*Curriculum Vitae *First name: Armindokht

Last name: shahsanai

Place of Birth: Isfahan, Iran

Sex: Female

Marital status: Married

Nationality: Iranian

Religion: Islam

Office Address: Department of Community and Family Medicine, School of Medicine,Isfahan University of Medical Sciences, (http://mui.ac.ir)P.O.Box. 81746-73461

Office Telephone: Tel: 0098 3137928119Fax: 0098 3137928110

E-mail: shahsanai @med. mui .ac.ir ,armin.shahsanai@gmail.com

Language Skills:

Farsi, English,

Education:

1-Specialty in community Medicine, Isfahan University of Medical

Sciences:2004- 2007.

2-Doctor of Medicine, kashan University of Medical Sciences: 1993-2000.

3-MS of medical education, Isfahan University of Medical Sciences .2009- present

Academic Appointments:

1- Having passed the Workshop on Advanced Research Methodology and Literature Review held by the Isfahan University of Medical Science, Isfahan, Iran, July 30- august 15, 2005

2- Having passed the Workshop on Questioner Design and Survey Study held by the Isfahan University of Medical Science, Isfahan, Iran, January 13-17, 2007.

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3- Having passed the Workshop on Nutrition with mother’s milk held by the Isfahan University of Medical Science, Isfahan, Iran, January 21-24, 2007.

4-Having passed the Workshop on sick children‘s health care held by the Isfahan University of Medical Science, Isfahan, February 25-28, 2007.

4- Having passed the Workshop on TA advanced training on the counseling skills held by transactional analytic centre for education, research and training. Academy of social transformation and family advocacy .held, in Isfahan, Iran. May 13-14 2007

5- Having passed the Workshop on TA held by transactional analytic centre for education, research and training. Academy of social transformation and family advocacy .held, in Isfahan, Iran. , May 10-11, 2007

6- Having passed the Workshop on advanced student evaluation and question design held by the Isfahan University of Medical Science, Isfahan, Iran, March 13, 2008.

7- Having passed the Workshop on design and analysis of cluster randomized trials held by the Isfahan University of Medical Science inCooperation with the International Society for Clinical Biostatistics, Isfahan, Iran, April 28-29,2008I

8- Having passed the Workshop on Critical Appraisal held by the Isfahan University of Medical Science, Isfahan, Iran, June 24, 2008

9- Having passed the Workshop on word software held by the Isfahan University of Medical Science, Isfahan, Iran, July 2-June 16, 2008

10- Having passed the Workshop on excel software held by the Isfahan University of Medical Science, Isfahan, Iran. September 1-17, 2008

11- Having passed the Workshop on scientific writing held by the Isfahan University of Medical Science, Isfahan, Iran, May,31 ,2010

12- Having passed the Workshop on letter writing held by the Isfahan University of Medical Science, Isfahan, Iran, December 11, 2010

13- Having passed the Workshop on writing references with endnote software held by the Isfahan University of Medical Science, Isfahan, Iran, June,22-23,2010

14-Having passed the Workshop on factor analysis held by the Isfahan University of Medical Science, Isfahan, Iran, November,9-10,2010

15- Having passed the Workshop on action research held by the Isfahan University of Medical Science, Isfahan, Iran, October, 28,2010

16- Having passed the Workshop on survival analysis held by the Isfahan University of Medical Science, Isfahan, Iran, July, 21,2011

17- Having passed the Workshop on writing references with Mendeley software ,held by the Isfahan University of Medical Science, Isfahan, Iran, October 29, 2014

18- Having passed the Workshop on advanced Slide and Poster design training, held by the Isfahan University of Medical Science, Isfahan, Iran, October 29, 2014

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Professional Appointments:-1 Assistant Professor and Member of Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences

2-Member of Iranian Medical Council, Iran, I.R. 2001-present

3-Member of Iranian Community and preventive Medicine Society, 2007-present

4- Member of EDC, Isfahan University of Medical Sciences, Isfahan, Iran, 2009- present

5- Member of Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran, 2013- present

6- Member of Porsinai Hakim ) digestive disease)Research Center, Isfahan, Iran,2006- present

Prizes:

1-The 14 th Quran Interpretation Festival. Iranian university of medical sciences( faculty member). Isfahan University of Medical Science, Isfahan, Iran.2009

2- The 4 th shahid motahari Festival on medical education, held by the Isfahan University of Medical Science, Isfahan, Iran, April 25, 2011

Congress Attendance:

A- Participation &Poster presentation:

1- National congress of Equity in health system held by the Isfahan University of Medical Science, Isfahan, Iran, March 10-11, 2009

2- National congress of Gerontology and Geriatric held by the Isfahan University of Medical Science, Isfahan, Iran, March 3-4, 2009.

3-National congress on health organization preparedness in disaster management held by the Isfahan University of Medical Science, Isfahan, Iran, february.17-19, 2009 4- -The2nd National congress on patient care and treatment by complementary and alternative held by the Isfahan University of Medical Science, Isfahan, Iran,october.20-22 ,2010

5-8th Asia Pacific Medical Education conference (APMEC).held by national university of Singapore, Singapore, January 26-30 , 2011

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6-The 3rd International congress on medical law, patients’ rights, international convention center Kish Island IR. Iran, Febriury.22-24, 2011

7-The 4 th shahid motahari Festival on medical education, held by the Isfahan University of Medical Science, Isfahan, Iran, April 25, 2011

8-The2nd National congress on Medical Ethics in the Health System held by the Isfahan University of Medical Science, Isfahan, Iran, Febriury 22-24 ,2012

B- Participation &Speaker:

1-The2nd National congress on Medical Ethics in the Health System held by the Isfahan University of Medical Science, Isfahan, Iran,feb 22-24 ,2012

2-The 3rd International congress on medical law, patients’ rights, international convention center Kish island ,Iran, February.22-24, 2011

3- Geriatric health care Workshop, , held by the state welfare organization of Isfahan. December , 2006

4-progect management- Workshop , held by Isfahan University of Medical Sciences, Isfahan, Iran. November 26, 2009- December 03, 2009

5- Community medicine education, held by the state welfare organization of Isfahan .2008

6- Nutrition with mother’s milk, monthly scientific and practical conference .held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran, July 30, 2006

7- Fasting, , monthly scientific and practical conference .held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran, September 24, 2006

8- Diabetes, monthly scientific and practical conference .held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran,2008

9-Colorectal cancer, monthly scientific and practical conference .held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran, October, 2010

10- Prevention of communicable disease after disaster, monthly scientific and practical conference .held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran, December 10, 2009

11- Drug abuse, held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran,2005

12-New advances in NAFLD (non alcoholic fatty liver diseases) Epidemiology, held by Poursina Hakim Research Center, Isfahan, Iran March 11, 2010

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13- Primary patient health care, held by Community and preventive Medicine Department of IUMS, Isfahan University of Medical Sciences, Isfahan, Iran ,January 06, 2011

14- Suitable Physical activity for children and adolescents -Retraining seminar, held by child growth and development research center, Isfahan University of Medical Sciences, Isfahan, Iran,December 19, 2013

15-Article writing- workshop held by child growth and development research center, Isfahan University of Medical Sciences, Isfahan, Iran,July 15, 2014

C-Participation:

1-health and Islam, held by the Isfahan University of Medical Science, Isfahan, Iran ,December 12-13,2006

2- The 2nd -International psychosomatic congress, held by the Isfahan University of Medical Science, Isfahan, Iran ,May 7-9.2008

3-Influenza A (H1N1) conference held by the Isfahan University of Medical Science, Isfahan, Iran. August 31, 2009

4- The3rd -International psychosomatic congress, held by the Isfahan University of Medical Science, Isfahan, Iran,May,25-27,2011

5-The 1st National Congress on health information systems and knowledge economy held by the Isfahan University of Medical Science, Isfahan, Iran. March 8-10,2011

6-The 4th Clinical Microbiology Congress. Held by the Isfahan University of Medical Science, Isfahan, Iran. 9-11 November 2010

7-The First International Congress on Prevention ,Diagnosis &Management of Hypertension &Developing the Iranian Guidelines held in Isfahan ,Iran .27-29 september 2011

8-Medical Education conference held by the Isfahan University of Medical Science, Isfahan, Iran.24 July 2011

9-ENT 2 held by the Isfahan University of Medical Science, Isfahan, Iran.4 March 2012

10- Endocrinology and Metabolism Congress, Held by the Isfahan University of Medical Science, Isfahan, Iran. 10-12,October, 2012

11-Prevention, immunizing and treatment of women against abuse, seminar, Held by the Isfahan University of Medical Science, Isfahan, Iran, March 11, 2013

12-Common Infectious disease, Scientific Conference, Held by the Isfahan University of Medical Science, Isfahan, Iran, December 22, 2013

13- Communication skills, Scientific Conference, Held by the Isfahan University of Medical Science, Isfahan, Iran, November 17, 2013

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14- Obsession, Scientific Conference, Held by the Isfahan University of Medical Science, Isfahan, Iran, November 7, 2013

15- Principles of rational prescribing and use of medications to treat high blood pressure, Scientific Conference, Held by the Isfahan University of Medical Science, Isfahan, Iran, December 8, 2013

16- Microelements and vitamin deficiency in children and adolescents, Held by the Isfahan University of Medical Science, Isfahan, Iran, January 23, 2014

17-Impact of Environmental Factors on the Incidence of non- communicable Diseases,seminar, Held by research institute for primary prevention of non- communicable Diseases, 14 October ,2014

Articles:

1-Sayed reza Eshaghi ,Mohammad Arash Ramazani ,Armindokh Shahsanai and Arash Pooya .

--validity and Reliability of the Short Form-36 Item Questionnaire as a measure of qualityof life in Elderly Iranian Population ,American Journal of Applied Siences 3(3):1763-1766,2006

Abstract: The utility of The SF-36 questionnaire for evaluation of health related quality of life was notclear in elderly people. The Cross-Sectional study was designed and Iranian version of The SF-36 wasadministered to random sample of 100 old subjects over 60 years old. Finding showed good internalconsistency over 0.7 for all subscales of questionnaire. Convergent validity was obtained for allsubscales with comparison for General Health Questionnaire-28 (GHQ-28) but was not strongly at 2subscales Role emotional and Role physical. Discriminant validity was addressed for gender but forage groups role emotional, mental health and general health subscales were not different significantly.A principal component analysis was leaded one factor structure. Evidence for reliability of thequestionnaire was good. But validity appeared moderate satisfactory. However this questionnaireseems the only measure for assessment of health related quality at life among elderly population.Key words: Validity, reliability, elderly, SF-36, quality of life, Iran

2- zamani ahmadreza, Shahsanai Armindokht*, Mohseni Maedeh

--Design, implementation and evaluation a tool to strengthen physicianpatient communication skills of medical studentsIranian Journal of Medical Education,2011;10(5):578-585AbstractIntroduction: How to communicate and interact with the patient play an effective role in patient satisfaction, treatment outcome, psychological effects, medical costs, clinical competence of physician, and even patient’s complaining. these skills can be learned. Studies showed that physician did not receive enough training communication skills of medical students in an effective and simple manner Methods: This quasi-experimental intervention study was performed on medical students of Isfahan University of Medical Sciences in Internship period in 1388. Participants were randomized to the intervention and control.groups (75 student in each group). intervention group received the tool were developed for guiding physicians to communicate with patient. After two

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months, physician- patient communication in two groups was assessed and compared. Finally, data analysis was performed with spss softwareResults: The overall mean was 29/36±7/2. mean score in both intervention and control groups were 32/5±7 and26/19±5/91 respectively. the mean difference between two groups was 6/35. Difference between intervention and control groups was significant (p<0/001Conclusions: The results showed the use of educational tools are effective on communication with patients. Education about effective communication with patients should be considered in educational l material for medical students. Keywords: doctor and patient relationship, Internship

3- fakhrai SH , kazemian M, Afjeh A, Rozati M, shahsanai A.

--Effect of change of infant position during phototherapy on the level of bilirubin .journal of Isfahan Medical School, Vol 29, No 153, 1st week, November 2011

Abstract: Change of the position of the infants during conventional phototherapy for hyperbilirubinemia is used in many hospitals. The aim of this study was to compare the efficacy of phototherapy in supine versus supine /prone position during phototherapy.

Methods: in a randomized clinical trial 40 term jaundiced neonates who were admitted to the neonatal ward of Mofid Children Hospital, a university Hospital affiliated to Shahid Beheshti University of Medical Sciences , Tehran, Iran were Selected. After entry into the study, infants were randomly assigned two groups: turning group were positioned alternately supine to prone every 6 hour and supine group were only positioned supine.Total serum bilirubin (TSB) were measured just prior to initiation and during 24-h of phototherapy.

Results: No statistically significant differences in TSB after 24-h were observed between the two groups. Key word: phototherapy- bilirubine- infant

4-Zamani A, Shahsanai A ,Kivan SH,Hematti S.Mokarian F,

-- Iranian physicians and patients attitude toward truth telling of cancerjournal of Isfahan Medical School ,Vol 29, No 143, 3rd week, August 2011

Background: Truth Telling has been found as one of the most important issues in physician patient communication. Therefore all of the physicians are concerned with this matter in some way. Disclosure or reticence of the truth has also caused ethical or legal problems. So correct approach to this issue is very important. truth – telling is more important especially in some diseases such as cancer because it has a meaning as same as death in many cultures. It seems stage of cancer, social culture, socioeconomic condition, intelligence,

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education and some other factors affect patients, view and duration of practice stage of disease and some other factors influence physicians, opinion the main goal of this plan is to determine the attitude of patients and physicians about truth telling to cancer patients.Methods: this study is a descriptive one that has been performed in Omid hospital in Isfahan. The bulk sample was considered 50 physicians and 150 patients. The sampling method was non probability for physicians and non probability ( sequentional )for patients. The tool of gathering the data were two standardized questioner’s (every include 22 questions) asking about attitude.Gathering data was analyzed by SPSS software.Results: all of the questionnaires were analyzed. About truth telling to early stage cancer patient %88 of patients and %90 physicians were agree and %78 patients and %72 physicians were agree with truth telling to terminal stage cancer patient. Both of physicians and patient were agree with frankness in telling the diagnosis, no effect of patient socioeconomic condition on truth telling and telling the truth immediately after diagnosis. In both group view doctor is the best person for telling the cancer diagnosis. The best place in patients, view is doctor office and in physicians, view is a quiet and undisturbed room. The majority of idea in both groups was giving the complete information to cancer patients about diagnosis, prognosis, treatment and side-effects of treatment Discussion : Noticing the obtained results in our society culture, the majority of patients regardless of age, sex, marring state level of education, job condition and incoming, and the majority of physicians regardless of age, sex, marring state, having relative with cancer and medical experience had positive attitude about truth telling to patients in different stages of cancer. So it seems it is one of the essentials to tell the truth based on a correct method.Key word: truth telling, early stage cancer, Terminal stage cancer, patients, and physicians, attitude.

5-Eshagi SR,Shahsanai A,Melat M .

--Assessment of Physical Activity among Elderly People in Isfahan, journal of Isfahan Medical School, Vol 29, No 147, 3rd week, September 2011

Introduction: Improvement of medical care and decreasing mortality, have lead to an increase in ageing in Iranian population and worldwide. One of the goals of Active aging is improving the quality of life of the elderly. One of the determinant factors is adequate physical activity.The aim of this study was to evaluate the physical activity of Isfahan's elderly population.Methods: This cross sectional study was carried out on 350 old residents of Isfahan between the years 2009-2010. Multi stage cluster sampling technique was used to collect the sample population. The tool of the study was Rapid Assessment of Physical Activity (RAPA) questionnaire for evaluating the physical activity. The physical activity Demographic data such as age, sex, education, job, and marital status were obtained and results were analyzed by SPSS 15 software.

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Results: Only 13.7% of Isfahan's elderly had adequate physical activity. This was significantly higher in men and in the elderly with higher income, the married, and the lower age and without any job. The level of education had no significant effect.Discussion: Level of physical activity of Isfahan’s elderly is low and the high risk groups are women elderly with higher age, lower income, single elderly and the one’s with job. There for these groups need more attentions for improved physical activity planning.Key words: Elderly, Physical activity, Socio-economic level.

6- Najmeh Jafari M.D, Armindokht Shahsanaei M.D, Mehrdad Memarzadeh M.D, Amir Loghmani M.D.

--Prevention of communicable disease after disaster: A reviewJournal of Research in Medical Sciences(ISI) July 2011; Vol 16, No 7.

Abstract:

Natural disasters are catastrophic events with atmospheric, geologic and hydrologic origins. In recent decades, natural disasters have killed millions of people, resulting in economic damage.Natural and complex disasters can cause a dramatic increase in mortality and morbidity due to communicable diseases. The major causes of communicable disease in disasters are categorized into four sections: Infections resulting from contaminated food and water, respiratory infections, vector and insect-borne diseases, and infections resulting from wounds and injuries. With appropriate intervention, high morbidity and mortality caused by communicable diseases is largely avoidable.This review article tries to provide the best recommendations for planning and preparing to prevent communicable disease after disaster in two phases: before disaster and after disaster.

7-Siadat Z., Abdoli A., Shahsanaei A

-Association of an adult obesity, blood pressure and smoking behavior with childhood and adulthood socio-economic positionJournal of Research in Medical Sciences(ISI)

Vol 17, No 3 (2012)

.Medical School, Isfahan University of Medical Sciences, Isfahan, IranBackground: The purpose of this study is to investigate an effect of childhood and adulthood socio-economic position on selectedcardiovascular risk factors including obesity, blood pressure level and smoking behavior. Materials and Methods: This is a crosssectionalstudy performed on 479 individuals, randomly selected by random clustered sampling from men and women aged 30-50years, living in Esfahan. Their demographic characteristics, education, occupation and smoking behavior were questioned. Their

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weight, height and blood pressure were also measured, and their BMI (Body Mass Index) was calculated. The data were analyzed bySPSS 19 software. Results: In men, the odds ratio for ever smoking to never smoking at higher levels of education in comparison withthe lower levels was 6.08 (2.65-14.11). For manual occupation to non-manual occupation, it was 3.55 (1.88-6.68). The odds ratio forobesity and overweight vs no overweight, for manual occupation to non-manual occupation was 3.12 (1.81-5.40) in men and for father’soccupation it was 2.03 (1.10-3.74). In women, their education with the odds ratio of 2.11 (1.17-3.82) and father’s occupation with theodds ratio of 6.63 (3.50-12.58) altered their chance of being obese or overweight. Also, in women, the mean systolic blood pressurewas significantly lower at higher educational levels and in those whose fathers’ occupation were manual but lower in manual workers.Conclusion: The current socio-economic position in individuals is associated with an obesity and smoking behavior, particularlyin men. Childhood socio-economic position increases the chance of an obesity and higher blood pressure, particularly in women.Key words: Blood pressure, obesity, risk factors, socio-economic status, smoking

8-Esfahani M. Abdar, A. K. Vosughi1, M. H. Fatehi , A. ShahSanai, A. Teimuri

-Evaluation of QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment4Journal of Research in Medical Sciences(ISI)( Vol 17, No 3 (2012)

Introduction: Methadone is a synthetic opioid, used in treatment of chronic pains. The current study was carried out to evaluatethe QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment. Materials andMethods: In 2010, one hundred war causalities in Isfahan who chronically take daily dose of 20 mg or more of methadone (morethan 2 weeks), and did not have the history of cerebrovascular or coronary artery diseases, cardiac pacemaker, congenital prolongedQTC, or taking drugs affecting QTc, or having electrolyte abnormalities, were selected for the study. An electrocardiogram was takenfrom each patient using cardiofax instrument, and QTC was calculated manually. The data was analyzed using SPSS software withdescriptive statistical methods and Pearson’s correlation coefficient. Findings: All patients were male and had the mean age of 45.6± 6.1 years. The patients received 20-240 mg methadone daily for 1 to 108 months. The QTc was prolonged in 25% of the patients(QTc ≥ 450 ms), with the mean of 472.72 ± 18.5 ms (range 450-508 ms) and the mean daily dose of methadone 85.2 ± 59.0 mg. No

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significant relationship was observed between QTC interval on the one hand, and methadone dose (R = 0.025, P = 0.8), duration oftreatment (R =-0.048, P = 0.68), age (R = 0.037, P = 0.71), and weight (R = 0.1, P = 0.21) of the patients, on the other hand. None ofthe patients had faint, syncope, arrhythmia, or sudden death. Conclusion: Oral methadone causes prolongation of QTC interval.However, the dosage of methadone and duration of treatment were not statistically related to QTC interval.Key words: Methadone maintenance treatment, methadone, prolonged QTC interval, war

9-Nadia Najafizade, Simin Hemati, Abbas Gookizade, Nezameddin Berjis1, Mostafa Hashemi1, Soheil Vejdani, Alireza Ghannadi2, Armindokht Shahsanaee3, Nafise Arbab

-Preventive effects of zinc sulfate on taste alterations in patients under irradiation for head and neck cancers: A randomized placebo-controlled trial Journal of Research in Medical Sciences(ISI)( Vol 18, No 2(2013)

ABSTRACT: Taste abnormalities are common among cancer patients after starting radiotherapy or chemotherapy. Considering the role of zinc and reports on its beneficial effects in taste perception, we evaluated the preventive effects of zinc sulfate on radiation-induced taste alterations. Materials and Methods: In a randomized, placebo-controlled trial, adult patients with head and neck cancers who were on schedule for radiotherapy, with or without chemotherapy, were allocated to receive zinc sulfate (50 mg, three times a day) or placebo; started with beginning of radiotherapy and continued for one month later. Taste acuity was determined by measuring detection and recognition thresholds for four taste qualities at baseline, at the end of radiotherapy, and a month later using the Henkin method. Results: Thirty-five patients (mean age = 59.2 ± 16.5, 60% male) completed the trial. The two groups were similar at baseline. After radiotherapy, and one month later, there was a significant increase in taste perception threshold for bitter, salty, sweet, and sour tastes in the placebo group (P = 0.001). In those who received zinc, there was only slight increase in threshold for perception of the salty taste (P = 0.046). No relevant side effects due to zinc sulfate were reported. Conclusion: Zinc supplementation in head/neck cancer patients under radiotherapy can prevent radiation-inducted taste alterations. Further studies with longer follow-ups and with different doses of zinc supplementation are warranted in this regard.Key words: Cancer, dysgeusia, radiotherapy, taste loss, taste perception, zinc sulfate

10- Majid Khademian1, Neda Farhangpajouh2, Armindokht Shahsanaee3, Maryam Bahreynian4, Mehran Mirshamsi5, Roya Kelishadi6

-Effects of zinc supplementation on subscales of anorexia in children: A randomized controlled trialPak J Med Sci 2014 Vol. 30 No. 6(ISI)

Objectives: This study aims to assess the effects of zinc supplementation on improving the appetite and its subscales in children.

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Methods: This study was conducted in 2013 in Isfahan, Iran. It had two phases. At the first step, after validation of the Child Eating Behaviour Questionaire (CEBQ), it was completed for 300 preschool children, who were randomly selected. The second phase was conducted as a randomized controlled trial. Eighty of these children were randomly selected, and were randomly assigned to two groups of equal number receiving zinc (10 mg/day) or placebo for 12 weeks.Results: Overall 77 children completed the trial (39 in the case and 38 in the control group). The results showed that zinc supplement can improve calorie intake in children by affecting some CEBQ subscales like Emotional over Eating and Food Responsible.Conclusion: Zinc supplementation had positive impact in promoting the calorie intake and some subscales of anorexia.KEY WORDS: Anorexia, Children, Randomized controlled trial, Zinc.Trial registry code: IRCT201302061434N7

11-Morteza Sadinejad, Roya Kelishadi,1 Mostafa Qorbani,2,3 Armindokht Shahsanai,4 Mohammad Esmaeel Motlagh,5,6 Gelayol Ardalan,5 Ramin Heshmat,7 and Mojtaba Keikha8

-A Nationwide Survey on Some Hygienic Behaviors of Iranian Children and Adolescents: The CASPIAN - IV StudyInt J Prev Med. Sep 2014; 5(9): 1083–1090

Abstract

Background:This study aims to assess the frequency of some hygienic behaviors that is, tooth brushing and hand-washing, in Iranian school students at national level.Methods:This nationwide study was conducted in 2011-2012 among 14,880 elementary, secondary and high school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. We used the global school-based health survey questionnaire of the World Health Organization.Results:The population of this survey consisted of 13,486 children and adolescents (participation rate of 90.6%) including 49.2% girls and 75.6% urban inhabitants. The mean age of participants was 12.5 years (12.3-12.6, 95% confidence interval) According to the self-report of students, 26.9% of them (20.2% of boys and 33.9% of girls) brushed their teeth more than once a day, 37.8% of boys and 42.1% of girls brushed their teeth once a day. In general, girls brushed their teeth more than boys. The frequency of those students who never brushed their teeth was twice in rural than in urban students (11.4% vs. 6.2%, respectively). In total, 3.4% of the students stated that their school had not an appropriate place for washing hands after toilet, with three-fold higher frequency in rural than in urban schools (6.8% vs. 2.3%, respectively). 85% of students (87% of girls vs. 83% of boys) reported that they had always washed their hands after toilet, 10.1% did it occasionally and 4.1% did not.Conclusions:This nationwide survey revealed that Iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however, still it is

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necessary to improve school health facilities and hygienic habits in Iranian students.Keywords: Children and adolescents, hygiene, Iran, school

12. Mostafa Sarvizadeh, Simin Hemati, Mohsen Meidani,1 Moghtada Ashouri, Mahnaz Roayaei, and Armindokht Shahsanai2

Morphine mouthwash for the management of oral mucositis in patients with head and neck cancerAdv Biomed Res. 2015; 4: 44. Published online 2015 Feb 11. doi:  10.4103/2277-9175.151254PMCID: PMC4358035

Abstract

Background:Oral mucositis is a debilitating side effect of cancer treatment for which there is not much successful treatments at yet. We evaluated the effectiveness of topical morphine compared with a routine mouthwash in managing cancer treatment-induced mucositis.Materials and Methods:Thirty head and neck cancer patients with severe mucositis (World Health Organization Grade III or IV) were randomized into the morphine and magic mouthwash groups. Patients received morphine sulfate 2% or magic solution (contained magnesium aluminum hydroxide, viscous lidocaine, and diphenhydramine), 10 ml for every 3 h, six times a day, for 6 days. Both groups received same dietary and oral hygiene instructions and care. Mucositis was graded at baseline and every 3 days after treatment. Patients’ satisfaction and drug effect maintenance were also evaluated.Results:Twenty-eight patients (mean age of 49.5 ± 13.2 years, 63.3% female) completed the trial; 15 in the morphine group and 13 in the magic group. There was a decrease in mucositis severity in both of the morphine (P < 0.001) and magic (P = 0.049) groups. However, at the 6th day, more reduction was observed in mucositis severity in the morphine compared with magic group (P = 0.045). Drug effect maintenance was similar between the two groups, but patients in the morphine group were more satisfied by their treatments than those in the magic group (P = 0.008).Conclusions:Topical morphine is more effective and more satisfactory to patients than the magic mouthwash in reducing severity of cancer treatment-induced oral mucositis. More studies with larger sample size and longer follow-up are required in this regard.Iran Red Crescent Med J. 2016 Aug; 18(8): e31099. Published online 2016 Jun 8. doi:  10.5812/ircmj.31099PMCID: PMC5065714Determinants of Tobacco and Hookah Smoking in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study13.Roya Kelishadi,1 Ramin Heshmat,2 Armindokht Shahsanai,1,3 Shirin Djalalinia,4,5 Mohammad Esmaeil Motlagh,6 Mojtaba Keikha,1 Gelayol Ardalan,1 Fereshteh Najafi,4 Maliheh Khoramdad,4 Hamid Asayesh,7 and Mostafa Qorbani2,8,*

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Abstract

Background

The consumption of tobacco through a hookah is growing in popularity, especially among children and adolescents, but little is known about the determinants of hookah smoking.

Objectives

The current study aimed to assess the determinants of tobacco smoking and hookah smoking in a nationally representative sample of Iranian children and adolescents.

Patients and Methods

This study was conducted as part of the fourth cross-sectional survey of a national school-based program. Using a cluster random sampling method, a validated questionnaire was completed anonymously by 14,880 students who were aged 6 - 18 years and living in urban and rural areas of 30 provinces in Iran.

Results

The final study group consisted of 13,486 children and adolescents (participation rate of 90.6%), of whom 49.2% were girls and 75.6% were urban residents. The mean age was 12.47 ± 3.36 years. According to the self-reports of the students, 2.6% (3.5% of boys and 1.7% of girls) were current tobacco smokers, 5.9% (7.5% of boys and 4.2% of girls) were ever tobacco smokers, and 1.8% (2.49% of boys and 1.14% of girls) were current hookah smokers. Based on a multiple logistic regression (MLR) model, the following factors increased the risk of current smoking: age, number of days spent with friends per week, hookah smoking or cigarette smoking by the father, hookah smoking by siblings, hookah smoking by other members of the family, and screen time. The age, number of days spent with friends, hookah or cigarette smoking by the father, hookah smoking by siblings, and screen time increased the risk of hookah smoking. Female gender and living in rural areas decreased the risk of current tobacco and hookah smoking.

Conclusions

Preventive measures against tobacco use should be underscored for Iranian families. The preparation of strategies on the promotion of a healthy lifestyle should be considered a health priority.

Keywords: Smoking, Hookah, Children, Adolescents, Iran

Iranian Journal of Public Health 2015. 44(1):53-61. Meal Frequency in Iranian Children and Adolescents at National and Sub-National Levels: The CASPIAN-IV Study14.Roya KELISHADI, Armindokht SHAHSANAI, Behzad SHAMS, Zeinab AHADI, Mohammad-Esmaeil MOTLAGH, Amir KASAEIAN, Gelayol ARDALAN, Zahra MADDADY, Hamid ASAYESH, Mostafa QORBANI, Ramin HESHMAT

Abstract

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Background: This study aims to assess the pattern of meal frequency consumption of Iranian children and adolescents at national and subnational levels according to the socioeconomic status (SES) of the living region.

Methods:  This multi-centric study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, who were selected by multistage random cluster sampling from 30 provinces. Meal frequency was assessed by the World Health Organization Global School-based student Health Survey (WHO- GSHS) questionnaire. Data were compared at national and sub-national levels according to the SES of the living region.

Results: Overall, 13486 students completed this study (participation rate: 90.6%). The frequency of breakfast, lunch, and dinner skipping was 32.08% (95% CI: 30.99, 33.2), 8.58% (95% CI: 7.71, 9.54), and 10.90% (95% CI: 10.21, 11.62), respectively. The frequency of consuming 1 meal, 2 meals, and 3 meals a day was 9.60% (95%CI: 8.94, 10.31), 29.28% (95% CI: 28.31, 30.26), and 61.12 % (95% CI: 59.89, 62.34), respectively. The mean number of days per week of breakfast consumption was 5.14 (95% CI: 5.08, 5.20), the corresponding figure was 6.39 (95%CI: 6.35, 6.42), and 6.24 (95%CI: 6.21, 6.28) for lunch and dinner, respectively. These frequencies had no significant difference according to the SES of the living region.

Conclusion: Most Iranian children and adolescents consumed all three main meals, however irrespective of SES; in general skipping breakfast was more frequent than skipping lunch and dinner. Regular meal intake, notably breakfast, should be considered in health promoting programs for all children and adolescents.

 

Iran Red Crescent Med J. 2016 May; 18(5): e21858. Published online 2016 Apr 27. doi:  10.5812/ircmj.21858PMCID: PMC4939238Tobacco Use and Influencing Factors Among Iranian Children and Adolescents at National and Subnational Levels, According to Socioeconomic Status: The Caspian-IV Study.15Roya Kelishadi,1 Armindokht Shahsanai,1,2 Mostafa Qorbani,3,4,* Mohammad Esmaeil Motlagh,5 Mohsen Jari,1 Gelayol Ardalan,1 Hossein Ansari,6 Hamid Asayesh,7 and Ramin Heshmat4,*

Author information ► Article notes ► Copyright and License information ►Go to:

Abstract

Background

Iran is facing an epidemiologic transition, with one of its features being the tendency towards smoking by adolescents. The findings of previous studies in Iran have shown that the pervasiveness of tobacco products among school students is high. No previous study has reported the prevalence and determinants of smoking in various socioeconomic statuses (SESs) and at the subnational level in Iran.

Objectives

To compare the prevalence of smoking and the factors that influence the initiation and continuation of tobacco use in a nationally representative sample of Iranian adolescents living in different regions with diverse socio-demographic patterns.

Patients and Methods

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This nationwide, cross-sectional study was conducted in 2011 - 2012 among 14,880 students, aged 6 - 18 years, selected by cluster sampling from 30 provinces. Anonymous questionnaires were completed about tobacco use and the main psychological determinants of initiation and continuation to smoke. The questionnaire was modeled on the world health organization global school-based student health survey (WHO-GSHS). The sub-national regions were defined by the criteria of geography combined with SES. According to this classification, the lowest to highest SESs were considered for the southeast, north-northeast, west, and central regions, respectively. Data were analyzed using the STATA statistical software package.

Results

Overall, 13,486 students completed this survey (participation rate of 90.6%). They consisted of 50.8% boys, 75.6% urban residents, with a mean age of 12.47 ± 3.36 years. According to the self-report of students, 2.6 % (3.5% of boys and 1.7% of girls) were current smokers, and5.9% (7.5% of boys and 4.2% of girls) had ever been smokers. The current use of tobacco was higher in participants aged 14 - 18 years (6.11%) than in those aged 10 - 13.9 years (1.18%) and 6 - 9.9 years (0.51%). Current and past tobacco use, respectively, had the lowest prevalence in the region with the lowest SES (2.2%, 3.7%) and the greatest prevalence in the highest SES region (4.3%, 8.9%). Entertainment was the most common reason for smoking initiation (83.65% of smokers) and continuation (77.01% of smokers), followed by feelings of pleasure, and enjoying the tobacco smell. These influencing factors did not differ significantly according to SES or gender.

Conclusions

Smoking is a health problem for Iranian adolescents, and has a higher prevalence in areas with higher SES. Entertainment and feeling pleasure were the commonest reasons for initiation and continuation of smoking. Tobacco-control programs should begin from childhood and family-centered preventive counseling should be intensified in Iran.

Iran J Child Neurol. 2016 Spring; 10(2): 74–81. PMCID: PMC4885158.16Demographic and Clinical Findings in Pediatric Patients Affected by Organic AcidemiaReza NAJAFI, MD ,1 Mahin HASHEMIPOUR, MD ,2 Neda MOSTOFIZADEH, MD ,2 Mohammadreza GHAZAVI, MD ,3 Jafar NASIRI, MD ,3 Armindokht SHAHSANAI, MD MPH ,4 Fatemeh FAMORI, MD ,5 Fatemeh NAJAFI, MSE ,6 and Mohammad MOAFI, MD MPH 7Author information ► Article notes ► Copyright and License information ►Go to:

Abstract

Objective

Metabolic disorders, which involve many different organs, can be ascribed to enzyme deficiency or dysfunction and manifest with a wide range of clinical symptoms. This study evaluated some of the demographic and clinical findings in pediatric patients affected by organic acidemia.

Materials & Methods

This cross-sectional study was part of a larger study conducted in patients with metabolic disorders during a period of 7 years from 2007 to 2014 in Isfahan Province, Iran. Our study covered a wide range of cases from newborn infants (one-week old) to adolescents (children up to the age of 17 years). This study evaluated patients’ demographic information, history of disease, developmental and educational status, clinical and general conditions. Phone and in-person interviews were used to gather information.

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Results

Out of 5100 patients screened in this study, 392 patients were affected by one of the different metabolic disorders and 167 individuals were diagnosed as organic acidemia. Propionic acidemia/methyl malonic acidemia (PA/MMA) was the most prevalent form of this metabolic disorder. The frequency of consanguinity was 84.7% in the group of patients. The mortality rate was 18.8% in patients with organic academia.

Conclusion

Each of the metabolic diseases, as a separate entity, is rare; nevertheless, in aggregate they have a somewhat high overall prevalence. These diseases result in mental and developmental disorders in the absence of quick diagnosis and initiation of treatment. Furthermore, more mutations should be identified in societies affected by consanguinity. Further research should also be conducted to determine worthwhile and more-efficient screening methods as well as long term neurological prognosis.

Key Words: Organic academia, Consanguinity, Developmental delay, Early Detection

Iran J Pediatr. 2016 Aug; 26(4): e3036. Published online 2016 Jun 12. doi:  10.5812/ijp.3036PMCID: PMC5065706Exposure to Hookah and Cigarette Smoke in Children and Adolescents According to Their Socio-Economic Status: The CASPIAN-IV Study.17Roya Kelishadi,1 Armindokht Shahsanai,1 Mostafa Qorbani,2,3 Gelayol Ardalan,4 Parinaz Poursafa,5 Ramin Heshmat,3 and Mohammad Esmaeil Motlagh4,6,*Author information ► Article notes ► Copyright and License information ►Go to:

Abstract

Background

Exposure to smoking or passive smoking is one of serious health problems especially in the pediatric age group.

Objectives

To compare the prevalence and determinants of passive smoking in a nationally representative sample of Iranian children and adolescents according to their socioeconomic status (SES).

Materials and Methods

This nationwide study was conducted in 2011 - 2012 among 14880 students aged 6 - 18 years, living in 30 provinces in Iran. Exposure to the smoke of hookah or cigarette was documented by using validated questionnaires. Possible influencing factors were determined and the frequency of passive smoking was compared according to the regional and familial SES.

Results

Participants consisted of 13,486 children and adolescents including 49.2% girls and 75.6% urban inhabitants (90.6% participation rate). The mean age of participants was 12.47 ± 3.36 years. Overall, 43.87% of them (44.07% of boys and 43.66% of girls) were exposed to second hand smoke at home. Exposures to hookah or

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cigarette smoke at home were respectively reported in 21.46% and 34.49% of participants. The prevalence of passive smoking was lower in children of families with higher SES level, but higher in high SES regions of the country than in low SES ones, and ranged from 39.2% in the region with lowest SES to 49.05% in the highest SES region. Higher education levels of fathers and mothers were significantly associated with lower frequency of passive smoking.

Conclusions

Exposure to second hand smoke is a major problem among Iranian children and adolescents. Low family SES and low parental education increased the frequency of passive smoking. Appropriate public health education and legislation for smoke free home as well as family-centered counseling should be strengthened.

Keywords: Passive Smoking, Determinants, Children and Adolescents, Socio-Economic Statu

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