The Association Between Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Symptoms in Medical Students.

ABSTRACT: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are the two most prevalent neurodevelopmental disorders affecting communication and behavior. The co-occurrence of these conditions is probable and can contribute to several challenges in adaptive functioning and academic achievement.In this cross-sectional study, 168 Iranian medical students (107 female, 61 male) studying at Tehran University of Medical Sciences in 2021 were enrolled. We administered the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) and Adult ADHD Self-Report Scale (ASRS) questionnaires online to assess different symptoms of ASD and ADHD in our sample. In this study, the RAADS-R was translated into Persian and validated for the first time in Iran.The correlation tests demonstrated a significant association between the total score and different subscales' scores of the RAADS-R and the total score and the two subscales' scores of the ASRS questionnaire ( p < 0.001, 0.27 < Spearman correlation coefficient < 0.51). This study also illustrated a high prevalence of ASD and ADHD symptoms among the participants. Moreover, male respondents had a significantly higher prevalence of ASD symptoms (57.3% in males vs . 28.03% in females, p < 0.001).This study indicated that the distinct impairments in behavior and cognition attributed to ASD and ADHD could be common manifestations in medical students. Given that the co-occurrence of these disorders may lead to significant challenges in their professional life, the early diagnosis and subsequent support for medical students with co-occurring expressions of ASD and ADHD could be extremely helpful, as it could indirectly improve the medical services provided to patients by future physicians, leading to an improvement in public health.

Antimicrobial investigation on the multi-state outbreak of salmonellosis and shigellosis in Iran.

Background: Foodborne diseases are caused by indigestion of contaminated food. In some cases they may result in either hospitalization or death. The Centers for Disease Control (CDC) and Prevention in 2017 stated that 10% reduction in foodborne illness would prevent nearly five million illnesses every year. Approximately one out of six Americans become ill from contaminated foods or beverages every year. Another problem is drug resistance which is responsible for approximately 2 million illnesses and around 23000 dead every year. Nearly 400,000 Americans acquire antibiotic-resistant Salmonella or Campylobacter each year. The aim of this study was to evaluate the outbreak of salmonellosis and shigellosis along with their antibiotic susceptibility patterns in different provinces of Iran. Methods: Over a period of 2 years from 2015 to 2016, a total of 1055 cases in 249 outbreaks reported in 20 provinces of Iran, as a part of surveillance by the National Institute of Health (NIH). The stool samples of patients were taken and tested for Salmonella spp. and Shigella spp. by conventional standard techniques. Disk diffusion was used for the antibiotic sensitivity test. Results: Of 1055 cases, 118 (11.2%) contained Shigella and 74 (7%) contained Salmonella. Antibiotic susceptibility tests showed that entirely 100% of Salmonella and Shigella isolates were susceptible to ciprofloxacin; whereas 12.2% of Salmonella and 98.2% of Shigella were resistant to cotrimoxazole. Conclusion: Our results show that there is a need for more food handling practices to minimize the exposure of consumers to Salmonella and Shigella , at all points along the distribution chain.

Structural equation modeling analysis of Iranian womens food consumption: influence of socio-demographic characteristics and the information, motivation, and behavioral skills model / Análise de modelagem de equações estruturais do consumo alimentar de mulheres iranianas: influência das características sociodemográficas e do modelo de Informação, motivação e habilidades comportamentais

ABSTRACT Objective This study aimed at examining whether food consumption varies in accordance with socio-demographic and behavioral factors in the conceptual model, analyzing adult women in Tehran, Iran, for that purpose. Methods This cross-sectional study was conducted with 247 women in childbearing age, who were selected through systematic cluster sampling from five regions in Tehran. Dietary assessment was done through a Food Frequency Questionnaire, and the anthropometric indices were measured. Data on socio-economic status and information-motivation-behavioral skills model were obtained through a questionnaire. Then, subjects were stratified according to the socio-economic status and model components. Statistical analysis was done using analysis of variance and structural equation modeling. Results Consumption of food groups among the participating women differed based on their living region, education, occupation, household expenditure, and model components (p<0.05). Intake of red and processed meat (p<0.05) was at the lowest level in illiterate or low educated women. Those with lower total expenditure had higher consumption of fats and oils (p<0.05). Women with higher perceived social support consumed more milk and dairy products (p<0.05), fats and oils (p<0.05), and less bread and cereals (p<0.05). Model components including information, attitude, social support, self-efficacy, and self-regulation were the most important factors negatively affecting the consumption of unhealthy foods (red and processed meat, fats and oils, sugar, and salty foods). Conclusion Considering the impact of model components on women's eating behaviors, the specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions targeting the promotion of healthy nutritional behavior.

RESUMO Objetivo Este estudo buscou examinar se o consumo de alimentos varia de acordo com fatores sociodemográficos e comportamentais no modelo conceitual entre mulheres adultas em Teerã, Irã. Métodos Este estudo transversal foi conduzido em 247 mulheres em idade reprodutiva, selecionadas por amostragem sistemática por conglomerados de cinco regiões de Teerã. A avaliação da dieta foi realizada por meio de um questionário de frequência alimentar, e os índices antropométricos foram medidos. Os dados sobre o status socioeconômico e o modelo de habilidades de informação-motivação-comportamento foram obtidos através de um questionário. Em seguida, os sujeitos foram estratificados conforme o status socioeconômico e os componentes do modelo. A análise estatística utilizou análise de variância e modelagem de equações estruturais. Resultados O consumo de grupos de alimentos entre as mulheres participantes diferiu de acordo com a região onde vivem, educação, ocupação, gasto familiar e componentes do modelo (p<0,05). A ingestão de carne vermelha e processada (p<0,05) foi mais baixa entre mulheres analfabetas ou com baixa escolaridade. Aquelas com menor gasto total apresentaram maior consumo de gorduras e óleos (p<0,05). Mulheres com maior apoio social percebido consumiram mais leite e derivados (p<0,05), gorduras e óleos (p<0,05) e menos pão e cereais (p<0,05). Os componentes do modelo, incluindo informação, atitude, apoio social, autoeficácia e autorregulação, foram os fatores mais importantes que afetaram negativamente o consumo de alimentos não saudáveis (carne vermelha e processada, gorduras e óleos, açúcar e alimentos salgados). Conclusão Considerando o impacto dos componentes do modelo nos comportamentos alimentares das mulheres, as estratégias de integração específicas delineadas para cada construto do modelo podem ser utilizadas para projetar intervenções baseadas em modelos visando promover um comportamento nutricional saudável.

Consistency between Sweat Rate and Wet Bulb Globe Temperature for the Assessment of Heat Stress of People Working Outdoor in Arid and Semi-arid Regions.

BACKGROUND: Heat stress is common among workers in arid and semi-arid areas. In order to take every preventive measure to protect exposed workers against heat-related disorders, it is crucial to choose an appropriate index that accurately relates environmental parameters to physiological responses. OBJECTIVE: To investigate the consistency between 2 heat stress and strain indices, ie, sweat rate and wet bulb globe temperature (WBGT), for the assessment of heat stress of people working outdoor in arid and semi-arid regions in Iran. METHODS: During spring and summer, 136 randomly selected outdoor workers were enrolled in this study. Using a defined protocol, the sweat rate of these workers was measured 3 times a day. Simultaneously, the environmental parameters including WBGT index were recorded for each working station. RESULTS: The level of agreement between sweat rate and WBGT was poor (κ<0.2). Based on sweat rate, no case exceeding the reference value was observed during the study. WBGT overestimated the heat stress in outdoor workers compared to sweat rate. CONCLUSION: It seems that the sweat rate standards may need some modifications related to real condition of work in arid and semi-arid regions in Iran. Moreover, it seems that judging workers solely based on monitoring their sweat rate in such regions, can probably result in underestimation of heat stress.

The cut-off point for tympanic temperature as a heat strain index for evaluation of outdoor workers: a field study.

OBJECTIVES: The aims of this study were (a) to assess the agreement coefficient between tympanic temperatures and the most popular and valid heat stress index, wet bulb globe temperature (WBGT), in outdoor environments; (b) to determine a cut-off point for tympanic temperature as a heat strain index for evaluation of outdoor workers. METHODS: 1452 measurements of WBGT index and tympanic temperature were recorded for outdoor workers from nine different climatic regions. Consistency of the WBGT and tympanic temperature were tested. The cut-off point for tympanic temperature in outdoor environments regarding WBGT evaluation was suggested based on obtained sensitivity and specificity from a receiver operating characteristic curve. RESULTS: The results showed that there were numerous situations in which WBGT exceeded the reference value, whilst the measured values of tympanic temperature rarely reached a permissible value for core temperature (38 °C). Therefore, appropriate consistency of results between the heat stress and strain indices was not achieved. CONCLUSION: The criterion of tympanic temperature equaling 37 °C was suggested as a cut-off point for tympanic temperature as a heat strain index for outdoor environment evaluation.

Determination of Air Enthalpy Based on Meteorological Data as an Indicator for Heat Stress Assessment in Occupational Outdoor Environments, a Field Study in IRAN.

BACKGROUND: Heat stress evaluation and timely notification, especially using meteorological data is an important issue attracted attention in recent years. Therefore, this study aimed at answering the following research questions: 1) can enthalpy as a common environmental parameter reported by meteorological agencies be applied accurately for evaluation of thermal condition of outdoor settings, and 2) if so, what is it's the best criterion to detect areas in stress or stress-free situations, separately. METHODS: Nine climatic regions were selected throughout Iran covering a wide variety of climatic conditions like those, which exist around the world. Three types of parameters including measured (ta, RH, Pa and WBGT), estimated (metabolic rate and cloth thermal insulation), and calculated parameters (enthalpy and effective WBGT) were recorded for 1452 different situations. Enthalpy as a new indicator in this research was compared to WBGT in selected regions. RESULTS: Altogether, a good consistency was obtained between enthalpy and WBGT in selected regions (Kappa value: 0.815). Based on the good ROC curve obtained using MedCal software, the criterion of the values more than 74.24 for the new index was determined to explain heat stress situation for outdoor environments. CONCLUSIONS: Because of simplicity in measurement, applicability of the indicator for weather agencies, the consistency observed between enthalpy and a valid as well as accurate index (WBGT), sensor requirements which take only a few seconds to reach equilibrium and so on, enthalpy indicator can be introduced and applied as a good substitute for WBGT for outdoor settings.

Technical Efficiency of Hospitals in Tehran, Iran.

BACKGROUND: Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran. METHODS: This research was a descriptive-analytical and retrospective study conducted in 2014-2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique. RESULTS: Seventeen (31/48) of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency. CONCLUSION: Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended.

Beneficial Effects of Coenzyme Q10 Supplementation on Lipid Profile and Intereukin-6 and Intercellular Adhesion Molecule-1 Reduction, Preliminary Results of a Double-blind Trial in Acute Myocardial Infarction.

BACKGROUND: The present investigation was aimed to improve the inflammatory factors and lipoproteins concentration in patients with myocardial infarction (MI) by supplementation with coenzyme Q10 (CoQ10). METHODS: In a double-blind, placebo-controlled study, we measured serum concentrations of one soluble cell adhesion molecules (intercellular adhesion molecule-1 [ICAM-1]), serum concentration of intereukin-6 (IL-6) and lipid profiles (high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], total cholesterol and triglyceride [TG]) in CoQ10 supplementation group (n = 26) compared with placebo group (n = 26) in hyperlipidemic patients with MI. Fifty-two patients were randomized to receive 200 mg/day of CoQ10 or placebo for 12 weeks. RESULTS: There were no significant differences for serum LDL-C, total cholesterol, and TG between two mentioned groups after the intervention. A significant enhancement in serum HDL-C level was observed between groups after the intervention (55.46 ± 6.87 and 44.07 ± 6.99 mg/dl in CoQ10 and placebo groups, respectively P < 0.001). Concentrations of ICAM-1 (415.03 ± 96.89 and 453.38 ± 0.7 ng/dl CoQ10 and placebo groups, respectively, P = 0.001) and IL-6 (11 ± 9.57 and 12.55 ± 8.76 pg/ml CoQ10 and placebo groups, respectively P = 0.001) in serum were significantly decreased in CoQ10 group. CONCLUSIONS: Supplementation with CoQ10 in hyperlipidemic patients with MI that have statin therapy has beneficial effects on their aspects of health.

Outdoor occupational environments and heat stress in IRAN.

BACKGROUND: The present study aimed at demonstrating the heat stress situation (distribution and intensity) based on a standard and common heat stress index, Wet Bulb Globe Temperature (WBGT), during hot seasons and interpret the obtained results considering global warming and rising temperature in different parts of the country based on climate changes studied in Iran. METHODS: Heat stress assessment was done using WBGT index. Environmental parameters were measured simultaneously in the early, middle and end of shift work. The personal parameters including cloth thermal insulation and metabolic rate of 242 participants from 9 climatic categories were recorded for estimating effective WBGT (measured WBGT plus cloth adjustment factor as well as metabolic rate effect). The values of the indicator were categorized in the statistical software media and then linked to the climatic zoning of the data in the GIS information layers, in which, WBGT values relating to selected stations were given generalization to similar climatic regionalization. RESULTS: The obtained results showed that in the summer about 60 % and more than 75 % of the measurements relating to 12 pm and 3 pm, respectively, were in heat stress situations (i.e. the average amount of heat stress index was higher than 28 °C). These values were found to be about 20-25 % in the spring. Moreover, only in the early hours of shift work in spring could safe conditions be seen throughout the country. This situation gradually decreased in the middle of the day hours and was replaced by the warning status and stress. And finally, in the final hours of shift work thermal stresses reached their peaks. These conditions for the summer were worse. CONCLUSIONS: Regarding several studies related to climate change in Iran and the results of present study, heat stress, especially in the central and southern parts of Iran, can be exacerbated in the decades to come if climate change and rising temperature occurs. Therefore, paying attention to this critical issue and adopting macro-management policies and programs in the field of workplace health is essential.

Air monitoring of aromatic hydrocarbons during automobile spray painting for developing change schedule of respirator cartridges.

In the absence of End of Service Life Indicator (ESLI), a cartridge change schedule should be established for ensuring that cartridges are changed before their end of service life. Factors effecting service life of cartridges were evaluated, including the amount of atmospheric contamination with aromatic hydrocarbon vapors in the workplace, temperature, and relative humidity of the air. A new change schedule was established based on comparing the results of air monitoring and workplace conditions, laboratory experiment, and the NIOSH MultiVapor software. Spray painters were being exposed to aromatic hydrocarbons in a range exceeding occupational exposure limits. The cartridge change schedule was not effective and could no longer provide adequate protection against organic contaminants for sprayers. Change schedules for respirator cartridges should be reduced from 16-24 hours to 4 hours. NIOSH's service life software program could be applied to developing cartridge change schedules.

Effects of coenzyme q10 supplementation on serum lipoproteins, plasma fibrinogen, and blood pressure in patients with hyperlipidemia and myocardial infarction.

BACKGROUND: Low plasma concentrations of coenzyme Q10 (CoQ10) have been associated with concentration of lipoproteins and other factors contributing to coronary heart diseases. OBJECTIVES: The present investigation aimed to improve the blood pressure and serum lipoproteins concentration in patients with myocardial infarction (MI) by CoQ10 supplementation. PATIENTS AND METHODS: In this randomized double-blinded controlled clinical trial, 52 Iranian patients with hyperlipidemia and MI were recruited to examine the effect of CoQ10 on serum total cholesterol (TC), LDL-C, HDL-C, triglyceride (TG), LDL-C/HDL-C ratio, TC/HDL-C ratio, fibrinogen, systolic blood pressure (SBP) and diastolic blood pressure (DBP). Individuals were randomly allocated to two groups for receiving either 200 mg/d of CoQ10 or placebo for 12 weeks. RESULTS: There were not significant differences in serum LDL-C (2.70 ± 0.31 vs. 2.70 ± 0.35 mmol/L), TC (4.47 ± 0.33 vs. 4.93 ± 0.57 mmol/L), TG (2.48 ± 0.12 vs. 2.25 ± 0.69 mmol/L), and fibrinogen (2.08 ± 0.99 vs. 38.7 ± 0.64 mg/dL) between CoQ10 and placebo groups. After 12 weeks, a significant enhancement in serum HDL-C (1.44 ± 0.18 vs. 1.14 ± 0.18 mmol/L) level was observed between groups after the supplementation (P < 0.001). A significant reduction of TC, LDL-C, and fibrinogen and a significant increase in HDL-C concentration was observed in CoQ10 group after intervention (P < 0.001). Our assessment demonstrated statistically significant differences between the two groups in SBP and DBP after intervention (P < 0.001). ANCOVA also revealed significant differences in the ratio of LDL-C/HDL-C and TC/HDL-C between the two groups (1.89 ± 0.42 vs. 2.39 ± 0.38, P = 0.002; and 3.2 ± 0.5 vs. 4.24 ± 0.66, P = 0.01, respectively). A significant reduction of LDL-C/HDL-C and TC/HDL-C was observed in CoQ10 group (P < 0.001). CONCLUSIONS: Twelve-week supplementation with CoQ10 in patients with hyperlipidemia and MI can improve blood pressure, serum HDL-C as well as LDL-C/HDL-C and TC/HDL-C ratios; therefore, it might decrease the risk of frequent MI.