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Abstract Background Gastrointestinal (GI) tract cancer is one of the common causes of the mortality due to cancer in most developing countries such as Iran. The digestive tract is the major organ involved in the cancer. The northern part of the country, surrounded the Caspian Sea coast, is well known and the region with highest regional incidence of the GI tract cancer. In this paper our aim is to study the most common risk factors affecting the survival of the patients suffering from GI tract cancer using parametric models with frailty. Methods This research was a prospective study. Information of 484 cases with GI cancer was collected from Babol Cancer Registration Center during 1990-1991. The risk factors we studied are age, sex, family history of cancer, marital status, smoking status, occupation, race, medication status, education, residence (urban, rural), type of cancer, migration status (indigenous, non-native). The studied cases were followed up until 2006 for 15 years. Hazard ratio was used to interpret the death risk. The effect of the factors in the study on the patients survival are studied under a family of parametric models including Weibull, Exponential, Log-normal, and the Log-logistic model. The models are fitted using with and without frailty. The Akaike information criterion (AIC) was considered to compare between competing models. Results Out of 484 patients in the study, 321 (66.3%) were males and 163 (33.7%) were females. The average age of the patient at the time of the diagnosis was 59 yr and 55 yr for the males and females respectively. Furthermore, 359 (74.2%) patients suffered from esophageal, 110 (22.7%) patients recognized with gastric, and 15 (3.1%) patients with colon cancer. Survival rates after 1, 3, and 5 years of the diagnosis were 24%, 16%, and 15%, respectively. We found that the family history of the cancer is a significant factor on the death risk under all statistical models in the study. The comparison of AIC using the Cox and parametric models showed that the overall fitting was improved under parametric models (with and without frailty). Among parametric models, we found better performance for the log-logistic model with gamma frailty than the others. Using this model, gender and the family history of the cancer were found as significant predictors. Conclusions Results suggested that the early preventative care for patients with family history of the cancer may decrease the risk of the death in the patients with GI cancer. The gender appeared to be an important factor as well so that men experiencing lower risk of death than the women in the study. Since the proportionality assumption of the Cox model was not held (p = 0.0014), the Cox regression model was not an appropriate choice for analysing our data.

Purpose of Review: The increasing rate of obesity is having an adverse impact on male reproduction., Recent Findings: The negative effect of reactive oxygen species on male reproductive tissues and the age of onset of obesity are new areas of research on male infertility., Summary: This review highlights how obesity impairs male reproduction through complex mechanisms, including metabolic syndrome, lipotoxicity, sexual dysfunction, hormonal and adipokine alterations as well as epigenetic changes, and how new management strategies may improve the reproductive health of men throughout life., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Currently, it is recommended to arrange screening for all women who are referred for prenatal care before the 20 th week of gestation. Congenital and genetic diseases lead to disability and death in 3% of babies. Prenatal diagnosis is the only way to prevent the birth of babies with genetic disorders. This study was conducted with the aim of investigating the indications of amniocentesis as well as its early and late complications., Materials and Methods: This retrospective study was conducted on 216 patients who were referred to the Perinatology Clinic of Sanandaj Besat Hospital in 2019-2020 and were candidates for amniocentesis. After collecting the data, analysis of data was done in SPSS software (version 21)., Results: In the investigation of complications caused by amniocentesis, spontaneous abortion occurred in five cases (2.31%), amniotic fluid leakage in nine cases (4.6%), spotting in seven cases (3.24%), chorioamnionitis in one case (0.46%), and premature birth in 35 cases (16.2%). In this study, there were no reports of skin and eye complications., Conclusion: Based on the results of this research, the most common early and late complications were amniotic fluid leakage and childbirth before 37 weeks of gestation, respectively., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

Context: Adipose steroid metabolism modifies body fat development in polycystic ovary syndrome (PCOS)., Objective: To determine whether subcutaneous (SC) abdominal adipose aldo-keto reductase 1C3 (AKR1C3; a marker of testosterone generation) is increased in normal-weight women with PCOS vs age- and body mass index (BMI)-matched normoandrogenic ovulatory women (controls) and is related to SC abdominal adipose activator protein-1 (AP-1; a marker of adipocyte differentiation) and/or androgen receptor (AR) protein expression in predicting fat accretion., Design: Prospective cohort study., Setting: Academic center., Patients: Eighteen normal-weight PCOS women; 17 age- and BMI-matched controls., Interventions: Circulating hormone/metabolic determinations, intravenous glucose tolerance testing, total body dual-energy x-ray absorptiometry, SC abdominal fat biopsy, immunohistochemistry., Main Outcome Measures: Clinical characteristics, hormonal concentrations, body fat distribution, SC adipose AKR1C3, AR, and AP-1 protein expression., Results: Women with PCOS had significantly higher serum androgen levels and greater android/gynoid fat mass ratios than controls. SC adipose AKR1C3, AR, and AP-1 protein expressions were comparable between the study groups, but groups differed in correlations. In PCOS women vs controls, SC adipose AKR1C3 protein expression correlated positively with android and gynoid fat masses and negatively with SC adipose AP-1 protein expression. SC adipose AR protein expression correlated negatively with fasting serum free fatty acid and high-density lipoprotein levels. In both study groups, SC adipose AKR1C3 protein expression negatively correlated with serum cortisol levels., Conclusion: In normal-weight PCOS women, SC abdominal adipose AKR1C3 protein expression, in combination with intra-adipose AP-1 and AR-dependent events, predicts fat accretion in the presence of physiological cortisol levels., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Background: According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials. Study Design: A systematic review., Methods: MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel's random-effects model. Then, Stata version 14 was used for statistical analysis., Results: In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; P =0.77; I 2 =0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; P =0.72; I 2 =0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61)., Conclusion: According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. According to the results of clinical trial studies carrying higher levels of scientific evidence, it can be concluded that vitamin D supplementation does not exert a significant effect on the incidence, mortality, and reduction of CVDs., (© 2023 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.)

Objective: Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past-month alcohol use and related factors among FSWs in Iran., Methods: We conducted a cross-sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face-to-face in a private room. Weighted analysis was used to determine the lifetime and past-month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables., Results: The most alcohol used in lifetime and past-month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31-40 years (AOR = 2.41, 95% CI: 1.13-5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31-4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01-3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41-3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06-1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80-5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82-3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use., Conclusion: Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs., (© 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Introduction: Drug use is highly prevalent among female sex workers (FSWs). Some forms of drug use, such as injecting drug users (IDU), put them at greater risks for HIV and blood born disease (BBD). In this study, the pattern of drug use and its related factors among Iranian FSWs were investigated., Materials and Methods: This cross-sectional study was performed based on the data of the integrated bio-behavioral surveillance-III (IBBS-III) on FSWs in 8 cities of Iran using the respondent-driven sampling (RDS) method conducting in 2019-2020. Of the 1515 FSWs participating in the IBBS-III study, 1,480 answered questions about drug use. To calculate the prevalence of drug use lifetime and in the past month, weighted analysis was used. Univariate and multivariate logistic regression was used to investigate the factors related to drug use., Results: The prevalence of lifetime drug use and the prevalence of current drug use (single and poly drug use) among FSWs were estimated to be 29.3% and 18.86%, respectively. According to multivariate regression analysis, the odds ratio (odds) of lifetime drug use showed a statistically significant association with lower education (AOR = 1.18; 95% CI: 1.07-1.3), being a direct sex worker (AOR = 1.77; 95% CI: 1.21-2.61), working in team houses or hangouts (AOR = 1.51; 95% CI: 1.10-2.06), a history of intentional abortion (AOR = 1.41; 95% CI: 1.07-1.87), condom use in the last sex (AOR = 1.61; 95% CI: 1.19-2.17), a history of imprisonment (AOR = 3.05; 95% CI: 2.25-4.14), HIV positive tests (AOR = 8.24; 95% CI: 1.66-40.9), alcohol use (AOR = 1.69; 95% CI: 1.29-2.29), and finding sexual clients in places such as parties, shopping malls, streets, and hotels, or by friends (AOR = 1.46; 95% CI: 1.01-2.12)., Conclusion: Given that drug use among FSWs is about 14 times higher than that of the Iranian general population, it is imperative that drug reduction programs be integrated into service packages. Specifically, prevention programs should be prioritized for occasional drug users within this population as they are at a greater risk of developing drug use issues compared to the general population., (© 2023. The Author(s).)

Purpose: Infertility affects one in four female physicians, yet current availability of fertility benefits within Accreditation Council for Graduate Medical Education (ACGME) accredited residency programs in the United States (US) is unknown. Our objective was to examine publicly available fertility benefits information for residents and fellows., Methods: The top 50 medical schools in the US for research were identified using US News & World Report 2022. In April 2022, we reviewed fertility benefits available to residents and fellows at these medical schools. Websites of their associated graduate medical education (GME) websites were queried for details surrounding fertility benefits. Two investigators collected data from GME and publicly available institutional websites. The primary outcome was fertility coverage and rates are reported as percentages., Results: Within the top 50 medical schools, 66% of institutional websites included publicly available medical benefits, 40% included any mention of fertility benefits, and 32% had no explicit information on fertility or medical benefits. Fertility benefit coverage included infertility diagnostic workup (40%), intrauterine insemination (32%), prescription coverage (12%), and in vitro fertilization (IVF, 30%). No information on coverage for third party reproduction or LGBT family building was available on public websites. Most programs with fertility benefits were in the South (40%) or Midwest (30%)., Conclusion: To support the reproductive autonomy of physicians in training, it is critical to ensure access to information on fertility care coverage. Given the prevalence of infertility among physicians and the impact of medical training on family planning goals, more programs should offer and publicize coverage for fertility care., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Gender-based violence (GBV) includes any physical, sexual, psychological, economic harms, and any suffering of women in the form of limiting their freedom in personal or social life. As a global crisis, COVID-19 has exposed women to more violence, which requires serious actions. This work aims to review the most critical dimensions of the GBV against women, effective factors on it, and strategies for combating it during the COVID-19 pandemic in order to provide recommendations for future pandemics., Methods: This study was conducted based on PRISMA-ScR. First, PubMed, Embase, Scopus, Web of Science, ProQuest, and Google Scholar were searched in April 2021 with no time limitation and location using the related keywords to COVID-19 and GBV. The searched keywords were COVID-19, gender-based violence, domestic violence, sexual violence, women, violence, abuse, and their synonyms in MESH and EMTREE. Duplicates were removed, titles and abstracts were screened, and then the characteristics and main results of included studies were recorded in the data collection form in terms of thematic content analysis., Results: A total of 6255 records were identified, of which 3433 were duplicates. Based on inclusion criteria 2822 titles and abstracts were screened. Finally, 14 studies were eligible for inclusion in this study. Most of these studies were conducted in the United States, the Netherlands, and Iran, mostly with interventional and qualitative methods., Conclusions: Strengthening ICT infrastructure, providing comprehensive government policies and planning, government economic support, social support by national and international organizations should be considered by countries worldwide. It is suggested that countries provide sufficient ICT infrastructure, comprehensive policies and planning, economic support, social support by collaboration between national and international organizations, and healthcare supporting to manage incidence of GBV against women in future pandemics., (© 2023. The Author(s).)

Background: If colorectal cancer (CRC) is diagnosed in the early stages, the patients will have higher survival rates. Although some other factors might affect the survival rate, the type of treatment available based on existing health and therapeutic facilities is extremely important as well. Accordingly, this study aimed to explore the best type of treatment for CRC patients., Study Design: This study employed a retrospective population-based cohort design., Methods: The data of 335 patients with CRC in Kurdistan province were collected through a population-based cancer registry system from March 1, 2009 to 2014. Demographic and clinical-pathologic data of the patients were gathered through their medical records, pathology reports, and reference to patients' homes. The survival rate was calculated using the Kaplan-Meier curve, log-rank test, and univariate and multivariate Cox regression. The data were analyzed using Stata 14 software., Results: In this study, the mean age±standard deviation at diagnosis was 61.7± 1.05 in men and 60.5± 1.12 in women, respectively, and 203 (60.5%) patients were males. There was less mortality rate among the patients who received both surgical and chemotherapy treatments compared to those who did not receive any treatment (Hazard ratio [HR]=0.57, 95% CI: 0.24-0.93)., Conclusion: When CRC patients are treated using both surgical and chemotherapy treatments, they will exhibit a higher survival rate. Therefore, it is suggested to use both treatments for CRC patients., (© 2023 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.)

Objectives: Different drugs have different effects on the prognosis of patients with COVID-19. This study aimed to evaluate the effect of different drug regimens on patients with COVID-19, hospitalized in Sanandaj city., Methods: In this retrospective cohort study, 660 patients with COVID-19, hospitalized in the Tohid, Kowsar and Besat hospitals located Sanandaj (Kurdistan Province, Iran) were studied from February 2020 to February 2021 with clinical symptoms and positive test results., Results: The results of multivariate regression analysis showed the days of hospitalization for patients who had received the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) was 1.92 times higher than those who had received the drug regimen 1 (hydroxychloroquine group or a combination of chloroquine and azithromycin) while a significant association was observed (OR = 1.92, 95% CI: 1.16-3.16, P = 0.011). Also, the hospitalization in ICU was longer in patients treated by the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) (OR = 4.63, 95% CI: 1.80-11.82, P = 0.001), however, drug regimens did not show a significant effect on mortality and use of ventilator in patients (P > 0.05)., Conclusion: The study results showed the drug regimens 2 and 5 increased the days of hospitalization and hospitalization in ICU, respectively, while the other drug regimens had no significant effect on mortality and use a ventilator in the studied patients and none of the drug regimens had an effect on reducing mortality compared to other ones., (© 2023. The Author(s).)

Objective: To investigate the effect of postoperative prune consumption on time to first bowel movement after benign gynecologic surgery., Materials and Methods: In this randomized, open label, controlled trial, 77 adult women who had benign gynecologic surgery that required at least one night in the hospital were enrolled from July 2018 to April 2019. Participants were randomized in a 1:1 ratio to one of two groups using a randomization assignment: 4 oz prunes daily plus docusate sodium 100 g twice daily versus docusate alone. The study's primary objective was time to first bowel movement (BM). Secondary outcomes were pain associated with first BM, stool consistency using Bristol stool scale, and patient satisfaction with bowel regimen and surgery experience., Results: Postoperative survey data was available for 68.4% of participants (n = 52). There was no difference in time to first BM between the two groups (p = 0.29); however, consumption of > 12 prunes was associated with an increased likelihood of having a BM in the study period. Among women who consumed at least 12 prunes, hospital discharge was earlier, and there was a not statistically significant greater satisfaction with postoperative bowel regimen., Conclusions: The addition of prunes to postoperative bowel regimen of docusate sodium may be a beneficial adjunct to postoperative bowel regimen., Clinical Trial: The Institutional Review Board at the University of Southern California approved the study, and the study was registered at clinicaltrials.gov (ID: NCT03523715)., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To identify relationships between the size of punctured ovarian follicles and subsequent embryology outcomes., Design: Prospective observational cohort study., Setting: Private fertility center., Patients: One hundred fifty-seven oocyte retrievals performed during the study period., Interventions: The diameter of punctured follicles was ultrasonically measured during routine oocyte collection. The resulting embryos were group-cultured to the blastocyst stage and classified into 8 groups according to follicle size (≤9.5, 10-12.5, 13-15.5, 16-18.5, 19-21.5, 22-24.5, 25-27.5, and ≥28 mm)., Main Outcome Measure: Rate of good-quality blastocysts per follicle puncture., Results: This study included 4,539 follicle punctures, 2,348 oocytes, 1,772 mature oocytes, 1,258 bipronuclear (2pn) oocytes, and 571 good-quality blastocysts derived from 157 oocyte retrievals. The per-puncture yields of oocytes, mature oocytes, 2pn oocytes, and good-quality blastocysts were associated with the size of the punctured follicle. The rates of good-quality blastocysts per punctured follicle were 2.2% (≤9.5 mm), 6.2% (10-12.5 mm), 11.9% (13-15.5 mm), 14.5% (16-18.5 mm), 18.9% (19-21.5 mm), 17.5% (22-24.5 mm), 15.9% (25-27.5 mm), and 16.0% (≥28 mm). When compared with the overall average, punctures of follicles in groups ≤12.5 mm in diameter had significantly inferior yields of good-quality blastocysts, whereas punctures of follicles in groups 19-24.5 mm in diameter were associated with significantly greater than average yields of good-quality blastocysts. Other groups did not differ significantly from average. No correlation was observed between follicle diameter and ploidy of biopsied blastocysts., Conclusions: Punctures of follicles ≤12.5 mm in diameter rarely result in good-quality blastocysts. The yield of good-quality blastocysts progressively increases with follicle size up to approximately 19 mm in diameter, with no substantial decline above that size. The ploidy of the blastocysts that form appears to be unaffected by follicle size., (Copyright © 2022 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Pregnancies conceived as contracted gestational carriers are a relatively new phenomenon for reproductive medicine. Since the intended parents control genetic screening decisions, there may be differences in genetic decisions made for gestational carrier (GC) in vitro fertilization (IVF) pregnancies as compared to traditional non-gestational carrier IVF pregnancies. Our goal was to investigate the frequency and types of these genetic testing decisions., Methods: We performed a retrospective study of GC pregnancies counseled at a private maternal-fetal medicine practice between January 2006 and January 2021. Inclusion criteria were pregnancies that completed counseling with a certified genetic counselor and obtained high-resolution imaging. Controls were non-GC IVF pregnancies seen in the same period matched by parity, estimated delivery date (EDD), and the oocyte age utilized in conception. Statistical analysis included patient demographics, pre-implantation genetic testing (PGT-A) frequency and results, ultrasound imaging results, and the frequency with results of prenatal genetic screening (first or second-trimester serum screens), non-invasive prenatal testing (NIPT), or diagnostic testing (chorionic venous sampling (CVS) or amniocentesis)., Results: One hundred and ninety one gestational carrier pregnancies were identified and 167 met inclusion criteria. Gestational carrier pregnancies were significantly more likely to pursue PGT-A, PGT-A with NIPT, first-trimester screening, and second-trimester screening. There were no differences in rates of amniocentesis or CVS over controls., Conclusions: Regarding genetic counseling and screening options, our series is the first to demonstrate that gestational carrier parents seek additional genetic counseling resources, even with reassuring PGT-A and ultrasound., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Epidemiological studies have shown that the risk of secondary malignancies may increase by radiotherapy. Lung cancer is the most important long-term complication of breast cancer radiotherapy., Methods: Major electronic databases including Scopus, Web of Science, and MEDLINE were searched. All cohort studies that investigated the association between radiotherapy for breast cancer and risk of primary lung, bronchus, and trachea cancers conducted until March 2021 were included. The study participants were evaluated regardless of their age and ethnicity. The Newcastle-Ottawa Scale was used to assess the quality of the studies. The designated effects were risk ratio (RR). The random-effects model was used to estimate the average effects., Results: Fifteen studies including 1,640,247 women with primary breast cancer were identified of which 937,151 had not received radiotherapy and 703,096 subjects had received radiotherapy. In general, there was no significant association between breast cancer radiotherapy and lung cancer based on 10 studies (RR = 0.95, 95% CI 0.87-1.02, P = 0.15), There was no association between breast cancer radiotherapy and lung, bronchus, and trachea cancers either based on 5 studies (RR = 0.98, 95% CI 0.93-1.02, P = 0.32)., Conclusion: Radiotherapy for breast cancer is not associated with an excess risk of lung cancer. Due to the limited number of studies, lack of data regarding smoking status, and substantial variation in exposure of the lungs in breast cancer radiotherapy worldwide, further investigations based on randomized controlled trials are suggested to address the potential risk of lung cancer after breast cancer radiotherapy., (© 2021. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)

Purpose: Urological complications are common and serious in kidney transplant patients. Correct diagnosis of urological complications and rapid intervention are very important to maintain the transplanted organ. Using endoscopic methods and rapid access to ureteral orifice can be effective in treatment and management of urological complications in transplant patients., Materials and Methods: In this retrospective cohort study, 934 medical records of kidney transplant patients who underwent surgery through Posterolateral Extravesical Ureteroneocystostomy (PLEVUNC) and anterior extravesical ureteroneocystostomy (AEVUNC) techniques from 2011 to 2018 were evaluated. The outcomes of PLEVUNC and AEVUNC techniques were evaluated in 461 and 473 transplant patients, respectively. The patients were followed up for 60 months. Immediate and delayed complications, urological complications requiring endoscopic intervention, duration of access to ureteral orifice, as well as ureteroscopic and endoscopic outcomes were evaluated., Results: The mean and ± SD (standard deviation) age of patients in PLEVUNC and AEVUNC groups were 46.2 7± 2.7 years and 47.3 ± 3.6 years, respectively. Urinary leakage and UTI were the most common immediate (7% and 6.2%) and delayed (5.5% and 5.5%) complications in both groups, respectively. The time to find ureteral orifice in patients requiring endoscopic intervention was significantly shorter in PLEVUNC group 3.5±1.2 compared with the AEVUNC group 10 ± 4.5 (P <.001). In 100% of PLEVUNC group and 62.6% of AEVUNC group, ureteral orifice of transplanted kidney was observed (P <.001). Ureteroscopy was reported successful in 94.5% and 37.4% of patients in PLEVUNC and AEVUNC groups, respectively., Conclusion: Easy and safe access to the ureteral orifice and to the upper urinary tract in transplant recipients can be achieved with the PLEVUNC technique. In case of urological complications this method facilitates endoscopy.

Objective: To identify transgender fertility content with the highest online engagement on social media, determine its accuracy and quality, and see how this has changed over a 2-year period., Design: BuzzSumo, a content research tool, was used to identify the top 10 article links related to transgender fertility most interacted with on the social media platforms of Facebook, Twitter, Pinterest, and Reddit. We compared article links from June 2019 to June 2020 and from June 2020 to June 2021. The articles were categorized as accurate or misleading based on the references cited and current research. A qualitative analysis was performed using article references to scientific literature and journal impact factors. User engagement was compared with the accuracy of online information using descriptive and χ 2 statistics., Setting: Not applicable., Patients: Not applicable., Interventions: Not applicable., Main Outcome Measures: Not applicable., Results: The top 10 article links for each time period were examined, with 7,077 total engagements. Fourteen articles referenced 14 unique scientific studies; no references were available for the remaining 6 articles. Alternative media was the primary source of popular article links, and accurate articles accounted for 74% of the total engagements. There was a significant association between the number of engagements with accurate articles and the time periods used for analysis ( P < .0001)., Conclusions: As the popularity of social media continues to rise, patients are more likely to turn to online platforms in search of information and advice regarding fertility. Transgender fertility is an emerging topic covered by scientific peer-reviewed journals, news organizations, and alternative media, and it is imperative for internet users to consider the accuracy of the information presented by social media platforms. Further, reproductive endocrinology and infertility physicians should use social media platforms to educate their patients on the topic of transgender fertility and prevent the spread of misinformation., (© 2021 The Authors.)

Background: The population-based survival rate is affected by the quality and effectiveness of health care systems. Overall, the survival of prostate cancer (PC) patients has improved over the past two decades worldwide. This study aimed to determine the overall survival rate and correlate it with the prognostic factors in patients with PC diagnosed in Kurdistan province., Methods: In a retrospective cohort study, 410 PC patients registered in Kurdistan province population-based cancer registry from March 2011 to 2018 were recruited. Kaplan-Meier method and log-rank test were used to analyze the overall survival rates of PC patients. A Multivariate Cox regression model was used to determine adjusted hazard ratios for different variables., Results: Of 410 patients with PC, 263 (64.1%) died within seven years due to the disease. The 1, 3, and 5 years survival rates were 93, 64.1, and 40.7%, respectively. According to the results of multiple Cox regression, the following factors were significantly related to PC survival: age at diagnosis (≥81-years old) (HR=2.23, 95% CI: 1.23-4.42) and 71-80 years old was (HR=1.26, 95% CI: 1.12-2.31), occupation (employee) (HR=0.42, 95% CI: 0.20-0.87), educational level: academic (HR=0.78, 95% CI: 0.64-0.91), AJCC stage of disease (HR=2.18, 95% CI: 1.9-3.68), Gleason score ≥ 9 (HR=7.12, 95% CI: 5.35-10.28), and Gleason score= 8 (HR=4.16, 95% CI: 2.50-6.93). There was less mortality rate among the patients who had received active care, radical prostatectomy, radiotherapy, combined treatment, and orchiectomy had a lower mortality rate than those who received no treatment (P<0.05)., Conclusions: This study demonstrated that factors such as age at diagnosis, level of education, occupation, AJCC stage of disease, Gleason score, and type of treatments were influential factors in the survival of PC patients in Kurdistan province and needed more attention., (© 2021. The Author(s).)

Objective: To study social media engagement on Black infertility to better understand why there is lower utilization of in vitro fertilization by Black women despite higher infertility rates., Design: The online analytics module BuzzSumo was used to quantify total engagements with the search term "Black infertility" across the commonly used social media platforms. The 10 article links with the highest engagement were selected from periods in 2020 and 2021. Sources cited in each article were reviewed to identify those that had citations of scientific peer-reviewed journals or national medical organizations. The contents of each article were reviewed for accuracy by comparing the article information against available scientific research and consensus data., Patients: Not applicable., Interventions: Not applicable., Main Outcome Measures: Not applicable., Results: After applying the exclusion criteria, nine article links remained in each date range. The highest engagement with the term "Black infertility" was found on Facebook for both 2020 and 2021. Ten percent of content regarding Black infertility in 2020 compared with 50% of content regarding Black infertility in 2021 referenced original studies in peer-reviewed journals. Links with greater social engagement were more likely to have academic sources in 2021 than in 2020 (odds ratio, 1.30). The highest user engagement was found for articles discussing the emotional toll of Black infertility., Conclusions: Social media users encounter misleading or inaccurate information regarding Black fertility at similar rates to accurate content. Social media can propagate misinformation, and this study identifies social media as an opportunity to improve education directed toward Black women to increase the utilization of in vitro fertilization services., (© 2021 Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.)

Purpose: To determine if the change in endometrial thickness following exogenous progesterone (P) initiation correlates with outcome following autologous transfer of a single thawed blastocyst., Methods: The study is a retrospective observational cohort study conducted at a private fertility center. Patients scheduled for thawed blastocyst transfer received artificial endometrial preparation (artificial cycle FET) and underwent serial ultrasonography. The main outcomes were the rate of ongoing pregnancy (fetal heart motion at 12 weeks of gestation) and early pregnancy loss. Logistic regression was used to test for correlations between these outcomes and the change in endometrial thickness while adjusting for potential confounders (patient age, embryo quality, and the use of genetic testing)., Results: There were 232 qualifying autologous single-blastocyst transfers in the 20-month study period ending 31 December 2019. Mean endometrial thicknesses were 3.8 mm, 10.0 mm, and 11.2 mm at baseline, P initiation, and at transfer, respectively. The change in endometrial thickness after exogenous P exposure ranged from - 5 to + 9 mm and negatively correlated with ongoing pregnancy in logistic regression analyses. Specifically, ongoing pregnancy rates per transfer were 63.2% in 19 cases where endometria compacted by 10% or more, 64.2% in 95 cases where there was unchanged endometrial thickness, and 52.5% in 118 cases where endometria expanded., Conclusions: The change in endometrial thickness after P initiation was associated with the probability of ongoing pregnancy but not with early pregnancy loss. Ongoing pregnancy rates were greater in endometria with negative growth (compaction) when compared to endometria that grew (expanded) after P exposure., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Fertility preservation is a critical patient counseling component following cancer diagnosis. The aim of this study was to compare change and quality of fertility preservation information available to patients on the websites of National Cancer Institute (NCI)-designated cancer centers over 5 years (2015 to 2020) for both women and men., Methods: All NCI-designated cancer center websites were queried for information on oncofertility in 2020 publicly available to patients using the methodology and rubric previously employed in 2015. Data was evaluated based on each center's city, county, and state by demographic data obtained from the US Census. Additionally, the yearly number of in vitro fertilization (IVF) cycles performed in the city, county, and state of each NCICC was included using websites of clinics reporting data to the Society for Assisted Reproductive Technology., Results: Significantly NCICCs have a standalone pages for fertility preservation in 2020 compared with 2015 (p = 0.004). There is a statistically significant association between discussion of male fertility and the number of fertility centers in the county and state of the NCICC (p = 0.04 and p = 0.001). NCICCs in counties in the highest quartile of per capita income were significantly more likely to address male fertility (p = 0.03)., Conclusions: Oncofertility information on NCICC websites has improved between 2015 and 2020. The impact of cancer treatment on male fertility, while improved, is still limited, particularly in counties with lower per capita income., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Given the various reports of the clinical spectrum of the disease, the aim of the present study was to determine possible scenarios of Coronavirus 2019 (COVID-19) iceberg using published articles. Methods: The present study was a rapid review of all international databases, including PubMed (Medline), Scopus, Web of Sciences, Embase, and Cochrane Library from January 1 to October 30, 2020. Results: In this review, 7 scenarios were considered for COVID-19 iceberg, in which the range of fatality percentage was estimated to be 0.5% to 7%, the range of asymptomatic cases 1% to 88.6%, the range of cases with mild symptoms 8% to 78%, no symptoms 1 % to 90 %, the range of intensive care unit (ICU) admission was 0.5% to 14.2%, and finally the intubation percentage was estimated to be 0.2% to 12.2%. The Scenarios Diamond Princess Cruise Ship and Iceland are closer to the reality of the clinical spectrum of COVID-19 around the world, which represent 0.6% and 0.5% of deaths, 0.7% and 1% of intubations, 2.5% and 9.7% of ICU admissions, 1.1% and 6% of hospitalizations, 15% and 31% of cases with mild symptoms, and finally 56.9% and 75% of asymptomatic cases of COVID-19, respectively, which should now be considered as the basis of the clinical knowledge of the disease. Conclusion: Understanding the clinical spectrum and natural knowledge of the disease and paying attention to asymptomatic or mild-symptom cases can help to make better decisions and develop more effective interventions to control COVID-19., Competing Interests: Conflicts of Interest: None declared, (© 2021 Iran University of Medical Sciences.)

Background and Purpose: We aimed at evaluating the effects of combinatorial treatments with carboplatin and epigallocatechin-3-gallate (EGCG) on the KYSE-30 esophageal cancer (EC) cell line and elucidate the underlying mechanisms., Experimental Approach: EC cells were harvested and exposed to increasing concentrations of carboplatin and EGCG to construct a dose-response plot. Cell inhibitory effects were assessed by the MTT method and apoptosis-related gene expression levels (caspases 8 and 9) and Bcl-2 mRNA were detected using real-time polymerase chain reaction. The lactate levels in the various treated cases were analyzed using the colorimetric assay kit. In addition, total antioxidant capacity was measured., Findings/results: The results indicated that, following treatments with carboplatin in IC 20 , IC 25 , and IC 10 concentrations when combined with EGCG in similar concentrations, synergistically decreased cell viability versus single treatments of both agents. Also, in combined treatments at IC 20 and IC 25 of both agents the gene expression ratio of caspases 8 and 9 upregulated significantly compared to monotherapies ( P < 0.05). Bcl-2 gene expression ratios were decreased in double agents treated cells versus monotherapies. Following treatment of KYSE-30 cells with carboplatin and EGCG in double combinations, lactate levels were significantly decreased compared with the untreated cells and single treatments ( P < 0.05). Also, in IC 25 , IC 20 , and IC 10 concentrations of both agents the total antioxidant capacity levels were decreased versus monotherapies and untreated cells., Conclusion and Implications: The presented study determined that treatment with carboplatin and EGCG was capable of promoting cytotoxicity in EC cells and inhibits the cancer progress. Combined treatments with low concentrations of carboplatin and EGCG may promote apoptosis induction and inhibit cell growth. These results confirmed the anticancer effects of carboplatin and EGCG and providing a base for additional use of EGCG to the EC treatment., Competing Interests: The authors declared no conflict of interest in this study., (Copyright: © 2021 Research in Pharmaceutical Sciences.)

Purpose: To study recent legal cases involving the transfer of the incorrect embryo into patients and learn how fertility clinics can better serve clients, protect themselves financially, and safeguard their physicians' personal assets., Methods: The Nexis Uni database was used to review legal cases, news, and business publications of previous cases of embryo mix-ups. County and district courthouse dockets were also queried for filings and court documents related to lawsuits involving embryo mix-ups using Public Access to Court Electronic Records (PACER). Emphasis was placed on court decisions, awarded damages, and legal and media coverage related to embryo mix-up events., Results: A case law review of US legal databases and courthouse dockets was conducted for cases between 2000 and 2020, focusing on lawsuits against reproductive endocrinologists and in vitro fertilization (IVF) facilities offering embryo transfer (ET). Improper labeling and ineffective communication led to errors in the cases reviewed., Conclusion: It is prudent for clinics to protect themselves from embryo mix-ups, which can subsequently lead to undesirable clinical outcomes, as well as lawsuits stemming from these errors. This article emphasizes following labeling guidelines when storing embryos, employing a two-step read back method prior to ET, and offering genetic testing when a discrepancy is found in the record. In the case an embryo mix-up does occur, it is recommended to protect personal assets through business organizing procedures and consider settlement offers for policy limits.

Background: The reproductive health and Prevention of Mother-to-Child Transmission (PMTCT) of HIV programs in Iran were integrated as a pilot project in September 2014. This study aims to provide a comprehensive evaluation and analysis of the PMTCT of HIV program in Iran., Methods: The pilot phase of PMTCT of HIV was launched in early September 2014 in selected centers including 170 health centers and 40 hospitals affiliated to medical universities of 16 provinces of Iran. In each medical university, a researcher-made checklist was administered to all newly-diagnosed HIV-positive pregnant women by an AIDS expert. Data was analyzed using SPSS 19., Results: Overall, 69.4% of eligible pregnant women were enrolled in the pilot phase. From 134 reactive cases, 76 (56.7%) were confirmed as HIV positive. ARV consumption was irregular in 10 (13.2%) of HIV positive pregnant women. Also, 82.5% had CD4 count more than 350 after treatment, with an average of 55.5% increase in the number of CD4 in comparison to the baseline, and 84.8% had viral load suppression (< 200 copies/ml). Counseling and testing was done for the husbands of 75% of the women that resulted in the identification of 15 (39.5%) new HIV cases among husbands. Among the tested individuals, 23 (60.5%) males already knew their HIV status and were registered as HIV patients. HIV was diagnosed in one (1.5%) newborn., Conclusion: Implementation of rapid HIV testing and PMTCT in Iran is one of the strengths of the national HIV control program. To eliminate MTCT, it is necessary to understand and overcome the barriers and challenges to the program in the pilot phase.

Purpose: The aim of this study was to evaluate the efficacy of transvesical open prostatectomy (OP) compared with transurethral resection of the prostate (TURP) in patients with benign prostate hyperplasia (BPH) with a prostate weight of 40-65 grams. The short-term and long-term complications of these two procedures were also assessed., Materials and Methods: In this retrospective study, we included 160 consecutive patients with BPH who had undergone TURP (n=80) or OP surgery (n=80) from 2006 to 2017. Inclusion criteria were positive history of BPH, definite indication for prostatectomy, and prostate weight between 40 to 65 grams. Patients were evaluated for duration of hospitalization, need for re-operation, short-term and long-term postoperative complications, urinary flow rate, peak flow rate (Q max) and international prostate symptom score (IPSS)., Results: The mean age ± Standard Deviation (SD) of patients' age was 62.4 ± 3.7 and 67.2 ± 4.6 years in the TURP and OP groups, respectively. Four (5%) and seven (8.7%) patients required transfusion in the TURP group and OP groups, respectively. Dysuria was significantly more frequent in the TURP group from week two to 12 months after surgery as compared with the OP group (P < .001). Hemodynamic changes and decrease in serum sodium level were not reported in either group. However, the urinary retention and need for urinary catheterization in the first year was significantly different between the two groups with 10 cases (12.5%) in the TURP group and no cases in the OP group (P<0.001). The need for reoperation in the TURP group was reported (27 procedures on 19 patients) (33.7%) of patients. Furthermore, retrograde ejaculation (RE) was reported in 65 (81.2%) and 80 patients (100%) of the TURP and OP group, respectively., Conclusion: Despite the fact that TURP is the standard method of treatment for BPH when the prostate weighs between 40-65 grams, the results of our study showed that OP is a more efficient and safe surgery for these patients and is associated with less complications. Furthermore, the need for re-operation seems to be higher in patients with TURP.

Background: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16., Methods: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes., Results: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05)., Conclusions: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.

Background: This study aims to determine the prevalence of physical inactivity in Iranian adolescents aged 10-12 years and the impact of socioeconomic inequality on it., Methods: In this descriptive study, the study population consisted of 10-12 years old adolescents from an Iranian population from Kurdistan, Fars and Markazi provinces in 2018. The sample size was 1590 individuals. The sampling method was cluster sampling. Data was collected using demographic questionnaire, modifiable activity questionnaire (MAQ) and socioeconomic questionnaire. Cut points on the MAQ for light activity, moderate activity and heavy activity were MET< 3, MET = 3-6 and MET> 6, respectively. Linear and logistic regression were used to estimate the final model and the Oaxaca analysis method was applied. All analyses were performed in Stata/SE 14.0., Results: Of the 1590 participants, 52.82% were male. The results showed that 25.79% of the subjects were physically inactive and 7.30% engaged in moderate physical activity during the week. The average physical activity during 1 week was more in boys than in girls (P-value< 0.05). Adolescents of mothers with secondary and high school education were more likely to have physical inactivity than mothers with a high school diploma or higher (AOR: 1.35, 95% CI: 1.02-1.77). The concentration index was -.11, indicating a greater concentration of physical inactivity in adolescents with low socioeconomic levels., Conclusion: One-fourth of the study population had physical inactivity in this age group. Socioeconomic levels, parental literacy, and sex of adolescents were associated with the level of physical activity.

Assisted reproductive technologies allow women to achieve pregnancy at ages beyond the limits of their natural reproductive lifespans. As women seek pregnancy later in life, physicians are challenged with balancing their professional autonomy against patient autonomy. Increased parental age increases risk to mother and fetus. Legal aspects of postmenopausal women desiring fertility services will vary by location. Ethically, the principles of beneficence, nonmaleficence, and justice become important factors in a physician's evaluation process. This article aims to highlight current guidelines for postmenopausal women desiring fertility services and address medical, legal, and ethical concerns that may arise when assessing these patients.

Background: The rapid spread of COVID-19 virus from China to other countries and outbreaks of disease require an epidemiological analysis of the disease in the shortest time and an increased awareness of effective interventions. The purpose of this study was to estimate the COVID-19 epidemic in Iran based on the SIR model. The results of the analysis of the epidemiological data of Iran from January 22 to March 24, 2020 were investigated and prediction was made until April 15, 2020., Methods: By estimating the three parameters of time-dependent transmission rate, time-dependent recovery rate, and timedependent death rate from Covid-19 outbreak in China, and using the number of Covid-19 infections in Iran, we predicted the number of patients for the next month in Iran. Each of these parameters was estimated using GAM models. All analyses were conducted in R software using the mgcv package., Results: Based on our predictions of Iran about 29000 people will be infected from March 25 to April 15, 2020. On average, 1292 people with COVID-19 are expected to be infected daily in Iran. The epidemic peaks within 3 days (March 25 to March 27, 2020) and reaches its highest point on March 25, 2020 with 1715 infected cases., Conclusion: The most important point is to emphasize the timing of the epidemic peak, hospital readiness, government measures and public readiness to reduce social contact., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Purpose: With the invention of miniature devices, it has been advised to apply less aggressive methods for the management of upper urinary tract stones, especially in children. In the recent years, ultra-mini percutaneous nephrolithotomy (UMP) has been used for the treatment of upper urinary tract stones in order to perform surgeries with less complications and more acceptable outcomes. Results reported from different medical centers have been promising., Materials and Methods: Twenty-two children aged less than 8 years old with upper urinary stones sized between 10-20 mm underwent UMP. Inclusion criteria was solitary unilateral kidney stone, stone size between 10-20 mm, normal renal function tests, absence of any congenital malformations, and history of previous ESWL failure. Data including age, sex, side of kidney involvement, size of stone, location of stone, duration of surgery, duration of hospitalization, stone composition, need for blood transfusion, damage to adjacent organs, postoperative fever, septicemia after surgery, need for narcotics, further need for a complementary method, stone-free rate, pre and post-operative hemoglobin levels, and urinary leakage from the access tract were extracted from patients' medical files and were recorded., Results: The mean age (± standard deviation) of children was 5.22 (±1.57) years. Fourteen (63.6%) patients were male. Fifteen (68.2%) renal stones were located in the right kidney, and 82% of patients had pelvis stones. 13 (59%) patients' stones were composed of calcium oxalate. Stone-free rate was 95.5%. In none of the cases urinary leakage, septicemia after surgery, injury to adjacent organs, and need for blood transfusions was reported., Conclusion: Ultra-mini percutaneous nephrolithotomy is an efficient and safe method for treating urinary stones sized between 10-20 mm in children.

Background: There is a controversy about the association between vitamin D and cardiovascular diseases (CVDs). The effect of serum 25-OH-vitD on the risk of CVDs was evaluated., Methods: Major electronic databases including Scopus, Science Direct, and PubMed were searched. All prospective cohort studies on the relationship between vitamin D status and CVDs conducted between April 2000 and September 2017 were included, regardless language. The study participants were evaluated regardless of their age, sex, and ethnicity. The Newcastle-Ottawa Scale was used to assess the quality of the studies. Two investigators independently selected the studies and extracted the data. The designated effects were risk ratio (RR) and hazard ratio (HR). The random effects model was used to combine the results., Results: A meta-analysis of 25 studies with 10,099 cases of CVDs was performed. In general, a decrease in the level of vitamin D was associated with a higher relative risk of CVDs (incidence-mortality combined) (RR = 1.44, 95% CI: 1.24-1.69). This accounts for 54% of CVDs mortality rate (RR = 1.54, 95% CI: 1.29-1.84(. However, no significant relationship was observed between the vitamin D status and incidence of CVDs (RR = 1.18, 95% CI: 1-1.39). In general, low serum vitamin D level increased the risk of CVD by 44% (RR = 1.44, 95% CI: 1.24-1.69). It also increased the risk of CVD mortality (RR = 1.54, 95% CI: 1.29-1.84) and incidence rates (RR = 1.18, 95% CI: 1-1.39)., Conclusions: The findings showed that vitamin D deficiency increases the CVDs mortality rate. Due to the limited number of studies on patients of the both genders, further research is suggested to separately evaluate the effect of vitamin D status on CVD in men and women.

Background: Simultaneous occurrence of colorectal malignancy with pelvic kidney has been considered a rare phenomenon. A review of the related literature revealed three previous reports of rectal cancer and pelvice kidney., Case Presentation: This case report describe the case of 40-year-old Asian man with complaints of bleeding and a feeling of discomfort in his anus. A colonoscopy revealed a raised large multilobulated mass in his rectum. Multiple biopsies of the lesion were done after detecting a tumor in his rectum 4 cm above the dentate line; a diagnosis of rectal adenocarcinoma was made by pathological examinations. Subsequent investigations, carried out by computed tomography (CT) scans, incidentally showed an ectopic pelvic kidney. Because of the progress of the rectal cancer, our patient was a candidate for neoadjuvant radiotherapy. Six weeks after radiotherapy, he underwent total mesorectal excision (TME) surgery maintaining the ectopic kidney after using a coloanal anastomosis for additional curative surgery. A very low anterior resection surgery was performed to maintain the ectopic kidney. Thereafter, adjuvant chemotherapy was performed., Conclusions: Due to the proximity of the tumor to the pelvic viscera, especially the ectopic kidney, the probability of inadequate abscission of the lesion in surgery and radiotherapy, as well as complications and localized relapse were increased so that the kidney could be maintained. Carrying out careful pre-treatment examinations can result in maintaining an ectopic kidney and its daily conditioned function dependent on the status of the patient, including the proximity of the ectopic kidney to the tumor, anatomical position, and prior damage. The lesson learned from the present case is that radiotherapy and surgery are possible treatments in the presence of pelvic kidney and rectal cancer without incurring renal damage.

Introduction: Hypoglycemia in critically ill infants is a frequent metabolic disorder which is often due to defective glucose homeostasis. If not recognized annotated early, it can result in severe neurological damage with high mortality and morbidity. Today, glucometer is recommended for fast measuring blood glucose. The aim of this study was to evaluate the accuracy of glucometer for early diagnosis of hypoglycemia in the acutely ill infant., Materials and Methods: This study evaluates 130 critically ill infants less than 1year of age who were admitted to Besat hospital - Sanandaj - IRAN. Blood sugar was measured by standard serum method (glucose oxidase) and glucometer reagent strip., Results: The overall means of blood sugar were 115.6 ± 1.75 with serum method and 119.1 ± 1.56 with glucometer method. The rates of sensitivity, specificity, positive predictive value and negative predictive value with glucometer method and with serum glucose method were 72%, 53%, 62%, and 77% respectively. The correlation between the two methods was significant (p < 0.001). Kappa statistics for the two methods was 42%., Conclusions: The results showed that in general, glucometer may be appropriate for rapid screening in emergency situations and when frequent blood glucose monitoring is needed but it cannot be regarded as a very suitable and reliable tool for diagnosis of hypoglycemia in critically ill infants., (Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background: Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Thus, it is necessary to evaluate the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control and basic principles., Methods: This cross-sectional study recruited 106 dentists in Sanandaj, Iran. The dentists' KAP regarding hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV/AIDS were evaluated. Chi-square test, student's t-test, and one-way ANOVA were used to assess differences between the groups. Data were analyzed in Stata 12., Results: The results showed that the majority of the subjects in the study population (53.8%) were female. The mean ± standard deviation (SD) for age and work experience was 39.6 ± 9.80 and 10.6 ± 8.7 years, respectively. The mean ± SD for knowledge, attitude and practices of participants was 37.3 ± 3.01, 22.9 ± 4.80 and 24.07 ± 5.06, respectively. The results also indicated that dentists' higher level of knowledge about HBV, HCV and HIV/AIDS was significantly influenced by work experience (≥10 years; P < 0.001) and graduation year (after 2006: P < 0.001). Positive attitude towards HBV, HCV and HIV/AIDS was considerably influenced by age group (< 30 years: P = 0.021), work experience (≥10 years: P < 0.001), and workplace (dental office: P = 0.016)., Conclusions: The results of this study demonstrated a satisfactory level of knowledge and attitude of dentists about HBV, HCV and HIV/AIDS infections, but some gaps were observed, suggesting that higher knowledge level of dentists plays a very important role in forming the attitudes and practices regarding patients with HBV, HCV and HIV/AIDS.

Objective: To determine if ulnar length obtained by the bedside nurse can be used to estimate patient length. To compare our findings to previous predictive equations of height and ulnar length. To evaluate the performance of predictive equations for height and ulnar length on patients with syndromes that affect height. Design: Retrospective observational study of prospectively collected data. Settings: Multidisciplinary Pediatric Intensive Care Unit in a university teaching hospital. Patients: 1,177 patients, ages 1 month to 23 years. Mean age was 79.7 months (1,3 IQR 19.5, 164.5 months) and 55.4% male. Measurements: Ulnar length was obtained using digital calipers by bedside nurses in PICU as well as height and weight. The electronic health care record was used to extract patient information. Main Results: The predictive equation for height for the entire group is: height (cm) = 0.59 * ulnar length (mm) + 13.1 ( r 2 = 0.93). Bland Altman analysis of the derivation formula applied to the testing group did not show any systematic bias. Conclusions: Our study shows that ulnar length measurements can be used to predict height with a simple linear formula in a PICU setting. Not having specific individuals or specific training for ulnar measurement did not seem to alter the accuracy ( r 2 = 0.93). The robust nature of the measurement and ease of use may make this an unconventional but reasonable alternative to obtaining height when that cannot be measured directly.

Purpose: The association between hypercalciuria and febrile convulsion is controversial. The present study aimed to investigate the statistical association between hypercalciuria and childhood febrile convulsions., Methods: Overall, 160 children aged 6 months to 5 years, including 80 children with febrile convulsion and 80 febrile children without convulsion (comparison group), were recruited. All laboratory tests, including 24-hour urine calcium, were undertaken in an academic clinical laboratory., Results: Forty-five children of the febrile convulsion group (60%) and 30 of the comparison group (40%) had hypercalciuria. There was a significant difference between the 2 groups ( P =0.02)., Conclusion: Our results indicated that there is a statistical association between convulsion and hypercalciuria in children. Since we found this association with a cross-sectional assessment, further studies, especially prospective and controlled designs, are needed., Competing Interests: Conflicts of interest: No potential conflict of interest relevant to this article was reported.

Colorectal cancer (CRC) survival varies at individual and geographically level. This population-based study aimed to evaluating various factors affecting the survival rate of CRC patients in Kurdistan province.In a retrospective cohort study, patients diagnosed as CRC were collected through a population-based study from March 1, 2009 to 2014. The data were collected from Kurdistan's Cancer Registry database. Additional information and missing data were collected reference to patients' homes, medical records, and pathology reports. The CRC survival was calculated from the date of diagnosis to the date of cancer-specific death or the end of follow-up (cutoff date: October 2015). Kaplan-Meier method and log-rank test were used for the univariate analysis of survival in various subgroups. The proportional-hazard model Cox was also used in order to consider the effects of different factors on survival including age at diagnosis, place of residence, marital status, occupation, level of education, smoking, economic status, comorbidity, tumor stage, and tumor grade.A total number of 335 patients affected by CRC were assessed and the results showed that 1- and 5-year survival rate were 87% and 33%, respectively. According to the results of Cox's multivariate analysis, the following factors were significantly related to CRC survival: age at diagnosis (≥65 years old) (HR 2.08, 95% CI: 1.17-3.71), single patients (HR 1.62, 95% CI: 1.10-2.40), job (worker) (HR 2.09, 95% CI: 1.22-3.58), educational level: diploma or below (HR 0.61, 95% CI: 0.39-0.92), wealthy economic status (HR 0.51, 95% CI: 0.31-0.82), tumor grade in poorly differentiated (HR 2.25, 95% CI: 1.37-3.69), and undifferentiated/anaplastic grade (HR 2.90, 95% CI: 1.67-4.98).We found that factors such as low education, inappropriate socioeconomic status, and high tumor grade at the time of disease diagnosis were effective in the poor survival of CRC patients in Kurdistan province; this, which need more attention.

Objectives: A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks., Methods: An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method., Results: In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72)., Conclusions: Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Background: Although the national guidelines recommend special antibiotics, based on the antibiogram of National Reference Laboratory, it seems that, because of uncontrolled usage of antibiotics in the society and due to the changes in the serotypes causing the disease, it is essential to monitor the status of drug resistance, permanently, and to revise the current prescriptions guidelines., Objectives: This study aimed to assess the epidemiological aspects and drug resistance pattern of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, in cholera outbreak, in Alborz province in Iran, during 2011., Materials and Methods: This is a cross-sectional study, which reviews a cholera epidemic that occurred in Iran. A total of 9844 specimens were taken from suspected cases, among diarrheal patients, via rectal swabs. The specimens were placed in Cary-Blair transport medium and sent to laboratory. Samples were enriched, in alkaline peptone water, and isolated on thiosulphate-citrate-bile salt-sucrose agar. From the 244 confirmed cases, 239 cases underwent antibiogram test, via disk diffusion method and based on national committee for clinical laboratory standards (NCCLS) instructions. The standard Escherichia coli ATCC 25922 was used for antibiogram quality control and, eventually, all results were interpreted and reported using NCCLS standard table., Results: In total, until October 22, 2011, which was announced as the end of outbreak, 9844 samples were taken from diarrheal patients. Regarding the type of V. cholerae, 244 El Tor biotype positive cases were reported. The case fatality rate was 1.3%. The mean age of patients was 37.8 years and the highest incidence rate occurred in the age group 21 - 30 years. After conducting antibiotic susceptibility test in the 244 V. cholerae, biotype El Tor, serotype Ogawa, it was found that ciprofloxacin had the highest level of antibiotic susceptibility (99.6%) and the highest level of antibiotic resistance was observed in co-trimoxazole (95.4%)., Conclusions: The results of our study show that the resistances to doxycycline and tetracycline, which are mentioned in multiple resources, as the most common antibiotic drugs for treating cholera, are increasing.

Background: Bloodstream infection (BSI) is one of the most common causes of nosocomial infection in neonatal intensive care units (NICU). The aim of the present study was to determine bacterial agents and their susceptibility patterns to antibiotics and to investigate the risk factors associated with BSI., Methods: This was a nested case-control study carried out from September 2009 to June 2010 in the NICU wards in Sanandaj hospitals western Iran. Cases were patients with BSI and controls were other patients who had negative blood culture. Bacteriologic diagnosis and antibiotic susceptibility pattern was performed based on the Edward & Ewings and the National Committee of Clinical Laboratory (NCCL) Standards., Results: Of 472 patients who hospitalized in NICU, 6.4% had BSI (n = 30) including 17girls (56.7%) and 13 boys (43.3%). Enterobacter SPP was the predominant isolated bacteria from blood culture (36.7%). The maximum antibiotic resistance and sensitivity were observed by Tetracycline and Ciprofloxacin respectively. Risk factors associated with BSI were age ≤ 7 days (p = 0.001), previous antibiotic consumption (p = 0.013), and low birth weight (LBW), (p = 0.001)., Conclusions: Gram negative bacteria and Entrobacter in particular are the most common pathogens. Improving prenatal health care, standards of infection control and choosing accurate antibiotics are recommended to avoid BSI in neonatal intensive care units.