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Using a rehabilitation program for the survivors of acute respiratory distress syndrome (ARDS) could be one of the important and fundamental steps to improve the pulmonary function and health-related quality of life (HRQoL) of patients. This study was carried out to evaluate the effect of two rehabilitation techniques (Family-Based Empowerment Model (FECM)/Continuing Care Model (CCM), or both of them) on pulmonary function, and HRQoL in ARDS survivors. From December 2009 to June 2016, ARDS survivors from mixed medical-surgical ICUs at four academic teaching hospitals in Tehran, Iran, were randomly assigned to one of three intervention groups (A, B, or C) or a control group (D). Pre- and post-interventions, pulmonary functions and HRQoL status of patients in all groups were collected 48 times via clinical measurements and various questionnaires during 5 years of follow-up. Significantly improvement was seen in the intervention groups compared to the control group, and the greatest benefit was observed in patients who received mixed of FCEM and CCM rehabilitation techniques. Co-administration of FCEM and CCM can improve pulmonary function as well as the life satisfaction of ARDS survivors. As a result, the execution of the empowerment model by nurses is recommended for ARDS survivors and the participation of their families at the same time.Trial registration: NCT02787720 (ClinicalTrial.gov, 24/05/2016).

Additional file 2: Table S2. The seasonal excess death rate, male to female ratio, and COVID-19 reported deaths coverage from winter 2020 to summer 2021. Table S3. Excess deaths at the province level in a year from summer 2020 until spring 2021 in Iran.

Additional file 3: Figure S2. Weekly all-cause death, COVID-19 reported death, and COVID-19 reported cases from 23 March 2019 to 22 September 2021. Figure S3. Relation of weekly all-cause death and COVID-19 reported mortality during the COVID-19 pandemic in Iran (From March 2020 until September 2021)

Additional file 1: Figure S1. The flow of mortality data through Iran’s death registration system. Table S1. The prediction model and fitness statistics are based on seasonal deaths from 2013 to autumn 2019 in Iran and Iran’s provinces.

Aim: We designed this study to evaluate the effectiveness of the combination of topical rectal therapy with biofeedback in treatment of solitary rectal ulcer compared to single biofeedback therapy. Background: Biofeedback therapy is an appropriate treatment for patients with solitary rectal ulcer syndrome (SRUS) but it seems that it is not effective alone. Topical medical therapies are supposed to have an additive role to biofeedback. Methods: This randomized, controlled trial was conducted on 63 patients with SRUS. Patients were randomly enrolled into two groups of combination and single therapy. The patients in combination group (n=31) received biofeedback plus a topical therapy (an enema contained dexamethasone, sulfasalazine and bismuth) and the patients in single therapy group (n=32) were treated with biofeedback alone. Results: Endoscopic responses to treatment in the combination and single groups were 80% and 50%, respectively (P

Aim: To estimate the epidemiological parameters related to the Covid-19 outbreak in Iran. Background: Estimating the epidemiological parameters of new public health threat (COVID-19) is essential to support and inform public health decision-making in different communities including Iran. Methods: We established a mathematical model to estimate the epidemiological parameters from 19 Feb to 15 March based on daily COVID-19 confirmed cases in Iran. Then, we estimated the effect of early traffic restriction on our estimation. Results: We estimated the R0 at 2.11 (95% CI, 1.87-2.50) and the infected number at 92,260 (95% CI: 59,263 -152,212) by 15 March. Our estimate for the ascertainment rate was about 1.2% (95% CI: 1.1-1.4). The latent period estimation was 4.24 (95% CI: 2.84-6.65). We observed a decline in our estimate after considering the traffic restriction. Conclusion: Our results suggest that health authorities in Iran must take impactful strategies to control the COVID-19 outbreak to reach R0

Background. Colorectal cancer (CRC) and inflammatory bowel disease (IBD) are closely interrelated. However, the effect of having a family history of one disease on the risk of another remains undetermined. Aim. The purpose of this meta-analysis was to estimate the prevalence of a family history of CRC among patients with IBD, as well as the prevalence of a family history of IBD among patients with CRC. Methods. PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched to identify studies reporting the prevalence of family history of IBD among patients with CRC, in addition to the prevalence of family history of CRC among IBD patients. Criteria for study inclusion consisted of the following: (1) studies that evaluated either IBD or CRC and dysplasia, (2) included all age groups, and (3) evaluated the family history effects for IBD or CRC. The total number of IBD patients and IBD patients with a family history of CRC and the total number of CRC patients and CRC patients with a family history of IBD were reviewed. The pooled prevalence of diseases was also estimated according to degree of relatives and geographical area. Random-effects models were used for estimating pooled prevalence. Results. A total of 27 studies were included with 26,576 IBD and 9,181 CRC or dysplasia patients. Eligible studies included 13 case-control, 10 cohort, and 4 cross-sectional types. The pooled prevalence of a family history of CRC among patients with IBD was 6% (95% CI: 4-9%). The pooled prevalence for first- and second-degree relatives (11%, 95% CI: 0-37%) was more than that for the other relative subgroups of relatedness degree. The prevalence in the American regions (8% (95% CI: 5-13%)) was higher than that in the others. The pooled prevalence for a family history of IBD among CRC or dysplasia patients was 11% (95% CI: 6-16%). The pooled prevalence for first-degree relatives (13% (95% CI: 3-28%) was higher than that for the other relative subgroups of relatedness degree; it was also greater in American countries (15%, 95% CI: 8-23%). Conclusion. This study emphasizes the relationship between a family history of IBD and CRC development. Additionally, there was notable prevalence for a family history of CRC among IBD patients. American countries and first-degree relatives were identified to have a higher prevalence for both disease processes.

Background and aim of the work: European COVID-19 statistics showed differentiation between mortality and new cases. Some studies suggested several factors including migration, cancer incidence, life expectancy and health system capacity maybe associated with differentiations. Up to now, impact of those factors in different European societies is not discussed and compared. Aim of the present study was to perform the cluster analysis in European countries in attention to clinical and epidemiological factors due to covid-19. Methods: We collected some appropriate extreme data of COVID-19 to access the situations by ANOVA post-hoc test in 3 scenarios, as well as to estimate regression coefficients in simple linear regression, and a cluster analysis using average linkage. The present study was designed to assess the situation in the European region in the face of COVID-19 from the beginning of the conflict to April 24, 2020. Results: Among 39 European countries, several countries reported highest rate of confirmed cases included of Italy (current statues=2270.52) and Spain (current status=2616.24). The highest rate of mortality was seen in France (current status=242.16), Italy (current status=305.52). Life expectancy (female) (P=0.01, 95%Cl=1521.27,15264.58), migration (P

Objective: Painful nipple fissure is a troublesome problem for breastfeeding mothers. This study was conducted to evaluate the effect of saqez (Pistacia atlantica) ointment on the improvement of nipple fissure in breastfeeding women during one-month follow-up. Materials and Methods: This randomized controlled clinical trial was conducted on 100 eligible women who visited the selected health centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, from July 2015 to December 2015 during their postpartum period. A total of 100 subjects were randomly divided into two equal groups of 50 women grouped as saqez ointment group and breast milk group, and followed-up for one month. Both groups received face-to-face instructions on breastfeeding techniques. For severity of nipple fissure, Storr scale and to measure the intensity of pain, visual analog scale (VAS) were used. Results: The results showed that the two groups were matched in terms of demographic and obstetric characteristics. Mean of nipple fissure severity in ointment group (42.62) was lower than that of the control group (48.02), that was significantly different between the two groups (p=0.047). In addition, Mean nipple pain intensity in ointment group (40.57) was lower than that of the control group (49.81), but there was no significant difference between the two groups (p=0.056). Conclusion: The present study showed that saqez ointment was more effective than breast milk in healing and controlling nipple fissures during one-month follow-up, without resulting in any side effects.

Aim: The aim of this study was to investigate the impact of diabetes and hypertension on colorectal cancer (CRC) mortality. Background: One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias. Methods: One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias. Results: The effect size with ignorance misclassification bias was 0.78 for diabetes and 0.94 for hypertension respectively which both of them were not significant. After adjusting the misclassification and performing the robust Bayesian analysis, we arrived at region (0.27, 3.4) for OR of diabetes and (0.21, 2.31) for hypertension. Conclusion: our study demonstrated that diabetes and hypertension increase the risk of mortality in CRC patients, using robust Bayesian analysis and misclassification in diagnosis these two exposure could change or confound the results of this association.

Pancreatic cancer is one of the deadliest cancers with short-term survival rates. Trends for pancreatic cancer incidence and mortality varied considerably in the world. To date, the causes of pancreatic cancer are not known sufficiently, although certain risk factors have been identified such as, smoking, obesity, life style, diabetes mellitus, alcohol, dietary factors and chronic pancreatitis. Since there are no current screening recommendations for pancreatic cancer, primary prevention is very important. Therefore, up-to-date statistics on pancreatic cancer occurrence and outcome are essential for the primary prevention of this disease. Due to the lack of information on epidemiology of pancreatic cancer in most Asian countries, and limited of statistics and registration system in this area, we conducted a systematic review study to evaluate the most recent data concerning epidemiology of pancreatic cancer in Asia-Pacific region. In this review we focused on collected recent data on incidence, mortality, survival and risk factors of pancreatic cancer in this region. In addition, we reviewed and used the data of GLOBOCAN 2012 in this paper to complete the information as a source of compiling pancreatic cancer incidence and mortality rate.

Aim: The aim of this study was to identify the esophageal cancer (EC) high risk regions to evaluate changes of relative risks (RRs) for both genders by time in Iranian provinces. Background: EC is one of the public health problems in Iran. In spite of this fact, there is not comprehensive study estimating RRs across the Iranian provinces. Methods: In this cross-sectional study the data for EC cases were extracted from Ministry of Health and Medical Education (MOHME) including 30 provinces from 2004 to 2010. For estimating the model parameters, we used Bayesian approach by regarding spatial correlations of adjacent provinces. Results: The Northern half of Iran has high risk and other half has low risk. During the time, the range of RRs has decreased for both gender and also the dispersion of EC is decreasing for women but nearly is fixed for men. Conclusion: While RR has declined during the study, focusing on the Northern half of Iran as high risk regions is a considerable fact for policymakers.

Introduction: Metabolic syndrome (MetS) may affect prognosis of the patients diagnosed with colorectal cancer (CRC). Objectives: This study was aimed to design a model and to examine the prognostic effect of MetS on survival time in the patients with CRC. Patients and Methods: Data were collected from 1127 cases of CRC from Cancer Registry Center of the Research Institute of Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. In this cohort study, patients were divided into two groups based on the presence of MetS. We tested the prognostic value of MetS in the patients by Cox proportional hazard modeling. Results: Mean ± standard deviation of the patients’ age at diagnosis in MetS group and non-MetS group was 56 ± 13 years old and 53 ± 15 years old respectively. Tumor stage as an independent variable affected CRC survival. The mean survival time of the MetS and non-MetS groups was 23 and 27 months respectively. Independent variables like tumor stage (hazard ratio [HR], 1.76; 95% CI, 0.29–0.90) and educational level (HR, 0.50; 95% CI, 0.23–0.97) had significant effect on CRC survival and MetS (HR, 0.95; 95% CI, 0.52–1.5), tumor size (HR, 1.390; 95% CI, 1.237–1.560), family history, age, gender, and smoking had non-significant effect on CRC survival. Conclusion: MetS could be a prognostic factor for survival in the patients with CRC. The results suggested that effect of MetS was not significant.

The cancers in the digestive system including gastric cancer, colorectal cancer, liver cancer, esophageal cancer and pancreatic cancer are one of the most common cancers in Asia. The burden of GI cancer is increasing in Asia because of aging, growth of the population and the risk factors including smoking, obesity, changing lifestyle and high prevalence of H pylori, HBV and HCV. In most Asian countries, cancer control programs or early detection and treatment services are limited despite this increase. There are many people in the developing countries inside Asia who have no health insurance and many of them are too poor to go for screening tests, early detection or medical treatments. Therefore, it is important for the health organizations and governments in each country to recognize these groups and reduce the incidence and mortality of gastrointestinal cancers, using simple and economic screening test, vaccination and changing risk factors such as smoking, diet and lifestyle by education programs.

Background Cancer is the third most common cause of death in Iran, the leukemia cancer is one of the most important causes of cancer mortality. Regarding cancer mortality, data would be important to monitor the program screening effects, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was mortality rates evaluating, then leukemia cancer trends among the Iranian population within almost a period of a decade, i.e. from 1995 to 2004. Methods National death Statistic Reported by Ministry of Health and Medical Education (MOH&ME) from 1995 to 2004, stratified by age group, sex, and cause of death, have included in this study. Leukemia cancer has expressed as the annual mortality rates/100,000, in general, and/or per gender, and age group. Results The general mortality rate of leukemia cancer has slightly increased within the mentioned study period, from 0.44 to 2.54, then leukemia cancer mortality has often seen in men more than women. Conclusion The mortality rate of leukemia has significantly increased throughout Iran. Associated risk factors with leukemia have headmost identified for their prevention and control. So, future studies to reveal leukemia risk factors among the Iranian population would be crucial in order to control its burden.

Aim The aim of this study was to evaluate the mortality rates and trends from Gastrointestinal (GI) cancer in Iranian population from 1995 to 2003. Background Cancer is the third most common cause of death in Iran. Gastrointestinal cancer is the most important causes of mortality due to cancer. The cancer mortality data is important to monitor the effects of screening program, earlier diagnosis, demographic data and other prognostic factors. Patients and methods National death Statistic Reported by the Ministry of Health and Medical Education (MOH&ME) from 1995 to 2003, stratified by age group, sex, and cause of death is included in this analysis. Colorectal cancer (CRC) [ICD-9; 153-154], Gastric cancer (GC) [ICD-9; 151], Pancreas cancer (PC) [ICD-9; 25], Esophageal cancer (EC) [ICD-9; C15] and Hepatocellular carcinoma (HCC) [ICD-9; 20] were expressed as the annual mortality rates/100,000, general and/or per gender, and age group. Results The cause specific mortality rate of CRC slightly increased during the years under study and for GC and EC showed a sharp increasing. In contrast, the mortality rate of PC decreased slightly during the years under the study. The rate of HCC mortality moderately increased. All mortality rates were higher for male than female. Conclusion Our study indicated remarkable increasing trends in mortality of GI cancer in Iran specifically for CRC and GC. Developing for a GC and EC for both primary prevention and early detection programs and providing the facilities for CRC screening, would be the options to control the mortality and burden of GI cancers in the future.

Aim The aim of this study is to estimate oral cavity cancer mortality for Iranian population, using Bayesian approach in order to revise this misclassification. Background Mortality is a familiar projection to address the burden of cancers, but according to Iranian death registry, about 20% death statistics were still recorded in misclassified categories. Patients and methods We analyzed national death statistic reported by the Iranian Ministry of Health and Medical Education from 1995 to 2004 stratified by age group, sex, and cause of death are included in this analysis. Oral cavity cancer [ICD-10; C00-08] were expressed as the annual mortality rates/100,000, overall, by sex and by age group (

Aim The aim of this study was to assess the incidence of irritable bowel syndrome in women undergoing hysterectomy and tubular ligation. Background The results of previous studies have shown an increased incidence of irritable bowel syndrome after gynecological surgeries. Patients and methods Participants were patients of Alzahra and Taleghani University hospitals in Tabriz. One hundred and seventy two women without gastrointestinal symptoms or a diagnosis of the irritable bowel syndrome underwent tubular ligation and 164 women underwent hysterectomy. Patients were assessed every 3 month after hysterectomy and tubular ligation for 12 months. Irritable bowel syndrome was diagnosed by a questionnaire based on Rome II criteria. Results During 12 months after surgeries, 19 (11%) patients in tubular ligation group and 19 (11%) in hysterectomy group had abdominal pain with at least two symptoms of irritable bowel syndrome. Irritable bowel syndrome was diagnosed in 9 (5%) patients in the tubular ligation and 13 (8%) patients in hysterectomy groups (P>0.05). In both studied groups, the most prevalent symptoms along with abdominal pain were chronic constipation and abnormal bowel movement and the least prevalent were diarrhea and passage of mucus. Conclusion These results suggest that gynecological surgeries (tubular ligation and hysterectomy) may predispose to the development of the irritable bowel syndrome.

Aim Leptin is a 16 kDa polypeptide hormone which secreted by adipose tissue and has an important role in energy balance, insulin pathway and inflammation, because of that it may play an important role in colorectal cancer (CRC). Leptin exerts its effect through the leptin receptor (LEPR) a member of the class I cytokine receptor family. Background We have investigated whether glutamine to arginine substitution (Gln223Arg) in exon 6 of the leptin receptor gene, has implications for susceptibility to CRC. Patients and methods Polymerase chain reaction (PCR) and restriction enzyme digestion (RFLP) was performed to evaluate the association between the Gln223Arg polymorphism of the LEPR and CRC risk in a case-control study in 346 subjects involving 173 cases with CRC and 173 controls. Results There was no statistically evidence of significant difference in genotype and allele frequencies between the cases with CRC and controls for the Gln223Arg polymorphism of LEPR, before or after adjusting for confounders (age, BMI, sex, and smoking status). Furthermore, no significant difference was observed between the CRC cases and controls by BMI, sex and smoking status. Conclusion Our findings suggest that the LEPR Gln223Arg polymorphism is not associated with the risk of CRC in Iranian population.

BACKGROUND: Data on age in developing countries are subject to errors, particularly in circumstances where literacy levels are not high. A common error in age reporting is the tendency of rounding the ages to the nearest figure ending in ‘0’ or ‘5’ or to a lesser extent, to the nearest even number. Because of this tendency, commonly known as “digital preference”, age heaping occurs at certain ages. The aim of this study was to study this phenomenon and both Myers’ and Whipple’s Indexes were employed to identify the digit preference in Iranian national census, 2005.METHODS: Myers’ and Whipple’s Indexes were employed to study the pattern of digit preference. The Myers' Blended Index shows heaping at ages ending in 0 and 5 years, and the pattern of heaping is pronounced for both urban and rural populations.RESULTS: The quality of age reporting for the 2005 census data was poor if compared to the 1995 census data. Digit preference occurred most often in the female population compared to male one, and in rural areas compared to urban ones.CONCLUSIONS: It can be concluded that both males and females tend to misreport their ages before age 60 especially in rural areas. So, whenever any data gathering regarding age information occurs, the ID card should be used regardless of person's self report.