The effect of spaced learning on the learning outcome and retention of nurse anesthesia students: a randomized-controlled study.

BACKGROUND: Poor learning and retention are common problems of students, which may be alleviated by optimization of widely used educational methods such as lectures. This study aimed to investigate the effect of spaced learning on the learning outcome and retention of nurse anesthesia students. METHODS: This was a randomized controlled study with a pre-and post-test design on 64 nurse anesthesia students who were divided into two groups of spaced lecture (n = 32) and conventional lecture (n = 32). The spaced lectures included three 30-minute training sessions with 10-minute intervals while the conventional sessions including 90 min of continuous training. Students' knowledge was measured using one valid and reliable questionnaire developed by the research team. All students in both groups took a pre-test, and their level of knowledge acquisition was evaluated immediately after the training. Their level of knowledge retention was tested two and four weeks after the lecture. RESULTS: There was no significant difference between the two groups regarding demographic characteristics (p > 0.05). In the pre-test, the mean score of knowledge in the intervention group was lower than that in the control group, there was no significant difference (p = 0.177). But after the intervention, the mean scores of learning outcome and retention in the intervention group were significantly higher than those in the control group (p < 0.001, eta = 0.576). Also, the results showed that learning outcome and retention across the three academic semesters in the two groups are significantly different, and students with a higher academic semester obtained a significantly higher mean score of knowledge and retention (p < 0.001, eta = 0.604). CONCLUSION: Spaced learning improves nurse anesthesia students' knowledge and retention more than conventional method. Future studies focusing on spaced learning should specifically examine the impact of duration and number of intervals, as well as the time gap between training and measurement of learning retention.

The role of mir-197-3p in regulating the tight junction permeability of celiac disease patients under gluten free diet.

BACKGROUND: Celiac disease (CD) is a hereditary immune-mediated disorder, which is along with the enormous production of pro-inflammatory cytokines and the reduced level of tight junction proteins. The aim of this study was to determine the expression of TNF-α, IFN-γ, IL-18, Occludin, miR-122-5p and miR-197-3p genes in duodenal biopsies of treated CD patients in comparison to the controls. METHODS AND RESULTS: Biopsy specimens were taken from the duodenum of 50 treated CD patients (36 (72%) females and 14 (28%) males with mean age of 37.06 ± 7.02 years) and 50 healthy controls (17 (34%) females and 33 (66%) males with mean age of 34.12 ± 4.9). Total RNA was isolated, cDNA was synthesized and mRNA expression of TNF-α, IFN-γ, IL-18, Occludin, miR-122-5p and miR-197-3p were quantified by relative qPCR using B2M and U6 as internal control genes. All data were evaluated using SPSS (V.21) and GraphPad Prism (V.5). Our results showed that there was no significant difference between patients and controls for intestinal mRNA expression of TNF-α, IFN-γ, IL-18, Occludin, and miR-122-5p (p > 0.05) and the expression of miR-197-3p was significantly increased in CD patients relative to control subjects (p = 0.049). CONCLUSION: This study suggests that adherence to GFD may have a positive effect on the tight junction (TJ) permeability and in this process, miR-197-3p plays an important role. Increased expression of miR-197-3p with a final protective effect on Occludin expression can be further studied as a complement therapeutic target for Celiac disease.

The association between dietary habits and metabolic syndrome: findings from the Shahedieh-cohort study.

OBJECTIVE: Metabolic syndrome (MetS) is a complex disorder with an increasing prevalence globally. Limited data are available about the association between dietary habits and the prevalence of MetS. The present cross-sectional study aimed to investigate the association between dietary habits and MetS in a large population sample from Iranians. METHODS: The study was conducted on 9261 adults aged 35-70 years who attended the baseline phase of Shahedieh cohort study, Yazd, Iran. Dietary habits including meal frequency, fried food consumption, adding salt to prepared meal, barbecued food consumption, used oil type and reuse oil number were assessed by a standard questionnaire. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Logistic regression was used in different adjusted models to investigate the relationship between dietary habits and MetS: (Model I: adjusted for age, sex and energy. Model II: Model I + adjusted for wealth score index and physical activity. Model III: Model II + adjusted for cardiovascular diseases and liver diseases). RESULTS: The subjects who ate barbecued-food more than 3 times/ month had 1.18 times greater odds for MetS than individual who ate this less than once/ month (OR: 1.18, 95% CI: 1.01-1.38). After further adjustment for other confounding variables, the association remained significant. No significant association was found between other dietary habits and odds of MetS. CONCLUSION: Higher intakes of barbecued-food consumption were related to the prevalence of MetS. Larger longitudinal studies in other population groups are needed to confirm these associations.

Colorimetric Comparison of Internal Bleaching with and without Removing Mineral Trioxide Aggregate (MTA) on Induced Coronal Tooth Discoloration by MTA.

Objective. This study aimed to colorimetric comparison of internal bleaching with and without removing mineral trioxide aggregate (MTA) on induced coronal tooth discoloration by MTA cement. In this experimental study, twenty human teeth were prepared. An OrthoMTA barrier was placed 1 mm below the CEJ. The teeth were restored with composite resin and were placed in the aging accelerator machine. Then, the specimens were divided into two groups (n = 10); in group A, part of the OrthoMTA was removed and the glass ionomer was placed on the OrthoMTA, and in group B, the OrthoMTA remained intact. Internal bleaching was performed 5 times in 6-day intervals using 37% carbamide peroxide gel. Color determination was performed in 5 stages: baseline, after OrthoMTA discoloration, before OrthoMTA removal, after OrthoMTA removal, and after bleaching treatment sessions. In group A, 8 specimens reached to ∆E < 3.3 after 2 times internal bleaching treatment, and in group B, 5 specimens reached to ∆E < 3.3 with almost 3 bleaching sessions (p > 0.05). Additionally, 5 specimens reached to the initial color (baseline) after bleaching treatment, 4 specimens in group A and 1 specimen in group B. After OrthoMTA removal, 2 specimens in group A reached to ∆E < 3.3. There was no significant difference between groups with or without OrthoMTA removal (p=0.06). Although, the specimens with OrthoMTA removal required fewer bleaching treatment sessions, and the mean value of ∆E was lower in this group.

Comparing the Effect of Arabic, Basil Seed and Salvia Macrosiphon Gums-Based Coatings on the Shelf-Life of Tomatoes.

A novel edible coating containing basil seed gum (0.1, 0.3, and 0.5%), Salvia macrosiphon seed gum (0.25, 0.5, and 0.75%), and Arabic gum (10%) at normal pH and pH 5/6 has been used as a postharvest treatment to maintain tomato quality and safety. In this study, the physicochemical properties of tomatoes were investigated during 35 days of storage at 4°C. During storage, coated fruit showed increases in vitamin C retention, reduced weight loss, color changes, and accelerated softening. However, treatment of tomatoes with gum significantly delayed onset of parameters related to loss of postharvest quality, and storability was extended. All the coated samples had increased vitamin C retention compared with controls, with highest contents observed for tomatoes coated in basil seed gum 0.1% and Arabic gum at pH 5.6. In conclusion, basil seed gum 0.1%, S. macrosiphon seed gum 0.25 and 0.5%, and Arabic gum at normal pH were the best treatments for maintaining postharvest quality of tomatoes.

Perceived barriers to healthy lifestyle from the parental perspective of overweight and obese students.

BACKGROUND: Over the last decades, childhood obesity has become a worldwide epidemic health problem. Identifying the barriers to a healthy lifestyle among children and adolescents is necessary for further effective intervention to prevent overweight and obesity. This study aims to assess the barriers to healthy lifestyle habits, including physical activity (PA), eating, and sleep among adolescents from the perspective of their parents. METHODS: In this cross-sectional study, the parents of obese and overweight middle school students were enrolled. Data were collected using a questionnaire about barriers of healthy nutrition and PA. RESULTS: Overall, 172 parents completed the questionnaire. Lack of access to affordable facilities for PA, lack of access to the appropriate place for PA, and lack of sufficient information on how to do or increase PA were the main barriers to PA. The barrier factors for healthy eating were media advertisement of unhealthy foods, lack of motivation to use healthy nutrition, and lack of adequate information about healthy eating. Regarding poor sleep, lack of knowledge about the benefits of sleep, prolonged watching television, and late sleep time of family members were reported as the main barriers. These findings were not statistically different according to the family socioeconomic level. CONCLUSION: Our findings propose that for improving healthy lifestyle in obese children and adolescents, access to facilities, and appropriate places for PA should be provided at the community level. Moreover, training parents and students about healthy lifestyle behaviors is necessary for families of all socioeconomic levels.

Association of urinary concentrations of phthalate metabolites with cardiometabolic risk factors and obesity in children and adolescents.

This study aimed to investigate the association of urinary concentration of phthalate metabolites with obesity and cardiometabolic risk factors in a pediatric population. This study was conducted in 2016 on 242 children and adolescents, aged 6-18 years, living in Isfahan, Iran. Urinary concentration of mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), Mono-2-ethylhexyl phthalate (MEHP), Mono-methyl phthalate (MMP), Mono (2-ethyl-5-exohexyl) phthalate (MEOHP), and mono (2-ethyl-5hydroxyhexyl) phthalate (MEHHP) metabolites were determined. The association of these metabolites with obesity and cardiometabolic risk factors was examined using student t-test, linear and logistics regression tests. Of the 242 participants studied, 140 (57.9%) were girls and 102 (42.1%) were boys. The mean (SD) age of the population was 11.34 (2.55) years and no significant difference existed in terms of age (p-value = 0.374). MBzP, MBP, MMP were observed in urine samples of all subjects, and MEHP, MEOHP, and MEHHP were observed in 99.6, 95.87, and 96.28% of the subjects, respectively. Of the total participants, 15.2% (n = 37) were obese and 37.7% (n = 92) were overweight. According to the logistic regression analysis, except MEOHP, all other pollutants were significantly associated with obesity (OR adjusted >1, p-value ≤ 0.002). A significant association existed between MBP and elevated blood pressure [OR crude in tertile3 = 4.87 (CI: 1.02-23.32), p-value = 0.024]. MBzP and MEHP were significantly associated with obesity, elevated levels of triglyceride and blood pressure. Increase in MBzP metabolite in the 3rd tertile resulted to about 2.5-fold increase in triglyceride levels than the first tertile [OR multivariate adjusted = 2.7 (CI: 1.23-6.22)]. The findings of this study clearly showed the association between phthalate metabolites with obesity, cardiometabolic risk factors in children and adolescents, however further longitudinal studies are necessary to evaluate the clinical effects of this finding.

Effect of fermented camel milk on glucose metabolism, insulin resistance, and inflammatory biomarkers of adolescents with metabolic syndrome: A double-blind, randomized, crossover trial.

BACKGROUND: This study, for the first time, aimed to assess the effects of fermented camel milk (FCM) on glycemic and inflammatory parameters related to metabolic syndrome (MetS), an aggregation of cardiometabolic risk factors, in adolescents. MATERIALS AND METHODS: In a double-blind, randomized crossover trial, overweight/obese adolescents (fulfilling MetS criteria, aged 11-18 years) were randomly assigned to receive FCM 250 cc per day for an 8-week period, a 4-week washout, and then diluted cow's yogurt (DCY) 250 cc/day for another 8-week period, or the reverse sequence. Fasting blood sugar (FBS), fasting insulin, insulin resistance by three equations, incretin hormone glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide-1 (GLP1) as well as inflammatory markers such as interleukin 6 (IL6) and tumor necrosis factor-alpha (TNF-α) were measured before and after each of the four periods. A 3-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS software considering the significance level of 0.05. RESULTS: Twenty-four participants with a mean (standard deviation) age of 13.77 (1.87) years (range: 10.45-16.25 years) (58% girls) completed the study. It resulted in nonsignificant mean reduction in IL6 (-18.28 pg/mL [95% confidence interval [CI]: -47.48; 10.90]; P = 0.20) and nonsignificant increase in glucose metabolizing hormones such as GIP (683.10 pg/mL [95% CI: -457.84; 1824.0]; P = 0.22) and GLP1 (6.98 pg/mL [95% CI: -66.61; 80.57]; P = 0.84) by FCM consumption in comparison to DCY. Nonsignificant decrease was observed in TNF-α in the first periods of the study. The changes of FBS, fasting insulin, and insulin resistance indices were not statistically significant as well. CONCLUSION: According to preliminary positive influences of FCM on inflammatory markers, and findings related to glucose metabolism, we suggest conducting further studies on its clinical impacts.

Positive Effect of Fermented Camel Milk on Liver Enzymes of Adolescents with Metabolic Syndrome: a Double Blind, Randomized, Cross-over Trial.

BACKGROUND: Metabolic syndrome (MetS) has several health consequences. Liver enzymes elevation is among them. AIM: This study aimed to assess the effects of fermented Camel milk (FCM), as a functional food and dairy, on some features of MetS in adolescents including liver enzymes status, serum lipids and anthropometric measures. METHODS: Overweight/obese adolescents with MetS were randomly assigned to FCM 250 cc per day for 8 weeks, a 4-week washout, and then to diluted Cow's yogurt (DCY) 250 cc per day for 8 weeks, or the reverse sequence. Anthropometric measures, liver enzymes and serum lipids were measured just before and after each one of the four periods. A three-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS soft-wares considering the significance level of 0.05. RESULTS: Twenty-four participants with a mean age (SD) of 13.77 (1.87) years (range: 10.45-16.25) (58% girls) completed the study. It resulted significant mean reduction of aspartate aminotransferase (AST) (-3.75 U/L [95% CI: -7.06; -0.43]; p=0.042) and alanine aminotransferase (ALT) (-2.54 U/L [95% CI: -3.33; -2.24], and p=0.006) and AST/ALT ratio (-0.16 U/L [95% CI: -0.28; -0.05]; p= 0.029) by FCM consumption in comparison to DCY. Non-significant favorable effects on anthropometric measures and serum lipids were seen as well. CONCLUSION: According to the observed favorable effects of fermented camel milk on liver enzymes, its consumption may be considered as a functional food supplement in related circumstances.

A Systematic Review of Studies on Blood Pressure in Iranian Pediatric Population: First Report From the Middle East and North Africa.

CONTEXT: Blood pressure (BP) tracks from childhood to adulthood, and has ethnic variations. Therefore, it is important to assess the situation of pediatric BP in different populations. This study aims to systematically review the studies conducted on BP in Iranian children and adolescents. EVIDENCE ACQUISITION: We conducted a systematic review on published and national data about pediatric BP in Iran, our search was conducted in Pub Med, Medline, ISI, and Scopus, as well as in national databases including Scientific Information database (SID), IranMedex and Irandoc from 1990 to 2014. RESULTS: We found 1373 records in the primary search including 840 from international and 533 from national databases. After selection and quality assessment phases, data were extracted from 36 papers and four national data sources. Mean systolic BP (SBP) varied from 90.1 ± 14 mmHg (95% CI 89.25, 90.94) to 120.2 ± 12.3 (118.98, 121.41) mmHg, and for diastolic BP (DBP) from 50.7 ± 11.4 (50.01, 51.38) to 79.2 ± 12.3 (77.95, 80.44) mmHg. The frequency of elevated BP had large variation in sub-national studies with rates as low as 0.4% (0.009, 1.98) for high SBP and as high as 24.1% (20.8, 27.67) for high DBP. At national level, three surveys reported slightly raised rates of elevated BP from 2009 to 2012. CONCLUSIONS: The findings provide practical information on BP levels in Iranian pediatric population. Although differences exist on the findings of various studies, this review underscores the necessity of tracking BP from childhood, and implementing interventions for primordial prevention of hypertension.

A nationwide report on blood pressure of children and adolescents according to socioeconomic status: The CASPIAN-IV study.

BACKGROUND: Hypertension is a major leading factor for global burden of diseases. Blood pressure (BP) tracks from childhood to adulthood. So, it is important to investigate its aff ecting factors. In this study we aimed to compare the BP status in the Iranian pediatric population according to the socioeconomic status (SES) of their living area. MATERIALS AND METHODS: In this nationwide study, a representative sample of 14,880 students, aged 6-18 years was chosen by multistage random cluster sampling from 30 provinces in Iran. Anthropometric indices and BP were measured. A validated questionnaire, including the questions of the World Health Organization Global School-based Student Health Survey was completed. Findings were compared across the four regions of the country, categorized based on their elevating SES: Southeast, north-northeast, west, and central. RESULTS: Participants consisted of 13,486 children and adolescents, that is, a participation rate of 90.6%, composed of 49.2% girls and 75.6% urban residents. The mean (standard deviation) age of participants was 12.47 (3.36) years. The region with highest SES (central) had the lowest rate of high BP (HBP), that is, 3.0% (95% of confidence interval [CI]: 2.4-3.9), and the region with lowest SES (southeast) had the highest rate, that is, 7.4% (4.4-12.2). The mean (95% CI) values of systolic BP for the four regions from lowest to highest SES were 100.5 (99.6-101.3), 100.9 (100.3-101.4), 101.7 (101.3-102), and 101.7 (101.2-102.1) mmHg. The corresponding mean Diastolic BP values were as follows: 65.4 (64.6-66.1), 63.4 (62.9-63.8), 65.6 (65.3-65.8), and 64.4 (64.0-64.7) mmHg. CONCLUSION: We found significant differences in mean BP and the frequency of HBP according to the SES of the living area. Further studies are necessary to find the underlying factors resulting in such differences.

Prevalence of Prehypertension and Hypertension in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study.

BACKGROUND: The global health burden has faced toward non-communicable diseases (NCDs). It is suggested that adulthood blood pressure (BP) is tracked from childhood. This study aims to evaluate the mean BP and the prevalence of prehypertension and hypertension in the Iranian pediatric population. METHODS: In a national survey as the 4(th) phase of Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable diseases study and through random multistage cluster sampling, a national sample of Iranian school students, aged 6-18 years, were recruited. Data gathered by means of modified World Health Organization Global school-based student health survey questionnaire, a weight disorders determinants questionnaire and anthropometric and BP measurements. Prehypertension (HTN) was defined as BP equal or greater than 90(th) age and sex specific percentile or ≥120/80 mmHg and HTN was defined as BP ≥95(th) percentile. RESULTS: A total of 13486 students entered the study (49.2% girls, 75.6% urban). Mean age of participants was 11.47 ± 3.36 years. A total rate of 4.17% (3.84-4.52 95% CI) for high systolic BP (SBP), 4.33% (3.99-4.68) for high diastolic BP (DBP) and 6.88% (6.45-7.32) for high SBP and/or DBP was depicted. CONCLUSIONS: The prevalence rate of high BP (pre-HTN together with HTN) is substantially high in this population. It is needed to study the causative situations and implement relevant interventions.

National and sub-national prevalence, trend, and burden of cardiometabolic risk factors in Iranian children and adolescents, 1990 - 2013.

BACKGROUND: Non-communicable diseases (NCDs) and their risk factors are a major health threat at the global level, notably for developing countries. The tracking of cardiometabolic risk factors from childhood to adulthood is well documented. Therefore, more attention needs to be directed at primordial and primary prevention of NCDs. Given the high prevalence of NCDs and their risk factors in Iranian population, a study was designed to determine the attributable burden of cardiometabolic risk factors in Iranian pediatric population during past decades. METHODS: This paper explains the definitions, organization, data sources, methods of data gathering or generating, data analyses, and the trend analysis of the study. A national expert working group addressed unmet needs and offered consultations on the selection of risk factors and the practical definition of disease. In the later stages, during the course of the study, they will supervise the statistical modeling methods, the interpretation of results, and the publication strategy. Also an international expert advisory group will collaborate with the project team. CONCLUSION: The findings of this study could provide basic information regarding NCD related risk factors, and their burden and trends in children, which is necessary for health policy decisions to reduce the burden of disease and to plan cost-effective preventive strategies.

Admission creatine phosphokinase in acute poisoning: is it a predictive factor for the treatment outcome?

BACKGROUND: Poisoning has reported to be a major cause of death and burden of disease in low- and middle-Income countries. Rhabdomyolysis is a common consequence of many poisoning cases and serum creatine phosphokinase (CPK) is a marker for it. The aim of the study was to assess whether the admission creatine phosphokinase in comatose patients with acute poisoning is a predictive factor for the treatment outcome. METHODS: In this prospective observational study, eighty poisoned comatose patients who were admitted with a serum CPK > 250 IU/L (not due to muscular trauma in accidents, myocardial ischemia and infarction, infections, hyperthermia, electrolytic disorders and diabetic ketoacidosis) were included. The severity of poisoning was assessed using Poisoning Severity Score. The admission CPK level; and outcome (survived with and without complication and death) for all patients were recorded. Patients were divided based on CPK levels into three categorizes: Low, medium and high. RESULTS: Seventy five percent of the patients in high CPK level group, 29.5% in medium CPK level group and 35% in low CPK level group developed complications or death. Binary logistic regression results indicated that the chance of complications is much higher for patients with high admission CPK levels (more than 10000 IU/L) [OR, 5.57; 95% CI (1.29-23.93)] than whom with low levels. CONCLUSION: We concluded that the admission serum CPK level for a poisoned patient, seems to be an acceptable predictor for the outcome in poisoned patients. Further studies are still needed.

Validation of Persian Version of PedsQL™ 4.0™ Generic Core Scales in Toddlers and Children.

INTRODUCTION: To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0™ 4.0) Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. METHODS: We followed the translation methodology proposed by developer to validate Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. RESULTS: The Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales discriminated between healthy and chronically ill children (healthy students mean score was 12.3 better than chronically ill children, P<0.001). Cronbachs' alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5-7 years old and 13-18 years old. Reliability of proxy reports for 2-4 years old was much lower than 0.7. Although, proxy reports for chronically ill children 8-12 years old was more than 0.7, these reports for healthy children with same age group was slightly lower than 0.7. Constructive, criterion face and content validity were acceptable. In addition, the Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales was feasible and easy to complete. CONCLUSION: Results showed that Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales is valid and acceptable for pediatric health researches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture.

Promising effect of infliximab on the extent of involvement in ulcerative colitis.

BACKGROUND: Ulcerative colitis (UC) is a disabling disease with increasing incidence in Iran. In spite of combined medical therapy, some patients eventually undergo total colectomy. Infliximab has proved itself as a rescue therapy and even as an early aggressive therapy for severe extensive UC. Meantime, there are concerns about its complications. The aim of this study was to evaluate the efficacy of infliximab in Iranian refractory UC patients. METHODS: This multi centric case-series study included 29 UC patients receiving two to three of the drugs prednisolone, AZT/6MP and 5ASA but yet having flare-ups. At first, the extent of colon involvement was determined by colonoscopy; then the drug was administered at baseline, 2nd week and 6th week and colonoscopy repeated afterwards. Clinical and laboratory data were also recorded. RESULTS: In first endoscopy 18 patients (62%) out of 29 suffered from pancolitis and none had normal results. In second examination (done on 19 patients), one was normal and only 8 of 18 (27.6%) had pancolitis. Considering missing cases, at least in 33.3% of patients the drug has reduced the extreme extent of colon involvement. Also a wilcoxon signed ranks test revealed significant reduction of the disease extension after this treatment (p = 0.008). There were only one leucopenic and one hypotensive reactions in short term. The drug showed effectiveness in the term of disease modifying, too. CONCLUSIONS: These data show the usefulness of the drug in refractory UC. Longer follow ups and controlled trials are needed.

The prevalence of thyroid dysfunction in an iodine-sufficient area in Iran.

BACKGROUND: The prevalence of hypothyroidism in Iran is unknown. The aims of the present study were to estimate the prevalence of overt and subclinical hypothyroidism among the adult population of Isfahan, a large metropolitan city in Iran, 15 years after universal salt iodization. METHODS: A cross-sectional survey was conducted from January 2006 through April 2006. The selection was conducted by stratified probability cluster sampling through household family members in Isfahan, Iran. Thyroid stimulating hormone (TSH) of 2523 men and women aged >20 years (mean: 39.0) was measured. Additional thyroid tests were done and serum levels of antithyroid antibodies were evaluated in individuals with elevated TSH. Elevated TSH with normal free T4 index (FT4I) at the second measurement was considered as subclinical and high TSH with low FT4I as overt hypothyroidism. RESULTS: The overall prevalence of hypothyroidism was 4.8% [95% confidence interval (CI) 3.7, 6.1] in men and 12.8% (95% CI 10.9, 14.6) in women; and 37.6% of hypothyroid men and women had positive antithyroperoxidase antibodies and/or antithyroglobulin antibody, while 19.3% of men and women were euthyroid. The mean (SE) of urinary iodine was 20.3 (0.55) microg/dL and 20.1 (1.37) microg/dL for euthyroid and hypothyroid individuals, respectively (P=0.65). Older age, female sex, and goiter were strongly associated with both overt and subclinical hypothyroidism. CONCLUSION: Hypothyroidism appears to be common in Isfahan, Iran. The high prevalence of hypothyroidism in Isfahan may be due to autoimmunity with no correlation to iodine intake.