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Introduction. Low birth weight is an important indicator of the health of babies. A low birth weight is a leading health problem and a major reason for death in newborns. This study targeted to assess the relationship between maternal and infant factors and low birth weight in Iran through a systematic review and meta-analysis. Methods and Materials. This paper was a systematic review and meta-analysis of the relationship between maternal/ infant factors and low birth weight based on the published research papers conducted in Iran. To achieve this goal, two trained researchers independently elicited all the relevant articles by using the appropriate keywords and their combinations in SID, Madlib, Iranmedex, Irandoc, Google Scholar, Pubmed, ISI, Scopus and Magiran databases. The results of the study were combined with SPSS 20 and STATA software. Results. In the initial stage, 25 more relevant articles out of 46 papers were selected. The gestational age with less than 37 weeks and prenatal care had the most (CI: 27- 14. 53, OR: 19.81) and the least (CI: 1.86, OR: 1.5) effect on the low birth weight in newborns, respectively. Conclusion. This study showed that there is a significant relationship between the low birth weight and multiple births, preeclampsia, maternal weight gaining during pregnancy, baby's gender, and pregnancy age. Hence, controlling the factors above in mothers during pregnancy by the health authorities could lead to the birth of infants with a healthy weight and consequently the number of infants with low birth weight will decrease. [ABSTRACT FROM AUTHOR]

Leishmania parasites can cause zoonotic cutaneous leishmaniasis (CL) by circulating between humans, rodents, and sandflies in Iran. In this study, published data were collected from scientific sources such as Web of Science, Scopus, PubMed, Springer, ResearchGate, Wiley Online, Ovid, Ebsco, Cochrane Library, Google scholar, and SID. Keywords searched in the articles, theses, and abstracts from 1983 to 2021 were cutaneous leishmaniasis, epidemiology, reservoir, vector, climatic factors, identification, and Iran. This review revealed that CL was prevalent in the west of Iran, while the center and south of Iran were also involved in recent years. The lack of facilities in suburban regions was an aggravating factor in the human community. Some parts of southern Iran were prominent foci of CL due the presence of potential rodent hosts in these regions. Rhombomys opimus, Meriones lybicus, and Tatera indica were well-documented species for hosting the Leishmania species in Iran. Moreover, R. opimus has been found with a coinfection of Leishmania major and L. turanica from the northeast and center of Iran. Mashhad, Kerman, Yazd, and sometimes Shiraz and Tehran foci were distinct areas for L. tropica. Molecular identifications using genomic diagnosis of kDNA and ITS1 fragments of the parasite indicated that there is heterogeneity in leishmaniasis in different parts of the country. Although cutaneous leishmaniasis has been a predicament for the health system, it is relatively under control in Iran.

Background: After hospitalization for cardiac disease, older patients are at high risk of readmission and death. Although geriatric conditions increase this risk, treatment of older cardiac patients is limited to the management of cardiac diseases. The aim of this study is to investigate if unplanned hospital readmission and mortality can be reduced by the Cardiac Care Bridge transitional care program (CCB program) that integrates case management, disease management and home-based cardiac rehabilitation.Methods: In a randomized trial on patient level, 500 eligible patients ≥ 70 years and at high risk of readmission and mortality will be enrolled in six hospitals in the Netherlands. Included patients will receive a Comprehensive Geriatric Assessment (CGA) at admission. Randomization with stratified blocks will be used with pre-stratification by study site and cognitive status based on the Mini-Mental State Examination (15-23 vs ≥ 24). Patients enrolled in the intervention group will receive a CGA-based integrated care plan, a face-to-face handover with the community care registered nurse (CCRN) before discharge and four home visits post-discharge. The CCRNs collaborate with physical therapists, who will perform home-based cardiac rehabilitation and with a pharmacist who advices the CCRNs in medication management The control group will receive care as usual. The primary outcome is the incidence of first all-cause unplanned readmission or mortality within 6 months post-randomization. Secondary outcomes at three, six and 12 months after randomization are physical functioning, functional capacity, depression, anxiety, medication adherence, health-related quality of life, healthcare utilization and care giver burden.Discussion: This study will provide new knowledge on the effectiveness of the integration of geriatric and cardiac care.Trial Registration: NTR6316 . Date of registration: April 6, 2017. [ABSTRACT FROM AUTHOR]

Background A hospital discharge is a critical period with respect to patient safety. Lack of communication, inadequate transfer of information between secondary and primary care and the patient can result in drug-related problems (DRPs). The objective of this study was to investigate the effect of an improved collaboration between secondary and primary care on the amount of DRPs post-discharge. Methods A prospective controlled multicenter study was conducted in two hospitals (OLVG and BovenIJ) and fifty community pharmacies in Amsterdam. Patients discharged from the internal medicine-, neurology-, cardiologyand pulmonology departments were included if at least one medication change was initiated during admission. Usual care patients received routine care: medication reconciliation at hospital admission and discharge by pharmacy technicians and pharmaceutical consultants (specialized pharmacy technicians). Intervention patients additionally received teach back at hospital discharge to assess whether the patient could specify which medication had changed during admission. Also, primary care providers (i.e. community pharmacy, general practitioner, home healthcare nurses) received a medication overview listing (reasons for) all in-hospital medication changes. Finally, the patient's community pharmacist performed a home visit ≤5 days post-discharge. Four weeks post-discharge DRPs (adverse drug events, practical problems, doubts and concerns on the effectiveness and safety of medication) were assessed during a structured telephone interview (primary outcome). Also, knowledge regarding all medication changes implemented in the hospital and satisfaction with medication use were measured. Data were analysed by means of descriptive statistics. The independent T test was used for continuous variables and the Chi square test for frequencies. Ordinal logistic regression analyses were performed adjusting for confounders. P-values and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results In total 456 patients were included (usual care: n = 234, intervention: n = 222). DRPs decreased significantly from 66% in the usual care group to 52% in the intervention group (P < 0.01, adjusted OR 0.57 (95% CI 0.37- 0.89)), primarily due to decreased post-discharge adverse drug events (25% versus 16%; P < 0.05). Furthermore knowledge regarding all medication changes implemented in the hospital improved significantly in the intervention group (30% versus 42%; P < 0.05). In total, 82% of the patients in the intervention group reported that they were satisfied with their medication compared to 68% in the usual care group (P < 0.01). Conclusion This study highlights the importance of an improved collaboration between primary and secondary healthcare providers to ensure continuity of care and to reduce patient harm due to medication. DRPs were significantly reduced [ABSTRACT FROM AUTHOR]

Background: Vaginal bleeding during pregnancy has been recognised as a significant risk factor for adverse pregnancy outcomes. This study aimed to investigate the association between vaginal bleeding during the first trimester of pregnancy and clinical adverse effects using a systematic review and meta-analysis. Methods: Databases of Scopus, Web of Science, PubMed (including Medline), Cochrane Library and Science Direct were searched until June of 2023. Data analysis using statistical test fixed- and random-effects models in the meta-analysis, Cochran and meta-regression. The quality of the eligible studies was assessed by using the Newcastle-Ottawa Scale checklist (NOS). Results: A total of 46 relevant studies, with a sample size of 1,554,141 were entered into the meta-analysis. Vaginal bleeding during the first trimester of pregnancy increases the risk of preterm birth (OR: 1.8, CI 95%: 1.6-2.0), low birth weight (LBW; OR: 2.0, CI 95%: 1.5-2.6), premature rupture of membranes (PROMs; OR: 2.3, CI 95%: 1.8-3.0), abortion (OR: 4.3, CI 95%: 2.0-9.0), stillbirth (OR: 2.5, CI 95%: 1.2-5.0), placental abruption (OR: 2.2, CI 95%: 1.4-3.3) and placenta previa (OR: 1.9, CI 95%: 1.5-2.4). Conclusions: Vaginal bleeding in the first trimester of pregnancy is associated with preterm birth, LBW, PROMs, miscarriage, stillbirth, placental abruption and placenta previa. Therefore, physicians or midwives need to be aware of the possibility of these consequences and manage them when they occur.

Introduction: Culex quinquefasciatus is one of the most important carriers of human pathogens. Using the insecticides is one of the most important methods of combating this vector. But the genetic resistance created in Culex quinquefasciatus led to disruption in the fight against this pest. Consequently, it is necessary to know the level of resistance to fight this vector. Based on this, the present study was conducted to investigate the prevalence of kdr resistance in Culex quinquefasciatus against organochlorine insecticides in the world., Methods: This study was conducted by systematic review, and meta-analysis on the prevalence of kdr resistance and mortality rate in Culex quinquefasciatus against organochlorine insecticides in the world. All pertinent articles were extracted and analyzed in accordance with this information during an unrestricted search of the scientific databases Web of Science, PubMed, Scopus, biooan.org, Embase, ProQuest, and Google Scholar until the end of November 2023. Statistical analysis of data was done using fixed and random effects model in meta-analysis, I2 index, Cochran's test, and meta-regression by STATA version 17 software., Results: Seventy articles were included in the meta-analysis process. Based on the findings, the prevalence of Kdr in Culex quinquefasciatus against organochlorine insecticide was estimated at 63.1%. Moreover, the mortality rate against the insecticide deltamethrin was 46%, DDT 18.5%, permethrin 42.6%, malathion 54.4% and lambdacyhalothrin 53%., Conclusion: More than half of Cx. quinquefasciatus had Kdr. This vector was relatively resistant to DDT and permethrin insecticides and sensitive to malathion, deltamethrin and lambdacyhalothrin. In order to prevent the development of resistance to alternative insecticides, it is consequently critical to combat this vector with efficacious insecticides., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abbasi, Daliri. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Cardiovascular diseases (CVDs) have been reported to occur in a significant number of patients diagnosed with coronavirus disease 2019 (COVID-19). We report our experience regarding the occurrence of symptomatic and asymptomatic CVDs in COVID-19 patients. In this cross-sectional study, 690 COVID-19 patients were included. Cardiovascular consultation had been requested for all of the patients based on their primary clinical examination, vital signs, and electrocardiogram (ECG). Additionally, 2D transthoracic echocardiography (TTE), and myocardial injury serum biomarkers assays (creatine phosphokinase-MB [CPK-MB] and cardiac troponins [cTn]) were measured once. Manifestations of CVDs, such as chest pain, abnormal serum markers, unstable angina, myocardial infarction (MI), myocarditis, and new-onset hypertension, were documented. The most common symptom was left hemithorax and interscapular pain (317 patients, 46%). New-onset high systolic and diastolic blood pressures were seen in 67 patients (10%). Unstable angina, MI, and myocarditis were, respectively, diagnosed in 20 (2.8%), five (0.7%), and 12 (1.7%) patients. On TTE, pericardial effusion was diagnosed in 139 patients (31.1%). The most common abnormal ECG changes seen were regarding the T-wave, including flat T-wave (148 cases, 21.4%) and inverted T-wave (141 cases, 20.4%). Serum cTn levels were positive or weekly positive in 17 cases (7.4%). The incidence rate of cardiovascular involvements was high in COVID-19 patients., Competing Interests: Conflicts of interest None declared., (Copyright © 2024 Medinews (Cardiology) Limited.)

Objective: To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors., Materials and Methods: Forty-six patients with symptomatic isthmocele diagnosed using transvaginal saline infusion sonohysterography were enrolled in this prospective cohort study. Patients underwent either laparoscopic or hysteroscopic isthmoplasty based on their residual myometrial thicknesses and fertility desires and were subsequently followed by clinical and ultrasonographic examinations., Results: Twenty-two patients underwent laparoscopy and 24 underwent hysteroscopic surgery. At baseline, there was no significant difference in the mean age and years since the last cesarean section between the two groups. However, the hysteroscopy group had a higher mean parity and previous cesarean sections (p=0.00, 0.03). The most common symptoms were abnormal uterine bleeding, infertility, and dysmenorrhea. The mean baseline residual myometrial thickness was significantly higher in the laparoscopy group (p=0.00), and only laparoscopic surgery led to a significant increase in residual myometrial thickness in patients (p=0.00). Both procedures significantly reduced abnormal uterine bleeding (p=0.00), but only laparoscopy reduced infertility (p=0.00) and hysteroscopy reduced dysmenorrhea (p=0.03). Hysteroscopy showed better symptom resolution in younger patients (p=0.01), whereas age did not affect laparoscopy outcomes., Conclusion: Both approaches showed similar effectiveness in resolving abnormal uterine bleeding, with laparoscopy excelling in infertility resolution and hysteroscopy excelling in dysmenorrhea resolution., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of Turkish Society of Obstetrics and Gynecology.)

Background: Injury is one of the leading causes of death worldwide, and the abdomen is the most common area of trauma after the head and extremities. Abdominal injury is often divided into two categories: blunt and penetrating injuries. This study aims to determine the epidemiological and clinical characteristics of these two types of abdominal injuries in patients registered with the National Trauma Registry of Iran (NTRI)., Methods: This multicenter cross-sectional study was conducted with data from the NTRI from July 24, 2016, to May 21, 2023. All abdominal trauma patients defined by the International Classification of Diseases; 10th Revision (ICD-10) codes were enrolled in this study. The inclusion criteria were one of the following: hospital length of stay (LOS) of more than 24 h, fatal injuries, and trauma patients transferred from the ICU of other hospitals., Results: Among 532 patients with abdominal injuries, 420 (78.9%) had a blunt injury, and 435 (81.7%) of the victims were men. The most injured organs in blunt trauma were the spleen, with 200 (47.6%) and the liver, with 171 (40.7%) cases, respectively. Also, the colon and small intestine, with 42 (37.5%) cases, had the highest number of injuries in penetrating injuries. Blood was transfused in 103 (23.5%) of blunt injured victims and 17 (15.2%) of penetrating traumas (p = 0.03). ICU admission was significantly varied between the two groups, with 266 (63.6%) patients in the blunt group and 47 (42%) in penetrating (p < 0.001). Negative laparotomies were 21 (28%) in penetrating trauma and only 11 (7.7%) in blunt group (p < 0.001). In the multiple logistic regression model after adjusting, ISS ≥ 16 increased the chance of ICU admission 3.13 times relative to the ISS 1-8 [OR: 3.13, 95% CI (1.56 to 6.28), P = 0.001]. Another predictor was NOM, which increased ICU chance 1.75 times more than OM [OR: 1.75, 95% CI (1.17 to 2.61), p = 0.006]. Additionally, GCS 3-8 had 5.43 times more ICU admission odds than the GCS 13-15 [OR:5.43, 95%CI (1.81 to 16.25), P = 0.002] respectively., Conclusion: This study found that the liver and spleen are mostly damaged in blunt injuries. Also, in most cases of penetrating injuries, the colon and small intestine had the highest frequency of injuries compared to other organs. Blunt abdominal injuries caused more blood transfusions and ICU admissions. Higher ISS, lower GCS, and NOM were predictors of ICU admission in abdominal injury victims., (© 2024. The Author(s).)

In today's world, high variability of body mass index (BMI) is known as a significant global health problem that can lead to many negative impacts on the cardiovascular system, including atrial fibrillation (AF) and coronary heart disease. The current systematic review aims to elucidate the effect of variability in BMI on the risk of cardiovascular outcomes. Four databases, including PubMed, Scopus, MEDLINE, and CENTRAL, were searched. All related articles up to 10 June 2022, were obtained. Titles, abstracts, and full texts were reviewed. After screening abstracts and full texts, four articles were included in our study. In these four cohort studies, 7,038,873 participants from the USA and South Korea were involved. These articles generally considered the BMI and outcomes including cardiovascular disease, AF, and coronary heart disease. All these articles reported an association between the variability of BMI and increased risk of cardiovascular outcomes. Due to the negative impact of the high variability of BMI on the risk of cardiovascular outcomes, health policymakers and practitioners should pay more attention to the significant role of BMI in health problems and physicians might better check the variability of BMI visits to visit., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Purpose: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients., Methods: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into 3 groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage., Results: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% - 100%, 22% - 100% and 29% - 100% for groups 1 - 3., Conclusions: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support., (Copyright © 2023 Chinese Medical Association. Production and hosting by Elsevier B.V. All rights reserved.)

Purpose: This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI)., Methods: The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews., Results: We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%., Conclusion: Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Trauma is a significant public health concern in Iran, with high mortality and morbidity rates. This study aimed to assess trauma patients' profiles in Shahroud, Iran. Study Design: A cross-sectional study., Methods: The study involved trauma patients who met specific criteria at Imam Hossein hospital in Shahroud, Iran, between 2016 and 2023, using the National Trauma Registry of Iran (NTRI). The relationship between injury characteristics and the cause of injury was analyzed using chi-square test and post hoc analysis. Quintile regression models assessed the association of demographic and clinical variables with length of stay., Results: Among 3513 trauma patients, road traffic crashes (RTCs) had a higher percentage of injuries with the Glasgow Coma Scale (GCS) between 9 and 12 (1.7%) compared to falls (0.3%) ( P <0.001). Falls caused more moderate cases with injury severity scores (ISS) ranging from 9 to 15 (22.7%) than RTCs (17.1%) ( P <0.001). RTC-related injuries required more ventilation (2.7%) and intensive care unit (ICU) admissions (11.1%) than falls ( P <0.001). After adjusting for age, GCS, ISS, and body region, fall had a median length of stay nine hours shorter than RTCs (95% CI = -16.2, -1.8)., Conclusion: Significant injury pattern differences were observed between RTCs and falls. RTCs had higher frequencies of injuries resulting in GCS scores between 9 and 12, while falls had higher frequencies of moderate ISS scores. In addition, patients with RTC-related injuries required more mechanical ventilation and ICU admissions. Moreover, after adjusting for various factors, patients with RTC-related injuries had a significantly longer hospital stay compared to those with fall-related injuries., (© 2024 The Author(s); Published by Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: Sudden infant death syndrome is the third leading cause of infant death in the first year of life and is one of the most important health problems around the world. The exact etiology of this phenomenon is not clear yet, but some risk factors, especially prone sleep positions, have been described. Fortunately, by modifying some environmental factors, the SIDS incidence might be decreased. Mothers' and caregivers' knowledge about this neglected event could be an important factor in determining SIDS prevalence., Materials and Methods: This cross-sectional study was conducted in the pediatric and neonatal specialty clinic of Bahar Shahroud Hospital in 2020. Five hundred and twenty-seven pregnant women of reproductive age (18 to 45 years) were included in the study. Assessment of mothers' knowledge was done using a sudden infant death syndrome risk questionnaire. Statistical analysis of data was performed using independent t -test, Chi-square, and logistic regression., Results: The number of 527 pregnant women of childbearing age participated in our study. 81.9% were under 35 years old. According to the study, factors such as maternal age, mother's level of education, number of pregnancies, and history of previous infant death syndrome had a significant relationship with the mother's level of knowledge about infant death syndrome. The findings showed that the mother's age is over 35 years old during pregnancy (CI: 0.95-0.46-OR: 1.53) and the level of education under a diploma (CI: 3.13-1.6: 06, OR: 1.86), and increasing parity is associated with a lower level of knowledge about infant death syndrome., Conclusion: According to mothers' lack of knowledge about SIDS and the availability of simple and cost-effective methods to prevent SIDS, improving mothers' knowledge about this important event in pregnancy and postpartum, educational sessions are crucial., Competing Interests: There is no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background: One of the high-risk groups exposed to the coronavirus disease 2019 (COVID-19) pandemic was pregnant women at risk of pregnancy complications due to a weakened immune system and inability to use various drugs to treat COVID-19. Accordingly, this study was conducted to investigate the complications in pregnancy before and during the COVID-19 pandemic., Material and Methods: This cross-sectional study was performed on all pregnant women in Shahroud, Iran. The time interval from February 18, 2019, to February 17, 2020, was considered before the COVID-19 pandemic and from February 18, 2020, to February 17, 2021, was considered the COVID-19 pandemic. Sampling was conducted by census and included 6851 pregnant women. The required information was extracted from hospitals' health deputy registration system and high-risk pregnancy registration program., Result: Based on the findings, hypertension disorder, gestational diabetes, placental abruption, pre-eclampsia, cesarean section, hospitalization in neonatal intensive care unit (NICU), preterm birth, and hospitalization in other hospital wards increased by 1.88%, 1.93%, 0.12%, 0.45%, 5.45%, 1.00%, 1.20%, and 1.40%, respectively, in 2020 compared to 2019. A statistically significant difference was also observed between them ( p < 0.05). Also, the regression results showed that the chances of high blood pressure, Gestational Diabetes Mellitus (GDM), placental abruption, and cesarean section were increased by 10.91, 1.53, 5.51, and 2.83 times, respectively., Conclusions: Pregnancy complications have increased during the COVID-19 pandemic. As a result, there is a need to take appropriate health and medical measures to reduce the risks associated with the COVID-19 epidemic for pregnant women and neonates., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Background/aims: Colorectal cancer is one of the most common cancers in the world. Various genetic, individual, and environmental factors are associated with this disease. Today, the role of environmental and geographical factors has been considered. Accordingly, the present study was conducted to determine the cumulative incidence and geographical distribution of colorectal cancer in Khuzestan province., Materials and Methods: This study was performed ecologically to determine the cumulative incidence of colorectal cancer and its geographical distribution in Khuzestan province between 2011 and 2019. The required information was extracted from the cancer registration program of the Ministry of Health and after refinement and replication., Results: The cumulative incidence of colorectal cancer in Khuzestan province between 2011 and 2019 was estimated at 40.18 per 100 000 people. The highest cumulative incidence was related to Ahvaz city (95.87 per 100 000 people) and the lowest was related to DashtAzadegan city (25.35 per 100 000 people). The highest cumulative incidence of colorectal cancer, based on climate conditions, is in dry geographical areas (63.77 per 100 000 people), based on average annual rainfall, is in areas with an average rainfall of 100-200 mm (66.28 per 100 000 people), and based on land use, belonged to areas with agricultural use (74.57 per 100 000 people)., Conclusion: The cumulative incidence of colorectal cancer is relatively high in Khuzestan province. The cumulative incidence of the disease was higher in the central regions of the province than in other regions. Also, based on geographical areas, the cumulative incidence of the disease was higher in areas with arid climates, the average rainfall was 100-200 mm, and in areas with agricultural land use.

Introduction: Pediculosis is one of the most common annoying infections caused by parasitic lice in humans. Pyrethroids are one of the main insecticides used to treat this infection. But recently, due to the Resistance of lice to this group of insecticides, its insecticidal effects have been affected. The present study was conducted through a meta-analysis to investigate the prevalence of pyrethroid resistance against these insecticides worldwide., Methods: This study was conducted as a meta-analysis of the prevalence of treatment resistance in human head lice against pyrethroid insecticides worldwide. Based on this, all articles published without a time limit until the end of June 2022 in PubMed/MEDLINE, Web of Science (ISI), Scopus, and Google Scholar databases were extracted and using random-effects meta-analysis model statistical methods in the meta-analysis, Cochrane, Index I 2, and funnel plot were analyzed by STATA software., Results: Twenty studies were included in the meta-analysis process. According to this, the prevalence of pyrethroid resistance insecticides in human head lice was estimated at 59% (CI95%: 50%-68%). Among pyrethroid insecticides, the highest prevalence of pyrethroid resistance against permethrin insecticide was 65%. Regarding the prevalence of Resistance by year, the prevalence before 2004 was estimated at 33%, but after 2015, this rate reached 82%. Also, the majority of pyrethroid resistance was estimated at 68% using genetic diagnosis methods and 43% using clinical diagnosis methods., Conclusion: More than half of human head lice pyrethroid resistance insecticides. Based on this, it is recommended that before using this treatment method to treat human head lice Infestation, it should investigate the prevalence of pyrethroid resistance in that area, and if the majority of Resistance is high, alternative or combined treatment methods should be used., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (© 2023 The Authors.)

Introduction: Although house flies ( Musca domestica ) do not directly cause disease in humans, they transmit pathogens to them, which provide the basis for many diseases. The main way to deal with this insect is to use insecticides. Due to the resistance from insecticides, the fight against house flies has been hampered. This study aimed to determine the prevalence of knockdown resistance against organochlorine insecticides in house flies worldwide., Methods: This study was conducted via a systematic review and meta-analysis to investigate the prevalence of knockdown resistance against organochlorine insecticides in house flies. Accordingly, by searching the databases of Web of Science, PubMed, Scopus, Proquest, Bioone, and Embase, all published articles were extracted, and reviewed until the end of May 2022. Statistical data analysis was performed using the random-effects model in the meta-analysis, meta-regression, and I 2 index., Results: Nine studies entered the meta-analysis process. Based on this, the prevalence of knockdown resistance against organochlorine insecticide in house flies was estimated to be 49.1%. Meta-regression showed that the prevalence of knockdown resistance increased with increasing years of study but decreased with increasing sample size., Conclusion: According to the findings, about 50% of house flies have knockdown resistance against organochlorine insecticide. As a result, it is necessary to adopt effective and combined methods to combat this insect to control it and prevent the transmission of diseases caused by it., Competing Interests: None is declared., (© 2023 The Authors. Published by Elsevier Ltd on behalf of World Federation of Parasitologists.)

Introduction: Toll-like receptors (TLRs) are an extensive group of proteins involved in host defense processes that express themselves upon the increased production of endogenous damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) due to the constant contact that airway epithelium may have with pathogenic foreign antigens. We have previously shown that COPD-like airway inflammation induced by exposure to an aerosolized lysate of nontypeable Haemophilus influenzae (NTHi) promotes tumorigenesis in a K-ras mutant mouse model of lung cancer, CCSP Cre /LSL-K-ras G12D (CC-LR) mouse., Methods: In the present study, we have dissected the role of TLRs in this process by knocking out TLR2, 4, and 9 and analyzing how these deletions affect the promoting effect of COPD-like airway inflammation on K-ras-driven lung adenocarcinoma., Results: We found that knockout of TLR 2, 4, or 9 results in a lower tumor burden, reduced angiogenesis, and tumor cell proliferation, accompanied by increased tumor cell apoptosis and reprogramming of the tumor microenvironment to one that is antitumorigenic. Additionally, knocking out of downstream signaling pathways, MyD88/NF-κB in the airway epithelial cells further recapitulated this initial finding., Discussion: Our study expands the current knowledge of the roles that TLR signaling plays in lung cancer, which we hope, can pave the way for more reliable and efficacious prevention and treatment modalities for lung cancer., Competing Interests: SM reports funding from Arrowhead Pharma and Boehringer Ingelheim outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Velasco, Khosravi, Castro-Pando, Torres-Garza, Grimaldo, Krishna, Clowers, Umer, Tariq Amir, Del Bosque, Daliri, De La Garza, Ramos-Castaneda, Evans and Moghaddam.)

Objective: suicide attempts and suicide death fall within a category of psychological disorders that is under the influence of economic, social, and cultural factors. Awareness of the prevalence of this phenomenon is essential for the adoption of preventive policies. Accordingly, the current study was carried out in order to determine the prevalence of suicide attempts and suicide deaths via Meta-analysis in Iran. Method : This study is a systematic review and meta-analysis of articles published between 2010 and 2021 to estimate the prevalence of suicide attempts and suicide deaths in Iran. Accordingly, databases including Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, SID, and Magiran were searched and all related articles were extracted by the statistical tests of random and fixed effects model, meta-regression, and funnel plot using the STATA software. These articles were then analyzed. Results: A total of 20 studies were entered into the systematic review, with a total of 271,212 attempted suicides and 22,780 suicide deaths. Accordingly, the prevalence of suicide attempts in the whole population was 131.0 (CI 95%: 124.0 - 137.0) per 100,000 people (152 per 100,000 women and 128 per 100,000 men). Moreover, the prevalence of suicide death was 8.14 (CI 95% 7.8 - 8.5) per 100,000 people in the general population (5.0 per 100,000 women and 9.1 per 100,000 men). Conclusion: According to these findings, Iran can be ranked among the countries with a low prevalence of suicide attempts and completed suicides (compared to the global average). Although the trend of completed suicides is declining, the trend of suicide attempts is increasing and has often affected young people., Competing Interests: None., (Copyright © 2023 Tehran University of Medical Sciences.)

Background: COVID-19 has rapidly become a global health emergency. This infection can cause damage to various organs. Injury to myocardial cells is one of the salient manifestations of COVID-19. The clinical course and outcome of acute coronary syndrome (ACS) are influenced by various factors, including comorbidities and concomitant diseases. One of these acute concomitant diseases is COVID-19, which can affect the clinical course and outcome of acute myocardial infarction (MI)., Methods: The present cross-sectional study compared the clinical course and outcome of MI and some of its practical factors between patients with and without COVID-19. The study population consisted of 180 patients (129 males and 51 females) diagnosed with acute MI. Eighty patients had COVID-19 infection concurrently., Results: The mean age of the patients was 65.62 years. The frequencies of non-ST-elevation MI (vs ST-elevation MI), lower ejection fractions (<30), and arrhythmias were significantly higher in the COVID-19 group than in the non-COVID-19 group (P=0.006, 0.003, and P<0.001, respectively). The single-vessel disease was the most frequent angiographic result in the COVID-19 group, while the double-vessel disease was the most frequent angiographic result in the non-COVID-19 group (P<0.001)., Conclusion: It appears that patients with ACS who are co-infected with COVID-19 infection need essential care., (Copyright © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Retinopathy of prematurity is the abnormal development of retinal arteries in preterm neonates less than 32 weeks and weighing 1500 g, and less, which can lead to visual impairment during life and blindness. This study aims to investigate the relationship between some clinical characteristics of neonates and mothers with Retinopathy of prematurity in the world via a systematic review and meta-analysis., Materials and Methods: The present study is a systematic review and meta-analysis on the relationship between maternal and neonatal clinical variables with Retinopathy of prematurity in the world from the beginning of 2000 to the end of 2020. Accordingly, all English articles published on the topic were searched in scientific databases of Web of Science, PubMed, Google Scholar, Science Direct, and Scopus. The articles were searched independently by two researchers. Statistical analysis of data was performed using fixed and random effects model statistical tests in the meta-analysis, Cochran, meta-regression, I 2 index, Funnel plot, and Begg's by STATA software program, version 14., Result: A total of 191 studies with a sample size of 140,921 persons were including in the meta-analysis. Accordingly, Preterm delivery ≤28 weeks (OR:6.3, 95% CI:4.9-8.1), Birth Weight ≤1000 g (OR:5.8, 95% CI:4.8-6.8), Birth Weight ≤1500 g (OR:4.8, 95% CI:3.8-6.1), PROM (OR:1.2, 95% CI:1.0-1.4), induced fertility (OR:1.9, 95% CI:1.1-3.0) and Chorioamnionitis (OR:1.5, 95% CI:1.0-2.2) There was a statistically significant association with retinopathy., Conclusion: Based on the results of the present meta-analysis, the risk of retinopathy of prematurity in neonates born at 28 weeks and less, LBW (weight 1500 g and less), neonatal hypotension, chorioamnionitis, and induced fertility increases.

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

Purpose: This study aimed to examine the effect of video training and intraoperative progress report on the anxiety of family caregivers awaiting relatives undergoing surgery., Methods: A three-armed randomized controlled design was used. One hundred and two participants were enrolled and randomly assigned to three groups: the video training group (n = 34), the intraoperative progress report group (n = 34), and the control group (n = 34). Interventions were performed when the relatives of the participants were undergoing surgery. The participants in the video training group received video training containing images of the operating room environment and animations related to the patient's surgical procedure, postoperative care, and possible complications from the surgery. In the intraoperative progress report group, information regarding the patient's general condition, the percentage of surgical progress, and the approximate time of the patient's transfer from the operating room were provided. The control group received routine care. A demographic data questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) was used for data collection., Results: It was found a statistically significant decrease in the state anxiety in the video training (p < 0.001) and intraoperative progress report (p < 0.001) group after the intervention when compared to before the intervention. It was found no significant difference among the study groups in terms of the level of state and trait anxiety after the intervention (p > 0.05)., Conclusions: This study found that both video training and intraoperative progress report are effective in reducing the state anxiety of family caregivers awaiting relatives undergoing surgery., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Objectives: Respiratory transmission, especially in mass gatherings, is considered one of the main ways of influenza transmission. The Hajj ceremony, as one of the largest gatherings worldwide, can increase the distribution of influenza infection. Thus, the present study aimed to evaluate the incidence of influenza among Hajj pilgrims., Methods: In this present systematic review and meta-analysis, all English studies published by 2019 were extracted from several databases such as the Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, and Google Scholar. Finally, the data were extracted using a pre-prepared checklist and then analyzed by fixed and random effects model tests in the meta-analysis, Cochran, meta-regression, and Begg's test., Results: Eighteen studies with a sample size of 62 431 were entered into the meta-analysis process. The overall prevalence of influenza, in addition to the prevalence of types A, B, and C influenza, was estimated at 5.9 (95% CI: 4.3-8.0), 3.6 (95% CI: 2.6-4.9), 2.9 (95% CI: 2.8-3.1), and 0.9% (95% CI: 0.5-1.5), respectively., Conclusions: In general, influenza remains widespread regardless of vaccinating pilgrims and following health protocols. Therefore, it is recommended that comprehensive management and educational approaches be used to reduce the prevalence of influenza and its adverse consequences among the pilgrims.

Aims: Medication non-adherence post-discharge is common among patients, especially those suffering from chronic medical conditions, and contributes to hospital admissions and mortality. This study aimed to evaluate the effect of the Cardiac Care Bridge (CCB) intervention on medication adherence post-discharge., Methods: We performed a secondary analysis of the CCB randomized single-blind trial, a study in patients ≥70 years, at high risk of functional loss and admitted to cardiology departments in six hospitals. In this multi-component intervention study, community nurses performed medication reconciliation and observed medication-related problems (MRPs) during post-discharge home visits, and pharmacists provided recommendations to resolve MRPs. Adherence to high-risk medications was measured using the proportion of days covered (PDC), using pharmacy refill data. Furthermore, MRPs were assessed in the intervention group., Results: For 198 (64.7%) of 306 CCB patients, data were available on adherence (mean age: 82 years; 58.9% of patients used a multidose drug dispensing [MDD] system). The mean PDC before admission was 92.3% in the intervention group (n = 99) and 88.5% in the control group (n = 99), decreasing to 85.2% and 84.1% post-discharge, respectively (unadjusted difference: -2.6% (95% CI -9.8 to 4.6, P = .473); adjusted difference -3.3 (95% CI -10.3 to 3.7, P = .353)). Post-hoc analysis indicated that a modest beneficial intervention effect may be restricted to MDD non-users (P interaction  = .085). In total, 77.0% of the patients had at least one MRP post-discharge., Conclusions: Our findings indicate that a multi-component intervention, including several components targeting medication adherence in older cardiac patients discharged from hospital back home, did not benefit their medication adherence levels. A modest positive effect on adherence may potentially exist in those patients not using an MDD system. This finding needs replication., (© 2021 British Pharmacological Society.)

Background: The effect of related factors on recovery or death rates may vary from country to country. Therefore, we aimed to investigate the relationship between demographic, clinical, laboratory factors on the survival rates of confirmed cases of COVID-19 in Shahroud, Iran., Methods: This is an analytical study of the estimation of the survival of patients with COVID-19. Patients who had positive PCR test were considered as COVID-19 cases, and the 2-month survival of these patients was estimated. Among the diseases, heart disease and diabetes were considered as separate variables, and the patients' histories of other diseases were included in the model as comorbidities., Results: Of 396 confirmed patients hospitalized, 109 patients (27.5%) had a history of heart disease, 100 (25.3%) were diabetic, and 80 (20.2%) had a history of other comorbidities. The number of deaths due to the disease was 59 (14.9%). The median age of those who died was 76 years. The multivariate Cox regression analysis shows that heart disease increases hazard ratio more than two times (HR=2.37, 95% CI: 1.33-4.23). The neutrophil-to-lymphocyte ratio (NLR) factor, (HR=1.15, 95% 1.08-1.22), and older age (HR=1.06, 95% CI: 1.03-1.08) increases the risk of death significantly., Conclusion: The heart disease history, NLR factor and older age are associated with death of COVID-19 and may be helpful for the early warning and prediction of disease progression., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright © 2022 Talebi et al. Published by Tehran University of Medical Sciences.)

Background: Disasters have undesirable effects on health among individuals such as psychosocial disorders which may lead lead to suicide in some cases. Thus, the present study aimed to measure the rate of suicide death after disasters all over the world., Methods: In the present meta-analysis study, all of the articles published in English until the end of 2019 were probed in electronic databases such as Web of Science, PubMed, Cochrane Library, Science Direct, PsycINFO, PsycARTICLES, and Google Scholar. Then, the data were imported to STATA ver.13 software and analyzed through fixed- and random-effects models, meta-regression, and Cochrane statistical tests., Results: A total of 11 studies including a sample size of 65495867 were considered. Suicide death rates before and after the disasters were calculated as 13.61 (CI95%: 11.59-15.77) vs. 16.68 (CI95%: 14.5-19:0) among the whole population, 28.36 (CI 95%:11.29-45.43) vs. 32.17 (CI95%: 17.71-46.62) among men, and 12.71 (CI95%: 5.98-19.44) vs 12.69 (CI95%: 5.17-20.21) among women. The rate of suicide death significantly increased in the whole population and men, while no significant difference was reported among women., Conclusion: Suicide death rate increases after disasters indicating the destructive impact of this phenomenon on peoples' health. Therefore, implementing supportive and interventional measures is highly suggested after disasters in order to prevent suicide death among the affected people.

Objective: After accidents and disasters, people suffer from mental disorders due to physical, economic and social injuries. These include anxiety, stress, depression, suicidal ideation, and suicide attempts. Due to the fact that some of these measures can endanger a person's life, it is important to pay attention to these psychological factors. Accordingly, the present study was conducted to investigate prevalence of suicidal ideation and suicide attempts after disasters in the world. Method: The present study was a systematic review and meta-analysis of the prevalence of suicidal ideation and suicide attempt after disaster in the world. Accordingly, all articles published English-language from the beginning of 2000 to the end of 2020 were extracted from Scopus, Web of Science, PubMed, Psych Info, Science Direct and Google scholar and evaluated. Statistical analysis of data was performed using the fixed and random effects model in meta-analysis and Cochran test. Results: A total of 33 studies with a sample size of 61,180 people entered the meta-analysis process. Accordingly, the prevalence of suicidal ideation was estimated at 12.9% (CI95%: 10.3% -15.5%) in the whole population, 10.6% (CI95%: 6.1% - 15.0%) in males and 15.8% (CI95%: 10.0% - 21.6%) in females. Moreover, prevalence of suicide attempt after disasters was estimated at 8.8% (CI95%: 6.6% - 11.0%). Conclusion: Based on the findings of the present study, prevalence of suicidal ideation and suicide attempt is high and prevalence of Suicide idea in women was about three times higher than in men., (Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: after hospitalisation for cardiac disease, older patients are at high risk of readmission and death., Objective: the cardiac care bridge (CCB) transitional care programme evaluated the impact of combining case management, disease management and home-based cardiac rehabilitation (CR) on hospital readmission and mortality., Design: single-blind, randomised clinical trial., Setting: the trial was conducted in six hospitals in the Netherlands between June 2017 and March 2020. Community-based nurses and physical therapists continued care post-discharge., Subjects: cardiac patients ≥ 70 years were eligible if they were at high risk of functional loss or if they had had an unplanned hospital admission in the previous 6 months., Methods: the intervention group received a comprehensive geriatric assessment-based integrated care plan, a face-to-face handover with the community nurse before discharge and follow-up home visits. The community nurse collaborated with a pharmacist and participants received home-based CR from a physical therapist. The primary composite outcome was first all-cause unplanned readmission or mortality at 6 months., Results: in total, 306 participants were included. Mean age was 82.4 (standard deviation 6.3), 58% had heart failure and 92% were acutely hospitalised. 67% of the intervention key-elements were delivered. The composite outcome incidence was 54.2% (83/153) in the intervention group and 47.7% (73/153) in the control group (risk differences 6.5% [95% confidence intervals, CI -4.7 to 18%], risk ratios 1.14 [95% CI 0.91-1.42], P = 0.253). The study was discontinued prematurely due to implementation activities in usual care., Conclusion: in high-risk older cardiac patients, the CCB programme did not reduce hospital readmission or mortality within 6 months., Trial Registration: Netherlands Trial Register 6,316, https://www.trialregister.nl/trial/6169., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction: The pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), or coronavirus disease 2019 (COVID-19), has affected many people in the world and has impacted the physical, social, and mental health of the world population. One of these psychological consequences is intimate partner violence affecting sexual health., Methods: This study was performed as a systematic review on the effect of the SARS-CoV-2 pandemic on sexual function and domestic violence in the world. Accordingly, all English-language studies conducted from the beginning of the SARS-CoV-2 pandemic to the end of 2020 were extracted by searching in the Scopus, Web of Science, PubMed (including Medline), Cochrane Library, and Science Direct databases and then reviewed. The quality of the articles was assessed using the STROBE checklist., Results: A total of 11 studies were included in the systematic review. Accordingly, domestic violence during the exposure to COVID-19 had increased. Moreover, the mean scores of sexual function and its components had reduced at the time of exposure to the pandemic compared to before., Conclusion: Given the potential long-term effects of the coronavirus crisis and the large population being affected by this disease, strategies to promote sexual health and fertility of families to prevent or further reduce violence and sexual functions should be chosen.

Background: Medication reconciliation (MR) is a widely recognised method to promote patient safety. However, its implementation is generally limited to an interaction at a single transition point., Objectives: To examine the rates and types of changes implemented in patient's medication regimens when MR is performed longitudinally at hospital admission, discharge and post-discharge, and to assess the clinical impact., Methods: A prospective multicentre cohort study was conducted in two hospitals. Patients received MR at admission, discharge and within five days post-discharge at home. Data was collected on rates and types of changes implemented in their medication regimens, due to MR, at all three transition points. These changes entailed corrections of unintentional discrepancies, e.g., between patients' actual medication use and physician prescriptions, and optimisations of pharmacotherapy, e.g., adding laxatives when opioids are prescribed. Using a validated instrument, the clinical impact of all medication changes were scored. Data were analysed using descriptive statistics., Results: In total, 197 patients with a median age of 73 years were included. In 86.3% of patients at least one change was implemented in the medication regimen due to longitudinal MR. At admission, discharge and post-discharge, changes in medication regimens were necessary in 66.5%, 62.9% and 52.8% of patients, respectively. At admission and post-discharge, mainly unintentional discrepancies were corrected, and at discharge mainly optimisations were implemented. Implemented medication changes, due to longitudinal MR, prevented potential harm in 161 patients (81.7%). Potentially serious medication errors were most often prevented at hospital discharge, and predominantly involved optimising antithrombotic agents., Conclusions: Changes in medication regimens were implemented in 86.3% of patients due to longitudinal MR at admission, discharge and post-discharge. The rates and types of medication changes vary over time. Hospital discharge is an important moment for optimising pharmacotherapy., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Harm due to medications is common during the transition from hospital to home. Approaches that seek to prevent harm often involve isolated medication-related interventions and show conflicting results. However, until now, no review has focused on the effect of intervention components delivered both in hospital and following discharge from hospital to home., Objective: To examine effects of medication-related interventions on hospital readmissions, medication-related problems (MRPs), medication adherence and mortality., Methods: For this systematic review and meta-analysis, we searched the PubMed, Embase, CINAHL and CENTRAL databases without language restrictions. Citations of included articles were checked through Web of Science and Scopus from inception to 20 June 2019. We included prospective studies that examined effects of medication-related interventions delivered both in hospital and following discharge from hospital to home compared with usual care. Three authors independently extracted data and assessed study quality in pairs., Results: Fourteen original studies were included, comprising 8182 patients. Interventions consisted mainly of patient education and medication reconciliation in the hospital, and patient education following discharge. Nine studies were included in the meta-analysis; compared with usual care (n=3376 patients), medication-related interventions (n=1820 patients) reduced hospital readmissions by 3.8 percentage points within 30 days of discharge (number needed to treat=27, risk ratio (RR) 0.79 (95% CI 0.65 to 0.96)). Meta-regression analysis suggested that readmission rates were reduced by 17% per additional intervention component (RR 0.83 (95% Cl 0.75 to 0.91)). Medication adherence and MRPs may be improved. Effects on mortality were unclear., Conclusions: Studied medication-related interventions reduce all-cause hospital readmissions within 30 days. The treatment effect appears to increase with higher intervention intensities. More evidence is needed for recommendations on adherence, mortality and MRPs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Disasters are increasing all over the world. Iran, is one of the high-risk countries in this regard; so it is unavoidable to prepare hospitals as vital centers when disasters happen. This study aimed to evaluation the hospital preparedness based on previous studies in Iran., Methods: A systematic review and meta-analysis by browsing through all articles published since 2006 to 2017, in English and Persian both languages were designed. Databases that we searched to, include Google Scholar, PubMed, Web of Science, Scopus, Medlib, Cochrane Library, Science Direct, Internationally and SID, Irandoc and Magiran, domestically. Two expert researchers investigated separately. Researchers used random and fixed effect models in the meta-analysis. Moreover, random and fixed effects model and meta-regression tests were applied by using STATA ver. 11. The P <0.05 was considered statistically significant., Results: Twenty-five studies with a sample size of 181 hospitals were introduced to the process of meta-analysis. Iranian hospital preparedness is 53%, totally, that is moderate. Preparedness in different categories is as follows: emergency services 62%, communication 57%, security 54%, education 57%, logistic 65%, human resources 52%, Management and command 64%, reception 43%, transfer and evacuation 44%, traffic 47%, non-structural safety 57%, and structural safety 49%., Conclusion: Hospital preparedness is moderate in Iran. Optimal management of existing resources and the use of Update technologies in the field of hospital services be directed towards improving the preparedness of hospitals for disasters., Competing Interests: Conflicts of interest None declared., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Financial fraud is among the main problems undermining the confidence of customers in addition to incurring economic losses to banks and financial institutions. In recent years, along with the proliferation of fraud, financial institutions began looking for ways to find a suitable solution in the fight against fraud. Given the advanced and varied changes in methods of fraud, extensive research has been conducted to detect fraud. In this paper, the Artificial Neural Network technique and Harmony Search Algorithm are used to detect fraud. In the proposed method, hidden patterns between normal and fraudulent customers' information are searched. Given that fraudulent behavior could be detected and stopped before they take place, the results of the proposed system show that it has an acceptable capability in fraud detection., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Sajjad Daliri.)

Background Congenital hypothyroidism (CH) is one of the main causes of mental retardation in neonates. The disease is associated with genetic, climatic and environmental factors. Accordingly, the present study was conducted to determine the incidence rate and correlation of geographic factors with CH in Isfahan province in order to explain the role of climatic factors in the incidence of disease in this province. Methods This cross-sectional study was conducted to determine the incidence rate and geographical distribution of CH in neonates born in the Isfahan province from the beginning of 2002 to the end of 2015. To estimate the geographic distribution, the ArcGIS software (version 10.3) was used and to investigate the relationship between geographical factors and CH, the Poisson regression test and dispersion diagrams were used. Data analysis was done using the SPSS16 software. Results According to the results of the screening of 1,006,404 neonates born in Isfahan, the mean incidence rate of CH in all infants was 2.3, and that in male and female infants was 2.39 and 2.2 per 1000 live births, respectively. There was a statistically significant correlation between the city of residence (p = 0.01), climatic conditions (p = 0.044), annual precipitation (p = 0.027), sunlight (p = 0.01) and CH. However, there was no significant relationship between the mean altitude above sea level (p = 0.6), land use (p = 0.4) and relative humidity (p = 0.24). Conclusions Based on the findings of this study, the incidence rate of CH in Isfahan province was higher than the average of the country. Moreover, among the geographical factors, climatic conditions, annual precipitation and sunlight were associated with CH.

Introduction: Congenital malformations are one of the main causes of death and disability in children. These malformations arise during embryogenesis and fetal development during pregnancy due to exposure to some environmental factors and genetic mutations. Given the high prevalence of congenital malformations in Iran, the current study was conducted to investigate the relationship between some neonatal and maternal factors during pregnancy with the prevalence of congenital malformations in Iran. Methods: This was a systematic review and meta-analysis study. All studies conducted in Iran were extracted between 2000 and 2016 during a search in internal and external databases of Medlib, Medline, Pubmed, Web of Science, Google Scholar, Scopus, Magiran, SID, Cochrane, Irandoc, and all articles published. Then, the required data were entered into the Spss16 software (SPSS Inc., Chicago, IL); and the model of fixed and random effects was analyzed in meta-analysis, Cochran, meta-regression using statistical tests. Results: A total of 30 studies with a sample size of 928,311 patients were enrolled. Baby's gender (1-1.55: CI95%) OR: 1.25, preterm delivery (1.71-3.69: CI 95%) OR: 2.51, low birth weight (1.13-2.67: CI95%) OR: 1.74, age older than 35 for the pregnant mother (1.41-6.3: CI 95%) OR: 2.98, multiple births (1.14-3.46: CI 95%) OR: 1.99, mother suffering from chronic diseases (1.68-3.31: CI 95%) OR: 2.36 are significantly related with the risk of congenital malformations. Conclusion: Based on the results the baby's gender, premature birth, low birth weight, mother's age, consanguineous marriages, multiple births, family history of congenital malformations, and the risk of chronic diseases in the mother during pregnancy increase the birth of children with congenital malformations. As a result, control or modification of the above factors implementing a health and education intervention program can reduce the birth of children with congenital malformations.

Background: During transitions from hospital to home, up to half of all patients experience medication-related problems, such as adverse drug events. To reduce these problems, knowledge of patient experiences with medication use during this transition is needed. This study aims to identify the perspectives of patients on barriers and facilitators with medication use, during the transition from hospital to home., Methods: A qualitative study was conducted in 2017 among patients discharged from two hospitals using a semi-structured interview guide. Patients were asked to identify all barriers they experienced with medication use during transitions from hospital to home, and facilitators needed to overcome those barriers. Data were analyzed following thematic content analysis and visualized using an "Ishikawa" diagram., Results: In total, three focus groups were conducted with 19 patients (mean age: 70.8 (SD 9.3) years, 63% female). Three barriers were identified; lack of personalized care in the care continuum, insufficient information transfer (e.g. regarding changes in pharmacotherapy), and problems in care organization (e.g. medication substitution). Facilitators to overcome these barriers included a personal medication-counselor in the care continuum to guide patients with medication use and overcome communication barriers, and post-discharge follow-up care (e.g. home visits from healthcare providers)., Conclusions: During transitions from hospital to home patients experience individual-, healthcare provider- and organization level barriers. Future research should focus on personal-medication counselors in the care continuum and post-discharge follow-up care as it may overcome communication, emotional, information and organization barriers with medication use.

Background: Medication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-discharge. We investigated the effect of a pharmacy-led transitional care program on the occurrence of medication-related problems four weeks post-discharge., Methods: A prospective multi-center before-after study was conducted in six departments in total of two hospitals and 50 community pharmacies in the Netherlands. We tested a pharmacy-led program incorporating (i) usual care (medication reconciliation at hospital admission and discharge) combined with, (ii) teach-back at hospital discharge, (iii) improved transfer of medication information to primary healthcare providers and (iv) post-discharge home visit by the patient's own community pharmacist, compared with usual care alone. The difference in medication-related problems four weeks post-discharge, measured by means of a validated telephone-interview protocol, was the primary outcome. Multiple logistic regression analysis was used, adjusting for potential confounders after multiple imputation to deal with missing data., Results: We included 234 (January-April 2016) and 222 (July-November 2016) patients in the usual care and intervention group, respectively. Complete data on the primary outcome was available for 400 patients. The proportion of patients with any medication-related problem was 65.9% (211/400) in the usual care group compared to 52.4% (189/400) in the intervention group (p = 0.01). After multiple imputation, the proportion of patients with any medication-related problem remained lower in the intervention group (unadjusted odds ratio 0.57; 95% CI 0.38-0.86, adjusted odds ratio 0.50; 95% CI 0.31-0.79)., Conclusions: A pharmacy-led transitional care program reduced medication-related problems after discharge. Implementation research is needed to determine how best to embed these interventions in existing processes., Competing Interests: The authors have declared that no competing interests exist.

Background: Multiple sclerosis (MS) is an autoimmune disease associated with inflammation of the central nervous system in humans. This disease is the most common neurological disease, especially in young people. Various factors, including biological, genetic, and environmental factors, are effective on the prevalence of MS disease. This study intends to determine the relationship between geographical factors, and the prevalence of MS disease was performed., Methods: This ecological study was carried out on 2000 patients with diagnosis of MS during the years 2001-2014 in Isfahan province. All patients' data including age, sex, marital status, year, and location of patients were extracted from the files. Arc geographic information systems version 10.3 software was used for geographical maps, and for statistical analysis of data, SPSS.16 software ANOVA tests, independent t -test, and Kruskal-Wallis were used., Results: Based on recorded cases of MS, the highest and lowest cumulative incidence of diseases was related to the city of Isfahan (75.92 in one hundred thousand) and Aran Bidgol (1.16 in one hundred thousand), respectively. A significant relationship was observed between the incidence and height above sea level ( P = 0.001), the average annual rainfall ( P = 0.001), and land use ( P = 0.001). With increase in the height above sea level and the average annual precipitation, the incidence of disease decreased., Conclusions: MS disease incidence is high in Isfahan province. The distribution of the disease is not the same in the cities of this province, and some cities have a higher incidence. Furthermore, the incidence of the disease is influenced by geographical factors such as height above sea level, average annual rainfall, and land use. Therefore, it is recommended that relevant authorities by the implementation of screening programs in high-risk areas take action to identify and treat patients in the early stages., Competing Interests: There are no conflicts of interest.

Objective: Domestic violence is the most common form of violence against women and a major health problem worldwide. The aim of this study was to examine the relationship between demographic factors and domestic violence during pregnancy through meta-analysis. Method : This meta-analysis study was conducted in Iran. All the articles published during 2001 up to Jun 2018 were extracted independently by 2 trained investigators from domestic and foreign databases including, Science Medlib, SID, Web of Science, PubMed, Science Direct, Irandoc, Medline, Scopus, Magiran, and Google Scholar with keywords and their compounds. The results of studies pooled using the random effects model Cochran and I2 tests were used to check heterogeneity. Data were analyzed using Stata Ver. 11.2. Results: A total of 28 articles with the sample size of 15 020 people were included in the study. The findings of the meta-analysis showed that low level of maternal education (OR:1.68) (CI 95%:1.15, 2.46), low education level of the spouse (OR:1.73) (CI 95%:1.31, 2.29), unemployment of the husband (OR:1.61) (CI 95%: 1.05, 2.48), and smoking of the husband (OR:2.51) (CI 95%: 1.64, 3.84) were important factors in the increase in domestic violence during pregnancy. Having 3 children or fewer (OR: 0.30) (CI 95%: 0.16, 0.56) and enough and regular visits to physicians to receive adequate prenatal care (OR: 0.31) (CI 95%: 0.16, 0.57) were deterrent for violence during pregnancy. Conclusion: Based on our findings, level of education, unemployment, prenatal care, smoking, and number of children are associated with violence during pregnancy. Thus, paying attention to these factors and controlling them can reduce violence during pregnancy and its adverse consequences.

Chronic obstructive pulmonary disease (COPD), an inflammatory disease of the lung, is an independent risk factor for lung cancer. Lung tissues obtained from human smokers with COPD and lung cancer demonstrate hypoxia and up-regulated hypoxia inducible factor-1 (HIF-1). HIF-1 activation is the central mechanism for controlling the cellular response to hypoxia during inflammation and tumor development. These facts suggest a link between COPD-related airway inflammation, HIF-1, and lung cancer. We have previously established a mouse model of COPD-like airway inflammation that promotes lung cancer in a K-ras mutant mouse model (CC-LR). Here we show that tumors in the CC-LR model have significantly elevated levels of HIF-1α and HIF-1 activity. To determine the tumor-promoting functions of HIF-1 in CC-LR mice, the gene Hif1a which encodes HIF-1α and is required for HIF-1 activity, was disrupted in the lung epithelium of CC-LR animals. Airway epithelial specific HIF-1α deficient mice demonstrated significant reductions in lung surface tumor numbers, tumor angiogenesis, and tumor cell proliferation in the absence or presence of COPD-like airway inflammation. In addition, when CC-LR mice were bred with transgenic animals that overexpress a constitutively active mutant form of human HIF-1α in the airway epithelium, both COPD- and adenocarcinoma-like phenotypes were observed. HIF-1α overexpressing CC-LR mice had significant emphysema, and they also showed potentiated tumorigenesis, angiogenesis, and cell proliferation accompanied by an invasive metastatic phenotype. Our gain and loss of function studies support a key role for HIF-1α in the promotion of lung cancer by COPD-like inflammation., Competing Interests: CONFLICTS OF INTEREST The authors declare no potential conflicts of interest.

Somatic KRAS mutations are the most common oncogenic variants in lung cancer and are associated with poor prognosis. Using a Kras -induced lung cancer mouse model, CC-LR, we previously showed a role for inflammation in lung tumorigenesis through activation of the NF-κB pathway, along with induction of interleukin 6 (IL6) and an IL17-producing CD4 + T-helper cell response. IL22 is an effector molecule secreted by CD4 + and γδ T cells that we previously found to be expressed in CC-LR mice. IL22 mostly signals through the STAT3 pathway and is thought to act exclusively on nonhematopoietic cells with basal IL22 receptor (IL22R) expression on epithelial cells. Here, we found that higher expression of IL22R1 in patients with KRAS -mutant lung adenocarcinoma was an independent indicator of poor recurrence-free survival. We then showed that genetic ablation of Il22 in CC-LR mice (CC-LR/IL22KO mice) caused a significant reduction in tumor number and size. This was accompanied by significantly lower tumor cell proliferation, angiogenesis, and STAT3 activation. Il22 ablation was also associated with significant reduction in lung-infiltrating inflammatory cells and expression of protumor inflammatory cytokines. Conversely, this was accompanied with increased antitumor Th1 and cytotoxic CD8 + T-cell responses, while suppressing the protumor immunosuppressive T regulatory cell response. In CC-LR/IL22KO mice, we found significantly reduced expression of core stemness genes and the number of prototypical SPC + CCSP + stem cells. Thus, we conclude that IL22 promotes Kras -mutant lung tumorigenesis by driving a protumor inflammatory microenvironment with proliferative, angiogenic, and stemness contextual cues in epithelial/tumor cells. Cancer Immunol Res; 6(7); 788-97. ©2018 AACR ., (©2018 American Association for Cancer Research.)

Background: Domestic violence during pregnancy is a public health crisis, because it affects both mother and fetus simultaneously, resulting in irreversible consequences for mothers and their newborns. This study was performed to determine the prevalence of sexual violence during pregnancy in the world and Iran as meta-analysis., Methods: This study is a meta-analysis on the prevalence of sexual violence during pregnancy in the world and Iran that was conductedon Persian and English published articles up to 2015. To this end, through searching the information by key words and their compounds at SID, Medlib, Irandoc, Google scholar, Pubmid, ISI, Iranmedex, Scopus and Magiran, all related articles were extracted independently by two trained researchers. The results of studies analyzed using the STATA and Spss 16 software., Results: In the initial searching of 167 articles, 33 articles related to Iran, 40 articles related to other parts of the world and totally 73 articles met inclusion criteria for study. The prevalence of sexual violence during pregnancy were estimated in the world 17% (CI 95%: 15% -18%) and in Iran 28% (CI 95%: 23%-32%). The prevalence of sexual violence during pregnancy in Iran is 11 percent more than the world., Conclusions: According to the present meta-analysis results, the prevalence of sexual violence during pregnancy in Iran is high. Given that sexual violence during pregnancy causes damage to the mother and infant, it is recommended that the relevant authorities with the implementation of intervention and educational programs reduce the prevalence of sexual violence during pregnancy.

Background and Aim: Some physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method., Methods: The present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16., Results: Based on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7-81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7-69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months' postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth., Conclusions: The results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.

WNT-5A is a secreted growth factor that belongs to the noncanonical members of the Wingless-related MMTV-integration family. Previous studies pointed to a connection between WNT-5A and the fibrogenic factor TGF-β warranting further studies into the functional role of WNT-5A in liver fibrosis. Therefore, we studied WNT-5A expressions in mouse and human fibrotic livers and examined the relation between WNT-5A and various fibrosis-associated growth factors, cytokines, and extracellular matrix proteins. WNT-5A gene and protein expressions were significantly increased in fibrotic mouse and human livers compared with healthy livers. Regression or therapeutic intervention in mice resulted in decreased hepatic WNT-5A levels paralleled by lower collagen levels. Immunohistochemical analysis showed WNT-5A staining in fibrotic septa colocalizing with desmin staining indicating WNT-5A expression in myofibroblasts. In vitro studies confirmed WNT-5A expression in this cell type and showed that TGF-β significantly enhanced WNT-5A expression in contrast to PDGF-BB and proinflammatory cytokines IL-1β and TNF-α. Additionally, TGF-β induces the expression of the WNT receptors FZD2 and FZD8. After silencing of WNT-5A, reduced levels of collagen type I, vimentin, and fibronectin in TGF-β-stimulated myofibroblasts were measured compared with nonsilencing siRNA-treated controls. Interestingly, the antifibrotic cytokine IFNγ suppressed WNT-5A in vitro and in vivo. IFNγ-treated fibrotic mice showed significantly less WNT-5A expression compared with untreated fibrotic mice. In conclusion, WNT-5A paralleled collagen I levels in fibrotic mouse and human livers. WNT-5A expression in myofibroblasts is induced by the profibrotic factor TGF-β and plays an important role in TGF-β-induced regulation of fibrotic matrix proteins, whereas its expression can be reversed upon treatment, both in vitro and in vivo. NEW & NOTEWORTHY This study describes the localization and functional role of WNT-5A in human and mouse fibrotic livers. Hepatic WNT-5A expression parallels collagen type I expression. In vivo and in vitro, the myofibroblasts were identified as the key hepatic cells producing WNT-5A. WNT-5A is under control of TGF-β and its activities are primarily profibrotic., (Copyright © 2017 the American Physiological Society.)