The collected data were analyzed through descriptive and inferential statistics [Fisher exact test] by SPSS v.15 and EPI6 computer softwares. The analyses showed that 77.4% of the participants did not pass any educational course regarding Pulse Oximetery, also 67.9% of them correctly identified what Pulse Oximeter measures, and 47.2% of the subjects correctly identified how a Pulse Oximeter works, and 13.2% identified its normal range, but only 26.4% had a correct understanding of the Oxhemoglobin dissociation curve and explained it completely true. It was found that the majority of the participants were wrong in their answers about Pulse Oximeter monitoring. They made mistakes in interpretation of the imaginary clinical scenarios. The results of the study showed that the majority of pediatric intensive care unit staffs have little knowledge regarding Pulse Oximeter monitoring, then with attention to the vast usage of the technology the necessity of formal educational programs in colleges and retraining courses during employment about the device for health care providers is apparent

[Study of the general mental health status in an area of Tehran: Tehran lipid and glucose study [TLGS]]

There are significant correlations between the mental health status of individuals and non-communicable mental or physical diseases. Epidemiological data regarding mental health indices plays an important part in the planning and designing of mental health programs. This study was conducted to evaluate the general mental health status of inhabitants in an area of Tehran as part of the TLGS. Materials and Method: In this cross-sectional study, 927 residents [20 years and older] of a specific area were randomly selected. Subjects completed the demographic data forms alongwith the General Health Questionnaires [GHQ], validated for the Iranian population. A cut off of 6 and above was used as threshold to identify the group suspected of having psychiatric disorders. To compare the scores of total GHQ and subscales between different demographic variables, the Chi square, Mann whitney and Kruskal wallis test were used. Logistic regression was used to identify variables related to the group that scored above threshold. The total sample studied consisted of 927 adults, of whom 401 [43.3%] were males and 526 [56.7%] females. Among them 489 [52.8%] were suspected of having psychiatric disorders. Mean score of total GHQ was 7.0 +/- 5.4 and regarding the subscales of the questionnaire including physical symptoms, anxiety and sleep disorders, social dysfunction and depression, mean scores were 1.2 +/- 1.7, 1.7 +/- 2.0, 3.4 +/- 2.0, 0.75 +/- 1.4 respectively and the median of mentioned subscales were 0, 1, 3 and 0 respectively. Frequency of women suspected of mental disorders was significantly higher than that of men [59.7% vs. 43.6%, p<0.001]. Taking into consideration the sample group and the method of gathering data, the frequency of those suspected of having psychiatric disorders in our study was higher as compared to other studies. Since mental health plays an important role in health promotion and community development, as well as the financial and psychological burden of illnesses, inplementation of policies in regard to implementation of related programs for prevention especially in women, seems vital

[Investigation of relation between dwell time of peripherally intravenous catheters in hospitalized neonates and children]

Peripherally intravenous catheters [PIVs] are an important part of therapy for hospitalized children. Although such catheters provide necessary vascular access, their use puts patients at risk for local and systemic infectious complications with serious morbidity. Migration of skin organisms at the insertion site into the cuetaneous catheter tract with colonization of the catheter tip is the most common route of infection for peripherally inserted catheters in adults but in children this is controversial. The objective of this study is to find any relationship between colonization and catheter-related consequences. In a descriptive cross-sectional study, 108 catheters of children and neonates hospitalized in NICU and infectious ward of Markaz Tebby Kodakan were cultured at a 2-month period. For all cases, a questionnaire of demographic characteristics and information about catheterization including location, dwell time, drugs and total parental nutrition was filled. The condition of catheterization for all cases was the same. Presence of only one colony was considered as positive colonization. Finally the data were analyzed by SPSS software. Excluding one case because of positive blood culture, from 107 catheters, 36 were colonized [33.6% of cases]. Coagulate negative staphylococcus was the most common pathogen seen in 50% of total positive cases. Although there was a clinically significance between the dwell time of catheter and colonization but there was not any statistical significant association between colonization and any other variables including sex, age, hospitalization time, ward, location of catheter, dwell time, infusion of parental nutrition, and the administered drug. This study is consistent with guidelines of CDC about avoiding unnecessarily routine replacement of catheters in neonates and children. As the risk of infection did not increase in association with dwell time of peripheral venous catheters, it seems it is better to leave catheters in place until there is a sign of local infection or infiltration

Distribution of non-HDL-cholesterol among Tehranian children and adolescents: Tehran lipid and glucose study

Serum Low-Density-Lipoprotein Cholesterol has long been used as an important assessment tool to predict the risk of coronary artery diseases, but due to certain limitations in the use of this index, it has been shown recently that Apo lipoprotein B is a better screening tool. Non-HDL cholesterol [total cholesterol minus HDL-C] includes all the lipoprotein particles, which contain Apo lipoprotein B, and could be a good screening tool for Apo lipoprotein B during CAD assessment and treatment. This study aims at assessing the distribution and correlation of non-HDL-C and related factors in a population of Tehranian children and adolescents. The study sample consisted of 4298, 3-19 year-olds, [2019 boys[47%] and 2279 girls[53%]] who had participated in the first phase of the Tehran Lipid and Glucose Study [TLGS], from 1998-2000. Anthropometric and clinical data were collected for analysis. Non-HDL-C levels were higher in girls than in boys of the same age groups, especially among the younger [3-4 year-olds] age groups. Body mass index and waist circumference were positively associated with non-HDL-C. Both non-HDL-C and LDL-C were strongly associated with each other and total cholesterol [r[2] = 0.81and p < 0.001]. Non-HDL-C and LDL-C are were associated with triglycerides, but the strength of this correlation with triglycerides was relatively weaker as compared to that with total cholesterol. Non-HDL-C showed a significant inverse relationship to HDL-C [r[2] = 0.01, p < 0.01]. It was also seen that non-HDL-C had a stronger correlation to BMI and body fatness indicies. Population based data on non-HDL-C are now available for children and adolescents, which may help improve the CAD risk assessment and related interventions

[Assessment of changes in lipid levels after 3 years Tehran lipid and glucose Study]

The purpose of the study was to assess changes in total cholesterol, LDL-C, HDL-C, non HDL-C and triglyceride levels over a 3-year period in subjects enrolled in the Tehran Lipid and Glucose Study. A total of 1839 males and 2553 females, aged 3 years and over, were included in this study. Baseline demographic characteristics and lipid levels were determined GTT was performed at baseline and after 3 years in subjects >/=20 years age. In both sexes, BMI and WHR, [waist-hip ratio], increased significantly from baseline. Mean BMI at baseline was 24.7 +/- 5.8, which in phase 2, rose to 26.0 +/- 5.6 kg/m2 [p=0.001]. In phase one, 32 and 18.6% of all subjects and in phase two, 34 and 23.4% respectively were overweight and obese [p=0.05]. Prevalence of impaired glucose tolerance, [IGT], and Diabetes mellitus increased in phase 2 of the study. 13% of all subjects in phase 1 had IGT and 11.4% had diabetes these statistics increased to 14.2 and 12.3% respectively in phase 2. In phase 2, systolic and diastolic blood pressure, mean cholesterol, LDL-C, HDL-C, non HDL-C and triglycerides decreased significantly from baseline levels. In phases one and two, 5.1% and 7.6% of subjects respectively were unaware of their diabetes. There is a high prevalence of cardiovascular risk factors, such as overweight, obesity, low HDL-C, IGT and diabetes in the urban population of Tehran. It was seen that although mean total cholesterol, LDL-C, non-HDL-C, TG, SBP and DBP decreased significantly after 3 years, IGT, DM, overweight, obesity and Low HDL-C increased from baseline values

[Non-communicable disease risk factors in children of parents with an ECG evidence of myocardial infarction Tehran lipid and glucose Study]

The aim of this study was to assess non-communicable disease risk factors in children of parents with an ECG evidence of myocardial infarction [MI], and compare them with children from families with no such parental history. Of 15005 participants in the Tehran Lipid and Glucose Study, all individuals over the age of 30 years underwent routine ECG exams. Among these, 303 off springs aged 3-30 years, who had one or two parents with possible or probable myocardial infarction [MI] according to the Minnesota coding were selected. An age and sex-matched sample of 601 off springs who had no parental evidence of ECG-defined MI were randomly selected as the control group. Risk factors studied were: BMI, blood pressure, FBS, total cholesterol, HDL-C, LDL-C, triglycerides and the metabolic syndrome. A "paternal" and "parental" history of MI was associated with a higher prevalence of overweight and obesity, respectively, [34.9% vs. 24.8%] and a lower prevalence of high blood pressure, [12.2% vs. 18.1%], in their off springs. Likewise, in male children of fathers or both parents with ECG evidence of MI, a lower prevalence of hypertension was noticed, Compared with the control group, in female children of mothers with a history of MI,a higher prevalence of elevated serum LDL-C was found [28.0% vs. 10.7%] [p<0.05]. Paternal MI was associated with increased prevalence of higher body mass indices [BMI] in their off springs [OR=1.6 95% CI: 1.1-2.4p<0.05]. There is a significant familial correlation between paternal history of MI and overweight and obesity in their offspring