Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68 ±2.32 kg/㎡ ), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡ ) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO 2peak ), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO 2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.

Objective: To determine the antibiotic resistance patterns of the Acinetobacter (A.) baumannii complex isolates that cause the confirmed infection. Methods: The present descriptive study was performed from March 2016 to March 2018 in three referral hospitals in Isfahan, Iran. All A. baumannii complex strains isolated from different clinical samples were identified by conventional phenotypic methods and antibiotic susceptibility pattern was detected. After the clinical investigation, contaminated samples were excluded and the source (hospital/community) and site of the infection were determined. Data on antibiotic susceptibility testing were extracted from WHONET software and analysis was done with SPSS. Results: From 254 patients who had confirmed A. baumannii complex infection, 158 (62.20%) cases were male, 27 (10.63%) were less than 20 years old, 172 (67.72%) had healthcare-Associated infections and 96 (37.79%) were admitted in intensive care units. The most frequent infection was bloodstream infections (111, 43.70%). Our results showed that most of the isolates were resistant to most of the antibiotics (more than 75.00%) and a lower rate of non-susceptibility was observed against minocycline (20, 44.44%) and colistin (0%). The rate of multidrug-resistant isolates was 88.97%. There was no significant difference between resistance of A. baumannii complex isolates according to age. However, the resistance to amikacin and minocycline and the rate of multidrug resistance (MDR) were significantly different between males and females. In patients with healthcare associated infection (HAI), MDR isolates were significantly different regarding admission in ICU ward. Resistance to levofloxacin and ciprofloxacin were lower in isolates from patients with bloodstream infections in comparison to other diagnoses. Conclusions: In our study, a high level of antibiotic resistance was detected in both community-Acquired and healthcare-Associated A. baumannii complex infections. Appropriate antibiotic prescription in a clinical setting is an essential need for the control and prevention of A. baumannii resistant infections.

Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68 ±2.32 kg/㎡ ), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡ ) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO 2peak ), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO 2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna (980-1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE, Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre- and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some organs. On the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

OBJECTIVES: Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents. METHODS: This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight. RESULTS: The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66). CONCLUSION: Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.
Adolescent ; Aggression ; Anxiety ; Body Image ; Body Weight ; Child ; Depression ; Education ; Female ; Humans ; Overweight ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Thinness ; Weight Perception

BACKGROUND: Metabolic syndrome (MetS) is a complex and multifactorial disorder characterized by insulin resistance, dyslipidaemia, hyperglycemia, abdominal obesity, and elevated blood pressure. The apolipoprotein A5 (APOA5) gene variants have been reported to correlate with two major components of MetS, including low levels of high density lipoprotein cholesterol (HDL-C) and high levels of triglyceride. In the present study, we explored the associations between five single nucleotide polymorphisms (SNPs) of APOA5 gene and the MetS risk. METHODS: In a case-control design, 120 Iranian children and adolescents with/without MetS were genotyped by polymerase chain reaction-sequencing for these SNPs. Then, we investigated the association of SNPs, individually or in haplotype constructs, with MetS risk. RESULTS: The rs34089864 variant and H1 haplotype (harboring the two major alleles of rs619054 and rs34089864) were associated with HDL-C levels. However, there was no significant association between different haplotypes/individual SNPs and MetS risk. CONCLUSION: These results presented no association of APOA5 3’UTR SNPs with MetS. Further studies, including other polymorphisms, are required to investigate the involvement of APOA5 gene in the genetic susceptibility to MetS in the pediatric age group.
Adolescent ; Alleles ; Apolipoproteins ; Blood Pressure ; Case-Control Studies ; Child ; Cholesterol, HDL ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Hyperglycemia ; Insulin Resistance ; Obesity, Abdominal ; Polymorphism, Single Nucleotide ; Triglycerides

BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.
Adolescent ; Blood Glucose ; Blood Pressure ; Body Mass Index* ; Body Weight ; Child ; Fasting ; Humans ; Joints ; Leisure Activities ; Linear Models ; Lipoproteins ; Motor Activity* ; Overweight ; Thinness ; Waist Circumference

Although several studies have assessed the influence of the glycemic index on body weight and blood pressure among adults, limited evidence exists for the pediatric age population. In the current study, we compared the effects of low glycemic index (LGI) diet to the healthy nutritional recommendation (HNR)-based diet on obesity and blood pressure among adolescent girls in pubertal ages. This 10-week parallel randomized clinical trial comprised of 50 overweight or obese and sexually mature girls less than 18 years of age years, who were randomly assigned to LGI or HNR-based diet. Macronutrient distribution was equivalently prescribed in both groups. Blood pressure, weight and waist circumference were measured at baseline and after intervention. Of the 50 participants, 41 subjects (include 82%) completed the study. The GI of the diet in the LGI group was 42.67 +/- 0.067. A within-group analysis illustrated that in comparison to the baseline values, the body weight and body mass index (not waist circumference and blood pressure) decreased significantly after the intervention in both groups (P = 0.0001). The percent changes of the body weight status, waist circumference and blood pressure were compared between the two groups and the findings did not show any difference between the LGI diet consumers and those in the HNR group. In comparison to the HNR, LGI diet could not change the weight and blood pressure following a 10-week intervention. Further longitudinal studies with a long-term follow up should be conducted in this regard.
Adolescent ; Adult ; Blood Pressure ; Body Mass Index ; Body Weight ; Diet ; Follow-Up Studies ; Glycemic Index ; Humans ; Longitudinal Studies ; Obesity ; Overweight ; Waist Circumference

OBJECTIVEThe prevalence of obesity is increasing in Iranian youngsters. This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour, a city in northeastern, Iran.

METHODSThis case-control study was conducted among 114 school students, aged 6-12 years, with a body mass index (BMI) ≥95th (based on percentile of Iranian children) as the case group and 102 age- and gender-matched controls, who were selected from their non-obese classmates. Nutrient intake data were collected by trained nutritionists by using two 24-hour-dietary recalls through maternal interviews in the presence of their child. A food frequency questionnaire was used for detecting the snack consumption patterns. Statistical analysis was done using univariate and multivariate logistic regression (MLR) by SPSS version 16.

RESULTSIn univariate logistic regression, total energy, protein, carbohydrate, fat (including saturated, mono- and poly-unsaturated fat), and dietary fiber were the positive predictors of obesity in studied children. The estimated crude ORs for frequency of corn-based extruded snacks, carbonated beverages, potato chips, fast foods, and chocolate consumption were statistically significant. After MLR analysis, the association of obesity remained significant with energy intake (OR = 2.489, 95%CI: 1.667-3.716), frequency of corn-based extruded snacks (OR = 1.122, 95%CI: 1.007-1.250), and potato chips (OR = 1.143, 95%CI:1.024-1.276). The MLR analysis showed that dietary fiber (OR = 0.601, 95%CI: 0.368-0.983) and natural fruit juice intake (OR = 0.909, 95%CI: 0.835-0.988) were protective factors against obesity.

CONCLUSIONSThe findings serve to confirm the role of an unhealthy diet, notably calorie-dense snacks, in childhood obesity. Healthy dietary habits, such as the consumption of high-fiber foods, should be encouraged among children.

Case-Control Studies ; Child ; Energy Intake ; Feeding Behavior ; Humans ; Iran ; epidemiology ; Logistic Models ; Obesity ; epidemiology ; etiology

OBJECTIVETo assess the predisposing factors, frequency and mortality of pneumothorax (PTX) among the newborns hospitalized in a neonatal intensive care unit (NICU) in Isfahan, Iran.

METHODSThe data of 43 cases of PTX among the 738 neonates hospitalized in the NICU were analyzed retrospectively according to gestational age, birth weight, Apgar score, type of delivery, age of mother, parity, perinatal asphyxia, resuscitation at birth, side of PTX, mechanical ventilation, surfactant therapy, and underlying lung disorders.

RESULTSMean gestational age was 31 weeks and birth weight was 1 596 g in the PTX cases. The gestational age of 12 (28%) neonates was less than 28 weeks. Twenty-eight (65%) neonates were below 1,500 g. In total, PTX occurred in 43 (5.8%) neonates. Sixty-three episodes of PTX (97%) were unilateral and 2 (3%) were bilateral. Respiratory distress syndrome (RDS) (40/43, 93%) and mechanical ventilation (37/43, 86%) were common predisposing factors of PTX. Overall, 28 (65%) neonates with PTX died. Birth weight, gestational age and chest tube duration were significantly different between dead and surviving infants. The mortality rate was significantly higher in neonates who required surfactant therapy than that in those who did not require it.

CONCLUSIONSThe incidence and mortality of PTX in this study were higher than some other reports and this might be attributed to lower birth weight and gestational age. RDS and mechanical ventilation were the most common predisposing factors for the development of neonatal PTX, and mortality increased with lower birth weight, lower gestational age and more severe underlying primary lung disease.

Humans ; Incidence ; Infant, Newborn ; Intensive Care Units, Neonatal ; Iran ; epidemiology ; Pneumothorax ; epidemiology ; etiology ; mortality ; Retrospective Studies