Iranian Journal of

---

Background & Objectives: Multiple Sclerosis (MS) is the most prevalent autoimmune disease of the nervous system in young adults. There are currently more than 30000 cases in Iran and the number is increasing everyday.The objective of this study was to measure the amount of vitamin and mineral intake in MS patients and to compare it with reference values.
Methods: We randomly selected 108 relapsing-remitting MS patients from the Iranian MS society in Tehran in 2005. Two questionnaires- covering personal information and medical data- were filled for each patient. Food intake was assessed by three 24-hour recalls and a quantitative food frequency questionnaire for the year preceding the study. The food intake recorded on the original questionnaire was changed to values in grams using “Manual for Household Measures” and then converted to corresponding amounts of nutrient ingredients by the “Nutritionist 3” program. Data analysis was performed by the SPSS software package. We calculated means and standard deviations for intake levels and applied t tests to compare the results with reference values.
Results: Women with MS took excessive amounts of vitamin A and vitamin C, while their daily intake of folate, vitamin E, vitamin D, magnesium, iron, zinc, iodine and calcium was below reference values. Male patients had higher-than-recommended intake of vitamin A, phosphorous, manganese and iron. Their ingestion of folate, Vitamin D and E, magnesium, zinc, calcium and selenium was shown to be below the recommended amount.
Conclusions: In view of these results, higher intake of vitamin D and calcium is recommended. Women should be encouraged to take more iron and folate as many symptoms of anemia mimics MS symptoms. Considering the well-known role of oxidative stress in the pathogenesis of MS, men should be urged to increase their ingestion of antioxidant-rich foods. It appears that nutritional assessment, dietary counseling and education are necessary for Iranian MS patients.

---

Background & Objectives: Multiple Sclerosis (MS) is the most prevalent autoimmune disease of nervous system in young adults. The current number of diagnosed cases in Iran is above 40000 and is steadily increasing The objective of this study was to assess the daily macronutrient intake of MS patients and to compare this with reference values.
Methods: We randomly selected 108 relapsing-remitting patients were randomly from the Iranian MS society in 2005. Two questionnaires containing personal and medical information were filled for each patient. We assessed food intake by three 24-hour recalls and a semi-quantitative food frequency questionnaire dealing with intake over the past year. Using the Manual for Household Measures, the data were changed to values in grams and then turned to nutrient ingredients by applying Nutritionist-3. Data analysis was done using the SPSS package: m mean and standard deviation were computed for each nutrient and t tests were run to compare the figures with reference values.
Results: MS patients living in Tehran had a dietary intake of total fat, saturated fat and protein higher than recommended, while their intake of fibers was below the reference values. The body mass index was subnormal in 14.8% of the patients and above normal in 38%.
Conclusions: In light of the current pattern of macronutrient ingestion in MS patients in Tehran, a lower intake of total and saturated fat, consumption of vegetable proteins instead of animal protein and more dietary fiber are recommended. To meet this goal, vegetables, fruit, whole grains and beans are good suggestions. It seems that Iranian MS patients need nutritional assessment, counseling and education to improve their diet.

---

Background and Objectives: There are conflicting data on the effects of different types of fat on aortic atherosclerosis. This study used Wister rats to compare the atherogenic effects of a standard diet with a diet containing fish oil and another diet containing mixed oils (typical of the current consumption pattern in Iran).
Methods: Thirty female Wistar rats were randomly assigned to three diet groups: a standard diet (containing soy bean-oil as the only dietary fat), a diet containing fish oil and another diet which contained mixed oils and was designed on the basis of the current fat consumption pattern in Iran (butter, hydrogenated vegetable oil and sunflower oil). Mothers in each group were fed the same diet during pregnancy and lactation the litters were also weaned onto the same diet. Aortic samples were taken from the offspring at the time of weaning and puberty. Data were analyzed using SPSS software Kruskal-Wallis test was applied for comparison among groups.
Results: Rats that were fed soy bean oil showed less extensive fatty streaks and intimal thickening of aorta on weaning and at puberty. Rats fed fish oil and mixed oils showed more atherosclerosis lesions compared to those receiving soy bean oil.
Conclusions: It seems that diets with an omega-3 to omega-6 ratio of 0.6 can enhance aortic atherosclerosis. Diets with an Iranian fat consumption pattern also increase aortic atherosclerotic lesions because they contain substantial amounts of saturated fat.

---

Background & Objectives: Malocclusion is not a disease but rather a set of dental deviations, which in some cases can influence quality of life. The aim of this study was to assess the frequency of various dento–facial anomalies.
Methods: In this cross-sectional study in 2006 we assessed a sample of 600 randomly selected schoolchildren, with a mean age of 11.97 years, who were attending secondary school in various districts of Karaj. We used questionnaires to obtain information on extracted teeth, crowding, spacing, diastem, the severest disorders in anteriors (maxilla and mandible), overjet, negative overjet, open space between two jaws and antero-posterior molar relationship.
Results: Ninety-nine percent of children had no extracted teeth in maxillary anteriors, while 98.3% had no extracted teeth in mandibular anteriors. In 41.2% of the subjects there was no crowding, and 57.7% of the sample had no spacing. The mean diastem was 0.36 mm and the mean of the most severe disorders in anteriors was 1.08 mm in the maxilla and 0.78 mm in the mandible. Mean overjet was 1.98 mm, mean negative overjet 0.03 mm, and mean open space between two jaws was 0.28 mm. In 58.5% of the subjects the antero–posterior molar relationship was normal. The DIA ranged form 13 to 63, with a mean of 24.12.
Conclusions: This study indicates that over than one-third of the population needs different degrees of orthodontic treatment.

---

Methods: Thirty female Wistar rats were randomly allocated to three dietary groups: a standard diet (containing soy bean-oil), diet containing fish oil and diet containing mixed oil which was designed based on Iranian population fatty acid intake. Dams in each group were fed one of the diets during pregnancy and lactation and the pups were also weaned onto the same diet. Fasting serum glucose (Photometry) and insulin (ELISA) in pups were assessed and insulin sensitivity calculated on puberty.
Results: Fasting serum insulin in fish oil-fed group was significantly less than two other groups (P=0.018) and insulin sensitivity in fish oil-fed rats was significantly more than two other groups (P=0.002).
Conclusions: It seems a diet containing fish oil (rich in long chain omega-3 fatty acids) causes more insulin sensitivity comparing to diet containing soy bean oil (rich in omega-6 fatty acids) and diet with Iranian population fatty acid intake pattern (rich in saturated fatty acids).

---

Background & Objectives: Orthodontic treatment need and demand in 12-year-olds in Abadeh city has not previously been analysed in relation to geographic origin. The purpose of this study was to assess the12 year old students need and demand for orthodontic treatment.
Methods: Four hundred seventeen 12-year-old students was selected from public and private schools in Abade (Fars province, Iran). All the students were examined according to the AC and DHC component of Index of Orthodontic Treatment Need (IOTN) by a trained dentist. Students' and parents' perceived needs were also assessed using AC component and their demand for orthodontic treatment was asked through a questionair .
Results: Twenty two percent of the students were in "no need of treatment" group when assessed by DHC component, 29.5 % were in "average need" and 48.2% were in "definite need" group. When assessed by AC score, these percents were 61.9%, 29%, and 9.1%. Parents and students percieved need for definite orthodontic treatment according to AC score was 8.6% and 7.7%, respectively. The students and their parents’ demand for treatment were 40.6% and 44.9%, respectively.
Conclusion: Orthodontic treatment need in Abade is higher in comparison with other reports according to DHC. DHC is not correlated with orthodontic treatment demand of 12 years old students, but AC had a strong relationship with treatment demand.

---

Background & Objectives: One of the problems of diagnostic accuracy studies is verification bias. It occurs when standard test performed only for non-representative subsample of study subjects that diagnostic test done for them. In this study we extend a Bayesian method to correct this bias.
Methods: Patients that have had at least twice repeated failures in cycles IVF ICSI were included in this model. Patients were screened by using an ultrasonography and those with polyps recommended for hysteroscopy. A logistic regression with binomial outcome fit to predict the missing values (false and true negative), sensitivity and specificity. Bayesian methods was applied with informative prior on polyp prevalence. False and true negatives were estimated in Bayesian framework.
Results: A total of 238 patients were screened and 47 had polyps. Those with polyps are strongly recommended to undergo hysteroscopy, 47/47 decided to have a hysteroscopy and 37/47 were confirmed to have polyps. None of the 191 patients with no polyps in ultrasonography had hysteroscopy. The false negative was obtained 14 and true negative 177, so sensitivity and specificity was estimated easily after estimating missing data. Sensitivity and specificity were equal to 74% and 94% respectively.
Conclusion: Bayesian analyses with informative prior seem to be powerful tools in simulation experimental

---

Background & Objectives: There have been several reports showing that the rate of anabolic-androgenic steroids abuse has increased in athlete and non-athlete adolescents. Therefore, the objective of this study was to assess, attitude and awareness of side-effects of these drugs in male bodybuilders.
Methods: 227 bodybuilders completed a tridimensional questionnaire that investigated demographic information, prevalence of anabolic-androgenic steroids (AAS) and attitude towards steroids abuse.
Results: Forty percent of participants (40.1%) of bodybuilders had used anabolic-androgenic steroids at least one time. The main reasons for taking this medication were strength, muscle mass, speed and endurance, respectively and 7.73% did not know the reason of using it. 32.6% of bodybuilders believed that anabolic steroids increased muscle size without exercise and without proper exercise and nutrition. The mean score of awareness and attitude of athletes who used these drugs were significantly higher than the athletes who did notuse (P=0.001). Athletes with Championship history were more aware regard to adverse effects of steroids than athletes with no history of championship.
 Conclusion: The findings of this indicating that that abusing AAS seems to be increased and become a public health concern that implies the need to implement educational programs by health care professionals and sport specialists.

---

Background and Objectives: Analysis of ordinal data outcomes could lead to bias estimates and large variance in sparse one. The objective of this study is to compare parameter estimates of an ordinal regression model under maximum likelihood and Bayesian framework with generalized Gibbs sampling. The models were used to analyze ovarian hyperstimulation syndrome data.
 
Methods: This study used the data from 138 patients of a clinical trial phase III to compare the efficacy of intravenous Albumin and Cabergoline in prevention of ovarian hyperstimulation syndrome. The original study was done between 2010 to 2011 in Royan institute. We compared maximum likelihood and Bayesian estimation with generalized Gibbs sampling for an ordinal regression model based on confidence intervals and standard errors. The model were fit through R 3.3.2 software version.
 
Results: Markov Chain Monte Carlo results reduced the standard errors for estimates and consequently, narrower confidence intervals. Autocorrelations for generalized Gibbs sampler reached to zero in compare to standard Gibbs sampler for shorter time.
 
Conclusion: It seems that confidence intervals of an ordinal regression model are shorter for generalized Gibbs sampler in compare to standard Gibbs and maximum likelihood. It suggests doing more studies to warrant the results.

---

Background and Objectives: A great number of tuberculosis (TB) patients present to the private sector to receive care; therefore, integrating TB control programs into private sector activities can enhance the control of TB. The Public-Private Mix (PPM) program is suggested by the World Health Organization to engage the private sector in TB control programs. In this study, a plan designed for PPM was piloted Karaj, Alborz Province, Iran.
 
Methods: In this community trial, pre-intervention assessment covered 18 months prior to the study. The intervention was a PPM package that was integrated into the health system by Karaj County Health Center. Then, three-month post-intervention data were collected. Analysis was performed with the SPSS 16 software using chi-square test.
 
Results: After the intervention, there was an increase of 40.7% in suspected cases of TB per month and an increase of 101.7% in smear positive TB cases diagnosed by Karaj laboratories. The ratio of smear positive cases to all suspected TB patients was 4.57% before and 6.56% after the intervention. The percentage of three sputum sample positive patients was 75.5% and 89.9% before and after the intervention, respectively.
 
Conclusion: The developed PPM program markedly improved the case detection; therefore, it is suggested to fix the potential defects of the program and implement it in all parts of the country.

---

Background and Objectives: Vaccine acceptance could seriously affect global efforts to control the Covid-19 pandemic. The aim of this study was to estimate the Covid-19 vaccine acceptance and its related factors in Tehran and Kermanshah.
 
Methods: A population-based cross-sectional study was conducted on 850 participants in Tehran and Kermanshah using the random digit dialing method. Multiple logistic regression was used to estimate the adjusted odds ratio of factors related to vaccine acceptance.
 
Results: The frequency of the Covid-19 vaccine acceptance was 66.47% (95% confidence interval: 69.57%, 63.21%). Moreover, 86.02% of the participants stated that they would use any type of (Iranian / foreign) vaccine approved by the Iranian Ministry of Health. However, 13.98% of the participants stated that they only preferred foreign approved vaccines (if available). The variables of age, fatalism, and socioeconomic status had significant associations with the Covid-19 vaccine acceptance.
 
Conclusion: Based on the results of this study, the Covid-19 vaccine acceptance was moderate. In order to achieve herd immunity by vaccination faster in our society, the strategy of prioritizing vaccination can be planned based on the related variables such as religious beliefs and fatalism, younger age groups, and people with higher socio-economic status that are willing to receive the vaccine.