Iranian General Population Research Articles

Prevalence of major depressive disorder in the general population of Iran: A systematic review and meta-analysis.

Background: Major depressive disorder (MDD) is the most common psychological disorder and affects many people worldwide. Surveying the prevalence of mental disorders, especially general disorders, such as major depressive disorder, is highly important for health professionals and policymakers. Due to a wide variation of studies concerning the prevalence of major depressive disorder in Iran, the present study was conducted to integrate such results. Methods: To conduct this study, English (PubMed/Medline, Scopus and Web of Science) and Persian (MHRN, Noormgs, Magiran, Iran-Medex, Irandoc, and SID) databases, from 1990 to 2018, were explored. All articles related to the point prevalence of depressive disorders in the general population of Iran were reviewed. The inclusion criteria of the present study were as follow: cross sectional studies based on general populations; the expression of the point prevalence rate and incidence of major depressive disorder for people over 15 years; and the use of a structured or semi-structured clinical interview for diagnosis of the disorder. Studies that were not original (such as review studies) and those that did not represent general populations were excluded from the study. To analyze the data obtained from this study, the second version of Comprehensive Meta-Analysis (CMA) software was used. The total point prevalence was calculated using the meta-analysis method, and the I2 index was used to measure the heterogeneity of the studies. Results: Of 6734 studies, 30 studies with a total sample size of 37 867 were finally included based on proposed inclusion and exclusion criteria. The sample included 20641 women (55%), and 17 226 (45%) men. In the present meta-analysis study, due to significant heterogeneity (I=97.1%, p=0.001) among studies, the randomized method was used, and the total point prevalence was 4.1% (CI: 3.1% 5.5%). The overall point prevalence of major depressive disorder was 4.8% (CI: 3.6% -5.6%) in women and 2.3% (CI: 1.6% -3.6%)in men, which indicated that the incidence of this disorder was 1.95 times more in women than in men. Conclusion: This meta-analysis study found a considerable prevalence of major depressive disorder among Iranian participants and revealed that the point prevalence of the disease was more than two-fold in women compared to men. Considering these findings and the high burden of this disorder for communities, the need to formulate and implement prevention and treatment programs is highly required.

The prevalence of tropia, phoria and their types in a student population in Iran

ABSTRACT Purpose The aim of this study is to determine the prevalence of tropia, phoria, and their types in Islamic Azad University students in Shahrekord, Iran. Methods Of 826 students that were invited, 752 participated in this cross-sectional study (response rate = 91.04%). After applying exclusion criteria, statistical analyses were performed on the data of 726 individuals. All participants underwent optometric tests including measurement of visual acuity, objective and subjective refraction, as well as binocular vision and ocular health examinations. The unilateral and alternate cover tests were done to detect the tropia and phoria at 6 m and 40 cm, respectively. Results The overall prevalence and 95% confidence interval (CI) of tropia, exotropia, and esotropia were 1.5% (0.8 to 2.7), 1.2% (0.6 to 2.4), and 0.3% (0.1 to 1.1), respectively. The prevalence of esotropia was significantly higher in older age groups (24 years old) (p = .040) . The prevalence of exotropia was significantly higher in females (0.039) and in myopic individuals (p = .001). The overall prevalence and 95% CI of phoria, exophoria, and esophoria were 12.9% (10.7 to 15.6), 11.7% (9.6 to 14.3), and 1.2% (0.6 to 2.3), respectively. There was a significant difference in the overall prevalence of exophoria according to the age (0.021). The prevalence of esophoria was significantly higher in females (p = .039). The prevalence of exophoria was significantly higher in myopic participants (p = .003). Exophoria and exotropia were the most common types of phoria and tropia, respectively. Conclusion The prevalence of strabismus in university students was similar to the Iranian general population but lower than other countries. One in every 10 students had phoria, which was much lower than similar reports on Iranian populations; however, due to near-work activity, these students are prone to asthenopia, early visual fatigue, and decreased productivity. Therefore, it is suggested that university students also undergo screening programs to detect the cases of tropia and phoria.

Prevalence of major depressive disorder in the general population of Iran: A systematic review and meta-analysis

Prevalence of major depressive disorder in the general population of Iran: A systematic review and meta-analysis

Parental consanguinity in patients with psychogenic nonepileptic seizures

PurposeThe aim of this study was to investigate the rate of consanguinity of parents of the patients with psychogenic nonepileptic seizures (PNES). This would provide important information for future studies on the potential genetic bases of PNES. MethodsIn this retrospective study, all patients with PNES, who were studied at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were recruited. We categorized the patients as (1) no consanguineous marriage of the parents and (2) with consanguineous marriage of the parents. ResultsThree-hundred and sixteen patients had the data on their parental consanguinity available and were studied. The sex ratio (female:male) of the patients was 1.92 (208:108). Parents of 110 (35%) patients had consanguineous marriage, and parents of 206 (65%) patients did not. Demographic variables, seizure-related variables, PNES-associated factors, and the use of antiepileptic drugs were not significantly associated with parental consanguinity in the patients. ConclusionsIn this study, we observed that more than one-third of the patients with PNES had parental consanguinity. This rate is very similar to the rate of consanguinity in the general population in Iran.

How Five-Factor Personality Traits Affect Psychological Distress and Depression? Results from a Large Population-Based Study

The objective of this study was to explore the association of five factors personality traits, as predictor variables, with the depression and psychological distress as joint-dependent variables in an Iranian general population. NEO-big five, Hospital Anxiety and Depression Scale and General Health Questionnaire (GHQ-12) were used for collecting data regarding personality traits and psychological problems from 3177 participants in a cross-sectional population-based study. Our findings showed that higher neuroticism scores increase the risk of psychological distress and depression score (p < 0.05). Participants with higher extraversion scores experienced lower levels of depression and lower risk of psychological distress (p < 0.05). Furthermore, higher scores of conscientiousness significantly increase, while agreeableness decreases the scores of psychological distress (p < 0.05). It is suggested to perform longitudinal studies focusing on both genetic and environmental factors on the relationships between personality and psychological disorders.

Private and social time preference for health outcomes: A general population survey in Iran.

Despite the recent increase in economic evaluations of health care programs in low and middle income countries, there is still a surprising gap in evidence on the appropriate discount rate and the discounting of health outcomes such as quality adjusted life years (QALYs). Our study aimed to calculate the implied time preference rate for health outcomes in Iran and its key determinants. Data were gathered from one family member from each of the 650 households randomly selected in Tehran. The respondents’ private and social preferences for health outcomes were calculated using the time trade-off (TTO) technique based on the discounted utility model. We investigated the main assumptions of the discounted utility model through equality of mean comparison, and the association between private time preference and key socio-economic determinants using multilevel regression analysis. The mean and median implied rates were 5.8% and 4.9% for private time preference and 25.6% and 20% for social time preference respectively. Our study confirmed that magnitude, framing and time effects have a significant impact on implied discount rates, which means that the conventional discounted utility model’s main assumptions are violated in the Iranian general population. Other models of discounting which apply lower rates for far health outcomes might provide a more sensible solution to discounting health interventions with long-term impacts.

Cigarette Smoking and Health-related Quality of Life in the General Population of Iran: Independent Associations According to Gender.

Background:Associations between smoking and health-related quality of life (HRQoL) in the general population remain unclear. The aim of the study was to quantify the independent associations between smoking and HRQoL.Methods:A cross-sectional population-based study was conducted on a total sample of 2197 participants obtained by multistage sampling to investigate the associations between smoking and HRQoL in the general population of southeast and southwest of Iran, aged 18–100 years in 2012–2013. Data were collected using a self-administrated of the 36-Item Short Form Survey (SF-36) questionnaire. Linear regression analyses were used to evaluate the associations between HRQoL and smoking while adjusting for various socioeconomic variables. In this study, P < 0.05 was considered a significant difference.Results:Out of the total of 2197 participants, current smokers and never smokers accounted for 13% and 87%, respectively. The mean HRQoL indices were for the current smokers 66.66 ± 17.86, and never smokers 71.35 ± 18.47 (P < 0.001). Independent associations between smoking and HRQoL were found, including negative associations (P < 0.001). The multivariate associations between smoking status and HRQoL, male smokers had a lower physical functioning, mental health, and total SF-36 score.Conclusions:Smoking was independently related to HRQoL, with large differences according to the gender. This study showed that there is a significant difference in the quality of life related to health in male smokers compared to male nonsmokers.

Awareness and Attitude Towards Opioid and Stimulant Use and Lifetime Prevalence of the Drugs: A Study in 5 Large Cities of Iran.

Background: Providing population-based data on awareness, attitude and practice of drug and stimulant use has policy implications. A national study was conducted among Iranian general population to explore life time prevalence, awareness and attitudes toward opioids and stimulant use. Methods: We recruited subjects from 5 provinces with heterogenic pattern of drug use. Participants were selected using stratified multistage cluster sampling. Data were collected using a validated self-administered questionnaire. Logistic regression model was applied to identify the variables that are associated with drug and stimulant use. Results: In total 2065 respondents including 1155 men (33.96 ± 10.40 years old) and 910 women (35.45 ± 12.21 years old) were recruited. Two-third of respondents had good awareness about adverse effects of opioid use. Corresponding figure in terms of stimulants was 81.4%. Almost 95% of participants reported a negative attitude towards either opioid or stimulant use. The lifetime prevalence of opioid use and stimulant use were 12.9% (men: 21.5%, women: 4.0%) and 7.3% (men: 9.6%, women: 4.9%), respectively. Gender (adjusted odds ratio [AOR]M/W=6.92; 95% CI: 2.92, 16.42), education (AORundergraduate/diploma or less =0.49; 95% CI: 0.26, 0.90), and marital status (AORothers/single=2.13; 95% CI: 1.36, 3.33) were significantly related with opioid use. With respect to stimulant use, age was negatively associated with the outcome (AOR60+/20-29 years = 0.08: 95% CI; 0.01, 0.98) and men were 2 times more likely than women to use stimulants (ORM/W=2.15: 95% CI: 0.83, 5.56). In addition, marital status (AOROthers/singles = 3.45; 95% CI: 1.09, 10.93), and awareness (AORWeak and moderate/good =0.40; 95% CI: 0.25, 0.61) were independently correlated with stimulants use. Conclusion: While the attitude of Iranian adults toward opioid and stimulant use was negative, their awareness was not that adequate to prevent the drug use. Men and those with lower socio-economic status (SES) should be the focus of health promotion programs regarding opioid use. However, regarding stimulants use, promotion programs should target younger age groups and those with higher SES status.

Accessing free quality health care services and premature death.

The type of health insurance may affect the likelihood of mortality of insured people. We conducted this study to determine if accessing free quality health care services could decrease the premature mortality of people in a developing country. In a multicenter cross sectional study, "years-life-lost" (YLL) due to premature death was evaluated in 202671 insured people residing in six large regions in Iran. The participants had access to free quality health care services. The number of insured people that died in the six regions during March 20, 2014, to March 20, 2015, as well as their sex, age, and cause of the death, were collected, and the YLL was calculated based on assumptions made in Global Burden of Disease Study 2010 (GBD2010). The crude mortality rate was 2.3 per 1000, significantly lower than the overall rate of 4.6 per 1000 people in general population of Iran. The average YLL was 47years per 1000 persons, significantly lower than that in general population of Iran and many industrialized countries. The most common causes of death (and YLL) were cardiovascular diseases and malignancies. Having access to free quality health care services is associated with a significant decrease in premature death.

Epidemiology of hyperthyroidism in Iran: a systematic review and meta-analysis.

Hyperthyroidism is a systemic disorder that causes severe morbidity and is even fatal. Several studies have been performed in Iran to determine the epidemiologic properties of hyperthyroidism; however, they did not use a systematic approach or meta-analysis to evaluate the results. Therefore, this systematic review and meta-analysis aimed to evaluate the epidemiologic data on hyperthyroidism in Iran. In order to find all relevant papers published by October 2017, we searched both international (Web of Science, Scopus, PubMed, Embase, and Cochrane library) and Persian databases (Scientific Information Database, Magiran, and Barekat Knowledge Network System). Meta-analysis was performed using metaprop random effects analysis for prevalence and metaprop fix effect analysis for incidence by Stata statistical software. I2 was used for the demonstration of heterogeneity. Of 7667 published papers or conference proceeding, 7448 studies were removed after eliminating duplicates and reviewing titles/abstracts. Finally, after reviewing 219 full texts, 18 papers met the inclusion and exclusion criteria. The pooled prevalence of total, overt, and subclinical hyperthyroidism in general population were 2.43% (95% CI: 0.23-4.63%), 0.69% (95% CI: 0.21-1.18%), and 1.52% (95% CI: 0.14-2.89%), respectively. The pooled annual incidence of total hyperthyroidism was 2.2 (95% CI: 1.1-3.3) per 1000 population: 0.8 (0.1-1.4) and 1.3 (0.4-2.2) per 1000 population for overt and subclinical hyperthyroidism, respectively. This is the first systematic review and meta-analysis, which investigated the epidemiology of hyperthyroidism in Iran. It seems that the prevalence and incidence of hyperthyroidism among the general population in Iran is similar to that in other parts of the world.

The First Comprehensive Study of H-Deficient Phenotypes in Iran

Summary Background: The lack of correct blood grouping practices can lead to missing of the rare Bombay Oh phenotype and subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients is a challenge. We performed this study in order to estimate the prevalence of the Bombay blood group (Oh) in Iran and to determine whether consanguinity plays a role in the prevalence of Oh group. Methods: This is a descriptive study in the Immunohematology Reference Laboratory of the Iranian Blood Transfusion Organization (IBTO) Tehran, Iran, over a period of 7 years. All donor blood samples showing blood group O and a strong initial reaction with blood group O RBC control cells were tested with anti-H lectin. Also blood samples from blood group O patients were tested with anti-H lectin if all cells on both antibody screening tests and antibody identification panels were reactive with negative auto control test. Specialized tests like adsorption/elution technique and inhibition assay for determination of secretor status were performed on Oh cases. Any history of consanguineous marriages were recorded. All variables were categorical variables, and percentage and proportions were calculated manually. Results: Analysis of the results of over 7 million first-time blood donors in Iran showed that the most common ABO blood group was O, with 2,520,000 (36%) subjects. 56 Oh individuals' (donors and patients) phenotypes (0.0008%) were detected. Consanguinity was observed in 50 cases (89%). Conclusions: This study shows that the prevalence of Bombay blood group in the general population of Iran is relatively high (0.0008%) and associated with consanguineous marriage. Thus, consanguinity is still an important risk factor present.

Demographic aspects of human hydatidosis in Iranian general population based on serology: A systematic review and meta-analysis.

Aim:Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus cestodes, is a globally distributed chronic disease that is an important socioeconomic and public health problem in humans and livestock in developing countries, including Iran. The aim of this study was to determine the overall seroprevalence of hydatid infection in the general population of Iran.Materials and Methods:This systematic review began by searching electronic databases in English (PubMed, Science Direct, Scopus, and Google Scholar) and Persian (Magiran, Scientific Information Database, Iran Medex, and Iran Doc).Results:Our search resulted in a total of 40 reports published from 1995 to 2015. Of 49,460 individuals surveyed, 3090 cases of hydatidosis were reported. Community-based studies showed that the seroprevalence of CE in the Iranian general population was 6.0% (95% confidence interval: 5.0-7.0%). The age group with the highest CE seroprevalence was 20-40 years, and the lowest one was in the under 20 year’s group. The seroprevalence of hydatidosis in males was significantly higher than that in females. In addition, the intended rate was significantly higher in rural regions than in urban areas.Conclusion:Management program for developing more efficient diagnostic tests should be established. Further, cost-effective preventive approaches, including relevant research, should be considered. Finally, hydatid cyst control programs that are important for interrupting the transmission of human CE should be improved.

Epidemiology of Human T-lymphotropic Virus Type 1 Among Blood Donors and General Population in Iran: A meta-analysis

Aim: The present meta-analysis aims to assess the epidemiology of human T-lymphotropic virus type 1 (HTLV-1) among blood donors and general population in Iran. Methods: The present study was designed according to PRISMA guidelines. Results: The prevalence of HTLV-1 in 34 studies with a sample size of 3,626,364 blood donors was 0.20% (95% CI: 0.15–0.26) and the prevalence of this virus among men and women blood donors was 0.20% (95% CI: 0.15–0.27) and 0.64% (95% CI: 0.13–3.01), respectively and the female-male odds ratio was 3.13 (1.35–7.25, p = 0.008). In five studies consisting of 4763 individuals, the prevalence of HTLV-1 among the general population who lived in the main HTLV-1 endemic regions (Khorasan provinces, in northeastern Iran) was 2.5% (95% CI: 1.3–4.7) and the prevalence of this virus among men and women was 2.4% (95% CI: 0.8–7.1) and 3.4% (95% CI: 2.0–5.7), respectively. According to the systematic review, the prevalence of HTLV-1 in general population living in non-endemic regions of HTLV-1 was reported to be 0.07% to 1.8%. Conclusion: Considering the high prevalence of HTLV-1 in the main HTLV-1 endemic regions of Iran, persistent prevention programs are required in blood transfusion centers in these regions.

Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review.

The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I2 = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high-risk populations, such as patients with hypertension and diabetes.

Does Crosswise Method Cause Overestimation? An Example to Estimate the Frequency of Symptoms Associated With Sexually Transmitted Infections in General Population: A Cross Sectional Study

Background: Crosswise, as an indirect questioning method, is not applied to the general population. The current study aimed at assessing the feasibility of crosswise among Iranian general population to estimate the frequency of sexually transmitted infection (STI) symptoms. Methods: To estimate the frequency of STI-associated symptoms among the general population of Kerman, Iran, in 2014, participants were inquired to specify whether their “yes or no” answers to a set of paired questions (sensitive/non-sensitive) were the same (concordance) or different (discordance). Based on the frequency of concordance response and known prevalence of positive response to non-sensitive questions, the frequency of positive responses to the sensitive questions was estimated. The estimations were compared with the results of a population-based survey, conducted at the same time and setting, in which participants directly responded to the sensitive questions. Results: The current study recruited 128 people aged 18 - 60 years (50% male). The estimated frequency for genital ulcer in crosswise method was 53.1% and 34.9% in males and females, respectively. The estimated frequency of urethral discharge in crosswise method was 72.3%. The crosswise method outcomes were significantly different from those of the survey (P > 0.05). Conclusions: The estimated frequency of STI-associated symptoms in crosswise was unexpectedly higher than that of obtained by the population-based survey. Hence, experts in the field of STIs did not accept the crosswise estimations. This overestimation could be a result of differences in the ability of people, with various socioeconomic levels, to understand conceptually how to answer the questions along with the influence of study setting and administration method of questionnaires on the participants self-reports.

Design and Validation of a Persian Knowledge, Attitude, and Practice Questionnaire for Rabies (PKAP-Rabies) in the General Population of Iran

Design and Validation of a Persian Knowledge, Attitude, and Practice Questionnaire for Rabies (PKAP-Rabies) in the General Population of Iran

How and Where Do We Ask Sensitive Questions: Self-reporting of STI-associated Symptoms Among the Iranian General Population.

Background: Reliable population-based data on sexually transmitted infections (STI) are limited in Iran and self-reporting remains the main source of indirect estimation of STI-associated symptoms in the country. However, where and how the questions are asked could influence the rate of self-reporting. In the present study, we aimed to assess what questionnaire delivery method (ie, face-to-face interview [FTFI], self-administered questionnaire [SAQ], or audio self-administered questionnaire [Audio-SAQ]) and setting (ie, street, household or hair salon) leads to more reliable estimates for the prevalence of self-reported STI-associated symptoms. Methods: This cross-sectional study was conducted in winter 2014 on a gender-balanced (50.0% men) sample of 288 individuals aged 18–59 years old in Kerman, Iran. Respondents were recruited in (a) crowded public places and streets, (b) their households, and (c) hair salons. Data was collected on history of current and 6-month (ie, past 6 months) STI-associated symptoms. Three different methods including FTFI, SAQ and or Audio-SAQ were applied randomly in households and non-randomly in streets and hair salons to collect data among the respondents. Generalized estimating equation (GEE) was used to compare the settings and methods separately. Results: A total of 2.8% of men and 9.4% of women self-reported at least one STI-associated symptom. Respondents were significantly more likely to report STI-associated symptoms when completing questionnaires on the street compared to their household (P = .0001). While women were less likely to report symptoms in FTFI compared to SAQ (P = .036), no significant differences were found between men’s responses across different methods (P = .064). Conclusion: Further research is needed to evaluate the effect of different combinations of methods and settings to find the optimal way to collect data on STI-associated symptoms.

Research Paper: Patterns of Drunk and Drugged Driving in Fatally Injured Drivers in Tehran, Iran

Background: Substance abuse in drivers is a global public health concern. We investigated patterns of alcohol and illicit drug consumption in drivers died in traffic accidents in Tehran Province, Iran. Methods: In this cross-sectional study, presence of alcohol and illicit drugs in the body of dead drivers referred to Tehran Legal Medicine Organization during April 2016 to April 2018 were investigated. All participants underwent autopsy and their urine, visceral and vitreous samples were examined for alcohol and illicit drugs. Victims with Complete Toxicology Tests for both alcohol and non-alcoholic drugs and those autopsied during their first 24 hours of death were included. Victims’ demographic characteristics, results of their toxicology tests and accident-related factors were investigated, too. To warrant confidentiality of information, identities of victims were concealed. The obtained data were analyzed by SPSS V. 16 and statistically significant level was set at less than 0.05. Results: Of 618 study participants (mean age of 36.95 years), 601 (97.3%) were male. Of victims, 566 (91.3%) were city inhabitants and 471 (76.2%) were with educational attainment of lower than high school. The majority (93%) of crashes happened inside the city. Causes of death were head trauma in 519 (84%) cases, multiple traumas in 62 (10%) cases and bleeding in 37 (6%) cases. Multiple and single-vehicle accidents account for 498 (80.5%) and 98 (17.5%) crashes, respectively. A total of 73 (11.8%) cases were found positive for alcohol/drug consumption: 24 (4%) were alcohol positive, 52 (8.4%) were positive for non-alcoholic drugs (3 were positive for both). Main detected non-alcoholic drugs were morphine and tramadol. There was statistically significant association between drug/alcohol consumption of drivers and cause of death and crash mechanism (Both P<0.001). Multiple traumas and single vehicle crashes were more prevalent among drivers with drug/alcohol positive tests. Conclusion: Rate of alcohol use in our drivers was lower than many countries which is attributed to religious and legal issues. Consistent with the reported pattern of drug abuse in Iranian general population, opioids and tramadol were the main drugs of abuse among studied drivers. Drug or alcohol use result in drivers’ distraction and more fatal injuries.

Depression among Iranian nurses: A systematic review and meta-analysis.

Background: Depression is one of the most commonly diagnosed mental disorders. Nurses and other hospital service providers are a group at high risk for developing depression. Thus, knowing the prevalence of depression among nurses can help the health care decisionmakers to plan ad hoc prevention programs to control depression in this group. This study was conducted to quantitatively assess the prevalence of depression in nurses by performing a systematic review and meta-analysis. Methods: ISI/Web of Science (WoS), PubMed/MEDLINE via Ovid, PsychInfo, and Embase, as well as Iranian databases such as Irandoc, SID, and Magiran were searched from January 2000 to March 2017. To calculate the pooled prevalence rate, the random effects model based on the DerSimonian-Laird approach was used. I2 and the Q tests were used to examine heterogeneity among studies. To investigate the causes and sources of heterogeneity, the impact of such variables as quality, sample size, geographic region, and criteria used to diagnose depression was analyzed performing subgroup analyses. The quality of reviewed studies was assessed according to the 22-item STROBE checklist. Sensitivity analysis was performed to investigate the stability and robustness of the obtained results. All data were analyzed using the "meta" package included in the R Software Version 3.4.0. Results: A total of 30 studies were retained in the current investigation. The overall prevalence of depression was 22% [95%CI 19- 27] among nurses, with a high statistically significant heterogeneity (I2= 94% and Q-test= 479.87). Conclusion: This rate was higher than the prevalence of depression among the general population in Iran. Presence of happy nurses with good mental state at hospitals is essential for promoting the care provided to patients.

Distribution of corneal thickness and its determinants in 6–12-year-old children in an Iranian general population

PurposeTo determine the central corneal thickness (CCT), apex, and paracentral thicknesses and their determinants in children aged 6–12 years. MethodsThe present study was part of the phase 1 of Shahroud School Children Eye Cohort Study in 2015. Cluster sampling was done in urban areas while all children were invited to participate in the study in rural areas. The Pentacam HR was used for measurements. CCT was measured within the central 3 mm zone of the cornea, and corneal thickness 3 mm further from the center was considered paracentral thickness. ResultsOf 6624 students who were selected, 5620 (84.8%) participated in the study. Among 4956 students, studied in this report, 52.2% were boys, and the mean age of the study participants was 9.75 ± 1.71 years (6–12). The mean CCT and apical thickness was 556.29 ± 34.04 and 557.43 ± 34.03 μm, respectively. The mean paracentral thickness was 657.62 ± 39.11 μm in the superior, 632.65 ± 37.63 μm in the inferior, 648.64 ± 38.75 μm in the nasal, and 617.36 ± 37.19 μm in the temporal region. A multiple regression model showed that CCT decreased by 4.70 μm with every 1 diopter increase in the mean keratometry and increased by 20.06 μm with every 1 mm increase in the anterior chamber depth (ACD) (Both P-Value < 0.001). Age, sex, ethnicity and residence place were also found to be associated with CCT. ConclusionsThis study is the first to describe the distribution of corneal thickness in Iranian children with a large sample size. This study showed that corneal thickness was significantly correlated with younger age, female gender, urban residence, and a number of biometric variables.