the prevalence of non-communicable diseases is increasing worldwide. Multimorbidity and long-term medical conditions is common among these patients. this study aimed to investigate the patterns of non-communicable disease multimorbidity and their risk factors at the individual and aggregated level. Data was inquired from the nationwide survey performed in 2011, according to the WHO stepwise approach on NCD risk factors. A latent class analysis on multimorbidity components (11 chronic diseases) was performed and the association of some individual and aggregated risk factors (urbanization) with the latent subclasses was accessed using multilevel multinomial logistic regression. Latent class analysis revealed four distinct subclasses of multimorbidity among the iranian population (10069 participants). Musculoskeletal diseases and asthma classes were seen in both genders. In males, the odds of membership in the diabetes class was 41% less by increasing physical activity; but with increased BMI, the odds of membership in the diabetes class was 1.90 times higher. Tobacco smoking increased the odds of membership in the musculoskeletal diseases class, 1.37 and 2.30 times for males and females, respectively. Increased BMI and low education increased the chances of females' membership in all subclasses of multimorbidity. At the province level, with increase in urbanization, the odds of membership in the diabetes class was 1.28 times higher among males (P = 0.027). Increased age, higher BMI, tobacco smoking and low education are the most important risk factors associated with ncD multimorbidity among iranians. interventions and policies should be implemented to control these risk factors.The World Health Organization (WHO) global status report on non-communicable diseases (NCDs) in 2014 reported that NCDs are globally the leading cause of death 1 . In 2016, NCDs killed 287000 people in Iran and the number of NCD related deaths and disability-adjusted life years (DALYs) have increased during the past decades. In just 2016, 6.5 million years of life loss (YLLs), and 8.2 million years of disability (YLDs) were attributed to NCDs in Iran 2 . According to 2017 reports, in the past 20 years, NCD mortality has risen by 14.5%, in Iran; and an adult Iranian's probability of dying prematurely (between 30 and 70 years) from one of the four main NCDs was 17% 3 .A systematic review in WHO Eastern Mediterranean countries in 2013 showed that the high mortality of NCDs is partially related to their multimorbidity 4 . More than half of the adults with NCDs have multimorbidity or multiple concurrent morbid conditions, and not one single chronic disease 5 .The prevalence of multimorbidity is increasing worldwide 6 . NCD multimorbidity affects more young people in low-and middle-income countries. The mean prevalence of multimorbidity was 7.8% in 28 developing open Scientific RepoRtS | (2020) 10:3034 | https://doi.org/10.1038/s41598-020-59668-y www.nature.com/scientificreports www.nature.com/scientificreports/ countries in 2015 7 . NCD multimor...
Non-alcoholic steatohepatitis is the most common cause of persistently elevated serum ALT in the asymptomatic Iranian blood donors in Tehran.
ContextNeonatal mass screening program for congenital hypothyroidism provides the best tool for prevention of its devastating effects on mental development. Despite the overall success of the screening programs in detecting congenital hypothyroidism and eliminating its sequelae and new developments made in the program design, high recall rate and false positive results impose a great challenge worldwide. Lower recall rate and false positive results may properly organize project expenses by reducing the unnecessary repeated laboratory tests, increase physicians and parents’ assurance and cooperation, as well as reduce the psychological effects in families.Evidence AcquisitionIn this review, we assessed the recall rate in different programs and its risk factors worldwide.MethodsPublications reporting the results of the CH screening program from 1997 to 2016 focusing on the recall rate have been searched. ResultsRecall rates vary from 0.01% to 13.3% in different programs; this wide range may be due to different protocols of screening (use of T4 or TSH or both), different laboratory techniques, site of sample collection, recall cutoff, iodine status, human error, and even CH incidence as affected by social, cultural, and regional factors of the population.ConclusionsIt is suggested to implement suitable interventions to reduce the contributing factors by improving the quality of laboratory tests, selecting conservative cut off points, control iodine deficiency, use of iodine free antiseptic during delivery, and use of more specific markers or molecular tests. Applying an age dependent criteria for thyrotropin levels can be helpful in regions with a varied time of discharge after delivery or for preterm babies.
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