This study aims to determine the difference of serum Pb and Hg levels in adolescents with or without metabolic syndrome (MetS) and the association of serum levels of these heavy metals with cardiometabolic risk factors and liver enzymes in Iranian adolescents. The study population consisted of 320 adolescents (160 with MetS and 160 healthy controls). The relationship between serum heavy metals and cardiometabolic risk factors was assessed by linear regression. The odds ratios (OR) of having metabolic syndrome across Pb and Hg quartiles were determined by multiple logistic regression analysis. The mean (SD) of Pb and Hg concentrations were higher in adolescents with MetS than in those without it (0.83 (0.27) and 0.17 (0.01) vs. 0.65 (0.15) and 0.10 (0.08) μg/L, P = 0.01 and 0.0001, respectively). Increase in serum Pb and Hg was associated with increase in some cardiometabolic risk factors. Among boys and girls, diastolic blood pressure (DBP), fasting blood glucose, total cholesterol (TC), triglycerides (TG), and alanine aminotransaminase increased significantly across quartiles of serum Pb. Among girls, SBP, DBP, TC, and TG had a significant increase across Hg quartiles. The corresponding figure among boys was significant for SBP, DBP, and TG. Higher quartiles of Pb increased the risk of having MetS (OR 95 % CI 3.10, 2.25-4.27), the corresponding figure was 2.03, 1.75-3.16, across Hg quartiles. Our study showed significant associations between serum Pb and Hg levels with cardiometabolic risk factors in adolescents. In future surveys, the role of potential confounders should be considered more extensively. The clinical significance of these findings needs to be confirmed in longitudinal studies. By considering the origins of chronic diseases from early life, controlling environmental pollutants should be considered as a health priority for primordial or primary prevention of noncommunicable diseases.

Background:Various species of Candida, especially Candida albicans was known as the most important etiological agent of fungal infections. Oral candidiasis is the most common fungal infection in patients undergoing chemotherapy. The purpose of this study was to identify Candida species from oral lesions of these patients and antifungal susceptibility of the clinical isolates.Materials and Methods:Among 385 patients with cancer, 55 (14.3%) showed oral lesions. Oral swabs were performed to identify the yeasts using direct smear and CHROMagar medium. Micro dilution method was prepared in different concentrations of fluconazole and minimum inhibitory concentration and minimum fungicidal concentration of each species were compared.Results:Oral candidiasis confirmed in 36 cases by direct examination and culture. C. albicans and non-albicans represented in 26 (72.2%) and 10 (27.8%) of the isolates, respectively. 76.5% of C. albicans and 23.5% non-albicans isolates were resistant to fluconazole. Data were shown that 62% and 30.7% of resistant strains of C. albicans were found in patient with gastrointestinal cancer and lymphoma respectively.Conclusion:Data were shown that C. albicans is the most commonly identified species in oral candidiasis and majority of fluconazole resistant C. albicans were found in patients with gastrointestinal cancer and lymphoma. Therefore, we recommend an alternative drug instead of fluconazole as a first line of treatment for these type of cancers and administration of fluconazole in patients undergoing chemotherapy should be prescribed in accordance with the type of cancer.

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This study aimed to evaluate the accuracy and performance of modified blood pressure‐to‐height ratio (MBPHR) for identifying high blood pressure (HBP) in a large population of children. This multicentric cross‐sectional study was conducted on a nationally representative sample of 7349 Iranian students aged 7‐12 years living in 30 provinces in Iran. High systolic blood pressure and diastolic blood pressure were defined according to the 2017 American Academy of Pediatrics (AAP) guidelines. The BP‐to height ratio (BPHR) was calculated as BP (mmHg)/height (cm), MBPHR3 as BP (mmHg)/(height (cm) + 3 (13‐age)), and MBPHR7 as BP (mmHg)/(height (cm) + 7 (13‐age). The receiver‐operating characteristic curve analysis was used to evaluate the performance of these three ratios for identification of HBP in children compared to the 2017 AAP guidelines as the gold standard. Mean age of participants was 12.29 ± 3.15 years and 3736 (50.8%) were girls. The prevalence of HBP was 11.9% (11.5% in boys, 12.3% in girls). The area under the curve (AUC) was higher for MSBPHR3/MDBPHR3 (0.97/0.98) than MSBPHR7/MDBPHR7 (0.96/0.97) and SBPHR/DBPHR (0.96/0.95) for identifying high Systolic and diastolic BP. The optimal cut‐off points for MSBPHR3/MDBPH, MSBPHR7/MDBPHR7, and SBPHR/DBPHR were 0.76/0.50, 0.69/0.46, and 0.81/0.52 respectively. Negative predictive value was nearly perfect for three ratios (≥98%). Positive predictive value was higher for MBPHR3 (52.7%) than MBPHR7 (51.0%) and BPHR (39.8%). Overall, MBPHR3 had better performance than MBPHR7 and BPHR for identification of HBP in Iranian children and it may improve early hypertension recognition and control in primary screening.

Anthropometric indices have been used as indicators for predicting hypertension (HTN) in children and adolescents but it is not clear which anthropometric measures are a better index for identifying elevated blood pressure (EBP) risk factors in pediatric population. Body mass index (BMI), waist circumference (WC), weight‐height ratio (WHR), a body shape index (ABSI) and blood pressure were measured in 14 008 children and adolescents aged 7‐18 years in a national school‐aged survey CASPIN V. Hypertension (HTN) was defined according to the 2017 American Academy of Pediatrics guidelines, using the 95th percentile. The predictive power of anthropometric indices for HTN risk factors was examined using receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to compare areas under ROC curves (AUCs) among the four anthropometric indices. BMI, WC, WHR, and ABSI were significantly higher in adolescents than in children. EBP was more prevalent in boys (7.2%) than girls (5.5%), whereas the prevalence of HTN was higher in girls (11.3%) than boys 10.4%. Prevalence odds ratio was around 2 for BMI, WC, and WHR with AUCs scores of nearly 0.6 to predict EBP in both children and adolescents of both sexes. Thus, the ability of BMI z‐score, WC, WHR or ASBI to identify Iranian children and adolescents at higher risk of EBP was week. WC, WHR or ASBI in combination with BMI did not improve predictive power to identify subjects at higher risk of EBP.

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Background Musculoskeletal symptoms often occur in more than one anatomical site. The present study aimed to define specific patterns of multisite musculoskeletal disorders and examine how these patterns are related to common psychological problems. Methods Using the data from an interview-based health survey of 358 samples of the industrial manufacturing male employees, we derived major patterns of musculoskeletal complaints using latent class analysis and investigated its association with psychological problems score extracted from depression, anxiety, and stress measured by Depression/Anxiety/Stress Scale (DASS-21). Musculoskeletal disorders were assessed by Nordic Musculoskeletal Questionnaire (NMQ). The statistical analysis was carried out by Mplus 8. Results Complaints in the lower back (42.1%) and neck (30.7%) had the highest prevalence, and in the hip (15.0%) and ankle (12.2%) the lowest. Three major patterns of musculoskeletal disorders were extracted using latent class analysis. Class 1 (12.9%) was characterized by a high rate of complaints in upper musculoskeletal sites, such as the neck, shoulder, and joints; class 2 (38.2%) was identified by a higher rate of complaints in the lower and upper back; and class 3 (48.9%) was marked by low rates of complaints in all musculoskeletal sites. After adjustment for confounding variables and specifying class 3 as the reference, it turned out that there was a statistically significant association between the psychological problems score and the chance of being in class 1 (OR = 2.47, 95% CI 1.66–3.68), but not a significant association with the chance of being in class 2 (OR = 1.51, 95% CI 0.83–2.72). Conclusion Musculoskeletal disorders can be summarized in the latent class-derived patterns in the adult study population and provide additional prognostics. Common psychological problems are significantly associated with the type of musculoskeletal disorder patterns. The findings in this study could be useful for dealing with prevention and treatment programs.

Objectives. The aim of the current study was to investigate the growth status of CH, generate specialized growth charts of CH infants, and compare them with their counterparts of regional normal infants. Methods. In this prospective cohort study, 760 (345 girls and 415 boys) neonates born in 2002–2009 diagnosed by neonatal CH screening program in Isfahan were followed up from the time of diagnosis. 552 healthy children were recruited as a control group. The empirical 3rd, 15th, 50th, 85th, and 97th percentiles for height, weight, and head circumference of both sexes were determined and compared with their counterpart values of the control group. The relative frequency of patients with impaired growth for each studied variable was determined. Also, specialized growth charts of CH patients were generated. Results. The percentiles of weight, height, and head circumference of studied patients are significantly different from regional healthy children (P < 0.001). The relative frequency of impaired head circumference was decreased to less than 3% at the 3rd year of age and for height it reached gradually 3% and 9% at the 5th year of age for boys and girls, respectively (P < 0.05); however for weight still it was statistically more than 3% in both sexes. Conclusion. CH patients had impaired growth development which was improved during follow up, but the catch-up time was earlier for head circumference and later for weight.