Sperm retrieval in patients with klinefelter syndrome: a skewed regression model analysis

Background: The most common chromosomal abnormality due to non-obstructive azoospermia [NOA] is Klinefelter syndrome [KS] which occurs in 1-1.72 out of 500-1000 male infants. The probability of retrieving sperm as the outcome could be asymmetrically different between patients with and without KS, therefore logistic regression analysis is not a well-qualified test for this type of data. This study has been designed to evaluate skewed regression model analysis for data collected from microsurgical testicular sperm extraction [micro-TESE] among azoospermic patients with and without non-mosaic KS syndrome

Materials and Methods: This cohort study compared the micro-TESE outcome between 134 men with classic KS and 537 men with NOA and normal karyotype who were referred to Royan Institute between 2009 and 2011. In addition to our main outcome, which was sperm retrieval, we also used logistic and skewed regression analyses to compare the following demographic and hormonal factors: age, level of follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone between the two groups

Results: A comparison of the micro-TESE between the KS and control groups showed a success rate of 28.4% [38/134] for the KS group and 22.2% [119/537] for the control group. In the KS group, a significantly difference [P<0.001] existed between testosterone levels for the successful sperm retrieval group [3.4 +/- 0.48 mg/mL] compared to the unsuccessful sperm retrieval group [2.33 +/- 0.23 mg/mL]. The index for quasi Akaike information criterion [QAIC] had a goodness of fit of 74 for the skewed model which was lower than logistic regression [QAIC=85]

Conclusion: According to the results, skewed regression is more efficient in estimating sperm retrieval success when the data from patients with KS are analyzed. This finding should be investigated by conducting additional studies with different data structures

Analyzing Gensini score as a semi-continuous outcome

Background: Investigators frequently encounter continuous outcomes with plenty of values clumped at zero called semi-continuous outcomes. The Gensini score, one of the most widely used scoring systems for expressing coronary angiographic results, is of this type. The aim of this study was to apply two statistical approaches based on the categorization and original scale of the Gensini score to simultaneously assess the association between covariates and the presence and severity of coronary artery disease [CAD]

Methods: We considered the data on 1594 individuals admitted to Tehran Heart Center with CAD symptoms from July 2004 to February 2008. The participants' baseline demographic and clinical characteristics were collected, and their coronary angiographic results were expressed through the Gensini score. The generalized ordinal threshold and two-part models were applied for the statistical analyses

Results: Totally, 320 [20.1%] individuals had a Gensini score of zero. The results of neither the two-part model nor the generalized ordinal threshold model showed a significant association between Factor V Leiden and the occurrence of CAD. However, based on the two-part model, Factor V Leiden was associated with the severity of CAD, such that the Gensini score increased by moving from a wild genotype to a heterozygote [beta = 0.44; 95% CI: 0.20-0.69 in logarithm scale] or a homozygote mutant [beta = 0.70; 95% CI: 0.28- 1.12 in logarithm scale]. The proportional odds assumption was not met in our data [= 54.26; p value < 0.001]; however, a trend toward severe CAD was also observed at each category of the Gensini score using the generalized ordinal threshold model

Conclusion: We conclude that besides loss of information by sorting a semi-continuous outcome, violation from the proportional odds assumption complicates the final decision, especially for clinicians. Therefore, more straightforward models such as the two-part model should receive more attention while analyzing such outcomes

Models predicting success of infertility treatment: a systematic review

Background: Infertile couples are faced with problems that affect their marital life. Infertility treatment is expensive and time consuming and occasionally isn't simply possible. Prediction models for infertility treatment have been proposed and prediction of treatment success is a new field in infertility treatment. Because prediction of treatment success is a new need for infertile couples, this paper reviewed previous studies for catching a general concept in applicability of the models

Methods: This study was conducted as a systematic review at Avicenna Research Institute in 2015. Six data bases were searched based on WHO definitions and MESH key words. Papers about prediction models in infertility were evaluated

Results: Eighty one papers were eligible for the study. Papers covered years after 1986 and studies were designed retrospectively and prospectively. IVF prediction models have more shares in papers. Most common predictors were age, duration of infertility, ovarian and tubal problems

Conclusion: Prediction model can be clinically applied if the model can be statistically evaluated and has a good validation for treatment success. To achieve better results, the physician and the couples' needs estimation for treatment success rate were based on history, the examination and clinical tests. Models must be checked for theoretical approach and appropriate validation. The privileges for applying the prediction models are the decrease in the cost and time, avoiding painful treatment of patients, assessment of treatment approach for physicians and decision making for health managers. The selection of the approach for designing and using these models is inevitable

Socioeconomic inequalities in nonuse of seatbelts in cars and helmets on motorcycles among people living in Kurdistan province, Iran

The aim of this study was to determine the socioeconomic inequalities in nonuse of seatbelts in cars and helmets on motorcycles in Kurdistan Province, west of Iran, 2009. The data used in this study was collected from the data gathered in non-communicable disease surveillance system [NCDSS] in 2009 in Kurdistan. A total of 1000 people were included in this study. The outcome variable of this study was the nonuse of seatbelts and helmets. The socio-economic status [SES] was calculated based on participants' residential area and assets using Principal Component Analysis [PCA] method. The concentration index, concentration curve, and comparison of Odds Ratio [OR] in different SES groups were used to measure the socioeconomic inequalities using logistic regression. In order to determine the contribution of determinants of inequality, decomposition analysis was used. The prevalence of nonuse of seatbelts in cars and helmets on motorcycles were 47.5%, 95%CI [44%, 55%], respectively. The Concentration index was -0.097, CI [-0.148, -0.046]. The OR of nonuse of seatbelts in cars and helmets on motorcycles in the richest group compared with the poorest group was 0.39, 95%CI [0.23, 0.68]. The results of the decomposition analysis showed that 34% of inequalities were due to SES, 47% were due to residential area, and 12% were due to unknown factors. There is a reverse association between SES and nonuse of seatbelts in cars and helmets on motorcycles. This issue must be considered while planning to reduce traffic accidents injuries

Adherence and attrition in a web-based lifestyle intervention for people with metabolic syndrome

The aim of this study was to determine adherence and attrition rates in a lifestyle intervention for people with metabolic syndrome. Adherence and attrition data from a randomized controlled trial were collected. Participants were classified as adherence group if they completed assessments at 3 and 6 months follow-up and as attrition group if they did not. Physical activity and quality of life was measured using the International Physical Activity Questionnaire [IPAQ] and the Short Form Health Survey [SF-36]. Generalized Estimating Equations [GEE] was used to explore predictors of attrition. The mean age of participants [n=160] was 44.1 years. Attrition rate in the intervention and control groups at first follow-up were the same [20%]. However, the control group had significantly higher attrition rate [%33.7] compared to the intervention group [%20] at 6 months follow up. Results showed that low educated participants were more likely to not stay in the study than better educated participants [OR=2.95,CI:1.39-6.33,P=0.05]. According with length of the study, attrition was decreased at six month [OR=0.66,CI:0.52-0.83,P<0.001]. Also, some aspects of health-related quality of life contributed to the attrition rate. Those who had higher scores on general health [OR=0.66,CI:0.54-0.97,P=0.023], social functioning [OR=0.44,CI:0.40-0.76,P=0.032], role emotional [OR=0.74,CI:0.54-0.98,P=0.18], vitality [OR=0.55,CI:0.38-0.90,P=0.015] and mental health [OR=0.63,CI:0.45-0.85,P=0.033] were more likely to stay in the study. It remains a concern that Web-based lifestyle programs may fail to reach those who need it most. Participant in the study generally had better quality of life than those who were lost to follow up

Social network size estimation and determinants in Tehran province residents

Network scale-up is an indirect method for estimating the size of hidden, hard-to-count or high risk populations. Social network size estimation is the first step in this method. The present study was conducted with the purpose of estimating the social network size of the Tehran Province residents and its determinants. Maximum Likelihood Estimation was applied to estimate people's network sizes by using populations of known sizes and the scale-up method. Respondents were selected from Tehran province through convenience sampling in 2012. Out of thirteen selected subpopulations with known size, ten had minimum accuracy which used in our analysis. Of the 1029 respondents in this study, 46.7% were male. The social network size of Tehran Province residents was estimated to be 259.1 [CI[95%]: 242.2, 276] based on the ten known populations remained in this study. This size was 291.8 in men and 230.4 in women. Younger people [18-25 years old] had larger network sizes compared to the other age groups [P<0.001]. Our estimation for social network size of Tehran inhabitants was smaller than that previously estimated size for the whole country [c=380]. In addition, we found that the social network of subpopulations was different. This difference means that we need local estimations for sub-populations to improve the accuracy of population size estimation using network scale up method

Histopathologic and sonographic analysis of laparoscopic removal ovarian nonendometriotic cyst: the evaluating effects on ovarian reserve

Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts [17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts] underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger teratomas and more parenchyma inadvertently removed during their excision [1.64, 0.255] reduced AFC was seen and in simple serous cysts with more removed parenchyma amount [1.5] reduced AFC occurred. In our study simple cysts excision led to a loss in AFC that was not associated with any other cyst parameters. Mucinous cysts resection led to no specific ovarian reserve damage. Laparoscopic cystectomy for non-endometriosis leads to reduced ovarian reserve

Multi-state survival analysis in renal transplantation recipients

Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models. This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multistate models. During 4.06 years [median] of follow-up; 28 [6.9%] recipients died and allograft failure occurred in 51 [12.6%] recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure [HR=0.38; 95% CI: 0.17- 0.87], pre-transplant hypertension [HR=2.94; 95% CI: 1.54- 5.63] and serum creatinine levels >1.6 upon discharge from the hospital [HR=7.38; 95% CI: 3.87- 7.08] increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly [HR=0.18; 95% CI: 0.04- 0.93]. It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type

Application of capture-recapture for fine-tuning uncertainties about national maternal mortality estimates

Maternal mortality ratio [MMR] is one of the main indicators of the millennium development goals and its accurate estimation is very important for the countries concerned. The objective of this study is to evaluate the applicability of capture-recapture [CRC] as an analytical method to estimate MMR in countries. We used the CRC method to estimate MMR in Iran for 2004 and 2005, using two data sources: The maternal mortality surveillance system and the National Death Registry [NDR]. Because the data registry contains errors, we defined three levels of matching criteria to enable matching of cases between the two systems. Increasing the matching level makes the matching criteria less conservative. Because NDR data were missing or incomplete for some provinces, we calculated estimates for two conditions: With and without missing/incomplete data. According to the CRC method, MMR in 2004 and 2005 were 33 and 25 in the best-case scenarios respectively and 86 and 59 in the worst-case scenarios respectively. These estimates are closer to the ones reported by United Nations Agencies published in 2010, 38 and Hogan's study, 30 in 100,000 live births in 2005. The MMR estimation by CRC method is slightly different from the international studies. CRC can be considered as a cost-effective method, in comparison with cross-sectional studies or improvement of vital registration systems, which are both costly and difficult. However, to achieve accurate estimates of MMR with CRC method and decrease the uncertainty we need to have valid databases and the absence of such capacities will limit the applicability of this method in developing countries with poor quality health databases

Modifiable lifestyle risk factors and metabolic syndrome: opportunities for a web-based preventive program

Lifestyle is recognized as a key factor as the cause and management of the metabolic syndrome. The aim of this study was to identify individuals at increased cardiovascular diseases risk and determine main features of lifestyle of participants with metabolic syndrome via internet. The study was conducted from Jun 22 to August 22, 2012 in Tehran, Iran. Recruitment was carried out through the study website. Participants with metabolic syndrome who were interested and met the study criteria were invited for free clinic visits and clinical assessments. Baseline measurements were metabolic syndrome risk factors. Physical activity and dietary intake were measured by international physical activity questionnaire [IPAQ- short form] and the frequency food questionnaire [FFQ] respectively. Metabolic syndrome was defined according to Adult Treatment Panel III diagnostic criteria. Mean [SD] age for men and women were 41.9 [10.4] and 48.1 [7.8] yr respectively. Men were well educated and more likely to participate in the study than women. Men with metabolic syndrome had larger waist circumference [105.5] and lower BMI [29.1] than women with metabolic syndrome [P<0.001]. Approximately 73% of the sample was inactive and 3% of participants had health enhancing physical activity. There were significant differences in the intakes of total fat and cholesterol between men and women [P<0.001]. Because of the high prevalence of metabolic syndrome, national lifestyle modification policies must be developed for population. Web-based healthy lifestyle programs may contribute to the reduction of the metabolic syndrome components

Factors affecting the survival of patients with gastric cancer undergone surgery at Iran cancer institute: univariate and multivariate analyses

Gastric cancer is the most prevalent cancer among men and the third most prevalent cancer among women in Iran. Its most important reason for death is its belated diagnosis at the advanced stages of the disease. Various factors can be effective on the survival of these patients after surgery, which are the major concern in this study. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995 to 1999 were analyzed. The Survival Time of patients was determined after surgery and the effect of individual and demographic; clinical and diagnostic; and treatment and post-surgical factors on patients' survival was studied. For data analysis, Kaplan- Meier, Log-Rank test and Proportional Hazards Model were used. The median of survival time was 16.33 months. The one-year, three-year, and five-year survival rates were, 0.66, 0.31, and 0.21. Based on univariate analysis results of age[P<0.001], metastases[P=0.012], disease stage[P=0.016], and number of renewed treatments[P<0.001], as well as multivariate analysis which was used to investigate the simultaneous effect of influencing variables on patients' survival showed that age[61-70:HR=1.40,>70:HR=2.08], marital status[HR=0.39], number of renewed treatments[1:HR=0.54,2:HR=0.30,3:HR=0.22], relapse[HR=1.51], type of gastrectomy [Subtotal: HR=1.12, Distal:HR=0.49, Partial:HR=0.94, Proximal:HR=0.52], liver metastases [HR=1.79], distance metastases[HR=1.84], and disease stage[II:HR=1.28,III:HR=2.12,IV:HR=1.90] variables had a significant effect on patients' survival. Patients who call on doctors in early stages of disease will have a higher survival rate due to early diagnosis whereas disease progression will increase the risk and will decrease the survival. Identifying factors affecting patients' survival and improving diagnostic methods can prevent disease progression and increase survival rate

Socioeconomic inequality of non-communicable risk factors among people living in Kurdistan province, Islamic republic of Iran

The most fundamental way to decrease the burden of noncommunicable diseases [NCDs] is to identify and control their related risk factors. The goal of this study is to determine socioeconomic inequalities in risk factors for NCDs using concentration index based on Non-Communicable Disease Surveillance Survey [NCDSS] data in Kurdistan province, Islamic Republic of Iran in 2005 and 2009. The required data for this study are taken from two NCDSSs in Kurdistan province in 2005 and 2009. A total of 2,494 persons in 2005 and 997 persons in 2009 were assessed. Concentration index was used to determine socioeconomic inequality. To assess the relationship between the prevalence of each risk factor and socioeconomic status [SES], logistic regression was used and odds ratio [OR] was calculated for each group, compared with the poorest group. The concentration index for hypertension was -0.095 [-0.158, -0.032] in 2005 and -0.080 [-0.156, -0.003] in 2009. The concentration index for insufficient consumption of fruits and vegetables was -0.117 [-0.153, -0.082] in 2005 and -0.100 [-0.153, -0.082] in 2009. The concentration index for the consumption of unhealthy fat and oil was -0.034 [-0.049, -0.019] in 2005 and -0.108 [-0.165, -0.051] in 2009. The concentration index for insufficient consumption of fish was -0.070 [-0.096, -0.044] in 2005. The concentration index for physical inactivity was 0.008 [-0.057, 0.075] in 2005 and 0.139 [0.063, 0.215] in 2009. In all the cases, the OR of the richest group to the poorest group was significant. Hypertension, insufficient consumption of fruits and vegetables, consumption of unhealthy fat and oil, and insufficient consumption of fish are more prevalent among poor groups. There was no significant socioeconomic inequality in the distribution of smoking, excess weight, and hypercholesterolemia. Physical inactivity was more prevalent among the rich groups of society in 2009. The reduction of socioeconomic inequalities must become a main goal in health-care policies

Effect of family structure and behavioral and eyesight problems on caries severity in pupils by using an ordinal logistic model

Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft / DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7-4.4 and high as dmft/DMFT>4.4. The Cochran-Armitage test and ordinal logistic regression were employed for data analysis. Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems [OR=2.37, 95% CI: 1.29-4.38] and girls [OR=1.6, 95% CI: 1.22-2.06] were higher than in other categories. In addition, pupils with eyesight problems [OR=0.58, 95% CI: 0.37-0.90] and overweight pupils [OR=0.46, 95% CI: 0.31-0.71] had lower caries severity than others. The effects of parents' education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity [P>0.05]. Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries

Comparing the effects of group and home-based physical activity on mental health in the elderly

The present study focuses on comparing the effects of home based [HB] and group based [GB] physical activity on mental health in a sample of older adults in Shahr-e-kord. In this quasi-experimental study, a twice weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups [HB and GB]. The outcome, mental health, was measured with the 28 item General Health Questionnaire [GHQ 28]. Mental health status improved after participation in the physical activity program. The decrease in GHQ 28 total score in GB group, 3 months after intervention, was 3.61 +/- 2.28 [P < 0.001]. In HB group, this reduction was 1.20 +/- 2.32 during the same period [P < 0.001]. The difference of these "before-after differences" between the two groups in the GHQ 28 and all its subscales was statistically significant [P < 0.001]. Also, the effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.

Prevalence of primary infertility in Iran in 2010

Infertility is one of the most significant medical, as well as social problems that affect psychological health of families and societies. Determining the prevalence of infertility is important for evaluating the potential of fertility. There are different reports on the prevalence of infertility in Iran, but the current research employs fertility history in order to provide an unbiased estimation of primary infertility. Data from a national survey of Iranian women aged 20-40 years was used in this study in year 2011. Totally, 1011 clusters were randomly selected according to post office codes, proportional to the population of the province. We evaluated the history of fertility as the basis for gathering information. Accordingly, we designed a questionnaire. Subsequently, we recruited and trained nurses and obstetricians to call on married women to fill the questionnaires. Primary infertility refers to a condition in which couples have not been able to conceive a child after one year of unprotected intercourse. In this research, we questioned 17187 women in 1011 clusters. The mean age of the women at the time of their marriage was 20.1, and that of their husbands was 25.4 years. The mean age of women at the time of their first pregnancy was 21.1. This research revealed the prevalence of primary infertility to be 20.2% in Iran. The prevalence of primary infertility in Iran seems to be higher than the world average. Therefore, it is crucially important to support the large number of couples who face this problem

[Waiting time to visit an endocrinologist in Iran: shortage of workforce or inappropriate distribution of patients?]

Objective [s]: Shortage in human resources is an important challenge for health sector. It is the main cause of demand rationing and queues to receive services. Proper information about the present situation helps to manage queues and waiting time. This study aimed to estimate waiting time to visit an endocrinologist and provide practical solution for its management

Method: This was a cross - sectional study. Samples were selected from participants of the annual Iranian endocrinologist conference, 2008 in Tehran. Twenty four endocrinologist completed the questionnaires. The research tool was a self - administered questionnaire

Results: The study findings showed that the median and mean waiting time of endocrinologists was 15 and 30 days for first visit respectively [0 -135 days]. Number of endocrinologists' activity was the only variable that had positive correlation with waiting time [P= 0.027]. About % 41.7 of endocrinologists had the possibility of increasing their clinical working hours by 10.8 hours per week

Conclusion: Waiting time to visit an endocrinologist seems occurred due to inappropriate distribution of patients and not the shortage of workforce

Factors affecting survival of patients with oesophageal cancer: a study using inverse Gaussian frailty models

<p><b>INTRODUCTION</b>Oesophageal cancer is one of the most common causes of cancer mortality in developing countries, including Iran. This study aimed to assess factors affecting survival of patients with oesophageal cancer using parametric analysis with frailty models.</p><p><b>METHODS</b>Data on 359 patients with oesophageal cancer was collected from the Babol Cancer Registry for the period 1990-1991. By 2006, the patients had been followed up for a period of 15 years. Hazard ratio was used to interpret the risk of death. To explore factors affecting the survival of patients, log-normal and log-logistic models with frailty were examined. The Akaike Information Criterion (AIC) was used for selecting the best model(s). Cox regression was not suitable for this patient group, as the proportionality assumption of the Cox model was not satisfied by our data (p = 0.007).</p><p><b>RESULTS</b>Multivariate analysis according to parametric models showed that family history of cancer might increase the risk of death from cancer significantly. Based on AIC scores, the log-logistic model with inverse Gaussian frailty seemed more appropriate for our data set, and we propose that the model might prove to be a useful statistical model for the survival analysis of patients with oesophageal cancer. The results suggested that gender and family history of cancer were significant predictors of death from cancer.</p><p><b>CONCLUSION</b>Early preventative care for patients with a family history of cancer may be important to decrease the risk of death in patients with oesophageal cancer. Male gender may be associated with a lower risk of death.</p>

Analysis of familial aggregation in total, against-the-rule, with-the-rule, and oblique astigmatism by conditional and marginal models in the Tehran eye study

The purpose was to determine the familial aggregation of the total, against-the-rule [ATR], with-the-rule [WTR], and oblique astigmatism by conditional and marginal models in the Tehran Eye Study. Total, ATR, WTR, and oblique astigmatism were studied in 3806 participants older than 5 years from August 2002 to December 2002 in the Tehran Eye Study. Astigmatism was defined as a cylinder worse than or equal to -0.5 D. WTR astigmatism was defined as 0 +/- 19[degree sign], ATR astigmatism was defined as 90 +/- 19[degree sign], and oblique when the axes were 20-70[degree sign] and 110-160[degree sign]. The familial aggregation was investigated with a conditional model [quadratic exponential] and marginal model [alternating logistic regression] after controlling for confounders. Using the conditional model, the conditional familial aggregation odds ratios [OR] [95% confidence interval] for the total, WTR, ATRs, and oblique astigmatism were 1.49 [1.43-1.72], 1.91 [1.65-2.20], 2.00 [1.70-2.30], and 1.86 [1.37-2.54], respectively. In the marginal model, the marginal OR of the parent-offspring and sib-sib in the total astigmatism were 1.35 [1.13-1.63] and 1.54 [1.13-2.11], respectively; WTR 1.53 [1.06-2.20] and 1.94 [1.21-3.13] and; ATR 2.13 [1.01-4.50] and 2.23 [1.52-3.30]. The model was statistically significant in sib-sib relationship only for oblique astigmatism with OR of 3.00 [1.25-7.20]. The results indicate familial aggregation of astigmatism in the population in Tehran adjusted for age, gender, cataract, duration of education, and body mass index, so that the addition of a new family member affected with astigmatism, as well as having a sibling or parents with astigmatism, significantly increases the odds of exposure to the disease for all four phenotypes. This aggregation can be due to genetic and/or environmental factors. Dividing astigmatism into three phenotypes increased the odds ratios

Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire [SDQ]. The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 +/- 2.19 years. The mean total score of difficulties in participants was 14.34 +/- 5.81. According to these results 813 [17.8%] adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems [20.5%]. According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle

[Association between body mass index and socioeconomic status in female students in Kish, Iran]

Objectives: Malnutrition among adolescents is not only an important health problem but also an economic development problem in Iran and other developing countries. The home environment is found to be related to the development of malnutrition in children. Information on this relationship is important to identify the target risk groups for nutritional intervention. The objective of this study was to determine the association between socioeconomic with BMI status in Middle school adolescent girls in Kish Island

Methods: In a cross- sectional study, without sampling, 488 girl students aged 11-15 years were selected from all Kish Island Middle schools. Weight and height were measured and BMI was calculated. Weight status was determined based on the CDC 2000 reference for BMI-for-age. Data on socioeconomic factors like age, parental education, and parental job was collected through a questionnaire

Results: Father's literacy and mother's literacy had significant association with BMI status [P=0.001, P=0.06 respectively]. Analyses by chi-square and Pearson correlation tests showed mother's literacy and father's literacy were strong predictors for overweight and obesity

Conclusion: Increasing parental nutritional knowledge is necessary to initiate changes in nutritional conduct. In addition, a longitudinal study of adolescent nutrition and its associated factors is suggested