Iranian Journal of

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Background & Objective: Because of uncertainty in interpretation of some tests for diagnosing TB, decision making for the tuberculosis treatment is based on multiple diagnostic tests. This study was conducted to assess the accuracy of Quanti FERON-TB Gold test in tuberculosis diagnosis.
Methods: The study was carried out on 30 cases and 46 controls. Statistical indices of sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, odds ratio and Receiver Operating Characteristics (ROC) curve were estimated.
Results: Sensitivity of QFT-G was 90.0% (95% CI=73.0-97.6), specificity 95.7% (95% CI=83.8-99.3), positive predictive value 93.1% (95% CI=76.3-98.9), negative predictive value 93.6% (95% CI=81.3-98.4). The area under ROC curve was 0.942 (95% CI=0.88-1.00), that significantly differed from chance diagonal area (P<0.0001). The optimum cut point for the Quanti FERON-TB Gold test was 0.35 IU/ml, with sensitivity of 0.90 and specificity of 0.957.
Conclusions: The Quanti FERON-TB Gold test displayed good validity indices in this study. Since the utility of this test has a high cost therefore this test would not be offered for routine tuberculosis detection. It suggested that this test are applicable for smear and culture negative tuberculosis, child tuberculosis, and assessment of TB contact tracing.

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Background & Objectives: Obesity is associated with increased resistance to insulin, hypertension, hyperlipidemia, hyperinsulinemia, and cardiovascular diseases. The purpose of this study was to investigate some factors associated with overweight and obesity among normal, overweight, and obese women aged 30 to 50 years from Sabzevar.
Methods: A questionnaire with 56 questions was prepared. The Beck questionnaire was used to measure the physical activity level. Weight, height, and waist circumference of the participants were measured using standard methods. Overweight (BMI ≥25 kg/m2), obesity (BMI ≥30 kg/m) and abdominal obesity (WHR ≥0.85) were also evaluated. MANOVA, Tukey post-hoc test, Pearson and Spearman correlation coefficients, Kruskal-Wallis and chi-square test were used for the statistical analysis of test variables. P ≤0.05 was considered significant.
Results: The results showed that 22.5% of women had normal weight, 42.4 percent were overweight, 31.6 percent were obese, and only 3.5 percent of women were underweight.
Conclusion: Our results showed that the prevalence of overweight and obesity was 74% in women living in Sabzevar, indicating the necessity of using educational methods to familiarize people, especially women, with weight control issues and prevention of obesity. The findings revealed that age, number of children, number of pregnancies, age at menarche, number of family members, working with the computer, and high-fat meals may increase the risk of obesity. Lifestyle modification and physical activity, as the most affordable and safest methods of preventing obesity, require more attention.

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Background and Objectives: Muscle weakness and fatigue decrease the functional capacity and quality of life of multiple sclerosis patients. Although routine exercise is acceptable in these patients, its impact has not been proven. The aim of this study was to assess the effect of exercise on muscular performance and function, degree of disability, fatigue, and quality of life of patients with MS.
Methods: Twenty-four women aged 20-50 years old with multiple sclerosis and an expanded disability status scale (EDSS) of 2- 5 were randomly divided into two groups of control (12 patients) and case (12 patients). The training program included three sessions per week, lasting for 12 weeks (two sessions of aerobic training and one session of resistance training).
Results: The results showed that 12 weeks of combined training caused a significant improvement in lower body strength (P=0.019), upper body strength (P=0.001), dynamic balance (P=0.025), gait speed (P=0.008), endurance (P=0.0001), quality of life (P=0.007) and a significant decrease in the degree of disability (P=0.007) and fatigue (P=0.001). 
Conclusion: In general, a combined training program, including aerobic and resistance training, in three non-consecutive days per week is helpful for women with MS and improves their sensorimotor function. The relevant specialists can use these exercises along drug therapy to reduce the clinical complications of MS.

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Background and Objectives: Investigation of child mortality is one of the most important strategies for improving children's health. The purpose of this study was to investigate the age distribution, trends, and projections of mortality in children under 5 years old in Khorasan Razavi province.
 
Methods: The study population included under-5 mortality data from Khorasan Razavi Province during 2012-2017 extracted from the Causes and Mortality Classification System of Vice-Chancellery of Health, Mashhad University as well as five universities and faculties. Cause of mortality was classified according to the ICD10 codes. Data were controlled using the ANACod software. Descriptive statistics methods and autoregressive integrated moving average (ARIMA) modeling were applied to explore the mortality trend during the time of study using the Minitab.15 and STATA16.
 
Results: According to the results, the highest mortality rate for children under five was in 2014 and the lowest in 2017. Using the differencing method, the data were stabilized. Finally, the ARIMA model (1,1,2) was identified as a suitable model using the MINITAB software.
 
Conclusion: The mortality rate of children under five has declined sharply in the last four years in Khorasan Razavi Province. It is predicted that this reduction will continue according to fitted model. However, we are still far from mortality rates in developed and some developing countries; therefore, efforts should be made to reduce the under-five mortality rate by increasing the level of health services, the awareness level of families, and improving maternal and childbirth care.