AIMTo investigate the relation between plain water drinking and risk of depression and anxiety among a large sample of Iranian adults.METHODSA total of 3327 Iranian general adults were included in this cross-sectional study. Validated Iranian version of the Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Water consumption was assessed by asking about the number of glasses of water that consumed daily. Water consumption was categorized into < 2, 2-5, and ≥ 5 glasses of water/d.RESULTSIn the crude model, the lowest level of water drinking (< 2 glasses/d) compared with reference group (≥ 5 glasses/d) doubled the risk of depression and anxiety (P < 0.0001). After adjusting potential confounders, this inverse link remained significant for depression (OR: 1.79; 95%CI: 1.32, 2.42; P < 0.0001), but not for anxiety (OR: 1.49; 95%CI: 0.98, 2.25; P = 0.109). In stratified analyses by sex, after controlling for potential confounders, water drinking < 2 glasses/d was associated with 73% and 54% increment in the risk of depression in men and women, respectively (P < 0.05), whilst no significant association was observed for anxiety either in men or in women.CONCLUSIONWe found inverse associations between plain water consumption and depression. Also, these findings showed a tended risky association, but not statistically significant, between lower levels of water consumption and anxiety. These findings warrant evaluation in prospective and clinical trials studies to establish the plausible role of water in mental health status.

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Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiological data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms, and gastroesophageal reflux disease (GERD) in a large group of Iranian adults. Design, Setting, and Subjects: In a cross-sectional study on 3,363 Iranian adults, we calculated the “healthy lifestyle score” for each participant by summing up the binary score given for 5 lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking, and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire, and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. To assess FGIDs, a validated Persian version of ROME III questionnaire was used. Results: After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (OR: 0.21; 95% CI: 0.05–0.92) and GERD (OR: 0.26; 95% CI: 0.09–0.69), respectively, compared with those with the lowest score. They were also less likely to have early satiation (OR: 0.28; 95% CI: 0.11–0.73), postprandial fullness (OR: 0.22; 95% CI: 0.09–0.50), and epigastric pain (OR: 0.44; 95% CI: 0.21–0.92). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits, and nonsmoking were separately and protectively associated with FGIDs. Conclusion: We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD, and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions.

Background and purpose Performing a proper causative workup for ischemic stroke patients is essential as it guides the direction of primary and secondary preventions. We aim to investigate the etiological evaluation of these patients in university and nonuniversity hospitals. Method We enrolled subjects from the Persian Registry of Cardiovascular Disease–stroke. Stroke patients were categorized base on an etiological-based classification (Trial of Org 10172 in Acute Stroke Treatment or TOAST) into five groups. We also separated patients with ischemic stroke of undetermined etiology due to incomplete standard evaluation from ischemic stroke of undetermined etiology due to negative standard evaluation. The etiological subtypes and diagnostic evaluations were compared between the two hospital groups. Result Ischemic stroke of undetermined etiology was the most common subtype overall (43%). The prevalence of ischemic stroke of undetermined etiology (incomplete standard evaluation) was significantly higher in patients evaluated in nonuniversity hospitals versus university hospital (46.2% vs. 22.3%). Patients with ischemic stroke of undetermined etiology (negative standard evaluation) and large-artery atherosclerosis were significantly more prevalent in university hospitals (10.3% vs. 4.6% and 13.9% vs. 4.4%, respectively). All diagnostic workups were performed more significantly for university hospital patients. Patients with Ischemic stroke of undetermined etiology (negative standard evaluation). Patients were significantly younger (64.91 ± 14.44 vs. 71.42 ± 12.93) and had lower prevalence of risk factors such as hypertension (48.5% vs. 65.4%) and diabetes (19.4% vs. 33.1%) than patients in ischemic stroke of undetermined etiology (incomplete standard evaluation) subgroup. University hospital patients had better clinical outcomes in terms of mortality and degree of disability during one-year follow-up. Conclusion The high clinical burden of ischemic stroke of undetermined etiology especially in nonuniversity hospitals shows the rational for promoting ischemic stroke evaluation and providing specialized stroke centers for these hospitals in a developing country like Iran.

Objective: To evaluate the cumulative prevalence of atherosclerotic cardiovascular disease risk factors in a representative sample of Iranian adolescents. Methods:The subjects of this cross-sectional study were 1,000 girls and 1,000 boys, ages 11-18 years, selected by multi stagerandom cluster sampling from urban and rural areas of three cities in Iran.Results: The prevalence of physical inactivity, dyslipidemia, smoking, high blood pressure and obesity (body mass index >95th percentile) were 66.6, 23.7, 8.7, 5.7 and 2.2%, respectively. Of subjects studied, 79.1% had at least one and 24.6% had two cardiovascular disease risk factors. The prevalence of physical inactivity was significantly lower in boys than girls [53.9 vs. 79.3%, respectively, OR 95%CI, 0.44 (0.39-0.51)]. The prevalence of smoking was higher in boys than girls [13.1 vs. 4.2%, respectively, OR 95%CI, 3.4 (2.4-4.9)]. Conclusion:Considering the high prevalence of cardiovascular disease risk factors in adolescents, age-appropriate and culturally sensitive interventions for lifestyle change are warranted, so that preventive measures can be taken in a timely manner. ResumoObjetivo: Avaliar a prevalência cumulativa de fatores de risco para doenças cardiovasculares ateroscleróticas em uma amostra representativa de adolescentes iranianos.Métodos: Os sujeitos incluídos neste estudo transversal foram 1.000 meninas e 1.000 meninos com idades entre 11 e 18 anos, selecionados em amostragem aleatória de residentes em áreas urbanas e rurais em três cidades do Irã.Resultados: As prevalências de sedentarismo, dislipidemia, tabagismo, hipertensão e obesidade (índice de massa corporal > 95º percentil) foram de 66,6,23,7,8,7,5,7 e 2,2%, respectivamente. Dentre os sujeitos avaliados, 79,1% apresentavam pelo menos um fator de risco e 24,6% apresentavam dois fatores de risco para doença cardiovascular. A prevalência de sedentarismo foi significativamente mais baixa nos meninos do que nas meninas [53,9 versus 79,3%, respectivamente, RC de 95%IC, 0,44 (0,51)]. A prevalência do tabagismo foi mais alta nos meninos do que nas meninas [13,1 versus 4,2%, respectivamente, RC 95%IC, 3,4 (2,4-4,9)].Conclusão: Considerando a alta prevalência de fatores de risco para doenças cardiovasculares em adolescentes, são justificadas intervenções adequadas à idade e cultura dos sujeitos, com o objetivo de promover mudanças de estilo de vida necessárias para que medidas preventivas possam ser tomadas oportunamente.J Pediatr (Rio J). 2005;81(6):447-53: Doença cardiovascular, fatores de risco, adolescente, prevalência.

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Background:Psychological profile of inflammatory bowel disease patients is not well studied in Iran. We investigated the psychological status of Iranian patients with ulcerative colitis (UC) and its relationship with disease activity and quality of life (QOL).Materials and Methods:A cross-sectional study was conducted on adult UC patients. The Lichtiger Colitis Activity Index, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, and WHOQOL-BREF, were completed by the patients.Results:From 120 studied patients, 35 (29.2%), 48 (40.0%), and 46 (38.3%) had significant anxiety, depression, and psychological distress, respectively. Anxiety, depression, and psychological distress were strongly correlated with disease activity (r = 0.357 to 0.439, P < 0.01). Disease activity was negatively correlated with all QOL dimensions (r = −0.245 to −0.550, P < 0.01). Anxiety, depression, and psychological distress were also negatively correlated with all QOL domains (r = −0.356 to −0.789, P < 0.01). In the regression models, anxiety was independently associated with active disease (β = 4.150, P = 0.049). Furthermore, disease activity was associated with the physical health (β = −0.371, P < 0.001). For almost all of the QOL domains, depression and psychological distress were independent predictors (β = −0.296 to −0.453, P < 0.001).Conclusion:Anxiety, depression, and psychological distress are highly frequent in UC patients of our society and are strongly associated with disease activity. Depression and psychological distress are important predictors of poor QOL in these patients. Further prospective studies, as well as clinical trials, are warranted in this regard.

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