Iranian Journal of

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Background & Objectives: Iron is a major essential micronutrient during pregnancy and has an important role in intrauterine fetal growth and safe delivery. This survey was designed to study the status of anemia, iron deficiency and iron deficiency anemia in pregnant Iranian women. The results can help health policy-makers with the design and implementation of targeted strategies to overcome these problems.
Methods: This cross-sectional study involved 4368 women at gestational ages ranging from 6 to 9 months. Subjects were drawn through cluster sampling from 11 different regions of the country. Hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV) and serum ferritin levels were measured and the prevalence of anemia, iron deficiency and iron deficiency anemia (IDA) was determined both nationwide and separately in each region.
Results: Overall, 21.5% of the women suffered from anemia 42.7% were iron deficient and the prevalence of IDA was found to be 10.4%. The prevalence of anemia s was significantly greater in rural areas than in urban settings (22.2- 27.8% compared to 17.1 -21.6%, 95%CI). The highest prevalence of anemia and low Hct was seen in the women of region 5 (including Sistan and Baluchistan, South Kerman and South Khorasan with rates of 44.2% and 40.5% respectively). Region 6 (covering Isfahan, Yazd, Kohkilooyeh-Boyerahmad and North Kerman) had the lowest prevalence of anemia and low Hct (9% and 10.8% respectively). Use of iron supplements (even irregular) had a positive effect in reducing anemia. It affected Hct levels only when taken regularly.
Conclusions: Anemia is still a major health issue for pregnant Iranian women. Although supplementation should be continued, there is a need for more comprehensive interventions addressing all target groups, especially women of child-bearing age.

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Background & Objective: Malnutrition is one of the main nutritional problems among children under 5 years especially in developing countries. The effects of malnutrition in this range of age group includes disorder of mental and physical growth and development, increase in the morbidity and mortality, decrease of the learning capacity. A detailed epidemiological picture of the prevalent malnutrition status among children under 5 years in different regions of Iran enables health policy makers to identify priorities, establish political commitment and design appropriate interventional programs to prevent and control malnutrition and improve nutritional status of children. To determine the prevalence rate of malnutrition among children under 5 years.
Methods: Demographic data, weight and height of 34200 Iranian children between 0-72 months old in 28 provinces of the country in 2005 year based on a cluster sampling were gathered. The subjects' weight and height were measured by trained staff. Prevalence of underweight, stunting, and wasting indicators was determined by measuring the weight and height of subjects in urban and rural areas. EPI6 statistical software, version b6/04, was used for all statistical analyses.
Results: 4.7% of the children aged less than five years suffered from stunting (95% CI: 4.5- 4.9%) The prevalence of this type of malnutrition among urban children is significantly less than rural children (95% CI: 3.1- 3.5% and 6.5-7.1% respectively). Meanwhile the prevalence of underweight was 5.2% in the country (95% CI: 5.1-5.4% while the prevalence of this type of malnutrition was significantly less among urban children than those in rural ones. Moreover, the prevalence of wasting was 3.7% (95%CI: 3.5-3.9%) and there was a significant difference in this regard between the urban and rural children. Thus this indicator was significantly higher among urban children than those in rural areas (95%CI: 3.8-4.3% and 3.0-3.5% respectively).
Conclusion: The results of the study show that the prevalence of protein-energy malnutrition was low among Iranian children under five years old. In comparison with previous studies, it is felt that there has been a prudent decrease in all malnutrition in all levels. However, there were significant differences in the prevalence of malnutrition in different provinces, which has resulted in the differences in their developmental stages as well. It appears that subjective strategies are required to improve the nutritional and health status among children under five in all provinces.

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Background & Objectives: Triglyceride/HDL-cholesterol ratio (TG/HDL-C) has been shown as an indicator for metabolic syndrome (MetS). This study aimed to detect the role of this ratio to predict coronary heart disease (CHD) outcome in an Iranian men population with high prevalence of MetS.
Methods: 1824 men ≥ 40 years old, free of clinical cardiovascular disease at baseline, were included in the study from February 1999 to August 2001. Serum level of total cholesterol (TC), HDL-C, TG, and risk factors of CHD including age, systolic blood pressure, diastolic blood pressure, body mass index, diabetes, smoking and family history of cardiovascular diseases were measured at initial phase of study.
Results: During a median follow up of 6.5 years until March 2007, a total of 163 new CHD events occurred. According to a Cox proportional hazard modeling, after adjustment for TC and other risk factors, men in the top quartile of TG/HDL-C relative to first quartile had a significant hazard ratio (HR) of 1.85 (95% CI, 1.07-3.17). Combined HR for TC and TG/HDL-C (men in the top quartiles of both TC and TG/HDL-C relative to first quartiles) after adjustment for other risk factors was 6.13 (95% CI, 2.37-15.86).
Conclusions: The evaluation of both TG/HDL-C ratio and TC should be considered for CHD risk prediction in Iranian male population.

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Background & Objectives: Medical Tourism has been recently paid more attention. Individual practitioners and medical organizations must be able to provide accurate information about this rapidly evolving trend. Since there has been little known about this issue, we decided to assess the knowledge about and attitude towards medical tourism in Rafsanjan, Iran.
Methods: A questionnaire including XXX questions were completed by Rafsanjan Medical University staff. All information was analyzed by SPSS software.
Results: Only 8.3% of individuals sated that they studied some articles about Medical Tourism, and only 14.7% of them had deal with these kinds of patients. The majority of participants (80.7%) hadn’t had any idea about the quality of medical expenses by Medical Tourists. Mainly (68.7%) believed that development of Medical Tourism in Iran would not have any bad social consequences and 62% believed that its development in Iran could improve the knowledge of Iranian doctors. The majority (67.3%) agreed to arrange for inviting tourism to Iran in order to use of Medical Tourists and 54.3 of them believed that development of Medical Tourism could improve treatment of Iranian patients.
Conclusions: The knowledge of participants seems is very low therefore appropriate educational programs should be tailored by responsible organizations in Iran. However medical staff’s attitude towards medical Tourism seems is very positive which indicates having necessary potential for any activity in this regard in future.

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Background & Objectives: Although the population of elderly is increasing in Iran, few studies carried out on this group. The aim of this study was to identify life expectancy and contributory risk factors for the Tehranian elderly of ages above 60 years.
Methods: Individuals above 60 years old whom were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001 were followed up for 12 years and their vital status were registered (1998-2011). Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and by using Cox proportional hazard model the mean of survival time and hazard rates with respect to risk factors were estimated.
Results: Life expectancy for females and males after crossing 60 years of age reaches to 81 and 80 years, respectively without any statistically significant differences between these two groups. Cox model showed that diabetes, BMI>33Kg/m2 and non ischmecic heart disease reduced survival time in women significantly. While diabetes, smoking, hypertension, ischemic heart disease, history of MI, stroke or sudden death of father, brother or son, lack of physical activity and antihypertensive medications are among the hazardous risk factors for men.
 Conclusion: Among the variables studied, only three (ABC) of them were found as risk factors of women's life, while for men seven risk factors were identified. It seems that more studies are needed to determine the risk factors for women.