Comparison of Competitive Models of Metabolic Syndrome Using Structural Equation Modeling: A Confirmatory Factor Analysis

BACKGROUND: The purpose of this study was to apply the structural equation modeling (SEM) to compare the fitness of different competing models (one, two, and three factors) of the metabolic syndrome (MetS) in Iranian adult population. METHODS: Data are given on the cardiometabolic risk factors of 841 individuals with nondiabetic adults from a cross-sectional population-based study of glucose, lipids, and MetS in the north of Iran. The three conceptual hypothesized models (single factor, two correlated factors, and three correlated latent factors) were evaluated by using confirmatory factor analysis with the SEM approach. The summary statistics of correlation coefficients and the model summary fitting indexes were calculated. RESULTS: The findings show that a single-factor model and a two-correlated factor model had a poorer summary fitting index compared with a three-correlated factor model. All fitting criteria met the conceptual hypothesized three-correlated factor model for both sexes. However, the correlation structure between the three underlying constructs designating the MetS was higher in women than in men. CONCLUSION: These results indicate the plausibility of the pathophysiology and etiology of MetS being multifactorial, rather than a single factor, in a nondiabetic Iranian adult population.

Effects of Regular Treadmill Exercise on a DNA Oxidative-Damage Marker and Total Antioxidant Capacity in Rat Hippocampal Tissue

BACKGROUND AND PURPOSE: Regular exercise can result in changes in the levels of oxidative stress in the hippocampus; however, little attention has been paid to physical-activity-induced neuronal protection to exposure to lead compounds. This study investigated the effects of regular treadmill exercise on a DNA oxidative-damage marker [8-hydroxy-2'-deoxyguanosine (8-OHdG)] and the total antioxidant capacity (TAC) of hippocampal tissue in lead-acetate exposed rats. METHODS: This study investigated the effects of 8 weeks of regular treadmill exercise on 8-OHdG and the TAC of hippocampal tissue in lead-acetate-exposed rats. Wistar rats were randomly divided into four groups: baseline, sham (control), lead, and exercise+lead. The exercise program involved running on a treadmill with increasing intensity five times a week for 8 weeks. Animals in the lead and exercise+lead groups received lead acetate at 20 mg/kg body weight intraperitoneally three times weekly for 8 weeks. Animals in the sham group received solvent (ethyl oleate) at 30 mg/kg body weight three times weekly for 8 weeks. TAC and 8-OHdG were measured by spectrophotometric and ELISA techniques, respectively. Data were analyzed by ANOVA and Tukey's post-hoc test with a significance cutoff of p≤0.05. RESULTS: The level of 8-OHdG and the TAC were significantly higher and lower, respectively, in the lead group than in the baseline and sham groups (p<0.01). However, the 8-OHdG level and TAC value in hippocampal tissue were significantly decreased and increased, respectively, in the exercise+lead group relative to the lead group (p<0.05). CONCLUSIONS: The TAC of hippocampal tissue may be directly associated with neural protection mechanisms of exercise following lead acetate injection, and the beneficial effects of regular exercise in preventing hippocampal neuronal damage could be due to decreased hippocampal oxidative stress such as reflected by a lower 8-OHdG level and increased TAC.

Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment

Background: The use of assisted reproductive technology [ART] is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection [ICSI], single fresh embryo transfer [ET] and frozen-thawed embryo transfer [FET]

Objective: The objective of this study was to compare pregnancy rate in fresh ET and FET

Materials and Methods: In this retrospective cross-sectional study 1014 ICSI-ET cycles [426 fresh ET and 588 FET] from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed

Results: There were no significant differences between biochemical pregnancy rate [23% versus 18.8%, OR 1.301; 95% CI .95-1.774], gestational sac [95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67], and fetal heart activity [87.2% versus 93.6% OR .46; 95% CI .16-1.32] in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures

Conclusion: Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET

Awareness, attitude, and practice of Breast Cancer screening women, and the associated Socio-Demographic characteristics, in Northern Iran

Background: Breast cancer is the most common malignancy among women, with a high rate of mortality. The burden of disease and its serious outcome could be prevented by early detection

Objectives: Thus, the objective of this study was investigation the awareness, attitude and practice of breast cancer screening women

Patients and Methods: This cross-sectional study has conducted on 500 representative samples of women aged 20 - 65 years who referred to urban area of Babol health centers in 2012. The data have collected with standard questionnaire. The demographic data, the knowledge of risk factors and symptoms and sign, the health belief, and the practice of women in breast cancer screening have collected by interview

Results: The results show that only 14.8% of participants had a high level of knowledge for breast cancer risk factors and 33.8% at high level of awareness of symptoms and signs. The level of awareness has significantly associated with higher age [P = 0.03] and higher educational level [P = 0.04]. Only 10.2% and 8.4% of women have performed breast self- examination [BSE] monthly and breast clinical examination [BCE] annually respectively. The practice of women with BSE has significantly associated with aging [P = 0.005], higher educational level [P = 0.007], higher knowledge [P = 0.001] and positive attitude toward perceived benefits and confidence and health motivation [P = 0.001]

Conclusions: The low level of awareness and practice of breast cancer screening have found in this study, emphasized an extension of framework health educational program, particularly in younger and low educated women

Trend of stillbirth rates and the associated risk factors in Babol, northern Iran

Stillbirth is an important public health concern and its rate indicates the sanitary development of society. The purpose of this study is to determine the trend of stillbirth rates and its risk factors in Babol. A retrospective study was conducted based on the data of hospital charts of two major Gynecological wards in Shahid Yahyanejat and Babol clinic hospitals in Babol, Northern Iran. In the first phase, the frequencies of stillbirths and live birth deliveries were collected for the period of 1999-2008. In the second phase, a case-control study of 150 stillbirths cases and 300 live births as controls was conducted. The risk factors data included maternal age, gestational age, gravity, history of stillbirth, abortion, diabetes mellitus, preeclampsia, fetal sex, residence area, birth interval and prenatal care. The odds ratio for risk factors with 95% confidence interval for stillbirths was calculated using the logistic regression model. Stillbirth rate was reduced significantly from 10.51 in 1999 to 8.57 per 1000 deliveries in 2008 [p=0.001]. A significant association was found between preterm delivery [p=0.001] and preeclampsia [p=0.01] with stillbirths. Although the proportion of stillbirths was higher among mothers with history of diabetes, abortion and maternal age of more than 35 years, the odds ratio was not statistically significant. There is a relationship between stillbirth, preterm delivery and preeclampsia. Thus, we can considerably prevent stillbirths with sanitary remedial interference on these risk factors

discriminatory performance of body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio for detection of metabolic syndrome and their optimal cutoffs among Iranian adults

The superiority of either of body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and waist-to-height ratio [WHtR] for prediction of metabolic syndrome [MetS] is remained controversial in Asian population. The objective of this study was to compare the discriminative capacity of either of these measures in prediction of non-adipose components of MetS. In this population-based cross sectional study, 1000 representative samples of adults were recruited in Babol, northern Iran. The demographic, anthropometric measures and blood pressure were determined by standard method. Fasting plasma glucose [FPG], triglycerides [TG], total cholesterol [CHL], high density lipoprotein [HDL] cholesterol levels were measured with enzymatic methods by an auto analyzer. The presence of two or more any of four non-obese components were considered as MetS. The diagnostic accuracies [AUCs] of four different measures were rather similar. While AUC for BMI [AUC=0.684; 95% CI: 0.633, 0.736] slightly tended to be higher than that of WC [AUC=0.640; 95% CI: 0.587, 0.693] and WHtR [AUC=0.649; 95% CI: 0.596, 0.701] in men but the accuracy of WC [equivalently WHtR [AUC=0.708; 95% CI: 0.664, 0.751] is tended to be greater than that of BMI in women. The optimal cut-off value for WC was higher in men compared with women. Overall, BMI, WC and WHtR were significant predictors of MetS equally but WC [equivalently WHtR] was a better predictor than BMI and WHR in women. The optimal cut-offs of WC are lower compared with western population for men but not for women

comparison between international obesity task force and center for disease control references in assessment of overweight and obesity among adolescents in Babol, Northern Iran

This study compares the Center for Disease Control [CDC] and International Obesity Task Force [IOTF] references in assessment of overweight and obesity among Iranian adolescents. The data of this study was drawn from a cross sectional study of a representative sample of 1200 adolescents aged 12-17 years in Babol, northern Iran. A standard procedure was used to measure height and weight and the body mass index was calculated. Each subject was classified as overweight and obese based on IOTF cut off values of BMI and CDC references BMI percentile sets by age and sex. The kappa coefficients were estimated for the degree of agreement. In assessment of obesity/overweight prevalence, the CDC and IOTF references produced a similar estimate by age group and sex. The maximum differences was about 1% and the kappa coefficients was 0.96 to 1 [P = 0.001]. While for assessment of obesity, the CDC reference produced slightly a higher rate of obesity and the difference in prevalence between the two sets of references was ranged from 1.4% to 3.2% with kappa coefficients: 0.90 to 0.70 [P = 0.001] depending on the age group and sex and a greater difference was observed among younger age group. The findings suggest an excellent agreement between the TOTF and CDC references in assessment of overall overweight/ obesity prevalence among adolescent boys and girls. While in assessment of obesity prevalence alone the degree of agreement between the two sets of references slightly diminished. Overall, the two references are comparable and the agreement varies a little with respect to age and sex

Comparison of maternal and neonatal serum leptin levels in preeclampsia and normal pregnancy

Leptin is a protein product of obesity gene and is synthesized mainly by adipose tissue. The aim of this study was to determine maternal and neonatal serum leptin levels in term preeclamptic and normal pregnancies. This cross sectional study was performed on 37 preeclamptic and 40 normotensive term pregnant women without other disease. Serum level of leptin was measured in all of pregnant mothers and after delivery, their neonates. This study was performed in Babol Yahyanejad Hospital from March 2006 to December 2006. Infants with preeclamptic mothers had significantly lower leptin level than control group [p=0.02]. There was no significant difference in serum leptin levels between normal and preeclamptic women [p=0.749]. According to the results, it would be concluded that leptin level in infants of preeclamptic mothers is lower than infants of normal mothers. This can only confirm the diagnosis of disease after birth but it cannot predict the preeclampsia

Comparison of the effect of azelaic acid 20% and clindamycin 1% in the treatment of mild and moderate acne

Topical antimicrobials, such as clindamycin, are effective in the treatment of acne and azelaic acid, due to the lack of bacterial resistance, could be a useful alternative in topical treatment of acne. The aim of this study was to compare the effect of topical azelaic acid 20% with clindamycin 1% lotion for the treatment of acne. This randomized clinical trial study was performed on 108 patients with mild and moderate acne. Patient were randomly assigned to one of the two groups of treatment with azelaic acid 20% cream [50 patients] or clindamycin 1% lotion [58 patients]. The patients were evaluated by grading and lesion counting methods before treatment and one month and two months after the treatment. The mean age of the patients in clindamycin group and azalic acid was 19. 6 +/- 3. 9 and 20. 3 +/- 4. 5 years, respectively [P=0. 41]. The mean score of acne severity decreased after treatment according to grading and lesion counting methods [P<0. 05]. Reduction of acne severity score between two group was not significant in second and third visit compared to before treatment [P>0. 05]. Result showed that the azelaic acid 20% topical cream was as effective as clindamycin 1% lotion for treating mild to moderate acne

[Birth intervals and associated factors in multi-para women residing in Babol, northern Iran]

Birth spacing has become a main strategy within health promotion programs for mothers and their children during the past two recent decades in the Islamic Republic of Iran. The present study was aimed to determine the patterns and factors associated with birth intervals in Multi-Para women residing in Babol. We conducted a cross-sectional study with samples consisting of 500 Multi-Para women, who were referred to the hospital and the Health Center for delivery in Babol, Northern Iran, during 2007. The data was collected using a designed questionnaire, including birth intervals between index child and prior, demographic and fertility variables, such as maternal education, maternal age at birth of index child, sex before index child, still birth, child status before index child, parity, duration of breast feeding, residence area, contraception methods, and attending family planning clinic. The data was analyzed using the logistic regression model. The mean [SD] of birth intervals was 61 +/- 25.7 months. Birth interval in 3.8% of mothers was less than 2 years and 41.7% of mothers had 4 to 6 years, while 28% had >/= 6 years. In the majority of women, [76.8%] pregnancies were from 20 to 34 years of age. In spite, pregnancy was observed in 22.4% cases in age 35 or over, while 0.8% of pregnancies were in the age range less than 20 years. Maternal age, duration of breast feeding, child sex before index child, still birth, history of infant mortality before index child, type of contraception, attending family planning clinics and parity showed a significant relation with birth intervals. Maternal age, parity, duration of breastfeeding, still birth, history of infant mortality, attending family planning clinics and using modern contraceptive methods are shown to be determinants of birth intervals. Although our findings indicated that in the majority of Multi-Para women, birth intervals was within the accepted range previously recommended by the Ministry of Health in Iran, over a quarter of women had birth intervals of >/= 6 years. Due to increasing maternal age associated with high risk pregnancies [aged > 35years] by long birth intervals, it is necessary to revise educational programs for prevention of long birth intervals, that would induce the subsequent pregnancies in becoming high risk

effect of human recombinant erythropoietin on prevention of anemia of prematurity

Premature infants often develop significant anemia that requires blood transfusion, this carries significant risks. This study was carried out to determine the effect of recombinant human erythropoietin [r-HuEPO] on prevention of anemia of prematurity. From April 2001 to March 2002, 24 neonates in newborn services at Amirkola children's hospital randomly were assigned to erythropoietin group and control [no treatment] group. Inclusion criteria were birth weight of

effect of topical application of human milk, ethyl alcohol 96% and silver sulfadiazine on umbilical cord separation time in newborn infants

Several agents have been used for neonatal umbilical cord care, but we did not find any study evaluating the effect of human milk on umbilical cord separation time. The purpose of this study was to compare the effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants. This study was undertaken place at a primary-level newborn nursery at a university teaching hospital and a private hospital. Of 373 singleton near- to full-term newborns enrolled in the study, 312 completed the study. Newborns from birth were randomized to either: 1] mother's milk group, 2] alcohol group, 3] silver sulfadiazine group, and 4] control [no treatment] group. Mother's milk for group 1, ethyl alcohol for group 2, and silver sulfadiazine ointment for group 3 were applied to the umbilical stump three hours after birth and continued every eight hours until two days after umbilical cord separation. The time to umbilical cord separation and any discomfort such as infection, hemorrhage, and granuloma formation were reported by mothers. Nothing was applied to the umbilical stump of the control group and they received dry cord care only. It was observed a significant difference in the mean cord separation time among the four group. No significant complications were observed in any group. Breast milk could be substituted for other topical agents for umbilical cord care, but a multicenter study is required in order to advise it for routine umbilical cord care