Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study / 한국역학회지

OBJECTIVES@#Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). @*METHODS@#In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. @*RESULTS@#The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. @*CONCLUSIONS@#The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study / 한국역학회지

OBJECTIVES@#Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). @*METHODS@#In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. @*RESULTS@#The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. @*CONCLUSIONS@#The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.METHODS: Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.RESULTS: The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).CONCLUSIONS: Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES@#We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.@*METHODS@#Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.@*RESULTS@#The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).@*CONCLUSIONS@#Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models. METHODS: Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS: The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02). CONCLUSIONS: Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.METHODS: Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of follow-up was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.RESULTS: During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.CONCLUSIONS: These results suggest that PA is inversely associated with AF in women.

Decomposing gender disparity in total physical activity among Iranian adults / 한국역학회지

OBJECTIVES: While gender differences in physical activity (PA) have been reported, their origin is not well understood. The present study aimed to identify factors contributing to this disparity.METHODS: This was a population-based cross-sectional study based on the 2011 surveillance of risk factors of non-communicable diseases that was conducted among Iranian adults. Multi-staged sampling was performed to obtain the required study sample. The primary outcome was gender differences in the prevalence of sufficient physical activity (SPA). Total physical activity (TPA) was calculated as metabolic equivalents (MET) per minute during a typical week, as recommended by the World Health Organization. On this basis, achieving 600 MET-min/wk or more was defined as SPA. The nonlinear Blinder-Oaxaca decomposition technique was used to explain the disparity.RESULTS: The predicted gap was 19.50%. About one-third of the gap was due to differences in the level of observable covariates. Among them, work status contributed the most (29.61%). A substantial portion of the gap remained unexplained by such differences, of which about 40.41% was related to unobservable variables. The differential effects of standard of living, ethnicity, and smoking status made the largest contribution, accounting for 37.36, 35.47, and 28.50%, respectively.CONCLUSIONS: Interventions to reduce the gender gap in PA should focus on increasing TPA among housewives and women with chronic diseases, as well as those with a higher standard of living. In addition, it is essential to explore the impact of ethnicity and smoking status on women's TPA in order to promote health.

Avoidable Burden of Risk Factors for Serious Road Traffic Crashes in Iran: A Modeling Study / 예방의학회지

OBJECTIVES: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. METHODS: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. RESULTS: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. CONCLUSIONS: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

Decomposing gender disparity in total physical activity among Iranian adults / 한국역학회지

OBJECTIVES: While gender differences in physical activity (PA) have been reported, their origin is not well understood. The present study aimed to identify factors contributing to this disparity. METHODS: This was a population-based cross-sectional study based on the 2011 surveillance of risk factors of non-communicable diseases that was conducted among Iranian adults. Multi-staged sampling was performed to obtain the required study sample. The primary outcome was gender differences in the prevalence of sufficient physical activity (SPA). Total physical activity (TPA) was calculated as metabolic equivalents (MET) per minute during a typical week, as recommended by the World Health Organization. On this basis, achieving 600 MET-min/wk or more was defined as SPA. The nonlinear Blinder-Oaxaca decomposition technique was used to explain the disparity. RESULTS: The predicted gap was 19.50%. About one-third of the gap was due to differences in the level of observable covariates. Among them, work status contributed the most (29.61%). A substantial portion of the gap remained unexplained by such differences, of which about 40.41% was related to unobservable variables. The differential effects of standard of living, ethnicity, and smoking status made the largest contribution, accounting for 37.36, 35.47, and 28.50%, respectively. CONCLUSIONS: Interventions to reduce the gender gap in PA should focus on increasing TPA among housewives and women with chronic diseases, as well as those with a higher standard of living. In addition, it is essential to explore the impact of ethnicity and smoking status on women's TPA in order to promote health.

The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women. METHODS: Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of follow-up was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates. RESULTS: During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men. CONCLUSIONS: These results suggest that PA is inversely associated with AF in women.

Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study / 한국역학회지

OBJECTIVES: The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality. METHODS: Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model. RESULTS: Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality. CONCLUSIONS: This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.

Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran / 한국역학회지

OBJECTIVES: Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012. METHODS: The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs. RESULTS: Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries. CONCLUSIONS: This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Occupational exposure of a medical school staff to formaldehyde in Tehran

Cadavers are preserved in a fixing solution containing formalin. Formaldehyde [FA] released from formalin is inhaled by the personnel in the anatomy laboratory. Exposed personnel have reported respiratory problems and various symptoms. Due to the toxicity of FA as a strong irritant and carcinogen and also lack of a national study assessing occupational exposure to FA in gross anatomy labs in Iran, the present study aimed at occupational monitoring of personnel exposed to FA and evaluating relevant symptoms in them. A total of 20 subjects [all the staff] working in a gross anatomy lab and 20 library personnel were considered for occupational monitoring of exposure to FA during three months with various climatic conditions. They were also monitored for respiratory symptoms. Air sampling and analysis of its FA content were conducted according to the NIOSH method No.2016. Symptoms of cases and controls [library personnel] with active and passive exposure to formaldehyde were also studied by a self-report questionnaire. In the first stage of monitoring with ventilation [supply-exhaust] system on, the exposure of personnel [Mean +/- SE] was 306 +/- 21ppb. In the second stage of monitoring the personnel's exposure was 317 +/- 26ppb with only the ventilation supply system on and in the final monitoring stage this rate was 698 +/- 34ppb with the ventilation system [supply and exhaust] off. In this study, personal's exposure level to FA was higher than the indoor concentration, and the individual exposure levels of instructors were higher than those of the students. Exposure of library personnel in the adjacent department [central library] was about 50ppb. Most important complaints reported by actively exposed staff members and library personnel were the unpleasant odor [68%], cough [64%], throat irritation and runny nose [56%], burning and itching of nose [52%] and irritating eyes [48%]. Considering the level of exposure of all subjects in this study and existence of clinical symptoms, better control of the exhaust system in the gross anatomy lab and use of a more efficient ventilation system are recommended to protect the staff and instructors of the Anatomy Department

[Pattern of internet use in high school students and its safety in Tehran]

Internet is one of the most important tools to information access. Pattern of internet use in high school students and its safety in Tehran was studied. By stratified sampling all of 19 education districts were divided to three areas [North, Centre, and South]. A cross-sectional study was conducted on 552 subjects according to subjects' distribution in each region. Questionnaire was validated by content validity and reliable by test- re- test. Trained interviewers collected data after provided written informed consent. Mean age of subjects was 16.4 +/- 1.704,range [14-19] years. Pattern of internet use showed that: the most usable cite was music [45.3%] and favorite cites was image [41.7%] among subjects.43% of subject were familiar to ban cites. Among 70/I% of subjects place of internet was at personal room and its location was at home [67.2%]. 28.3% of subject used from internet at night and chat room and filter breaker. A significant difference was observed in filter breaker using and banned cite among boys 43.3% than the girls 3l% and in internet using and eye pain among girls 18.1% than the boys 12.7% [p<0.001]. Near to half of subject were familiar to ban cite. According to internet using pattern received of pornographic pictures or other ban cites was probably. Safety of internet using needs to more attention by family and community

Study of risky behaviors leading to unintentional injuries among high school students in Tehran, Iran

To determine risky behaviors leading to unintentional injuries among Tehrani high school students in 2009. This cross-sectional study was carried out between October and December 2009. Out of 237,300 [185151 governmental, 52149 non governmental] Tehrany high school students in both genders, 727 subjects were selected by multistage randomized sampling. Among 20 education districts, 8 districts were selected and divided by stratified sampling into 3 areas: North, Center, and South. Data were collected by cluster random sampling in each district using the standard questionnaire of the Management Diseases Center of America, which had been validated in Iran. Subjects were healthy students aged 12-18 years. Risky behaviors including fall, burn, poisoning, and road traffic injuries were studied. The mean age of subjects was 16.8 +/- 1.2, range 12-18 years. Overall, 44% of boys and 38% of girls were exposed to risky behaviors leading to unintentional injuries. Significant differences were observed in driving without licence among boys and in governmental schools [p=0.000]. Using a motorcycle was more prevalent in the south of Tehran [p=0.000]. Significant differences were observed among boys related to poisoning substance exposure, driving without a license, motorcycle driving, and non-helmet use during motorcycle driving [p=0.000]. Approximately half of the boys and more than one-third of the girls were exposed to risky behaviors leading to unintentional injuries. Prevention of unintentional injuries caused by children's risky behaviors is crucial, particularly among boys and those from deprived areas

[ role of pupil liaisons' on traffic penalties and road traffic injuries]

To determine the role of pupil liaisons' education on social discipline promotion and road traffic injury prevention. This was a before-after interventional study on 2800 pupils randomly selected from 6 different districts of Tehran, Iran. The pupils were taught about common driving offences and were asked to note and prevent offences if their parents performed offences. Data were collected by a questionnaire for childern's performances and other demographic information. Subjects were pupils 8-15 years. The mean age of participants was 11 years. Overall, 47.7 percent of pupils were boys. Non use of seat belt [39.1%], speaking with mobile while driving [31.8%] and speeding [29.8%] were major offences as noted by pupils' liaisons. Recorded offences by traffic police before the intervention for thease families was 2789 cases. A significant differences with 17.9 percent reduction in offences were observed after intervention [2290 cases, P<0.001]. The most offences reduction were eating and drinking during driving [92.7%]. Pupil liaisons' program was effective on reduction of driving offences. The most reduction was eating or drinking during driving. All 9 common offences which were monitored by pupil liaisons' were effective on reduction of offences except for mobile speaking while driving

[Association of provisional driver licensing intervention by police with changes in incidence and severity of road traffic injuries in Iran]

This study was conducted for external evaluation of one intervention that has been carried out by traffic police. In this study the efficacy of provisional driver licensing on reducing traffic injuries and the intensity of injuries [fatal or non-fatal] was investigated. Data on traffic accidents and injuries from one year before till two years after the implementation of provisional driver licensing were obtained from traffic police data base. After data cleaning and stratification traffic injuries and mortalities, the implementation of graduate driver licensing compared in those in early years of their driving experience. Drivers under 23 years of age consisted 22.8% of total road traffic injuries [RTIs] in the year prior to the implementation of graduate driver licensing. This proportion reduced to 15.5% and 16.1% in the first and second year after implementation, respectively, among holders of provisional B1 type driver license [P<0.001]. Our findings suggested that this intervention was efficient in reduction of intensity of traffic injuries and provisional driver licensing was also efficient in reducing the crude number of traffic injuries. More interventions such as demerit points, license suspensions and vehicle confiscation might be implemented to prevent RTIs in long term

[Effect of iron supplementation on zinc and magnesium concentrations in maternal milk and plasma]

Iron in the diet can influence the absorption of certain elements including zinc [Zn] and magnesium [Mg]. In this study the effect of iron supplementation on zinc and magnesium concentrations in maternal milk and, plasma at puerperal period were evaluated. Ninety nine non anemic mothers with single pregnancy and normal delivery were randomly enrolled in two groups [iron and placebo group]; blood samples were collected at the time of delivery and also 140 mid 40 days after delivery. Milk samples were collected twice; at two weeks [transient milk] and 40 days after the delivery [mature milk]. They were supplemented orally with either 150mg ferrous sulfate or placebo from the time of delivery for 40 days. Zinc and magnesium concentrations were measured using atomic absorption spectrometry. The maternal dietary intake for zinc and magnesium were similar between two groups. Mean iron indexes [ferritin, serum iron and TIBC] were not significantly different between two groups at the time of delivery. No significant differences in Zn and Mg levels were detected in maternal milk between two groups but in plasma although there was no significant difference in plasma magnesium concentrations; The zinc concentrations was significantly [p<0.001] decreased in the group receiving iron supplementation [0.076 +/- 0.047mg/dL] compared with the group receiving placebo [0.163 +/- 0.137] until 40 days after delivery. Data from this study suggest that iron supplementation does not affect the contents of these elements in maternal milk but despite the possible improvement in body iron status, it can decrease the plasma zinc concentrations, so the zinc supplementation may be needed with iron

Does health-related quality of life predict injury event?

Unintentional injury is a leading threat to children's health. Some human factors have been determined as predictor of unintentional injury. Association between Health-Related Quality of Life [HRQOL] as a human factor an unintentional injuries is unclear. The objective of study is to examine the association between HRQOL and unintentional injuries among primary school children. This study was a cross-sectional conducted in Ahwaz, a city in Iran. Overall, 3375 children aged 6-10 years were randomly selected from primary school. HRQOL was measured by 56 items taken from seven domains of Netherlands Organization for Applied Scientific Research Academic Medical Center [TNO AZL] child quality of life [TACQOL] parent form. Parents were interviewed to collect information about incidence, cause and a brief description of injury within the past 12 months prior to the study. The response rate was 3375 of 3792 [98%]. There was a significant trend for increasing occurrence of injury with decreasing of HRQOL score [P<0.001]. Adjusted OR for injury was significantly higher in very low [2.38, 95% CI: 1.45-3.86], low [2.18, 95% CI: 1.34-3.56], and medium [1.73, 95% CI: 1.06-2.83] HRQOL groups compared to reference group [very high HRQOL]. The median of total HRQOL [P<0.001] and all its domains [P=0.017] [except autonomous functioning] was lower in injured group compared to uninjured one. This study found an association between HRQOL and unintentional injury among primary school children. This is a preliminary finding and further investigations with a well-defined analytical design are needed

Prevalence of scoliosis in female students 11-15 years of age in Ahwaz, Iran

To determine the prevalence of scoliosis in school-going children of different age groups for correct diagnosis and treatment of scoliosis. In 2004, we screened 1400 children from secondary schools in Ahwaz City, Southwestern Iran, for scoliosis. We carried out random sampling and used the necessary equipment for measurement and examination. Our results indicate that the prevalence of scoliosis was 2% among all the candidates. However, the prevalence of scoliosis among 12-year-old children was 42.9%, while, among 11 and 15-year-old children was 3.6%, showing that the prevalence of scoliosis was higher in children 12-year-olds compared with 11 and 15-year-olds. Among all the candidates, 12 had deformities, such as, lordosis and kyphosis. Our data showed a significant difference between scoliosis and deformity [p<0.001]. We also report that there was no significant relationship between hand dominance, and the weight of healthy persons compared with scoliosis subjects. The correct diagnosis and treatment in the early stages of adolescence can prevent the spread of scoliosis