Search

Background: Congenital hypothyroidism (CH) is one of the most preventable causes of mental retardation throughout the world. The aim of this study was to evaluate the sensitivity and specificity of filter paper in screening for congenital hypothyroidism and to determine an appropriate cut-off point for filter TSH for recalling screened neonates. Methods: In this cross-sectional study (descriptive analytic), the records of 2739 neonates who had been recalled during the CH screening program in the east of Tehran, Iran (health care centers of the Iran University of Medical Sciences), from March 2011 to March 2015, were studied. According to the CH screening program in Iran, the TSH on filter paper>5 is the current cut-off point for recalling the neonates. The data was analyzed with SPSS software, version 21. The ROC curve was used to determine the TSH cut-off point and the sensitivity and specificity of the filter test. The relationship between the filter and serum TSH was also determined. The study was approved by the Ethics Committee of the Iran University of Medical Sciences. Results: The recall rate was 5.4%. The prevalence of hypothyroidism was 3/1000 neonates (164). The prevalence in males and females was 51.1% and 48.9%, respectively, with no significant difference. The number of recalled neonates diagnosed as patients with congenital hypothyroidism based on the filter TSH level was 5

Background: Given the limited resources of health system, economic evaluations studies can provide appropriate evidences for resource allocation by clarifying the possible consequences of a decision. Present study aimed to evaluate the implemented approaches for economic evaluation studies of pharmacoeconomic in Iran. Methods: This study was carried out using the critical review method. All studies related to economic evaluation studies of pharmacoeconomic in Iran, indexed in PubMed and SID databases and Google Scholar search engine, were searched by using appropriate keywords and search strategies until 2021. Further, published papers from Iranian researchers in the field of health economics and pharmacoeconomics and pharmaceutical administration were extracted with the scientometric system of the Health Ministry. Then, retrieved papers were screened by title, abstract, and the whole text. Finally, papers were evaluated by applying the Drummond quality assessment checklist, and finally appropriate ones were selected. Finally, 29 papers were selected and analyzed. Results: Out of total available papers (n=1324), 29 papers had inclusion criteria to evaluate. The selected papers were analyzed based on 10 parameters, including type of analysis, type of comparator, source of clinical effectiveness, time horizon, used model, perspective of the analysis, measured expected outcomes, discounting of costs and outcomes, sensitivity analysis, and subgroup analysis. Most studies have used cost utility analysis. Shortcomings were found in some aspects as follows: some studies did not mention the applied model, or the time horizon. Moreover, some studies had time horizon more than one year, while the cost and consequences were not discounted. Conclusion: In recent years, economic evaluation studies in the field of pharmacoeconomic in Iran have been center attention in line with global trend. In order to make a decision regarding the allocation of resources based on the findings of economic evaluation studies, these studies should be conducted with the systematic and transparent approach. Therefore, it is necessary to develop a standard framework for implementing and reporting the results of economic evaluation studies in Iran. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease today is a major contributor to mortality and morbidity from cardiovascular disease. The drug, interventional and surgical methods are used to treat coronary artery stenosis. Statins are the most commonly used drugs for stenosis and coronary artery disease. Low-density lipoprotein (LDL) The purpose of this study was to evaluate the effect of atorvastatin on LDL and C-reactive protein (CRP) reduction in patients. Methods: This study was a systematic review and meta-analysis. Articles were selected using the keywords of atorvastatin, LDL, C-reactive protein (CRP) and reduction, and searches in Scopus, Google Scholar and PubMed databases from March 2003 to February 2018. For this purpose, all analytical, clinical trials, cross-sectional, and casecontrol studies were searched and collected in association with the efficacy of atorvastatin on low density lipoprotein and CRP. Results: In the initial search, 90 papers were found and evaluated. Finally, 20 papers were analyzed. The studies were published. The total sample size was 21609 persons with an average sample size of 1080 in each study. Twenty studies were entered into the final analysis. The LDL-lowering rate was 51 mg/dl with atorvastatin (I2=98.48, P<0.001). Also, CRP reduction before and after administration of atorvastatin was 1.99 (0.96-3.03) and 0.76 (0.08-1.43), respectively. The results of meta-regression of age-related studies showed that LDL levels were low in studies with lower age, and LDL levels were low in studies with higher age. The results of a meta-regression study of atorvastatin in terms of body mass and the association of low-density lipoprotein with atorvastatin showed that in those with a higher body mass, low-density lipoprotein decreased. Conclusion: According to the results, the use of atorvastatin reduces the amount of Creactive protein (CRP). The rate of low density lipoprotein (LDL) reduction was better and faster in young and obese people. It is recommended that people have a proper diet and regular exercise in their daily schedule. [ABSTRACT FROM AUTHOR]

The recording of electrophysiological activities of brain neurons in the last half century has been considered as one of the effective tools for the development of neuroscience. One of the techniques for recording the activity of nerve cells is the multi-electrode arrays (MEAs). Microelectrode arrays (MEAs) are usually employed to record electrical signals from electrogenic cells like neurons or cardiomyocytes. MEAs consist of an array of planar or three-dimensional electrodes that act as electrical interfaces and record cellular signals or stimulate cells. These platforms can be used in different applications including neuroscience studies, prostheses and rehabilitation, deep brain stimulation (DBS), cardiac pacemakers, retinal and cochlear implants, or for brain-computer interfaces (BCI) in general. Multi-electrode arrays are known as longterm recording and non-invasive devices. The MEA structure includes arrays of electrodes with micrometer and nanometer dimensions which are designed to stimulate and record the electrical activity of cells, and are fabricated using micromachining technologies. MEAs should be biocompatible to serve as a substrate for cell growth. On the other hand, they must have low impedance to be able to provide a high signal-tonoise ratio, and small size to offer a suitable spatial resolution for recording. MEAs are usually fabricated on glass substrates patterned with high-conductivity metals such as gold, iridium or platinum, which are insulated with a biocompatible layer. Despite fast progress, current multi-electrode arrays for neural applications still face limitations such as low signal-to-noise ratio and spatial resolution. To achieve better spatial resolution and lower noise levels and therefore more accurate signal, it is necessary to develop arrays with smaller sizes and lower impedance. Meanwhile, many nanostructures such as graphene, carbon nanotubes, gold nanoparticles, and also conductive polymers have become attractive candidates for this application due to their interesting properties. In this paper, the technology of multi-electrode arrays, how it works and its various parts are introduced, and finally, the challenges and developments in this field are investigated. Multi-electrode array technology is used for neuroscience research, neural network analysis, drug effects screening, and neural prosthesis studies. [ABSTRACT FROM AUTHOR]

Background: Given the limited resources of health system, economic evaluations studies can provide appropriate evidences for resource allocation by clarifying the possible consequences of a decision. Present study aimed to evaluate the implemented approaches for economic evaluation studies of pharmacoeconomic in Iran. Methods: This study was carried out using the critical review method. All studies related to economic evaluation studies of pharmacoeconomic in Iran, indexed in PubMed and SID databases and Google Scholar search engine, were searched by using appropriate keywords and search strategies until 2021. Further, published papers from Iranian researchers in the field of health economics and pharmacoeconomics and pharmaceutical administration were extracted with the scientometric system of the Health Ministry. Then, retrieved papers were screened by title, abstract, and the whole text. Finally, papers were evaluated by applying the Drummond quality assessment checklist, and finally appropriate ones were selected. Finally, 29 papers were selected and analyzed. Results: Out of total available papers (n=1324), 29 papers had inclusion criteria to evaluate. The selected papers were analyzed based on 10 parameters, including type of analysis, type of comparator, source of clinical effectiveness, time horizon, used model, perspective of the analysis, measured expected outcomes, discounting of costs and outcomes, sensitivity analysis, and subgroup analysis. Most studies have used cost utility analysis. Shortcomings were found in some aspects as follows: some studies did not mention the applied model, or the time horizon. Moreover, some studies had time horizon more than one year, while the cost and consequences were not discounted. Conclusion: In recent years, economic evaluation studies in the field of pharmacoeconomic in Iran have been center attention in line with global trend. In order to make a decision regarding the allocation of resources based on the findings of economic evaluation studies, these studies should be conducted with the systematic and transparent approach. Therefore, it is necessary to develop a standard framework for implementing and reporting the results of economic evaluation studies in Iran. Keywords: cost-benefit analysis, cost-effectiveness analysis,

Background: The advent of Severe Acute Respiratory Syndrome Coronavirus 2 (socalled SARS-CoV-2) causing Coronavirus Disease 2019 (so-called COVID-19) occurred in Dec. 2019 in Wuhan, China. Having an inconceivable worldwide contagion, the outbreak was labeled a pandemic by the WHO. Dental services and related professions (including dentists, dental assistants, dental hygienists and the personnel of cleansing, remedial, triage, dental laboratories, radiographic laboratories and other related paraclinicals), facing galore aerosol and droplets, are in the topmost risk groups exposed to the queer virus. This study was fulfilled to round up evidencebased data to break a link at any part of the virus transmission chain in dental services and related professions. Methods: Relevant online databases, as PubMed, MEDLINE, Embase, Scopus, Google Scholar and TripDatabase were searched meticulously and evaluated for relevant published original research papers. Subsequently, to fulfill the investigation, ADA, CDC and WHO websites were reviewed to gain relevant guidelines and protocols. Consequently, 476 resources were included considering the canonical inclusion criteria. For the sake of quality assessment of the resources, an authentic checklist was exploited to score the resources from 1 to 15, wherein the admissible score was 10. After deliberation of resources, 366 of them were excluded and finally, 110 resources were selected and overhauled to attain a comprehensive perception on the subject of the investigation. Results: Transmission of SARS-CoV-2 includes direct transmission (via droplet and aerosol inhalation) and indirect transmission (via surface and instrument contamination), which can amply occur in dental services and related professions. Therefore, an all-inclusive evidence-based miscellany was rallied on several exigent topics, containing genuine esteem in reputable scientific authorities, to present a consummate report for the dental clinicians and related practitioners, working in the course of the running pandemic. Conclusion: Contemplating the ongoing crisis, undertaking a set of miscellany elected guidelines and protocols, is indispensable in this vital interval of history to bridle the current pandemic, which has been abridged via this systematic perusal. [ABSTRACT FROM AUTHOR]

Background: Accurate and early detection of non-alcoholic fatty liver, which is a major cause of chronic diseases is very important and is vital to prevent the complications associated with this disease. Ultrasound of the liver is the most common and widely performed method of diagnosing fatty liver. However, due to the low quality of ultrasound images, the need for an automatic and intelligent classification method based on artificial intelligence methods to accurately detect the amount of liver fat is essential. This paper aims to develop an advanced machine learning model based on texture features to assess liver fat levels based on liver ultrasound images. Methods: In this analytic study, which is done from April to November 2020 in Tehran, ultrasound images of 55 obese people who have undergone laparoscopic surgery have been used and the histological result of a liver biopsy has been employed as a reference for liver fat. First, 88 texture-based features were extracted from the images using the Gray-Level Co-Occurrence Matrix (GLCM) method. In the next step, using the method of minimum redundancy and maximum correlation, the top features were selected from among 88 features and applied to the classifier input. Finally, using the three classifiers of linear discriminant analysis, support vector machine and AdaBoost, the images were classified into 4 groups based on the amount of liver fat. Results: The accuracy of the automatic liver fat prediction model from ultrasound images for AdaBoost classification was 92.72%. However, the accuracies obtained for support vector machine and linear discriminant analysis classification were 87.88% and 75.76%, respectively. Conclusion: The proposed approach based on texture features using the GLCM and the AdaBoost classification from ultrasound images automatically detects the amount of liver fat with high accuracy and can help physicians and radiologists in the final diagnosis. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is the most prevalent age-related neurodegenerative disorder worldwide, and no cure or prevention has been found for it. Extracellular senile plaque and intracellular neurofibrillary tangles are two important histopathological hallmarks of AD, which are both harmful for the cell. Senile plaques are composed of amyloid beta and neurofibrillary tangles are formed by hyperphosphorylated Tau proteins. In AD, several cellular changes also occur, including oxidative stress, neuroinflammation, accumulation of misfolded proteins, and mitochondrial dysfunction. These events promote neuronal death and finally decline memory and cognition. Lack of success of the available chemical anti-AD therapeutic agents has attracted attention to the concept of the administration of naturally occurring compounds in the treatment of AD. These compounds can be employed as a substitute for the chemical agents or complementary regimens. Several natural products are deemed capable of crossing the blood-brain barrier and are known for their central nervous system-related activity. Among the most important of them are flavonoids. Recent evidence has demonstrated their neuroprotective effects. These plant-derived compounds have strong effects on dementia-induced brain disorders because of their ability to produce antioxidants. Numerous mechanisms have been proposed for flavonoids through which they act for the prevention or recession of the disease process. According to evidence, flavonoids inhibit acetylcholinesterase (AChE), β-secretase (BACE1) and free radicals. They reduce the amyloid-beta toxicity and prevent the formation of neurofibrillary tangles. Also, they help to inhibit apoptosis induced by oxidative stress and neuroinflammation. These products have a role in synaptic plasticity and the generation of new neurons. They can affect various signaling pathways like Extracellular signal-regulated kinase (Erk), Phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen-activated protein kinase (MAPK). Overall, these processes can prevent the progression of AD and improve cognitive symptoms. In the present paper, the effect of the most important plant-derived flavonoids is briefly reviewed in different models of AD. The mechanism of action and the important signaling pathways in reducing neuroinflammation, apoptosis, and oxidative damage are discussed. It is concluded that despite the beneficial effect of these compounds, future studies are needed before flavonoids can be used as a drug in the treatment of Alzheimer’s disease. [ABSTRACT FROM AUTHOR]

Background: Infectious diseases in the pandemic stage have significant lifethreatening, psychological and social effects. Identifying the characteristics associated with people's cooperation in self-care leads to greater immunity for themselves and others. Therefore, this study was conducted to predict the self-care of the Iranian people according to their individual and social characteristics in face of the Covid-19 pandemic. Methods: A survey study was conducted on 1056 adults aged 18 and over in different provinces of Iran through a form of answering online researcher-made questions (n=40, α=0.9) in social networks in four days. This paper studies the level of self-care of people against Covid 19 pandemic which was conducted with the support of Isfahan University of Medical Sciences in April 2016. Data were analyzed using Student t-test and variance. Moreover, "decision tree technique" was used to identify communication patterns. Results: The findings showed that the average self-care score in women, the most educated, married women, women aged 41 to 55, housewives and some other occupations was very high. However, the average self-care score of single men with a diploma was average. In general, the mean score of women's self-care was higher than men (P<0.0001) and the educated were more than the less educated literate (P=0.007). There was no significant difference between the self-care scores of the respondents in terms of their marital status and employment. Conclusion: The results showed that the average scores of self-care in women, more educated people, married women, women in the age group of 41 to 55 years, housewives and some other occupations were reported to be very high; While the average self-care score reported in single men with a diploma was average. Overall, the mean score of self-care reported in women was higher than men (P<0.0001) and people with doctoral education reported more self-care than illiterate people (P=0.007). Besides, there was no significant difference between the self-care scores of the respondents in terms of their marital status (single and married) and their employment status (employed and non-employed). [ABSTRACT FROM AUTHOR]

Background: There are many conservative interventions to reduce the symptoms of coccydynia, but it is not clear which treatment can be more effective. The aim of this review study was to evaluate the types of conservative interventions and the effectiveness of each of them in reducing coccydynia symptoms. Methods: This systematic review was carried out based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) instruction. A search for research studies published up to October 2021 was conducted in Neuromusculoskeletal Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran, using Scopus, Science Direct, Web of Knowledge and Cochrane without data constraints. The search was carried out in October 2021 and continued for seven months. The quality of the articles was evaluated using the Physiotherapy Evidence Database scale (PEDro). All prospective randomized clinical trial studies in which participants suffered from coccydynia and were treated with nonsurgical treatments were included. Results: 945 articles were found in the primary search of the databases. After eliminating 493 repetitive papers, 452 studies remained which were screened by the two researchers of this study in terms of the title and abstract. 40 studies were selected for full-text evaluation. Finally, 12 articles were included in the review study. Two papers used extracorporeal shockwave, two papers used impar ganglion block, three papers manual therapy, and four studies injection. The remaining four studies used iontophoresis with ketoprofen, biofeedback therapy, acupuncture, and physiotherapy with Kinesio taping. Conclusion: Treatment with extracorporeal shock wave and impar ganglion block significantly improve tailbone pain and show more permanent effects on patients' symptoms. Manual therapies are mostly used in cases where the tailbone is stable. It seems that achieving the desired response requires more than six sessions, which is not pleasant for patients. Injections, especially those performed under fluoroscopic guidance, require high skill in addition to being unpleasant and painful. However, this procedure is done in one session, so there is no need for the next visit.

Background: One of the today most common and incurable diseases that is associated with central neural system is ‘MS' disease. Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. In this disease become apparent a wide spectrum of symptoms such as lose muscles control and their coordination and vision derangement. The goal of this research is to consider to two problems: 1- Recognition of effective clinical symptoms on MS disease and 2- Considering levels of effectiveness of age, sex and education levels factors on MS disease and association between these factors according to verity of categories of this disease. Methods: Data mining science in medicine is worthy of attention with main application in diagnosis, therapy and prognosis, respectively high volume of collected datum. The data that were used in this article are about patients of Chaharmahal and Bakhtiari Province and collected by cure assistance. In this paper classification and association methods in software engineering field are used. Classification is a general process related to categorization, the process in which ideas and objects are recognized, differentiated, and understood. Association rules are created by analyzing data for frequent if/then patterns and using the criteria support and confidence to identify the most important relationships. Results: In consideration of first problem in this paper, concluded vision-clinical symptoms are the most effective symptoms and in consideration of second problem, concluded that from 584 records, women affected four times more than men. In other word 70% of MS patients with high graduate are in relapsing-remitting category and 62.5% of MS patients are 20-40 years old. Conclusion: Some of symptoms are quite temporary and transitory and are ignored by people. Awareness of clinical-symptoms prevalence manner can be warning for people before starting critical cycle of illness. This would cause early diagnosis, effective therapy and even prevention of disease progress, respectively to MS chronicity. [ABSTRACT FROM AUTHOR]

Background: Cupping is one of the most common traditional medical procedures in Iran, which is widely used and prescribed from long time ago. Putting a cup on the skin with induction of negative pressure, causes an artificial inflammation with collection of some body fluids under the skin which can be extracted by scarification. Different mechanisms and effects are attributable to cupping based on several assumptions and theories. Regarding to the vast use of this traditional therapeutic method and relatively different point of views about the effects of cupping, this study was performed to systematically assess published studies in this field and also to find probable indications of cupping. Methods: In this systematic review, according to search via Google Scholar, PubMed, Scopus databases and Iranian databases (IranMedex and SID), 99 different scientific articles about cupping and it`s positive and negative effects were assessed. Different diseases categorized in 19 groups according to the pathophysiology and organ similarities for better presentation Results: More than 50 different disorders have been studied in randomized or nonrandomized clinical trials. 84.9% of reviewed papers have reported significant positive effects of cupping. The most common disorders studied in the reviewed papers were musculoskeletal, pain and skin disorders, especially low back pain has been studied more with positive results of cupping. Conclusion: In Iran the prevalence of cupping performance is really high. The reported positive effects and also complications especially infection were also dramatic. It seems performing systematic studies on cupping effects in different disorders and designing and implementing an active surveillance system for cupping in our country is essential. According to the type of studies, authors concluded that cupping have been reported as an effective intervention for some diseases such as musculoskeletal and skin disorders, but further methodologically elaborated studies with larger sample sizes should be considered for recommending this intervention scientifically. [ABSTRACT FROM AUTHOR]

Background: Currently, share of the scientific output, citation per paper, and coauthorship for articles indexed in databases such as ISI Web of Science, are very important criteria for the evaluation and ranking of countries, researchers, institutes, articles, disciplines and journals in the world. Therefore, the main objectives of the study were to determine co-authorship, the average citation per paper and the most prolific Iranian university or institution in the field of immunology. Methods: For performing this scientometric study, we employed survey methods and citation analysis of the indexed papers in the ISI Web of Science from 1974 to 2010. Results: A total of 1775 articles by Iranian authors in the field of immunology had been indexed in the database for the aforesaid period. Most collaborations and co-authorship of Iranian authors was with their counterparts from the USA. The average citation per paper in the field was 6.26 per paper. Tehran University of Medical Sciences had the highest number of articles in the database. Conclusion: According to the results, Iranians collaborated with American peers more than any other nationality and the average citation per paper in the field of immunology is higher than that of other fields in Iran but lower than the global average. Tehran University of Medical Sciences is the most prolific university in the field. [ABSTRACT FROM AUTHOR]

Background: Medical errors are those errors or mistakes committed by healthcare professionals due to errors of omission, errors in planning, and errors of execution of a planned healthcare action whether or not it is harmful to the patient. Medical error in hospitals increases morbidity and mortality and decreases patient satisfaction and hospital productivity. This study aimed to determine the prevalence of medical errors in Iranian hospitals. Methods: This study was conducted using systematic review and meta-analysis approaches. All articles written in English and Persian on the prevalence of medical errors in Iranian hospitals up to March 2019 were searched in Web of Science, PubMed, Elsevier, Scopus, Magiran, IranMedex and Scientific Information Database (SID) databases, and Google and Google Scholar search engines. In addition, reference lists of the retrieved papers were hand-searched. A total of 9 studies matching the inclusion criteria were identified, reviewed, and analyzed using comprehensive metaanalysis software. Results: The prevalence of medical errors was reported in 9 studies and prevalence rate ranged from 0.06% to 42%. Most studies used reporting forms completed by hospital employees for determining the prevalence of medical errors (67%). Only three studies collected data by reviewing patients’ medical records. Accordingly, the overall prevalence of medical error in Iran's hospitals based on the nine published articles was 0.01% (95% Cl 0%-0.01%) during 2008 to 2017. The highest medical error was recorded in a hospital in Shiraz, 2.1% (95% Cl: 1.4%-2.7%) in 2012. A significant statistical correlation was observed between medical errors and sample size (P<0.05). Conclusion: The prevalence rate of medical error in Iran is low. It is strongly recommended to use more advanced and valid methods such as occurrence reporting, screening, and the global trigger tool for examining medical errors in Iranian hospitals. Proving adequate education and training to patients and employees, simplifying and standardizing hospital processes, enhancing hospital information systems, improving communication, promoting a safety culture, improving employees’ welfare and satisfaction, and implementing quality management strategies are useful for reducing medical errors. [ABSTRACT FROM AUTHOR]

Herpes zoster (Shingles; Zona) is an acute infectious skin disease that is caused by the reactivation of varicella zoster virus (VZV). After the initial infection (chickenpox) or vaccination, the virus remains inactive or latent in the dorsal root ganglia (DRG); when decreasing cell mediated immunity (CMI) occurs, the virus is reactivated from a latent phase to a lytic phase and frequently replicated in the dorsal ganglion cells then move to the sensory nerves into the skin and causes herpes zoster, which is typically characterized by painful neuralgia and unilateral dermatomal vesicular rash that normally lasts 3 to 5 weeks. The most common complication of herpes zoster is chronic pain owing to postherpetic neuralgia (PHN), which is estimated to occur in approximately 20% of the people aged 50 and over. Although herpes zoster is rarely fatal, the pain related to the acute phase of herpes zoster and subsequent PHN can cause psychological distress, physical disability, impaired sleep and consequently negatively affect the quality of life that can be significantly reduced by all of these occurrences. Due to increasing trend in the incidence of herpes zoster and increasing older people population, it will be expected that herpes zoster and subsequent PHN cause a significant economic burden to the healthcare system, the government, and families along with reducing the quality of life. The average lifetime risk of herpes zoster is estimated to be approximately 30% in developing countries. Although the risk of herpes zoster significantly increases with increasing age and diminished immune system function, any factor impacting on VZV-specific humoral and cellular immune responses may affect the risk of herpes zoster. This paper is provided an overview of the incidence and potential risk factors of herpes zoster with emphasis on the role of micronutrients and their deficiencies in the impaired immune system function. Also, the common method for prevention by zoster vaccine and the role of micronutrients in the efficacy of vaccination are shown. [ABSTRACT FROM AUTHOR]

Chronic lymphocytic leukemia (CLL) is a malignancy of B CD5+cells and is the most common type of leukemia in adults. The disease is more common in men over 50 years in western countries. CLL is associated with defective apoptosis in B cells. CLL was traditionally regarded as a disease that occurs before naïve B cells meet the antigen in the lymph nodes. Laboratory diagnosis requires white blood cell count, blood smear and immunophenotyping of lymphoid cells by flow cytometry. The disease most often associated with the accumulation of CD5+ CD19+ and CD23+ B cell with reduced number of surface membrane immunoglobulin in peripheral blood, bone marrow, and lymph nodes. Clinical progression of CLL is heterogeneous, some patients need treatment immediately after diagnosis, and others do not require treatment for many years after diagnosis. Over the past decades, considerable effort has been made to understanding the molecular mechanisms underlying the heterogeneous clinical course of the disease and finding prognostic markers for clinical classification. Patients with advanced Binet or Rai stages of disease require treatment. In addition to the interactions that exist between CLL cells, number of non-tumor cell types such as bone marrow stromal cells (BMSCs), nurse like cells (NLCs), follicular dendritic cells (FDCs), T cells, and some cytokines like IL-4 in tumor microenvironment play an important role in the CLL pathogenesis. Various factors including: IGVH mutation status, genetic variation, patient age and presence of other disorders are important for disease management and the type of treatment. CLL patients carrying p53 pathway dysfunction have poor prognosis and poor responses to therapy and very short survival. Available treatments include chemotherapy, chemoimmunotherapy, or drugs targeting B cell receptor signaling, Bruton's tyrosine kinase (BTK) or inhibitors of apoptosis, such as BCL2 and new class of small molecules. Understanding the CLL biology is important in identifying high-risk patients as well as the drug and relevant therapeutic methods for better management of patients. In this review paper, the microenvironment and genetic abnormalities in the CLL as well as new diagnostic and therapeutic approaches based on the new understanding of molecular biology of CLL are discussed. [ABSTRACT FROM AUTHOR]

Background: According to the previous studies, stress influences on eating behavior and is associated with unhealthy food selection. Furthermore, the research literature indicates that stress, anxiety, and depression can cause polyphagia and overweight. The purpose of present study is to investigate the relationship between depression, anxiety, and stress scales and dietary behavior in female high school students. Methods: The cross-section study was carried out from April to December 2016 on high school female students of Tehran City by confirmation and protection of Nutrition Sciences and Food Technology Faculty at Shahid Beheshti Medical Sciences University, Tehran, Iran. 400 samples were selected by using multistage cluster sampling method. After receiving consent and recording socio-economic information, the data associated with stress, anxiety, and depression score were collected by a short questionnaire of Depression Anxiety Stress Scales 21 (DASS-21). In order to survey the dietary behavior of students, the 168-item semi-quantitative food frequency questionnaire (FFQ) was applied. In addition, to assess the association between dietary behavior and stress, anxiety and depression, chi-squared test and logistic regression model were employed. Results: Based on the results of the present paper, 49.8 percent of students, studied in this research, had stress levels, 56.3 percent of them suffered from anxiety and 55.3 percent of them had depression levels. The salt intake amounts of students who had high stress, depression, and anxiety, were more than of normal ones (respectively P=0.01, 0.02, 0.006). Additionally, fast food consumptions of students, suffering from anxiety, were also higher than normal (P=0.07). Subjects, which were categorized in depressed group, rarely eat natural fruit juice (P=0.03), and, stressful students use few natural fruit juices (P=0.006) and few fresh fruits too (P=0.02). Conclusion: Students with levels of stress, depression and anxiety in comparison to normal students, have more undesirable food habits, such problems may lead dietary behavior to unhealthy foods. More studies are required to clarify the relationships between dietary behavior and stress, depression and anxiety. [ABSTRACT FROM AUTHOR]

Background: Due to the overlap between the databases of the subject and content, resulting in the purchase of duplication and waste of resources, in this study, the degree of overlap between respiratory system papers indexed in the database, Scopus and Web of Science during the years 2001 to 2010 were examined. Methods: In this survey study, researcher followed by obtaining percent overlap in the articles related to respiratory system field from 2001 to 2010. At first sub-headings contained in the following subject headings from medical thesaurus of (Mesh 2012) extracted and then each keyword in title of articles in both database search and articles were retrieved. Then bibliographic information of these articles enter into EndNote version X3 (Thomson Reuters Inc., New York, NY, USA) and then in alphabetical order title arranged and as a result, common articles between the two databases and unique articles to each site was determined. Using SPSS software version 0.1.0.8 amount of the relative overlap and traditional overlap between the two databases was calculated and the results by using descriptive statistics to determine and were presented in tables. Results: In total 18099 articles were retrieved. That number of 9768 common articles, there were 7225 articles uniquely Scopus and 1106 articles from Web of Science. Amount of percent traditional overlap 53.97% and the overlap percent Web of Science with Scopus was 57.48% and Scopus with Web of Science was 89.83%. Conclusion: Because of overlaping the contents of two information databases such as scopus and web of sciences searching for accessing to respiratory system from scopus is better due to containing unique papers, However it is highly recommended to pay to this point while buying and sharing the mentioned resources. [ABSTRACT FROM AUTHOR]

Cancer immunotherapy refers to any intervention that leverages the immune system to eliminate a malignancy. Successful cancer immunotherapies generate an anti-cancer response that is systemic, specific, and durable and overcome to the primary limitations of traditional cancer treatment modalities. In this review paper, the effective methods in immune system to treat cancer, such as immunosuppression in tumor microenvironment (TME), cancer vaccines and T cell adaptive therapy are mentioned. Engineered T cells can use for destruction of the different cancer tissues to diagnose tumor surface antigens. Promotion in culture of T cell methods and their engineering with retroviral vectors that carry T cell receptors or chimeric antigen receptors (CAR) by co-stimulator domains, provide opportunity to treat tumor by T cells. The tumors with high genome mutation, such as lung and melanoma, have severe environmental mutagenesis that is induced by ultra violet light in melanoma and Tobacco in lung cancers. Expression of tumor specific receptors is increased by engineered T cells. The neo-antigens conduct the intensity of intra tumor T cell response. The present of CD8+ in tumor site with more mutation is higher and the mutation load is showed strong relation with the clinical response. In addition to the successful approaches to cancer immunotherapy, the other combination and molecular therapies by nanomaterials are listed. Nanomaterials as efficient modulators and diverse vaccine have been developed in the treatment of cancer. In recent cancer vaccine development has been on subunit vaccines that contain purified tumor antigens or antigenic epitopes as an antigen source. However, soluble bolusbased subunit vaccines typically induce weak cytotoxic T lymphocyte responses which limit their utility for cancer. To overcome this, nanoscale colloids can be used to promote more efficient antigen presentation by acting as phagocytic substrates. Nanomaterials are showed co-suppression and immunization in tumor microenvironment by multiple additive functions in preclinical models. In this manner, they exhibited good prospects because of the good results in overcoming the limitations of current therapies. In this review paper is tried to provide new prospect for therapies and hope it creates highest efficacy and lowest side effects for the treatment of patients in the near future. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most common disorder of dementia, which has not been cured after its occurrence. AD progresses indiscernible, first destroy the structure of the brain and subsequently becomes clinically evident. Therefore, the timely and correct diagnosis of these structural changes in the brain is very important and it can prevent the disease or stop its progress. Nowadays, remark to this fact that magnetic resonance imaging (MRI) provides very useful and detailed information, and due to non-invasiveness, this method has been great interest to the researchers. The aim of this study was diagnosis of AD with MRI by support vector machine model (SVM). Methods: This is an analytical and modeling research which done in School of Public Health, Kermanshah University of Medical Science, Iran, from February 2017 to November 2017. The data used in this study was a database named Miriad containing brain MRI of 69 individuals (46 Alzheimer's disease and 23 healthy subjects) that was collected at the central hospital in London. Individuals were categorized into two groups of healthy and Alzheimer's disease with two criteria: NINCDS-ADRAD and MMSE (as the golden standard). In this paper SVM model with three linear, binomial and Gaussian kernels was used to distinguish Alzheimer`s disease from healthy individuals. Results: Finally, SVM model with Gaussian kernel, separated AD and healthy subjects with 88.34% accuracy. The most important Areas for Alzheimer were three Area: Right para hippocampal gyrus, Left para hippocampal gyrus and Right hippocampus. The clinical result of this study is to identify the most important ROI for the diagnosis of Alzheimer's by a clinical specialist. Experts should focus on atrophy in the three Areas. Conclusion: This study showed that the SVM model with Gaussian RBF kernel can separated AD from healthy subjects by high accuracy. Based on results of this study, can make a software to use in MRI centers for screening AD test by people over the age of 50 years. [ABSTRACT FROM AUTHOR]

Background: Accurate detection of deep sleep (Due to the low frequency of the brain signal in this part of sleep, it is also called slow-wave sleep) from awakening increases the sleep staging accuracy as an important factor in medicine. Depending on the time and cost of manually determining the depth of sleep, we can automatically determine the depth of sleep by electroencephalogram (EEG) signal processing. In this paper a new EEG bispectrum based feature is introduced for deep sleep discrimination. Methods: This cross-sectional study was conducted at Isfahan University of Medical Sciences, Faculty of Advanced Technologies in Medicine, from February to October 2017. In this study a gray scale image was made of electroencephalogram bispectrum amounts and converted to binary image with Otsu's Thresholding. Then the ratio of white bits in the above of the secondary diagonal to white bits in the down of secondary diagonal (low to high frequencies bispectrum rate) is extracted as a new feature. This feature is an effective method for detecting deep sleep from awakening. Results: One of the important methods in biomedical signal processing is the use of the power spectrum or signal energy. In sleep studies, energy-related features have also been used to determine the depth of sleep. Low to high frequencies bispectrum rate is able to separate deep sleep from awakening by accuracy of 99.50 percent, while energy-based features as one of the most important approaches to sleep classification do not have this ability. Conclusion: In this study we show that “Low to high frequencies bispectrum rate" feature has this capability to use in sleep staging. It is not used in previous works. The accuracy obtained in deep sleep separation from the awakening with the introduced feature (99.50 percent) is greater than the accuracy obtained by all the energy-based features (The simultaneous use of the 6 bands energy leads to 99.42 percent accuracy). This feature indicates the ratio of the phase coupling at low frequencies to high frequencies and can be used in all cases where the bispectrum is used (such as determining the depth of anesthesia). [ABSTRACT FROM AUTHOR]

Background: Various prediction models have been developed aiming to estimate riskadjusted mortality, morbidity and length of intensive care unit stay following cardiac surgeries. The European system for cardiac operative risk evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death. The objective of this study was to evaluate the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries. Methods: A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool. Results: A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%. Conclusion: Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran. [ABSTRACT FROM AUTHOR]

Background: Due to intrinsic heterogeneity of cellular distribution and density within diffusion weighted images (DWI) of glioblastoma multiform (GBM) tumors, differentiation of active tumor and peri-tumoral edema regions within these tumors is challenging. The aim of this paper was to take advantage of the differences among heterogeneity of active tumor and edematous regions within the glioblastoma multiform tumors in order to discriminate these regions from each other. Methods: The dataset of this retrospective study was selected from a database which was collected at the medical imaging center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran. The quantification was performed as a part of a research study being supported by the Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran, between May and September 2017. Twenty patients with histopathologically-confirmed GBM tumors who had been imaged on a 3T MRI scanner prior to their surgery, were included. Conventional and diffusion weighted MR images had been carried out on the patients. The regions of interest including the regions of active tumor and edema were identified on MR images by an expert and overlaid on ADC-maps of the same patients. Histogram analysis was performed on each of these regions and 14 characteristic features were calculated and the best feature combination for discrimination of active tumor from edema was obtained. Results: It was shown that by combining 8 out of 14 histogram features, including median, normalized mean, standard deviation, skewness, energy, 25th, 75th, and 95th percentiles, differentiation with accuracy of 96.4% and diagnostic performance of 100% can be achieved. Furthermore, by combining mean, energy, and 75th percentile features of histograms, the active tumor region can be discriminated from the edematous region by 92.7% of accuracy and 98.9% of diagnostic performance. Conclusion: The present study confirms that the heterogeneity of cellular distribution can be a predictive biomarker for differentiation of edematous regions from active tumor part of GBM tumors. [ABSTRACT FROM AUTHOR]

Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition. Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 week of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition. Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient. [ABSTRACT FROM AUTHOR]

Today, the use of information and communication technology (ICT) is an important and key factor in the progress of all organizations, including health-centered and health systems. Given the importance of the subject matter above, these organizations have created a particular transformation and change in order to upgrade their systems in use, one of which is the creation of Electronic Health Records (EHR). This evolving system, by increasing productivity, both by increasing staffing efficiency and by increasing the effectiveness of the treatment process, simplifies the diagnosis path to treatment and prevents the submission of written and bulky reports. Given the ethical principles of protecting the privacy of patients and the confidentiality of their information, how to archive electronic medical records in a secure database is very important. This is one of the most important issues of ethics and hospital managers should provide mechanisms to keep all patient data properly stored and maintained. In this paper, we have tried to provide a model for the Electronic Health Record Hospital, which many of them could use to optimize their medical records systems. The purpose of this model is to accelerate and apply the process of creating electronic records in the health system, especially government hospitals with a large number of patients. By using this model, internal and external interaction of organization is facilitated, and agile responsiveness can be provided at a given time. In addition to the above, with the implementation and operationalization of the model, the possibility of reducing the volume of criticisms and complaints from hospitals will also be realized and the use of drugs will be based on the actual needs of the community and based on individual data. Implementation of this model also has barriers to addressing some of them in this article, but in order to overcome these barriers, more administrative effort and wider governmental support are needed. These efforts in the context of culture-building use of information technology, both among hospital personnel and among patients and healthcare users, are more important. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease today is a major contributor to mortality and morbidity from cardiovascular disease. The drug, interventional and surgical methods are used to treat coronary artery stenosis. Statins are the most commonly used drugs for stenosis and coronary artery disease. Low-density lipoprotein (LDL) The purpose of this study was to evaluate the effect of atorvastatin on LDL and C-reactive protein (CRP) reduction in patients. Methods: This study was a systematic review and meta-analysis. Articles were selected using the keywords of atorvastatin, LDL, C-reactive protein (CRP) and reduction, and searches in Scopus, Google Scholar and PubMed databases from March 2003 to February 2018. For this purpose, all analytical, clinical trials, cross-sectional, and case-control studies were searched and collected in association with the efficacy of atorvastatin on low density lipoprotein and CRP. Results: In the initial search, 90 papers were found and evaluated. Finally, 20 papers were analyzed. The studies were published. The total sample size was 21609 persons with an average sample size of 1080 in each study. Twenty studies were entered into the final analysis. The LDL-lowering rate was 51 mg/dl with atorvastatin (I2=98.48, P

An increase in the average age of the population and physical activities where the musculoskeletal system is involved as well as large number of people suffering from skeletal injuries which impose high costs on the society. Bone grafting is currently a standard clinical approach to treat or replace lost tissues. Autografts are the most common grafts, but they can lead to complications such as pain, infection, scarring and donor site morbidity. The alternative is allografts, but they also carry the risk of carrying infectious agents or immune rejection. Therefore, surgeons and researchers are looking for new therapeutic methods to improve bone tissue repair. The field of tissue engineering and the use of stem cells as an ideal cell source have emerged as a promising approach in recent years. Three main components in the field of tissue engineering include proper scaffolds, cells and growth factors that their combination leads to formation of tissue-engineered constructs, resulting in tissue repair and regeneration. The use of scaffolds with suitable properties could effectively improve the tissue function or even regenerate the damaged tissue. The main idea of tissue engineering is to design and fabricate an appropriate scaffold which can support cell attachment, proliferation, migration and differentiation to relevant tissue. Scaffold gives the tissue its structural and mechanical properties, for instance flexibility and stiffness that is related with the tissue functions. Biomaterials used to fabricate scaffolds can be categorized into natural or synthetic biodegradable or non-biodegradable materials. Polymers are the most widely used materials in tissue engineering. Growth factors are a group of proteins that cause cell proliferation and differentiation. Two main cell sources are specialized cells of desired tissue and stem cells. However, according to the low proliferation and limited accessibility to the cells of desired tissue, stem cells are better suggestion. Combination of mesenchymal stem cells harvested from bone marrow, adipose tissue and cord blood with proper scaffolds and growth factors could be a useful method in treatment of skeletal injuries. In this review paper, we focus on the application of mesenchymal stem cells in the repair of damaged bone, cartilage, meniscus, ligaments, tendons and spine tissue. [ABSTRACT FROM AUTHOR]

Intervertebral disks (IVD) acts as shock absorber between each of the vertebrae in the spinal column by keeping the vertebrae separated when the shock caused by the action. They also serve to protect the nerves that run down the middle of the spine and intervertebral disks. The disks are made of fibrocartilaginous material. The outside of the disk is made of a strong material called the annulus fibrosus. Inside this protective covering is a jelly-like substance known as mucoprotein gel. This interior is known as the nucleus pulposus. The nucleus pulposus consists of large vacuolated notochord cells, small chondrocyte-like cells, collagen fibrils, and aggrecan, a proteoglycan that aggregates by binding to hyaluronan. Attached to each aggrecan molecule are glycosaminoglycan (GAG) chains of chondroitin sulfate and keratan sulfate. Intervertebral disks degeneration is frequently associated with low back and neck pain, which accounts as a disability. Despite the known outcomes of the Intervertebral disks degeneration cascade, the treatment of IVD degeneration is limited in that available conservative and surgical treatments do not reverse the pathology or restore the IVD tissue. Regenerative medicine for IVD degeneration, by injection of Intervertebral disks cells, chondrocytes or stem cells, has been extensively studied in the past decade in various animal models of induced IVD degeneration, and has progressed to clinical trials in the treatment of various spinal disease. Despite preliminary results showing positive effects of cell-injection strategies for IVD regeneration, detailed basic research on Intervertebral disks cells and their niche demonstrates that transplanted cells are unable to survive and adapt in the avascular niche of the IVD. For this therapeutic strategy to succeed, the indications for its use and the patients who would benefit need to be better defined. To surmount these obstacles, the solution will be identified only by focused research, both in the laboratory and in the clinic. In present paper, the potential utilization of different adult stem cells for intervertebral disc regeneration has been reported. Bone marrow mesenchymal stem cells, adipose tissue derived stem cells, synovial stem cells and committed IVD cells have been studied for this purpose either in vitro or in vivo. [ABSTRACT FROM AUTHOR]

Cancer immunotherapy refers to any intervention that leverages the immune system to eliminate a malignancy. Successful cancer immunotherapies generate an anti-cancer response that is systemic, specific, and durable and overcome to the primary limitations of traditional cancer treatment modalities. In this review paper, the effective methods in immune system to treat cancer, such as immunosuppression in tumor microenvironment (TME), cancer vaccines and T cell adaptive therapy are mentioned. Engineered T cells can use for destruction of the different cancer tissues to diagnose tumor surface antigens. Promotion in culture of T cell methods and their engineering with retroviral vectors that carry T cell receptors or chimeric antigen receptors (CAR) by co-stimulator domains, provide opportunity to treat tumor by T cells. The tumors with high genome mutation, such as lung and melanoma, have severe environmental mutagenesis that is induced by ultra violet light in melanoma and Tobacco in lung cancers. Expression of tumor specific receptors is increased by engineered T cells. The neo-antigens conduct the intensity of intra tumor T cell response. The present of CD8+ in tumor site with more mutation is higher and the mutation load is showed strong relation with the clinical response. In addition to the successful approaches to cancer immunotherapy, the other combination and molecular therapies by nanomaterials are listed. Nanomaterials as efficient modulators and diverse vaccine have been developed in the treatment of cancer. In recent cancer vaccine development has been on subunit vaccines that contain purified tumor antigens or antigenic epitopes as an antigen source. However, soluble bolus-based subunit vaccines typically induce weak cytotoxic T lymphocyte responses which limit their utility for cancer. To overcome this, nanoscale colloids can be used to promote more efficient antigen presentation by acting as phagocytic substrates. Nanomaterials are showed co-suppression and immunization in tumor microenvironment by multiple additive functions in preclinical models. In this manner, they exhibited good prospects because of the good results in overcoming the limitations of current therapies. In this review paper is tried to provide new prospect for therapies and hope it creates highest efficacy and lowest side effects for the treatment of patients in the near future.

Breast cancer is the most common cancer in women and one of the leading of death among them. The high and increasing incidence of the disease and its difficult treatment specifically in advanced stages, imposes hard situations for different countries' health systems. Body temperature is a natural criteria for the diagnosis of diseases. In recent decades extensive research has been conducted to increase the use of thermal cameras and obtain a close relationship between heat and temperature of the skin's physiology. Thermal imaging (thermography) applies infrared method which is fast, non-invasive, non-contact and flexibile to monitor the temperature of the human body. This paper investigates highly diversified studies implemented before and after the year 2000. And it emphasizes mostly on the newely published articles including: performance and evaluation of thermal imaging, the various aspects of imaging as well as The available technology in this field and its disadvantages in the diagnosis of breast cancer. Thermal imaging has been adopted by researchers in the fields of medicine and biomedical engineering for the diagnosis of breast cancer. With the advent of modern infrared cameras, data acquisition and processing techniques, it is now possible to have real time high resolution thermographic images, which is likely to surge further research in this field. Thermography does not provide information on the structures of the breast morphology, but it provides performance information of temperature and breast tissue vessels. It is assumed that the functional changes occured before the start of the structural changes which is the result of disease or cancer. These days, thermal imaging method has not been established as an applicative method for screening or diagnosing purposes in academic centers. But there are different centers that adopt this method for the diognosis and examining purposes. Thermal imaging is an effective method which is highly facilitative for breast cancer screening (due to the low cost and without harms), also, its impact will increase by combining other methods such as a mammogram and sonography. However, it has not been widely recognizesd as an accepted method for determineing the types of tumors (benign and malignant) and diseases of breast tissue. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is known to be preventable because of long period of pre-invasive stage, availability of screening tools, and effective treatments for early invasive cervical lesions. Screening is main measures to prevent the disease and Pap smear is a screening strategy for cervical cancer. Current paper aimed to evaluate levels of awareness and practice regarding Pap smear screening among women aged between 20 to 65 years in Tehran (Iran). Methods: This was a descriptive-analytical study conducted in Tehran City of Iran in 2015 at Firoozgar Hospital. The research population included all married, widowed and divorced women aged 20-65 years. Data analysis was performed using the Pearson correlation and Student's t-tests in SPSS, ver. 23 (Chicago, IL, USA). Results: Among 90 individuals who have fill questionnaire completely, 66.6% subjects had Pap smear tests. 40% of the individuals aged between 30 to 39 and the education level is distributed equally between Intermediate, Diploma and graduate and only 3 percent of them, continue their education to higher level. There was a significant relationship between the awareness of Pap smear and educational level (of both wives and husbands). The people who have graduate degree, have the best awareness. Working women revealed higher level of awareness about Pap smear. Shame and fear of taking the cancer were the most common reasons which lead to avoidance in doing the test by the women, while the most encouraging factors for performing the test were the information mostly provided by physicians and after that, the information provided by friends. Conclusion: The awareness of Pap smear test which was measured by weighting different questions in the questionnaire by experts, prove that the women aged above 39, have an average level of awareness of Pap smear test. Due to high prevalence of cervical cancer and prolonged pre invasive course, role of Pap smear for early diagnosis necessitate the use of proper and inexpensive instructional methods to increase awareness in women about cervical cancer and preventive strategies. [ABSTRACT FROM AUTHOR]

Background: Data mining is known as a process of discovering and analysing large amounts of data in order to find meaningful rules and trends. In healthcare, data mining offers numerous opportunities to study the unknown patterns in a data set. These patterns can be used to diagnosis, prognosis and treatment of patients by physicians. The main objective of this study was to predict the level of serum ferritin in women with anemia and to specify the basic predictive factors of iron deficiency anemia using data mining techniques. Methods: In this research 690 patients and 22 variables have been studied in women population with anemia. These data include 11 laboratories and 11 clinical variables of patients related to the patients who have referred to the laboratory of Imam Hossein and Shohada-E- Haft Tir hospitals from April 2013 to April 2014. Decision tree technique has been used to build the model. Results: The accuracy of the decision tree with all the variables is 75%. Different combinations of variables were examined in order to determine the best model to predict. Regarding the optimum obtained model of the decision tree, the RBC, MCH, MCHC, gastrointestinal cancer and gastrointestinal ulcer were identified as the most important predictive factors. The results indicate if the values of MCV, MCHC and MCH variables are normal and the value of RBC variable is lower than normal limitation, it is diagnosed that the patient is likely 90% iron deficiency anemia. Conclusion: Regarding the simplicity and the low cost of the complete blood count examination, the model of decision tree was taken into consideration to diagnose iron deficiency anemia in patients. Also the impact of new factors such as gastrointestinal hemorrhoids, gastrointestinal surgeries, different gastrointestinal diseases and gastrointestinal ulcers are considered in this paper while the previous studies have been limited only to assess laboratory variables. The rules of the decision tree model can improve the process of diagnosing and treatment of the patients with iron deficiency anemia and reduce their costs. [ABSTRACT FROM AUTHOR]

Background: Warfarin is one of the most common oral anticoagulant, which role is to prevent the clots. The dose of this medicine is very important because changes can be dangerous for patients. Diagnosis is difficult for physicians because increase and decrease in use of warfarin is so dangerous for patients. Identifying the clinical and genetic features involved in determining dose could be useful to predict using data mining techniques. The aim of this paper is to provide a convenient way to select the clinical and genetic features to determine the dose of warfarin using artificial neural networks (ANN) and evaluate it in order to predict the dose patients. Methods: This experimental study, was investigate from April to May 2014 on 552 patients in Tehran Heart Center Hospital (THC) candidates for warfarin anticoagulant therapy within the international normalized ratio (INR) therapeutic target. Factors affecting the dose include clinical characteristics and genetic extracted, and different methods of feature selection based on genetic algorithm and particle swarm optimization (PSO) and evaluation function neural networks in MATLAB (MathWorks, MA, USA), were performed. Results: Between algorithms used, particle swarm optimization algorithm accuracy was more appropriate, for the mean square error (MSE), root mean square error (RMSE) and mean absolute error (MAE) were 0.0262, 0.1621 and 0.1164, respectively. Conclusion: In this article, the most important characteristics were identified using methods of feature selection and the stable dose had been predicted based on artificial neural networks. The output is acceptable and with less features, it is possible to achieve the prediction warfarin dose accurately. Since the prescribed dose for the patients is important, the output of the obtained model can be used as a decision support system. [ABSTRACT FROM AUTHOR]

Background: Presently, the graphical data of blood cells (histograms and cytograms or/ scattergrams) that they are usually available in all modern automated hematology analyzers are an integral a part of automated complete blood count (CBC). To find incorrect results from automated hematology analyzer and establish the samples that require additional analysis, Laboratory employees will use those data for quality control of obtaining results, to assist identification of complex and troublesome cases. Methods: During this descriptive analytic study, in addition to erythrocyte graphs from variety of patients, referring from March 2013 to Feb 2014 to our clinical laboratory, Zagros Hospital, Kermanshah, Iran, are given, the papers published in relevant literature as well as available published manuals of automatic blood cell counters were used. articles related to the key words of erythrocyte graphs and relevant literature as well as available published manuals of automatic blood cell counters were searched from valid databases such as Springer Link, google scholar, Pubmed and Sciencedirect. Then, the articles related to erythrogram, erythrocyte histogram and hematology analyzer graphs are involved in diagnosis of hematological disorder were searched and selected for this study. Results: Histograms and different automated CBC parameter become abnormal in various pathologic conditions, and can present important clues for diagnosis and treatment of hematologic and non-hematologic disorders. In several instances, these histograms have characteristic appearances in an exceedingly wide range of pathological conditions. In some hematologic disorders like iron deficiency or megaloblastic anemia, a sequential histogram can clearly show the progressive treatment and management. Conclusion: These graphical data are often accompanied by other automated CBC parameter and microscopic examination of peripheral blood smears (PBS), and can help in monitoring and interpretation of abnormal morphological changes. In the diagnosis and monitoring of anemias, analysis of histograms could also be considered as a new parameter in the combine with red blood cell indices. Histograms ought to use as a screening tool, and not considered diagnostic for pathological conditions. [ABSTRACT FROM AUTHOR]

Background: After primary infection, the number of CD4 T-cells decreases with disease progress. The patient's immunological status could inform by The CD4 T-cell counts over the time. The main purpose of this study is to assess the trend of CD4 cell count in HIV+ patient that received Antiretroviral Therapy (ART) by using a multistate Markov model to estimate transition intensities and transition probabilities among various states. Methods: A total of 122 HIV+ patients were included in this cohort study who are undergoing Antiretroviral Therapy treatment in the Iran AIDS center in Imam Khomeini Hospital in Tehran that inter during March 1995 to January 2005 and then fallow up to October 2014. All adults with at least two follow-up visits in addition to their pre-ART treatment were considered to be eligible for inclusion in the study. Continuous-time Markov processes are used to describe the evolution of a disease over different states. The mean sojourn time for each state was estimated by multi state Markov model. Results: Sample included 22 (18%) female with a mean age of 43.32 (standard deviation 8.33) years and 100 (82%) male with a mean age of 45.28 (standard deviation 8.34) year. Age was divided in to two categories, 40 years old and lower than that 66 (54.1) patents and persons older than 40 years old 56 (45.9) patents. A total of 122 patients were included. 29 patients died during follow-up. One year transition probability for staying in state 1 of CD4 cell count was 51%. This probability for six year was 33%. The mean sojourn time for sate 4 was 21 month. The hazard ratio of transition from state 3 to state 4 was 4.4 in men related to women. Conclusion: The use of antiretroviral therapy in the treatment of HIV infected persons reduce viral replication and increase in CD4 T lymphocyte count, and delay the progression of disease. This paper is shown the progression of this trend. [ABSTRACT FROM AUTHOR]

Background: Patient-centered care improves the quality of life and health care, and reduces the costs of care. The advent of new technologies such as health social networks, and personal health records (PHR), have significant impact on the patient-centered care. The aim of this article is to analyze and provide a set of features and requirements needed by the users of health social network serving as a PHR (Personal Health Record) system. The combination of capabilities offered by PHRs and social networks providing better delivery of patient-centered care. Methods: In this paper, after a brief study of capabilities and features of existing health social networks and based on a comparative study, a set of requirements which are necessary to create a comprehensive health social network as a PHR system are proposed. Identification of such a systems stakeholders and users e.g. healthcare professionals, patients, and healthcare organizations is important for categorizing the requirements. Also, classifying relatively vast range of existing systems is needed to have a better analyze and design. Results: The proposed health social network can be used by different user groups in healthcare e.g. healthcare professionals, patients, and healthcare organizations. According to the each user group's requirements, it provides separate facilities for them. The users of this integrated health social network can optionally share some of their information with other users in their group or with users in the other groups and interact with them. Studies show that the proposal requirements and capabilities for health social network not only cover the capabilities of similar systems but also satisfactory provide the requirements of a PHR system to deliver the patient-centered care. Conclusion: The proposed set of requirements are qualitatively compared with the other similar systems. Using the proposed health social network that provides PHR capabilities for its users will have an irrefutable impact on quality and efficiency of patient- centered care, and play an important role in improving the health of society. [ABSTRACT FROM AUTHOR]

Background: Currently, there are many techniques to measure subcutaneous body fat but these methods have many limitations. In this study, we tried to provide a clustering algorithm to measure the thickness of subcutaneous fat in thermography images. Methods: For the detection of subcutaneous adipose tissue in the midline area (from pubis to the xiphoid process), imaging takes place in the right or left lateral sides of the concerned person and to detect this tissue at the left and right flank (from ribs to the iliac crest), imaging takes place from the front. This study was done on 100 subjects (50 female, 50 male) of patients referred to the Shahid Mobini Hospital of Sabzevar since April 2013/4 to December, 2013 and the thickness of their subcutaneous fat in midline abdomen from pubis to the xiphoid process and flank from ribs to the iliac crest were measured based on thermal model and using K-Means and Fuzzy c-means (FCM) clustering methods and also recursive connected components algorithm. Results: Subcutaneous fat tissue can quickly appear in the thermogram as an area of low temperature and since in the thermal images, temperature is characterized by the color, as a result, subcutaneous fat tissue must have lower levels of color (temperature) relative to internal body tissues. All the measurements based-on thermal images to determine the maximum thickness of subcutaneous fat were compared with ultrasound. The results of our method were similar to the results of ultrasound method done by a radiologist, with the acceptable approximation. Conclusion: The method presented in this paper is considered as a noninvasive and cost-effective method to measure the thickness of subcutaneous body fat. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, involves almost all organs such as skin, heart, kidneys and central nervous system. The disease is characterized by vascular and connective tissue inflammation in a recurring pattern of remission and flare. Although the exact pathophysiology of disease has not been fully understood yet, the fundamental defect in SLE is attributed to dysfunction of T lymphocytes in controlling of B-cell that leads to polyclonal activation of B lymphocytes and production a large quantity of autoantibodies against nuclear and cytoplasmic components. These autoantibodies can damage tissues either directly or as a result of immune complex deposits. Several factors are involved in pathogenesis of SLE which can be divided into three major groups, environmental factors, genetic components, and immunological disturbances. They could breakdown body tolerance towards endogenous antigens and cause abnormal immunologic response to the healthy tissue, resulting in tissue damage. SLE occurs more frequently in female than male. It seems that immunological factors have important role in SLE. Inflammation and vascular endothelium irregularities are a number of main pathologies seen in SLE. Cytokines are protein mediators that play an essential role as regulator of innate and adaptive immune response against microbial agents or self-antigens. Influences of cytokines in autoimmune diseases such as SLE are poorly understood. Studies in both experimental animal models of lupus and patients with SLE have revealed a number of cytokine pathways that are important in the disease process. These studies showed that overexpression of inflammatory cytokines increases the proliferation of auto reactive B-cells and results in higher production of autoantibodies. Among them, the role of B-cell activating factor (BAFF), a proliferation-inducing ligand (APRIL), TNF-α, IFN-α, IL-6, IFN-ã, IL- 23/IL-17, IL-10, IL-21 are prominent, which is associated with the generation of pathogenic autoantibodies and formation of immune complexes. In this paper, the role of cytokines and their encoding genes are described, while therapeutic applications are also briefly presented. [ABSTRACT FROM AUTHOR]

Background: Protozoa are unicellular eukaryotes. A type of intestinal protozoan pathogens is the cause of infection and serious injuries in human with or without clinical symptoms. It seems that parasitic infections as a stressor factor can affect on stress system activity and immune system function and sensitivity. The major purpose of this paper was to evaluate serum cortisol level and the general inflammation by measuring neutrophil to lymphocyte ratio in patients with intestinal protozoa. Methods: A total of 40 men were entered in a case-control study in Besat and Baqyiatallah (a.s.) Hospitals in Tehran from April to September 2014. Men were equally divided into 2 groups based on infection with the intestinal protozoa (control and patient groups). This study was conducted on blood samples of these people. Serum cortisol level and neutrophil to lymphocyte ratio were determined in control and patient with the intestinal protozoa groups. Cortisol was measured using cortisol kit (Diagnostic Biochem, Canada) and by ELISA method. In addition, the samples were treated with Wright stain method, and neutrophil to lymphocyte ratio was calculated using WBC diffraction method. Results: According to the results of this study, mean age between control and patient groups was not statistically significant (P= 0.91). Serum cortisol concentration in patients with the intestinal protozoa was significantly higher than the control group (P= 0.043). In addition, a significant increase was observed in neutrophil to lymphocyte ratio in patients with parasitic infections compared to the control group (P= 0.026). Conclusion: Based on the results of this study, parasitic infection (intestinal protozoa) as a stressor factor can increase serum cortisol concentration. In addition, intestinal protozoa was reduced immune system sensitivity and function. It seems that the neutrophil to lymphocyte ratio can be a potential useful parameters for evaluating the stress system activity and function in patients infected with the intestinal protozoa. [ABSTRACT FROM AUTHOR]

Background: Approximately 50% to 80% of women experience varying degrees of postpartum depression. Oxidative stress is involved in many diseases, including depression. Common production of lipid peroxidation by oxidative stress is malondialdehyde (MDA). The endocannabinoid system is a nervous regulator and convoy the impression that the circulatory levels of endocannabinoid is significantly reduced in depressed women. The major purpose of this paper was to evaluate activity of the major antioxidant and endocannabinoid index in postpartum depression. Methods: A total of 130 women were entered in a case-control study in 12 Bahman Health Center from April 2011 to August 2011. In 4th to 6th week after delivery, women were equally divided into 2 groups based on Edinburg questionnaire (normal and postpartum depressive women). Serum MDA, total antioxidant capacity (TAC) and RBC catalase levels were determined to investigate the oxidative status. In addition, Mass spectrometry was applied for the analysis of serum anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). Results: Based on Edinburg questionnaire, however, women age, husband age, husband marital number, gravidity, children number, salary and house size have no significant effect on postpartum depression, marital period was significantly increased postpartum depression (P< 0.05). In addition, women education, husband education, wanted or unwanted pregnancy from women, neonatal sex, satisfaction of neonatal sex from women and husbands, breast feeding and delivery have no significant effect on postpartum depression, and women Job (P< 0.001), husband job (P< 0.001), wanted or unwanted pregnancy from husbands (P< 0.05) were significantly changed postpartum depression. Serum MDA and RBC catalase levels were not significantly higher in depress compared with the normal group. TAC was significantly decreased in patients having postpartum depression (P< 0.05). Serum AEA and 2-AG levels were significantly lower in depress compared with the normal group (P< 0.01). Conclusion: Women's Job, husband's job, wanted or unwanted pregnancy from husbands and marital period are associated to postpartum depression. In postpartum depression, TAC, AEA and 2-AG are reduced. So it can be concluded that both antioxidant system and endocannabinoid concentration involved in the development of postpartum depression. [ABSTRACT FROM AUTHOR]

Background: Correct clinical decision-making has a significant impact on the treatment process, achieving the expected clinical outcome and increasing patient satisfaction, and identifying the factors affecting it is essential for evidence-based medical education. This study aimed to determine the relationship between evidence-based medicine with academic self-efficacy and research self-efficacy of medical students. Methods: This descriptive analytical study conducted from October 2022 to October 2023 on 45 medical students at Abadan University of Medical Sciences. After obtaining consent from the students and registering demographic and educational information, data collection was performed using evidence-based medicine, academic self-efficacy, and research self-efficacy questionnaires. Then data analyzed by descriptive statistics, Pearson correlation coefficient, Spearman correlation coefficient, and regression model in SPSS. Results: The findings of our study showed that research self-efficacy in students who had research experience (189.03) was significantly higher than students who did not have research experience (140.76). In addition, the average score of academic and research self-efficacy and evidence-based medicine in students who had a history of membership in the student research committee was significantly higher than students who did not have a history of membership. Finally, it was found that evidence-based medicine had a direct and significant relationship with research self-efficacy (r=0.361, P<0.05) and academic self-efficacy (r=0.457, P<0.001). In examining the relationship between academic self-efficacy and research self-efficacy, it was also found that these two variables have a direct and significant relationship with each other (r=0.714, P<0.001). As well as, there was no significant relationship between academic selfefficacy, research self-efficacy, and understanding the characteristics of evidence-based practice with any of the variables of age, gender and entry year (P>0.05). Conclusion: According to the obtained results, it can be concluded that academic selfefficacy and research self-efficacy have an effect on evidence-based medicine, and all of the above can be improved by teaching medical students to participate in student research committees and doing research work. In this way, it improves the quality of treatment in doctors. [ABSTRACT FROM AUTHOR]

Left ventricular thrombosis (LVT) is a very serious condition and life-threatening complication that usually occurs after acute occlusion of the left anterior descending (LAD) coronary artery followed by acute myocardial infarction with ST-segment elevation (STEMI), which leads to significant regional wall motion abnormality (RWMA). It should be noted that its diagnosis, treatment, and management are challenging now and depend on various factors such as the type of thrombus, time of percutaneous coronary intervention (PCI), and underlying disease. The preferred diagnostic method is cardiovascular magnetic resonance imaging (CMR), but transthoracic echocardiography (TTE) is routinely used for diagnostic and screening purposes also follow-up of response to treatment. It is worth mentioning that when the diagnosis of left ventricular thrombus is not clear with conventional echocardiography, contrast echocardiography is used for more resolution and detailed information. Left ventricular thrombosis can appear in both acute and chronic forms and lead to significant complications, the most important of them are stroke and systemic arterial embolism (SE). According to previous studies, vitamin K antagonist (warfarin) by keeping INR within the therapeutic range currently used to treat left ventricular thrombosis. Although the use of direct oral anticoagulants (DOAC) has brought excellent outcomes, but due to the lack of large clinical trials, the routine use of these agents is controversial, and only in case of warfarin intolerance or contraindications, DOACs can be used as an alternative. Generally, the best way to prevent left ventricular thrombosis is primary percutaneous coronary angioplasty (primary PCI) which preserves left ventricular function. Depending on the sensitivity of the diagnostic method, thrombus will likely resolve in >50% of patients by six months after the MI. On the other hand, in rare cases, surgery is indicated if a thrombosis remains despite the medical treatment especially if it is accompanied by a left ventricular aneurysm. The purpose of this narrative review is to evaluate the latest evidence in the field of left ventricular thrombosis management and to adopt the best approach for these patients. [ABSTRACT FROM AUTHOR]

Background: Considering the high prevalence of breast masses and the importance of screening and follow-up for malignancies in women, and since age and hormonal changes during menopause play a role in determining the type of pathology and prognosis of the masses, the purpose of this study is to determine the relationship between menopause and mass pathology. Methods: This was a cross-sectional-analytical study that was conducted in order to investigate the types of pathology of breast masses and their relationship with the age of menopause in women referred to Shahid Beheshti Hospital in Qom between April 2013 and April 2019. The inclusion criteria include: having sufficient file information and having a contact number to complete personal information, no history of cancer in other parts of the body and simultaneous malignancies, and the exclusion criteria also include: samples that were taken by cellular aspiration sampling, There were women who had a history of first-degree breast malignancy and were previously diagnosed with breast cancer and there was a possibility that the new mass under study was metastatic. Finally, the patients' information was extracted from the files and recorded in pre-prepared checklists. And the supplementary information of the incomplete files was asked and completed using the contact information of the patients. After collecting the information, using SPSS software version 26 and with chi-square and t-test statistical tests and considering the significance level of 0.05 the data was analyzed. Results: He prevalence of malignancy in postmenopausal women was higher than in premenopausal women. Also, a significant difference was found between tumor size, the presence or absence of metastasis, and menopause (P<0.05), but no significant difference was found between tumor location and menopause (P>0.05). Conclusion: Breast malignancies (invasive ductal carcinoma, invasive mixed carcinoma, mucinous, medullary, and papillary carcinoma) were more common in postmenopausal women than non-menopausal women. In both groups, ductal dilatation and chronic inflammation were the most benign findings, and fibroadenoma was found at a much lower rate in menopausal women than in non-menopausal. [ABSTRACT FROM AUTHOR]

Background: Bone is one of the most common sites of metastatic disease in malignancies. Many of the cases are asymptomatic and may be diagnosed in primary or secondary follow-up, but in symptomatic cases pain is the prominent symptom which is mostly exaggerated at nights. The improved survival of cancer patients with bony metastases in recent years, specially in breast and prostate cancer, has given a greater importance to the careful choice of treatments in this setting. This can lead to a better quality of life, lower treatment cost, prevention of disabilities, less delay in primary cancer therapies, and decrease of life-threatening events for the patients. Here we review the metastatic disease of the bone and its treatments, with emphasis on local and systemic radiation therapy. Current literature about bone metastasis and its treatments was reviewed through a search of available databases on internet for papers published in 1995-2013. Special attention was given to the research trials and studies performed by the authors on this setting. Treatment of bone metastases consist of analgesics, radiotherapy, surgery and bisphosphonates. Control of bone metastases is a challenging process, necessitating a multidisciplinary approach and teamwork between the treating physicians. Radiotherapy is the most useful modality for this purpose in oncology, given both as a local and systemic therapy. We hope that this review would be able to help in choosing the best treatment option for this common palliative situation in Iranian cancer patients. [ABSTRACT FROM AUTHOR]

Background: Various surgical procedures were described for the correction of the external genitalia in male-to-female transsexualism. In all these methods complications such as vaginal stenosis, unpleasant appearance of external genitalia and lack of consent are seen. This paper describes a method of surgery for repair of these complications and success rate of this surgery. Methods: Reconstructive surgery was performed by one surgeon in 16 patients from 2009 to 2011 in Imam Reza Hospital of Mashhad. Mean age 25.75 years of age from 21 to 31 years. Due to the condition of each patient appropriate reconstructive surgery was performed. These surgeries include: clitoroplasty, inverted U flap, labioplasty, urethroplasty, removal of excess skin and increasing depth of vagina. After the surgery, the patients admitted for complete bed rest up to 5 days. They received postoperative prophylaxis medication for anti-thromboembolic events. Results: Only 3 complications were seen in all 16 patients. One hematoma of surgery site, one infection of surgery site and a blood transfusion. Eleven patients had history of vaginoplasty using small intestine and 10 patients with penile and perineal skin. From 3 to 24 months follow up after discharge were done, no patient had a major complication in long-term follow up and were generally satisfied with their sexual intercourse. Conclusion: This study has some limitations. Follow-up of the patients was performed for about one year that longer follow-up for these patients is favorable. Also, evaluation of patients' satisfaction from their intercourse was not performed as systematically with using an standard questionnaire and by a person who is blind to the study. Using this method of restoring external genitalia in the hands of expert surgeon, aesthetic and functional result would be expected very well. [ABSTRACT FROM AUTHOR]

Background: One of the today most common and incurable diseases that is associated with central neural system is ‘MS’ disease. Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. In this disease become apparent a wide spectrum of symptoms such as lose muscles control and their coordination and vision derangement. The goal of this research is to consider to two problems: 1- Recognition of effective clinical symptoms on MS disease and 2- Considering levels of effectiveness of age, sex and education levels factors on MS disease and association between these factors according to verity of categories of this disease. Methods: Data mining science in medicine is worthy of attention with main application in diagnosis, therapy and prognosis, respectively high volume of collected datum. The data that were used in this article are about patients of Chaharmahal and Bakhtiari Province and collected by cure assistance. In this paper classification and association methods in software engineering field are used. Classification is a general process related to categorization, the process in which ideas and objects are recognized, differentiated, and understood. Association rules are created by analyzing data for frequent if/then patterns and using the criteria support and confidence to identify the most important relationships. Results: In consideration of first problem in this paper, concluded vision-clinical symptoms are the most effective symptoms and in consideration of second problem, concluded that from 584 records, women affected four times more than men. In other word 70% of MS patients with high graduate are in relapsing-remitting category and 62.5% of MS patients are 20-40 years old. Conclusion: Some of symptoms are quite temporary and transitory and are ignored by people. Awareness of clinical-symptoms prevalence manner can be warning for people before starting critical cycle of illness. This would cause early diagnosis, effective therapy and even prevention of disease progress, respectively to MS chronicity.

Background: Cupping is one of the most common traditional medical procedures in Iran, which is widely used and prescribed from long time ago. Putting a cup on the skin with induction of negative pressure, causes an artificial inflammation with collection of some body fluids under the skin which can be extracted by scarification. Different mechanisms and effects are attributable to cupping based on several assumptions and theories. Regarding to the vast use of this traditional therapeutic method and relatively different point of views about the effects of cupping, this study was performed to systematically assess published studies in this field and also to find probable indications of cupping. Methods: In this systematic review, according to search via Google Scholar, PubMed, Scopus databases and Iranian databases (IranMedex and SID), 99 different scientific articles about cupping and it`s positive and negative effects were assessed. Different diseases categorized in 19 groups according to the pathophysiology and organ similarities for better presentation Results: More than 50 different disorders have been studied in randomized or nonrandomized clinical trials. 84.9% of reviewed papers have reported significant positive effects of cupping. The most common disorders studied in the reviewed papers were musculoskeletal, pain and skin disorders, especially low back pain has been studied more with positive results of cupping. Conclusion: In Iran the prevalence of cupping performance is really high. The reported positive effects and also complications especially infection were also dramatic. It seems performing systematic studies on cupping effects in different disorders and designing and implementing an active surveillance system for cupping in our country is essential. According to the type of studies, authors concluded that cupping have been reported as an effective intervention for some diseases such as musculoskeletal and skin disorders, but further methodologically elaborated studies with larger sample sizes should be considered for recommending this intervention scientifically.

Background: Prostate cancer is the third leading cause of death and is the most common cause of cancer in elderly men. Regarding to the low accuracy of screening methods such as prostate-specific antigen (PSA), Digital Rectal Examination (DRE) and trans rectal ultrasound (TRUS) in detection and localization of tumor, Magnetic Resonance Imaging (MRI) and Diffusion Weighted Imaging (DWI) attracted many attentions in the past years. DWI reveals micro-molecular diffusion, which is the Brownian motion of the spins in biologic tissues. This technique can delineate pathologic lesions with high tissue contrast against generally suppressed background signal. In this paper, the value of DWI in detection of prostate cancer is studied. Methods: In this cross-sectional study, the studied population are suspicious patients to prostate cancer based on high Prostatic Specific Antigen level or abnormal Digital Rectal Examination who refered for prostate biopsy to radiology department of Hazrate- Rasoul Hospital during the year 2011. The results of DWI are compared to biopsy results for all patients. Results: Eighty five patients are selected. The DWI sensitivity in detecting of prostate cancer is 100%, specificity 97.1% and positive and negative predictive values are 89.5% and 100%, respectively. The results showed that if DWI reports the prostate cancer as negative, the result was highly reliable and if it reports as positive, although the report was not 100% reliable, but it still had high reliability, more than 90%. Conclusion: DWI had high accuracy in detecting prostate cancer for patients with cancer. Also the accuracy of this method for patients without prostate cancer was acceptable compared to the other common methods. [ABSTRACT FROM AUTHOR]

Background: Unnecessary patient admission to a hospital refers to the hospitalization of a patient without clinical indications and criteria. Various factors related to the patient (e.g., age, disease severity, payment method, and admission route and time), the physician and the hospital and its facilities and diagnostic technologies affect a patient unnecessary admission in a hospital. Unnecessary patient hospitalization increases nosocomial infections, morbidity and mortality, and decreases patient satisfaction and hospital productivity. This study aimed to measure unnecessary patient admissions in hospitals in Iran. Methods: This study was conducted using a systematic review and meta-analysis at Tehran University of Medical Science in August 2019. Seven electronic databases were searched and evaluated for original research papers published between March 2006 and 2018 on patients’ unnecessary admission to a hospital. Finally, 12 articles were selected and analyzed using comprehensive meta-analysis software. Results: All studies used the appropriateness evaluation protocol (AEP) for assessing patients’ unnecessary hospitalization in the hospitals. Overall, 2.7% of hospital admissions were rated as inappropriate and unnecessary (CI 95%: 1.5-4.9%). The highest unnecessary patients’ admissions were 11.8% in a teaching hospital in Meshginshahr city in 2016, (CI 95%: 8.8-15.8%) and the lowest unnecessary patients’ admissions was 0.3% in a teaching hospital in Yasuj city in 2016 (CI 95%: 0-3.6%). Unnecessary patient admission in public hospitals was higher than private hospitals. A significant statistical correlation was observed between unnecessary patient admission, and sample size (P<0.05). Conclusion: The rate of unnecessary hospital admission in Iran is low. However, hospital resources are wasted due to unnecessary admissions. Expanding the primary health care network, reducing hospital beds, introducing an effective and efficient patient referral system, using a fixed provider payment method, and promoting residential and social services care at macro level, and establishing utilization management committee, using the appropriateness evaluation protocol, establishing short-stay units, and implementing quality management strategies at the hospital level are useful strategies for reducing avoidable hospital admissions. [ABSTRACT FROM AUTHOR]