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INTRODUCTION: This study aimed to evaluate the sensitivity of the erect chest X-ray for diagnosing subdiaphragmatic free air. Furthermore, we examined the effects of different parameters, including sex, age, size of perforation, and the location of perforation on the sensitivity of the erect CXR. METHODS: This study included all patients with perforated peptic ulcer (107 cases) referred to the Shahid Rajaei hospital of Tonekabon from April 2015 to August 2020. The perforated peptic ulcer was confirmed by laparotomy, and the erect chest X-ray was performed as a preoperative procedure. The collected checklist was analyzed using the IBM SPSS Statistics V22.0 software. RESULTS: Achieved results showed total sensitivity of 86% for the erect chest X-ray. The sensitivity of the erect CXR was calculated, 88.5% and 82.6% at males and females, respectively. However, the sensitivity for different age groups was about 86%. The larger perforations resulted in higher sensitivity. Furthermore, the erect chest X-ray sensitivity for duodenal perforations (92.5%) was significantly greater than the gastric perforations (75%). CONCLUSION: Based on this study, the erect chest X-ray could be utilized as a preoperative procedure with total sensitivity of 86% for gastroduodenal perforations. Patients' age and sex have no significant impact on the sensitivity (P-value > 0.05). However, the size and location of perforation significantly influenced the sensitivity (P-value < 0.05). The results demonstrated that larger perforations and duodenal perforations lead to the higher erect CXR sensitivity. IMPLICATIONS FOR PRACTICE: The erect chest X-ray is used as a routine procedure to detect subdiaphragmatic free air in gastroduodenal perforations. The effects of different factors such as age, sex, size of perforation, and the location of perforation on the sensitivity of the erect chest X-ray are discussed for the first time in this study.

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Iran lies at the southernmost range limit of brown bears globally. Therefore, understanding the habitat associations and patterns of population connectivity for brown bears in Iran is relevant for the species' conservation. We applied species distribution modeling to predict habitat suitability and connectivity modeling to identify population core areas and corridors. Our results showed that forest density, topographical roughness, NDVI and human footprint were the most influential variables in predicting brown bear distribution. The most crucial core areas and corridor networks for brown bear are concentrated in the Alborz and Zagros Mountains. These two core areas were predicted to be fragmented into a total of fifteen isolated patches if dispersal of brown bear across the landscape is limited to 50,000 cost units, and aggregates into two isolated habitat patches if the species is capable of dispersing 400,000 cost units. We found low overlap between corridors, and core habitats with protected areas, suggesting that the existing protected area network may not be adequate for the conservation of brown bear in Iran. Our results suggest that effective conservation of brown bears in Iran requires protection of both core habitats and the corridors between them, especially outside Iran's network of protected areas.

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To construct reference percentiles for blood pressure (BP) by sex, age and height for the first time in Iran, we used data on 16 972 healthy children, aged 1 month to 18 years, collected during 2000-2010 in Tehran. BP in this population rose steadily with age and height following a very similar trend in both genders up to the age of 14. Systolic BP (SBP) rise was more prominent in younger ages, and after puberty (15-18 years) was greater in boys compared with girls, while the rise in diastolic BP (DBP) was slightly higher in girls. Iranian norms, compared with 'Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents' (US-4th-Report) and the 'German BP Percentiles by Age and Height for Children and Adolescents' (KiGGS), showed a similar pattern of differences for both genders. For example, for Tehrani boys up to 6 years old whose heights were equal to 50th percentile of stature-for-age as well as length-for-age growth charts, the differences in 95th percentile for SBPs compared with the US-4th-report varied from 2-21 mm Hg while compared with KiGGS, maximum of differences was 9 mm Hg. For boys 7-15 years of age, ours were slightly higher than both. For ages of 16 and 17 years, we yielded figures lower than US-4th-report (2 mm Hg) but higher than KiGGS (3 mm Hg). Iranian 95th percentile for DBPs was lower than US-4th-report and KiGGS (1-11 mm Hg). Considering the differences with US-4th-report and KiGSS standards, the references presented in this study should rather be applied in Iranian population.

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BACKGROUND: The obesity and hypertension are the major risk factors of several life threatening diseases. The present study was aimed to investigate the relation between body mass index (BMI) the validated index of adiposity and different aspect of blood pressure (BP). METHODS: Systolic and diastolic blood pressures and also weight and height of 7 to 18 years old children and adolescent collected in 2002 and 2004 respectively. Data was consisted of 14865 schoolchildren and adolescents from representative sample of country. BMI was classified according to CDC 2000 standards into normal (BMI<85th percentile), at risk of overweight (BMI≥85th and <95th percentile) and overweight (BMI≥95th percentile). Then, age-sex specific prevalence of being overweight was derived. ANOVA was used to investigate the effect of BMI on systolic blood pressure and diastolic blood pressure and mean arterial pressure of participants. RESULTS: Mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly increased with BMI (P< 0.0001) and age groups (P< 0.0001), and was significantly (P< 0.0001) higher in boys than girls especially in older ages. (P< 0.0001, interaction of age and BMI level). The proportion of being overweight was significantly higher in boys than girls was (7.4% vs. 3.6%; P< 0.0001). CONCLUSION: There is an association between BP and BMI in children and adolescence. SBP, DBP and MAP are associated with rise in BMI and age, which was lower in girls. This data can provide basics for public health policy makers and primary prevention policies in the country.