BackgroundNoncommunicable diseases (NCDs) are the major causes of mortality across the globe, whi... more BackgroundNoncommunicable diseases (NCDs) are the major causes of mortality across the globe, which impose a substantial burden on health care systems, particularly in low‐ and middle‐income countries. The present study aimed to determine socioeconomic inequality in the prevalence of NCDs using the concentration index (CI).MethodsThis cross‐sectional study was conducted on the baseline data of the Bandar Kong cohort. The principal component analysis was used to determine people's socioeconomic status (SES). The CI and Lorenz Curve were used for the assessment of socioeconomic inequality. Multivariate logistic regression was used to assess the relationship between SES and the prevalence of NCDs. A p Value less than 0.05 is considered significant.ResultsFrequency and prevalence of diabetes was 653 (16.22%), hypertension 848 (21.06%), chronic lung diseases 161 (4%), epilepsy 70 (1.74%), mental disorders 191 (4.74%), stillbirth 299 (13.94%), thyroid disorders 391 (9.71%) and depress...
Background: The investigation of middle-aged women's mental and physical health measures should b... more Background: The investigation of middle-aged women's mental and physical health measures should be focused on menopause-a predictable physiological phenomenon in their lives. The prevalence of a majority of chronic diseases increases after this period. This study aimed to determine the risk factors of delayed menopause (climacterium tardum). Materials and methods: The current cross-sectional research was conducted on 1930 menopausal women who were referred to the cohort study of Fasa University of Medical Sciences, Fars Province, Iran, during 2014-2015. The data were extracted from the database, and then the variables were checked for accuracy. Finally, the data were analyzed using logistic regression analysis. Results: The study population included 1930 menopausal women with the mean age of 57.98 ± 5.8 years. Of these, 1555 (80.6%) were married, and the rest were single and widowed. The mean age at menarche was 13.7 ± 1.64 years. Additionally, 1726 women (89.4%) had experienced natural menopause, whereas the rest had experienced delayed menopause. The results of the multivariate analysis indicated that delayed menopause was associated with marital status, education level, age at menarche, occupation, abortion, and use of contraceptive methods. However, no significant relationship was found between delayed menopause and smoking, duration of lactation, duration of using contraceptive pills, and number of childbirths. Conclusion: Considering the increased life expectancy among women, delayed menopause, and its risk factors should be taken into account. Although genetic factors play key roles in age at the onset of menopause, the role of sociodemographic factors such as marital status and pregnancy should not be ignored.
Journal of Health, Population and Nutrition , 2023
Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholestero... more Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. Methods A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05). Conclusion The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.
Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholestero... more Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. Methods A total of 758 pre-diabetic patients aged 35–70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, t...
Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Di... more Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Dietary risks account for the most cause of CVDs mortalities. Evaluating overall dietary patterns (through the Latent profile of dietary intake) can provide a more accurate prediction regarding the prevalence of CVDs. The present cross-sectional study aimed to investigate the relationship between the latent profile of dietary intake and CVDs prevalence. The population of the Fasa Adults Cohort Study (FACS) (Fars Province, Iran) was employed to gather the data (n = 8319). A modified 125-item FFQ was employed to assess eating behaviors. Minerals, as well as the quantity of energy and total fiber, were measured using Nutritionist IV software (version 7.0). To estimate the prevalence of CVDs, accurate records of patients' histories were made. Individuals were clustered according to their dietary intake using latent profile analysis. The individuals who consume the highest, medium, and lowe...
Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients.... more Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients. CD4 cell count is one of the most critical indicators of the disease progression. With respect to the dynamic nature of CD4 cell count during the clinical history of HIV/AIDS, modeling the CD4 cell count changes, which represents the likelihood of disease progression, is of interest to establish or revise treatment strategies and, specifically, to determine the stage at which giving ART is more clinically effective. In this historical cohort study on 917 HIV/AIDS patients in the Iranian “National Registry of HIV/AIDS Care” database, we used the Markov chain model to predict the effectiveness of the ART based on the transition probability of CD4 cell count, measured before and after initiating ART. We found that when the ART was initiated in the earlier stages of HIV infection, good prognosis might be more accessible; that is, after initiating ART at state CD 4 ≥ 500 , the probability of...
Background Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probabl... more Background Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probable COVID-19 pandemic is affected its healthcare coverage. Methods The interrupted time series analysis is used to model the trend of diabetes healthcare indices, such as the health worker visits, physician visits, body mass index (MBI), fasting blood sugar (FBS), and hemoglobin A1c (HbA1c), before and after the start of COVID-19 pandemic. The reference of data was the totals of all T2DM patients living in Fars Province, Southern Iran, areas covered by Shiraz University of Medical Science (SUMS), from 2019 to 2020. Results A significant decrease for visits by the health workers, and physicians was observed by starting COVID-19 pandemic (β 2 =-0.808, P < 0.001, β 2 =-0.560, P < 0.001); Nevertheless, the coverage of these services statistically increased by next months (β 3 = 0.112, P < 0.001, β 3 = 0.053, P < 0.001). A same pattern was observed for the number of BMI, FBS and HbA1c assessments, and number of refer to hospital emergency wards (β 3 = 0.105, P < 0.001; β 3 = 0.076, P < 0.001; β 3 = 0.022, P < 0.001; β 3 = 0.106, P < 0.001). The proportion of T2DM patients with HbA1C < 7%, and controlled hypertension during study period was statistically unchanged. Conclusions When the COVID-19 pandemic was announced, T2DM healthcare coverage drastically decreased, but it quickly began to rebound. The health monitoring system could not have any noticeable effects on diabetes outcomes.
Background: The effect of interarm blood pressure difference on the development of diabetic retin... more Background: The effect of interarm blood pressure difference on the development of diabetic retinopathy, proteinuria and chronic kidney disease remains unknown. We investigated to determine the impact of interarm blood pressure difference on the prevalence of diabetic retinopathy, proteinuria and chronic kidney disease in patients with type 2 diabetes. Methods: The study included 563 patients with diabetes, who were evaluated with a simultaneous bilateral blood pressure measurement. The cutoff values for interarm blood pressure difference were 5, 10 and 15 mmHg. Logistic regression analysis was used to explore the relation between interarm blood pressure difference and diabetic retinopathy, proteinuria and chronic kidney disease. Results: Diabetic patients with systolic interarm blood pressure difference ⩾5, ⩾10 and ⩾15 mmHg showed an increased risk of diabetic retinopathy [adjusted odds ratio = 1.48 (95% confidence interval = 1.01–2.18), odds ratio = 1.80 (95% confidence interval =...
ObjectivesEpidemics are anticipated to influence the coverage of health services. We assessed the... more ObjectivesEpidemics are anticipated to influence the coverage of health services. We assessed the impact of the COVID-19 pandemic on maternal healthcare indices and care providers’ performance.Setting1801 maternal healthcare centres under the auspices of Shiraz University of Medical Sciences, Shiraz, Southern Iran.ParticipantsApproximately 63 000 pregnant women.Primary and secondary outcome measuresIn this prospective ecological study, interrupted time series analysis was used to model and compare the trend of maternal healthcare indices before and after the COVID-19 pandemic announcement.ResultsThe results showed a significant drop in count of preconception healthcare visits, first routine laboratory tests, first trimester prenatal care, first trimester sonography, prenatal screening for birth defects at weeks 11–13, prenatal care visits at weeks 16–20, second routine laboratory tests, second trimester sonography, prenatal care visits at weeks 24–30, prenatal care visits at weeks 3...
Background & Objective: Many different combination regimens have been used for the treatment of p... more Background & Objective: Many different combination regimens have been used for the treatment of patients infected with human immunodeficiency viruses (HIV). This study aimed to compare the efficacy of two antiviral drugs for the treatment of HIV-infected patients. Materials & Methods: This cross-sectional study was performed on HIV-positive patients in Fasa, Southwest Iran. Eighty patients were enrolled in the investigation who were then randomly divided into two groups and treated plus vonavir (tenofovir-emtricitabine-efavirenz) and cobavir (lamivudine-zidovudine) with efavirenz for six months. Blood samples collected from all patients were examined for viral load every six months using Real-time PCR and CD4 changes by flow cytometry. Result: During the six months of treatment, the CD4 response was not significantly increased in group one, treated with vonavir. In contrast, the CD4 value showed a significant increasing trend during the treatment course in group two treated with cob...
Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The pr... more Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep duration, physical activity, and ECG parameters in the Fasa Persian cohort study. Methods In this cross-sectional study, the basic information of 10,000 participants aged 35–70 years in the Fasa cohort study was used. The data used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep duration, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model. Results Based on multivariate linear regression analysis results, increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference, hip circumference and waist circumference significantly increased the mean values of the ECG param...
BackgroundNoncommunicable diseases (NCDs) are the major causes of mortality across the globe, whi... more BackgroundNoncommunicable diseases (NCDs) are the major causes of mortality across the globe, which impose a substantial burden on health care systems, particularly in low‐ and middle‐income countries. The present study aimed to determine socioeconomic inequality in the prevalence of NCDs using the concentration index (CI).MethodsThis cross‐sectional study was conducted on the baseline data of the Bandar Kong cohort. The principal component analysis was used to determine people's socioeconomic status (SES). The CI and Lorenz Curve were used for the assessment of socioeconomic inequality. Multivariate logistic regression was used to assess the relationship between SES and the prevalence of NCDs. A p Value less than 0.05 is considered significant.ResultsFrequency and prevalence of diabetes was 653 (16.22%), hypertension 848 (21.06%), chronic lung diseases 161 (4%), epilepsy 70 (1.74%), mental disorders 191 (4.74%), stillbirth 299 (13.94%), thyroid disorders 391 (9.71%) and depress...
Background: The investigation of middle-aged women's mental and physical health measures should b... more Background: The investigation of middle-aged women's mental and physical health measures should be focused on menopause-a predictable physiological phenomenon in their lives. The prevalence of a majority of chronic diseases increases after this period. This study aimed to determine the risk factors of delayed menopause (climacterium tardum). Materials and methods: The current cross-sectional research was conducted on 1930 menopausal women who were referred to the cohort study of Fasa University of Medical Sciences, Fars Province, Iran, during 2014-2015. The data were extracted from the database, and then the variables were checked for accuracy. Finally, the data were analyzed using logistic regression analysis. Results: The study population included 1930 menopausal women with the mean age of 57.98 ± 5.8 years. Of these, 1555 (80.6%) were married, and the rest were single and widowed. The mean age at menarche was 13.7 ± 1.64 years. Additionally, 1726 women (89.4%) had experienced natural menopause, whereas the rest had experienced delayed menopause. The results of the multivariate analysis indicated that delayed menopause was associated with marital status, education level, age at menarche, occupation, abortion, and use of contraceptive methods. However, no significant relationship was found between delayed menopause and smoking, duration of lactation, duration of using contraceptive pills, and number of childbirths. Conclusion: Considering the increased life expectancy among women, delayed menopause, and its risk factors should be taken into account. Although genetic factors play key roles in age at the onset of menopause, the role of sociodemographic factors such as marital status and pregnancy should not be ignored.
Journal of Health, Population and Nutrition , 2023
Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholestero... more Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. Methods A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05). Conclusion The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.
Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholestero... more Background The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. Methods A total of 758 pre-diabetic patients aged 35–70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, t...
Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Di... more Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Dietary risks account for the most cause of CVDs mortalities. Evaluating overall dietary patterns (through the Latent profile of dietary intake) can provide a more accurate prediction regarding the prevalence of CVDs. The present cross-sectional study aimed to investigate the relationship between the latent profile of dietary intake and CVDs prevalence. The population of the Fasa Adults Cohort Study (FACS) (Fars Province, Iran) was employed to gather the data (n = 8319). A modified 125-item FFQ was employed to assess eating behaviors. Minerals, as well as the quantity of energy and total fiber, were measured using Nutritionist IV software (version 7.0). To estimate the prevalence of CVDs, accurate records of patients' histories were made. Individuals were clustered according to their dietary intake using latent profile analysis. The individuals who consume the highest, medium, and lowe...
Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients.... more Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients. CD4 cell count is one of the most critical indicators of the disease progression. With respect to the dynamic nature of CD4 cell count during the clinical history of HIV/AIDS, modeling the CD4 cell count changes, which represents the likelihood of disease progression, is of interest to establish or revise treatment strategies and, specifically, to determine the stage at which giving ART is more clinically effective. In this historical cohort study on 917 HIV/AIDS patients in the Iranian “National Registry of HIV/AIDS Care” database, we used the Markov chain model to predict the effectiveness of the ART based on the transition probability of CD4 cell count, measured before and after initiating ART. We found that when the ART was initiated in the earlier stages of HIV infection, good prognosis might be more accessible; that is, after initiating ART at state CD 4 ≥ 500 , the probability of...
Background Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probabl... more Background Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probable COVID-19 pandemic is affected its healthcare coverage. Methods The interrupted time series analysis is used to model the trend of diabetes healthcare indices, such as the health worker visits, physician visits, body mass index (MBI), fasting blood sugar (FBS), and hemoglobin A1c (HbA1c), before and after the start of COVID-19 pandemic. The reference of data was the totals of all T2DM patients living in Fars Province, Southern Iran, areas covered by Shiraz University of Medical Science (SUMS), from 2019 to 2020. Results A significant decrease for visits by the health workers, and physicians was observed by starting COVID-19 pandemic (β 2 =-0.808, P < 0.001, β 2 =-0.560, P < 0.001); Nevertheless, the coverage of these services statistically increased by next months (β 3 = 0.112, P < 0.001, β 3 = 0.053, P < 0.001). A same pattern was observed for the number of BMI, FBS and HbA1c assessments, and number of refer to hospital emergency wards (β 3 = 0.105, P < 0.001; β 3 = 0.076, P < 0.001; β 3 = 0.022, P < 0.001; β 3 = 0.106, P < 0.001). The proportion of T2DM patients with HbA1C < 7%, and controlled hypertension during study period was statistically unchanged. Conclusions When the COVID-19 pandemic was announced, T2DM healthcare coverage drastically decreased, but it quickly began to rebound. The health monitoring system could not have any noticeable effects on diabetes outcomes.
Background: The effect of interarm blood pressure difference on the development of diabetic retin... more Background: The effect of interarm blood pressure difference on the development of diabetic retinopathy, proteinuria and chronic kidney disease remains unknown. We investigated to determine the impact of interarm blood pressure difference on the prevalence of diabetic retinopathy, proteinuria and chronic kidney disease in patients with type 2 diabetes. Methods: The study included 563 patients with diabetes, who were evaluated with a simultaneous bilateral blood pressure measurement. The cutoff values for interarm blood pressure difference were 5, 10 and 15 mmHg. Logistic regression analysis was used to explore the relation between interarm blood pressure difference and diabetic retinopathy, proteinuria and chronic kidney disease. Results: Diabetic patients with systolic interarm blood pressure difference ⩾5, ⩾10 and ⩾15 mmHg showed an increased risk of diabetic retinopathy [adjusted odds ratio = 1.48 (95% confidence interval = 1.01–2.18), odds ratio = 1.80 (95% confidence interval =...
ObjectivesEpidemics are anticipated to influence the coverage of health services. We assessed the... more ObjectivesEpidemics are anticipated to influence the coverage of health services. We assessed the impact of the COVID-19 pandemic on maternal healthcare indices and care providers’ performance.Setting1801 maternal healthcare centres under the auspices of Shiraz University of Medical Sciences, Shiraz, Southern Iran.ParticipantsApproximately 63 000 pregnant women.Primary and secondary outcome measuresIn this prospective ecological study, interrupted time series analysis was used to model and compare the trend of maternal healthcare indices before and after the COVID-19 pandemic announcement.ResultsThe results showed a significant drop in count of preconception healthcare visits, first routine laboratory tests, first trimester prenatal care, first trimester sonography, prenatal screening for birth defects at weeks 11–13, prenatal care visits at weeks 16–20, second routine laboratory tests, second trimester sonography, prenatal care visits at weeks 24–30, prenatal care visits at weeks 3...
Background & Objective: Many different combination regimens have been used for the treatment of p... more Background & Objective: Many different combination regimens have been used for the treatment of patients infected with human immunodeficiency viruses (HIV). This study aimed to compare the efficacy of two antiviral drugs for the treatment of HIV-infected patients. Materials & Methods: This cross-sectional study was performed on HIV-positive patients in Fasa, Southwest Iran. Eighty patients were enrolled in the investigation who were then randomly divided into two groups and treated plus vonavir (tenofovir-emtricitabine-efavirenz) and cobavir (lamivudine-zidovudine) with efavirenz for six months. Blood samples collected from all patients were examined for viral load every six months using Real-time PCR and CD4 changes by flow cytometry. Result: During the six months of treatment, the CD4 response was not significantly increased in group one, treated with vonavir. In contrast, the CD4 value showed a significant increasing trend during the treatment course in group two treated with cob...
Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The pr... more Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep duration, physical activity, and ECG parameters in the Fasa Persian cohort study. Methods In this cross-sectional study, the basic information of 10,000 participants aged 35–70 years in the Fasa cohort study was used. The data used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep duration, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model. Results Based on multivariate linear regression analysis results, increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference, hip circumference and waist circumference significantly increased the mean values of the ECG param...
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