Iranian Journal of

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Background & Objectives: Although it is important to study the association between caregiver burden and individual with dementia, a little has been paid attention to this issue in Iranian population therefore the aim of study was to investigate the frequency of psychiatric symptoms and patients with dementia and caregiver burden associated with individual with dementia.
Methods: In this study 84 patients who had referred to Iran Alzheimer’s Association, along with their caregivers were included in our study. Iranian Version of Caregiver Burden and NPI questionnaires were employed. Factors affecting factors on burden was analyzed by multivariate linear regression.
Results: Our findings showed that there was at least one psychiatric disorder in all patients. Among all psychiatric symptoms delusion and elation had the highest and lowest rates with 39.3 and 2.4 percentages, respectively. Linear regression indicated that “indifference” and “irritability” symptoms were the effective psychiatric symptoms on the amount of burden placed on the caregivers.
Conclusion: The symptom frequency of irritability and other symptoms showed a statistically significant positive correlation with caregiver's NPI-D score. These findings suggest that improvement of treatments for delusions, irritability among dementia patients may reduce caregiver burden.

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Background & Objectives: Benzodiazepines (BDZs) can have both beneficial and adverse effects and are the largest-selling drug group in the world. The potential of dependence with BDZ has been known for almost three decades now. The risk of misuse of and dependence on these drugs seems higher in countries where laws against unlicensed sale of BDZ are not implemented strongly. Since there is little know about the pattern of using BDZ in Iran therefore we designed this study to investigate to find out more about the prevalence of BDZ use in psychiatric patients in Mashhad, Iran.
Methods: Twenty pharmacies were chosen for this study carried out a cross-sectional survey over 3 months in outpatient of pharmacy in Mashad, Iran. Besides basic socio-demographic data the participants were asked if they were taking a BDZ at present and if yes, the frequency, route and dosage of the drug, who had initiated the drug and why it had been prescribed.
Results: Out of a total of 400 participants 17.5% of the participants had been currently using at least one BDZ for 4 weeks or longer. Only 45% of cases the BDZ had been initiated by a doctor. Gender, Educational status, employment status and smoking were associated with an increased likelihood of using BDZ.
Conclusion: The study shows most of the users were taking it for duration and with a frequency which puts them at risk of becoming dependent on BDZ. In most of the cases it had not been initiated by a doctor. Both patients and doctors need to be made aware of the risk of dependency associated with the use of BDZ.

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Dear Editor We read with interest the recent original article by Esmailnasab and his colleagues (1) discussing the issue of influencing factors on type 2 diabetes in Sanandajd. The authors are to be congratulated for conducting such an important topic both for healthcare providers and researchers. We have noticed that in that interesting paper the occupational status was classified unclearly into four categories as "housekeeper", "employee", "farmer and free job" and "unemployed" that the journals reviewers have been overlooked this easily. Since one of the main characteristic of occupation is making money, some groups such as "student" and "housekeeper" are excluded from this category. There are several international classifications for occupational status that can be used for national studies in Iran. These categorizations also called "social class" that considered to occupational exposure, amount of income and some other components. One of these classifications is presented by the International Labor Organization (ILO). A number of countries have localized this classification and many countries have used it without changes (2). The latest revised classification (ISCO) has been revealed 11 occupational groups (major group) provides the following (3): 1- Legislators, senior officials and managers, 2- Professionals, 3- Technicians and associate professionals, 4- Clerks, 5- Service workers and shop and market sales workers, 6- Skilled agricultural and fishery workers, 7- Craft and related trade workers, 8- Plant and machine operators and assemblers, 9- Elementary occupations, 11- Armed forces. It seems that with modification of such classifications, we could obtain a national standard categorization for occupation and then would be able to better understanding the role of occupation in development of disease and health problems.

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Background & Objectives: Study trend of observed rates changes provide valuable information for need assessment, plan, reload programs and develop indicators of each country. The main objective of this paper is to determine the changes in tuberculosis incidence rate trend in Iran by applying segmented regression model.
Methods: In this study, segmented Linear Regression employed to analyze the trend of changes in pattern of Tuberculosis incidence rate during past 44 years (1964-2008) in Iran. We used least square method and permutation test and Bayesian Information Criteria to decide which of the two segment regression model and poison regression would be better. Data analyzed by Joinpoint3.4 and SAS9.1 software. Results: According the permutation test, it was detected that there were two breakpoints over 1977 and 1993 years (p=0.0108). Incidence rate of tuberculosis during the first 11 years of review had declined with annual percentage change = -10.1%, for second segment it rose upward with 4.3% increase in per year and for end segment TB incidence rate again declined with annually 4.5%. The average annual change of Tuberculosis incidence rate in Iran for at least 10 years has been estimated -4.5 percentages.
Conclusion: The findings of this study have shown that the incidence rate of Tuberculosis decreased after 1992 that interestingly this decline seems faster than estimated by international TB control program. This indicates that preventive and treatment of Tuberculosis programs have been successful in Iran.

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Background and Objectives: Preterm birth (PTB) is a major clinical problem which is known to be associated with perinatal mortality and morbidity. The aim of the present study is to identify risk factors associated with PTB in Birjand, Iran.
Methods: One hundred and thirty premature (<37 week) and 130 term newborns were enrolled in this case-control study. It was conducted in Birjand Hospitals during the year 2007. Potential risk factors such as type of delivery, maternal disease, placenta problems, previous history of abortion in mothers, maternal addiction, prenatal care were identified from medical files.
Results: Previous of premature labor (OR=4.68), cesarean section (OR=3.34), pre-eclampsia (OR=7.72), premature rupture of memberanes (OR=11.3), inadequate prenatal care (<4 one) (OR=4.15), and placenta previa (OR=8.96) were found to be risk factors for preterm birth. Polyhydramnios, previous abortion and cervical incompetent with prematurity were not shown to be risk factors for preterm birth.
Conclusion: These findings reinforce the need for control of risk factors of prematurity for better out come.

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Background & Objectives: The Disability-Adjusted Life Year (DALY) was developed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. The aim of this study was to estimate and compare the burden of cesarean section (CS) and normal delivery (ND) in Isfahan during 2008 year by employing DALY.
Methods: Burden of CS and ND was estimated based on information provided by hospitals located in Isfahan. The incidence of complications of both vaginal delivery and cesarean section at the time of delivery and 2, 4, 6 weeks after calculated by using hospitals files. Dismod II and STAT.10 software were used to calculate YLD, YLL and DALY of delivery and their complications.
Results: DALYs for cesarean and vaginal deliveries were estimated to be 20.70 years per 1000 deliveries and 8.89 years per 1000 with their complications, respectively. DALY from cesarean section was 23.404 years per 1000 deliveries in private hospitals and 15.67 years per 1000 deliveries for governmental hospitals. DALY from vaginal delivery was 8.98 in private hospitals and 8.137 years in governmental hospitals per 1000 deliveries.
Conclusion: This study showed a considerable burden for cesarean section particularly in private hospitals. This important finding should be considered by health policy makers in Iran.

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مقدمه و اهداف: امروزه پزشکی مبتنی بر شواهد بعنوان یک رویکرد نوین و قابل اتکا در علوم پزشکی پذیرفته شده و جهت ارتقاء کیفیت مراقبت‌های بالینی بیماران مورد توجه قرار گرفته است. هدف این مطالعه تعیین میزان آگاهی و نگرش دستیاران بالینی دانشگاه علوم پزشکی کرمان در مورد مفهوم رویکرد پزشکی مبتنی بر شواهد و بررسی میزان کاربرد آن بود.
 روش کار: مطالعه به روش مقطعی و از طریق پرسشنامه‌ای که روایی و پایایی آن تایید شده بود، در آذر ماه سال 1388 انجام گرفت. داده‌ها با استفاده از نرم افزار SPSS مورد تجزیه وتحلیل قرار گرفتند.
نتایج: از مجموع 94 دستیار شرکت کننده در مطالعه 3/55% مرد، میانگین سن شرکت کنندگان 7/32 سال و متوسط زمان اتمام تحصیلات پزشکی عمومی آن‌ها 6/5 سال بود. 3/83 % شرکت کنندگان معتقد بودند که استفاده از EBM درمراقبت از بیماران مفید است، اما فقط 3/5% آن‌ها اظهار کردند که در بیش از نیمی از کارهای بالینی خود از رویکرد پزشکی مبتنی بر شواهد استفاده می‌کنند. 3/88% شرکت کنندگان به پیشرفت در زمینه EBM علاقمند بودند. منبع کسب اطلاعات برای تصمیم گیری بالینی، در6/59% دستیاران شرکت کننده کتاب، در 4/41% تجارب کلینیکی توام با کتب درسی و تنها در 2/19% آن‌ها مقالات بود.
نتیجه‌گیری: نتایج نشان داد که دستیاران دانشگاه علوم پزشکی کرمان شناخت کمی از پزشکی مبتنی بر شواهد دارند. لذا لزوم برنامه ریزی منسجم در زمینه آموزش پزشکی مبتنی بر شواهد و کاربرد عملی آن احساس می‌شود.

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Background & Objectives: The city of Jask in south east of Iran has been considered an endemic focus of leishmaniasis. PCR-based techniques can detect lower parasite burdens, reducing the number of false negatives and improving the quantification of Leishmania parasites in the sand fly. The aim of this epidemiological study was to detect vector(s) by PCR techniques in the city of Jask located in Hormozgan province.
Methods: Sand flies were captured using CDC miniature light traps and sticky papers during 2007-2008 and identified by their morphology. DNA extraction performed by Proteinase K and Phenol/Chloroform/Isoamyl Alcohol methods. Leishmania kinetoplast minicircle DNA was amplified by two Nested-PCR techniques using species-specific primers (LINR4-LIN17-LIN19) and (CSB1XR-CSB2XF-LiR-13Z).These primers could differentiate among Leishmania species of Iran.
Results: A total of 8123 sand flies were collected. The fauna was identified as eight species (3 Phlebotomus and 5 Sergentomyia). Phlebotomus papatasi, P. salehi and Sergentomyia theodori were the three most dominant species (59.91%, 17.21% and 7.32% respectively). 60, 50 and 40 parous unfed female specimens of P. papatasi, P. salehi and S. theodori were investigated for Leishmania DNA infection. Leishmania major DNA was detected in 3 (5%) specimens of P. papatasi and 2 (4%) specimens of P. salehi. Anthropophilic index of these two species were 29.6 & 18 percent, respectively.
Conclusion: This study was the first molecular study for detection of cutaneous eishmaniasis vectors in Hormozgan province in Iran. According to the findings of the present study P. papatasi and P. salehi are probable vectors of cutaneous leishmaniasis in this focus.

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Background & Objectives: Increasing in prevalence of juvenile myopia in recent decades in eastern and western countries, especially in urban elementary school children, suggests that changing in early life style may play an important role in development of myopia. Our aim was to determine the relationships between myopia and overweight in elementary school children of Eslamshahr a city near Tehran, Iran Methods: In a case control study, 240 new myopic primary school children (grade 2-4) identified as cases and 240 children without myopia in the same schools enrolled as control group. Anthropometric information was completed from schools’. Other information about pre-entrancing to school was collected by interviewing their parents. Children having a Body mass index BMI>=85th CDC2000 percentile were identified as overweight. Adjusted odds ratio for overweight was estimated after adjusting other potential risk factors.
Results: Of total 53.3% were girls. 23.8% of children in case group and 10.1% of them in control group were categorized in overweight group. After adjusting for other potential risk factors (family history, breast milk intake, near works, mother`s job and financial position) being overweight was independently associated to myopia (OR: 3.10, 95% CI: 1.9-5.03).
Conclusion: It is concluded that overweight in children in preschool age, is independently associated with increased risk of myopia in primary school children. Therefore health promotion programs in order to change of the life style in this group of children should be considered.

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Background & Objectives: Non-Communicable disease (NCD) is a main group of diseases which are responsible for a large proportion of the Global Burden of Disease around the world. Although disparities in the NCDs' risk factors can affect the goals of health for all, less attention has been paid so far on this topic. In this study, we investigated socio-economic inequality in the NCDs’ risk factors and evaluated the causes affecting on this inequality in Shahroud, Iran.
Methods: Conducting this survey, we used surveillance data for NCD of 1000 individuals who lived in Shahroud district during 2005. We determine a socio-economic variable which explained social and economic status of the people using Principal Component Analysis. We then evaluated each NCD risk factors at different levels of the socio-economic variable and calculated concentration index for the risk factors. The causes of the inequality were described by decomposition analysis of the concentration indices.
Results: Concentration indices for hypertension, smoking, insufficient physical activity, and unhealthy diet were -0.141, -0.191, -0.046 and -0.091, respectively. Differences of concentration curves of the risk factors from the line of equality were significant but not for diabetes, obesity and high blood cholestrol. Age, being a government employee, being unmarried, living in rural area and low economic status were the most important factors which influence on these inequalities.
Conclusion: Inequality in some NCD risk factors was significant in Shahroud district. More investigations with larger sample size and more appropriate variables to measure socioeconomic status are recommended.

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Background & Objectives: Cutaneous leishmaniasis (CL) is one the major health problem in tropical and sub– tropical countries. Bam district in Iran is an old focus of anthroponotic CL (ACL). The aim of this survey was to assess the prevalence rate of CL by case– finding, treatment of cases and training of primary school children in the city and suburb of Bam in 2010.

Methods: All school children in three levels (18501 children) were included. Children were physically examined for presence of sores or scars. Suspected cases were referred to the center for cutaneous leishmaniasis control (CCLC) for diagnosis and the CL positive children were treated, accordingly. School children were trained and also educational and informative pamphlets were given to their parents.

Results: After initial physical examination ,117 suspected school children (6.9%) were referred to the CCLC and 48 children (28 per 10000) diagnosed as CL patients, comprising of 19 females (39.5%) and 29 males (60.5%). Fifteen (31.2%) school children were identified as lupoid leishmaniasis, failure to treatment or non – healing cases.

Conclusion: The prevalence rate was decreased about 18– fold as compared to the previous investigation in 2005. Establishment of the CCLC, active case– finding and subsequent treatment, seem to be a successful model for controlling CL in the endemic countries.

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Background & Objectives: Nursing and midwifery students are at risk needlestick/sharps injuries (NSIs/Sis). Actual number of NSIs/SIs among students due to insufficient reporting it is not clear in Iran. The aim of this study was to explore the barriers of not reporting of NSIs/SIs among nursing students.
Methods: This descriptive cross-sectional study was conducted in Arak University of Medical Sciences in 2009. 207 and 68 nursing and midwifery students were participated in study, respectively. A questionnaire, consisting two sections of demographic information and questions about exposure to (NSIs/SIs) and frequency and barrier reporting of NSIs/SIs, was completed by students.
Results: According to the findings, 43% and 20.5% of nursing and midwifery students had experienced at least one contaminated NSIs/Sis in the past 12 months. Only 44.9 % (n=40) and 50% (n=7) of the nursing and midwifery who had experienced NSIs/Sis in the previous year, were reported all exposures to NSIs/Sis, respectively. The most important the reasons for not reporting injuries consisted of low probabilities of the infection risk of the injury source, not familiar with reporting process and fear of decreasing evaluation score.
Conclusion: NSIs/SIs and non-reporting of NSIs/SIs were highly prevalent in nursing and midwifery students. More education programs should be directed at students to increase their awareness of about NSIs/SIs. Also nursing and midwifery student’s instructors should give positive responses to nursing students for reporting NSIs/SIs.

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Normal 0 false false false EN-US X-NONE AR-SA The relationship between two things if one is another originator or creator, called causality. Although this concept is not specified to Medical Sciences and Epidemiology, the importance of this issue is more highlighted in the field of epidemiology. Causation is the most basic concepts in empirical sciences and is still under discussion because it is dependent on the basis of any scientific laws without acceptance something cease causality is impossible. With the increasing development of science as well as epidemiology, causality has found a broader concept and its application in analytical studies and logical interpretation of the results of this type of study, has a wider dimension. Due to developing new epidemiology courses at medical universities and increase the number of students, it is felt to talk more about the causality concept. In this review causality concepts in the humanities is overviewed, its history is briefly described, the causality of Medical Epidemiology and also Islamic religion is considered, then the causality framework, and models to interpret the conventional causality will be discussed.

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Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: Dental fluorosis is a kind of hypoplasia, enamel and dentin deficiency due to fluoride overuse. Since there is little known about this important dental problem in Southeast area in Iran we designed an analytic descriptive study to estimate the dental flurosis prevalence in 7-10 years old students.
Methods: Three hundred thirty four (334) children attending to community dentistry center during year 2006, were studied to evaluate the prevalence of dental fluorosis. Dental index (fluorosis rates) identified by a trained dentist. Criteria for definite diagnosis were existence of enamel defects with spread bilaterally and symmetrically. Children with hyperplasia tetracycline -induced, acute febrile illness in childhood and fetal birth  dental defects (Dentinogenesis imperfecta, Amelogensis imperfect) were excluded from this study.
Results: The prevalence of dental flurosis estimated to be 30.8 percent in this sample. Dental fluorosis protests in the subjects were so: enamel opacities (70. 6%),discoloration(14.2%), pit(1.36%), enamel opacities and discoloration(12.9%),enamel opacities and pit (1 %). Superior anterior teeth were the most effected by fluorosis. There are significant difference in dental fluorosis between boys and girls (P=0.004), and intensity was higher in boys (37.5% versus 22.6%). fluorosis pattern no clear difference in both sexes (P=0.27).
Conclusion: The prevalence of fluorosis was estimated 30.8% and intensity was higher in boys in Zahedan. Therefore it is essential that fluoride source and amount of fluoridation of drinking water be considered in Zahedan city.

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Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: Tuberculosis (TB) is an important issue which its control is still unsatisfactory at global level. Traditional diagnostic techniques for active TB diagnosis are inadequate: the diagnostic gold standard is the cultural exam which suffers from lengthy processing and requires highly specialized laboratories. Nowadays more specific tests have been recommended. The aim of this study is to evaluate the performance of Quanti FERON-TB (QFT)Gold In Tube-Test as a substitute for specific test tuberculin skin test for diagnosis of latent tuberculosis infection in high risk groups.
Methods: One hundred thirty four (134) individuals who worked in Bo-Ali hospital (Zahedan) enrolled in this study. They had no active tuberculosis. TST and QFT tests were performed. The cut-off point of TST was considered based on 15 (mm) or more indurations as positive. The result of QFT was evaluated by manufactured guidelines. Multivariate logistic regression was used to identify the putative risk factors of positive tests.
Results: Proportion of employees with latent TB were 111(82.8%) were positive by either TST or QFT, and 76(56.7%) were positive by both tests. Agreement between the tests was high (73.8%, k=0.39 95%CI:
0.21-0.44). Positive family history of Tuberculosis was significant risk factor for both positive tests. 
Conclusion: This study showed high latent tuberculosis infection prevalence in hospital workers and high agreement between TST and QFT. Decision to select one of the tests will be depended on the population, purpose of study and availability of resources. The results revealed that the QFT can be appropriate alternative test for high risk group.  

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Normal 0 false false false EN-US X-NONE AR-SA Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: Epidemiological surveillance of infectious diseases through the mandatory-reporting system is crucial for disease prevention program and success in it related to physician, partnership. The aim of this study was to identify statues of notification system among general practitioners (physicians) in Qom.
Methods: In this analytical cross section study a self-administered questionnaire was used to assess knowledge and attitude of notifiable diseases, self-reported practices, reasons for noncompliance with reporting requirements, and suggestions to improve compliance. A total 140 general physicians completed the questionnaire. Appropriate statistical analyses were performed.
Results: 14/3% and 13/6% had a good knowledge and attitude about notification and only 47% had good performance. There was significant association between the participants' self-reported practices and knowledge total scores and participating in continuing medical education. The major barrier of reporting notifiable diseases was poor knowledge of the list of reportable diseases and reporting requirements. The most frequent suggestions for improving physicians' compliance with disease reporting were to simplify the reporting process and giving awareness about list of notifiable diseases.
Conclusion: Our findings suggest inappropriate knowledge, attitude and practices about disease notification requirements among GPs. Modifying physisicans' knowledge and motivation, eliminating barriers to disease reporting, and promoting some facilitating factors could help reduce the underreporting of notifiable diseases.

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Background & Objectives: To assess vision related quality of life and determinants in patients afflicted with chronic eye disease.
Methods: In this analytical cross-sectional study, consecutive sampling was performed at Noor Eye Hospital between 2008 and 2009. A valid and standard 39-item visual functioning questionnaire (National Eye Institute visual functioning questionnaire, NEI-VFQ 39) was completed. The questionnaire consists of 11 domains related to vision and one domain about general health. The total score range from zero (0) to 100, where a higher score reflects better vision related quality of life. The independent t-test, pearson correlation coefficient as well as simple and multiple linear regression models were employed for statistical analysis.
Results: The mean overall score in patient and control groups were 54.5 [95% confidence interval (CI) 57.3 - 71.8] and 96.0 [95% CI: 88.2-103.9], respectively. Patients with cataracts had the highest score (64.6 95%CI: 57.3 - 71.8) and those with visual acuity of 20/70 or worse showed lowest scores (41.9 95%CI: 30.7 - 53.1). Age (P=0.006) and education level (0.001) were associated with quality of life score.
Conclusion: Based on our study findings, it could be concluded that low vision patients with a visual acuity of 20/70 or worse hardly received half of the total scores. Diabetic retinopathy, age related macular degeneration, glaucoma, and cataract stand in ascending rank order. The relatively lower scores as compared to results from other countries warrant further research into the causes of such differences.

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Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: Human papillomavirus (HPV) infection seems to be the most common sexually transmitted infection. High-risk (HR) human papillomavirus (HPV) prevalence has been shown to correlate well with cervical cancer incidence rates. Since there is little known about the epidemiology of this infection in Tehran, we designed to estimate the prevalence of HPV in some areas in Tehran. 
Methods: Cervical specimens were obtained from 825 married women aged 21-59 years from the general population of Tehran, Iran according to the standardised protocol of the IARC International HPV surveys. HPV was detected using a GP5+/6+ PCR-based assay.
Results: HPV prevalence in the general population was 7.8% (5.1% of high-risk types), with no statistically significant variations by age. Cervical intraepithelial neoplasia was diagnosed in 4.1% of women, of whom 35.3% were HPV-positive. HPV16 was confirmed as the most common type among women with both normal (1.8%) and abnormal (8.8%) cytology. HPV positivity was significantly higher among divorced women, women in polygamous marriages and those reporting husbands' extramarital affairs.
Conclusion: However the prevalence of HPV seems not high in comparison with other international data, more molecular and seroepidemiological survey in national level needs to have a better perspective.

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Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: Years of life lost (YLL) was designed by the World Health Organization (WHO) to measure and analyze the burden of various diseases. Intentional and unintentional injuries, is the second cause of death in Iran. Since there is little know about the burden of injuries, this study designed to measure YLL in this group as a key indicator of population health and priority setting in health. 
Methods: Years of life lost was calculated based on death data from Death Registration system in Mazandaran province.
Results: During the year 1387 in Mazandaran province, 39,421 years lost due to intentional and unintentional injury. 30,498 years that related to men and 8923 years related to women. In this province injury has been the first cause of YLL in both sexes and age groups 20-24, 25-29 and 15-19 years, respectively.
Conclusion: Considering the results of this study and the high number of years lost due to accidents in the province, especially in men, it seems that more appropriate interventions programs for at risk age group of men in province is required.

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Normal 0 false false false EN-US X-NONE AR-SA Background & Objectives: There is little known about the relation between metabolic syndrome and fiber intake are available in Iran. We evaluated the relation between total, and various types and sources of dietary fiber and the prevalence of the metabolic syndrome.
Methods: In this cross sectional study, 2457 adults, aged 19-84 years were studied. Total dietary fiber intake and its types and sources were assessed using a validated semi quantitative food-frequency questionnaire. Blood pressure, Anthropometric, and biochemical measurements were assessed. The metabolic syndrome was defined according to definition by Iranian National Committee of Obesity.
Results: In the multivariate-adjusted odds ratio, intakes of total (OR: 0.53 95% CI: 0.39-0.74), both soluble
(OR: 0.60 95% CI: 0.43-0.84) and insoluble dietary fiber (OR: 0.51 95% CI: 0.35-0.72), fruit fiber
(OR: 0.51 95% CI: 0.37-0.72), legume fiber (OR: 0.73 95% CI: 0.53-0.99) and cereal fiber
(OR: 0.74 95% CI: 0.57-0.97) were inversely associated with the metabolic syndrome. There was not significant association between using vegetable and nut fiber and prevalence of metabolic syndrome.
Conclusion: Total dietary fiber, both soluble and insoluble fibers, and especially fruit and legumes fibers, reduce the metabolic syndrome among adults in Tehran.