CONTEXT: Iran's culture and religion prohibit sexual contact prior to marriage. Due to the sensitivity of the topic, little is known about the sexual activity of unmarried adolescent males or about their knowledge of, and attitudes toward, sexuality and reproductive health. METHODS:A population-based study of 1,385 males aged 15-18 in Tehran was conducted using a self-administered questionnaire. Participants were questioned about their beliefs and knowledge regarding reproductive health, and asked whether they had engaged in sexual activity. Bivariate and multivariate analyses were performed to identify factors associated with sexual knowledge, attitudes and behavior.RESULTS: Twenty-eight percent of the sample reported having engaged in sexual activity. Sexual experience was associated with older age, access to satellite television, alcohol consumption and permissive attitudes toward sex. Substantial proportions of respondents held misconceptions regarding condoms, STIs and reproductive physiology. Attitudes toward premarital sex were more permissive among respondents who were older, were not in school, had work experience, had access to the Internet or satellite television, lived separately from their parents, or reported having used alcohol, cigarettes or drugs. CONCLUSION:The relatively high prevalence of sexual activity and the lack of knowledge regarding STIs and contraceptives pose a significant threat to the sexual and reproductive health of adolescent males in Iran. Programs are needed to provide adolescents with the information and skills to make safe sexual decisions.

Objective: To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran. Design and Settings: This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to noncommunicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. Subjects: The study population comprised 89 532 subjects aged over 15 years living in the 28 provinces of Iran. Results: Overall, 50.4% (n 5 45 113) of the participants were male and 64.6% (n 5 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) $ 25 kg m 22 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45-64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI. Conclusions: The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.

Aim/hypothesis The aim of the study was to determine the annual healthcare expenditures of an individual with diabetes in Tehran, between March 2004 and March 2005. Methods This prevalence-based 'cost-of-illness' study was conducted in two phases. In the first phase, 23,707 randomly selected individuals were interviewed to gather a cohort of participants with diabetes. In the second phase, 710 diabetic patients and 904 age-and sex-matched controls were followed up for 1 year at intervals of 3 months and the direct (physician services, medications and devices, hospitalisation, laboratory, paraclinical and transport) and indirect (loss of productivity) expenditures were recorded. The excess costs of a person with diabetes were estimated through comparison with matched controls. The estimates were also extrapolated to the total population of Tehran and Iran. The costs were converted from the Iranian rial to the US dollar (exchange rate September 2004).Results Total annual direct costs of diabetic and control participants were $152.3±14.5 and $52.0±5.8, respectively, which is indicative of 2.92 times higher costs in diabetic patients. The most expensive components of direct costs were medications and devices, and hospitalisation in diabetic patients (28.7% and 28.6%, respectively). Total indirect costs were $39.6±2.4 and $16.7±1.1 in diabetic and non-diabetic individuals. The aggregate annual direct costs of diabetes were estimated to be $112.424±10.732 million and $590.676±65.985 million in Tehran and Iran, respectively. Diabetes complications contributed 53% of the aggregate excess direct costs of diabetes. Conclusions/interpretation Diabetes is an expensive medical problem in Iran and planning of national programmes for its control and prevention is necessary.

Background-We assessed the validity of the atrial electromechanical interval, measured by transthoracic tissue Doppler echocardiography, in determining patients at risk of post-coronary artery bypass graft atrial fibrillation (AF). Methods and Results-This prospective study recruited 355 patients in sinus rhythm who were candidates for coronary artery bypass grafting. The patients underwent a preoperative transthoracic echocardiography with a tissue Doppler evaluation and were monitored with continuous ECG telemetry during their hospital stay. Sixty-eight patients had postoperative AF (19.2%), with the incident occurring 2.3Ϯ0.7 days after surgery. The median length of hospitalization was 7.0 days for the AF patients and 6.0 days for the non-AF patients (PϽ0.0001). The subjects with postoperative AF differed from the sinus rhythm patients in that the former had a lower ejection fraction (40.4Ϯ8.5% versus 48.4Ϯ9.4%), a reduced maximal A-wave transmitral Doppler flow velocity (44.3Ϯ4.6 versus 53.3Ϯ10.9 cm/s), an increased total atrial volume (68.7Ϯ12.6 versus 55.3Ϯ11.8 mL), and a prolonged atrial electromechanical interval (141.9Ϯ13.4 versus 100.3Ϯ10.3 ms, respectively; PϽ0.0001 for all). In addition, the AF patients were older than the sinus rhythm group (66.0Ϯ8.0 versus 59.8Ϯ8.5 years). The atrial electromechanical interval was the best independent discriminator of the history of AF. We defined a cutoff point for the atrial electromechanical interval and chose 120 milliseconds for categorization, which yielded 100% sensitivity and 94.8% specificity for the prediction of AF. Conclusions-The atrial electromechanical interval by transthoracic tissue Doppler echocardiography could be a valuable method for identifying patients vulnerable to post-coronary artery bypass graft AF.