Search

Background: Gender dysphoria, characterized by a misalignment between one's gender identity and assigned sex, propels individuals towards medical interventions like gender reassignment surgery (GRS) to harmonize their bodies with their gender. This process aims to enhance overall quality of life (QoL), functioning, and body image. Recognizing the importance of cultivating a positive body image for transgender individuals navigating societal norms, this narrative highlights the ongoing debate surrounding QoL post-GRS. In response, our study is outlined, aiming to scrutinize QoL and self-image among transgender men post-GRS, offering valuable insights into societal perceptions and psychological well-being in this context. Method: This cross-sectional survey focused on transgender men aged 15 to 35 who underwent gender reassignment surgery (GRS) in 2018–2022 in Shiraz, Iran. Participants, after passing psychiatric evaluations, completed World Health Organization Quality of Life (WHOQOL-100) questionnaires pre- and at least one-year post-surgery. The scores of the Brief-WHOQOL questionnaire were evaluated in four domains of physical health, psychological health, social relationships, and environmental health. Results: A total of 60 individual who underwent GRS completed our questionnaire. The average age of the patients was 24.1 ± 3.8 years. Following GRS, the most increase was observed in the psychological factor (by 25.6%). The increase in score was statistically significant in all subgroups (P < 0.001) after operation. Urban living location had a significant association with higher increase in physical health (P < 0.010), psychological health (P = 0.005), and environmental health (P = 0.012) after GRS. In regards to physical health, the low socioeconomic group had a significantly less physical score improvement in QoL compared to the moderate group (P = 0.024) following GRS. In regards to environmental health, the high socioeconomic groups had significantly higher improvement in QoL compared to the low (P = 0.006) and moderate (P < 0.001) group after operation. Conclusion: The results demonstrate that GRS brings about improvements across all aspects of QoL. However, this enhancement is less pronounced among patients hailing from low socioeconomic backgrounds and rural areas. [ABSTRACT FROM AUTHOR]

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior knee pain, and kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the international knee documentation committee, knee injury and osteoarthritis out-come score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the scores using the international knee documentation committee, knee injury and osteoarthritis outcome score, and Lysholm score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ; therefore, patients can bear full weight if they tolerate it. [ABSTRACT FROM AUTHOR]

Background: In Iran, there is a lack of information and studies on acute rheumatic fever (ARF), a global health issue. The limited understanding of ARF's prevalence and primary clinical symptoms has led to confusion. This research investigates the characteristics of children aged 3-17 years who experience ARF with monoarthritis as their initial symptom. Methods: A retrospective evaluation of medical records of children diagnosed with ARF was conducted. The study aimed to determine the prevalence of monoarthritis as the first manifestation of ARF and its association with age, gender, family history, and cardiac involvement. Categorical variables were analyzed using the chi-square test with a significance level of < 0.05 and a confidence interval of 95%, using SPSS software (Version 23). Results: The study included 62 patients with ARF, comprising 41 (66.1%) boys with an average age of 8.48±3.27 years. Among these patients, 12 exhibited cardiac involvement according to the revised Jones criteria, with 5 clinical carditis and 7 cases of subclinical carditis. Monoarthritis was the initial symptom in seven patients (11.29%); five (71.4%) also had carditis. There was a significant association (p<0.001) between monoarthritis and carditis. Conclusion: The study concludes that monoarthritis may be an early sign of ARF in children and correlates significantly with cardiac involvement. However, more extensive research with more significant participant numbers is necessary to understand ARF in Iran comprehensively. A thorough cardiac examination is also crucial for patients with ARF and monoarthritis. [ABSTRACT FROM AUTHOR]

Background: Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults. Methods: This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05. Results: The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (β = 0.636, p < 0.001) and the intention (β = 0.322, p < 0.001) were important factors for subsequent doses of COVID-19 vaccine uptake in older adults. Conclusion: So, planning and implementing promotional intervention programs for older people (over 65; 80), females, illiterate, widows and divorced, good economic status, and urban areas is essential. It seems that enabling factors such as free vaccinations, vaccination inaccessible places such as public social security agencies, social supports such as involvement of the government and physicians, and improving information by the medium or knowledge-sharing experience, which can be further used to enhance the acceptance of subsequent doses of COVID-19 uptake in older adults. [ABSTRACT FROM AUTHOR]

Background: The Apolipoprotein E (ApoE) polymorphism plays an important role in the pathophysiology of end-stage renal disease (ESRD). Additionally, ApoE may contribute to the progression of oxidative stress. Thus, this study aimed to determine the ApoE gene polymorphism and evaluate the malondialdehyde (MDA) level in ESRD patients and healthy individuals. Methods: The present cross-sectional study was conducted at 2010 at Kermanshah University of Medical Sciences (Kermanshah, Iran). The study population comprised ESRD patients (n=136) and healthy individuals (n=137). The MDA level was assessed using high-performance liquid chromatography (HPLC), and the frequencies of ApoE gene alleles were analyzed using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). The data were analyzed using Statistical Package for Social Sciences (SPSS), version 13. The significant differences of ApoE genotypes in case and control groups were assessed using Pearson's Chi square tests, and two-tailed Student's tests. A logistic regression model was used to calculate the odd ratio. P<0.05 was considered statistically significant. Results: According to the results, ESRD patients had a higher frequency of the E2/E3 genotype than the healthy group (P<0.001). The results indicated that E3/E4 genotype frequency in the patients' group was higher than that of the control group (P=0.026). Furthermore, the E3/E2 (OR=5.7, 95% CI=2.68-12.14) (P<0.001) and E3/E4 (OR=1.57, 95% CI=1.05-2.34) (P=0.029) genotypes were found to increase the risk of ESRD. Moreover, the MDA level in ESRD patients was higher than the healthy individuals (P<0.001). The patients with E3/E2 (P<0.001) and E3/E4 (P<0.001) genotypes had a higher level of MDA than the control group. Conclusion: According to the findings, patients with ESRD had higher genotypes of E3/E2 and E3/E4, which suggests a higher risk of developing ESRD. [ABSTRACT FROM AUTHOR]

This study aims to analyze flood resilience (FR) in Karaj City, Iran, using a new fuzzy method which combines several qualitative and quantitative indices. The qualitative part was estimated by a questionnaire consisting of 42 questions distributed into five indices (social-cultural, economic, infrastructural-physical, organizational-institutional, and hydraulic). A fuzzy method was used for analyzing the results. To quantify the hydraulic index, a 25-year flood was simulated in the Storm Water Management Model and the flooding volume at every grid was estimated. The idea was that the flooding amount could be representative of structural FR of drainage network that cannot be evaluated through a questionnaire well. To calculate the FR of different districts, the obtained FR indices were fuzzified then aggregated. Considering that clustering can assist managers and decision makers for more effective flood risk management, a fuzzy equivalence matrix concept was used for clustering FR in the city. Friedman test showed the significance of differences between FR of every two districts. Based on the results, northwestern and southeastern districts had the highest and the lowest resilience, respectively. Although the impact of infrastructure-physical index on the FR was similar in most of the districts, the contribution of social-cultural, organizational-institutional, and hydraulic indices was significantly different. Also, districts with low scores in the infrastructure-physical, organizational-institutional, and hydraulic indices need more attention for flood risk management. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the incidence of rheumatoid arthritis (RA) flare-ups following immunization with the Sinopharm COVID-19 inactivated virus-based vaccine. Methods: We conducted a retrospective observational study at the Rheumatology Clinic of Imam Hossein Hospital, incorporating 200 RA patients in remission undergoing non-biologic Disease-Modifying Antirheumatic Drugs (DMARDs) treatments. A rheumatologist confirmed a flare-up based on patients complain of arthralgia and joint stiffness and complete examination of joints over a three-month period following vaccination. Results: Twelve percent of all included patients experienced symptom recurrence. The average age of patients with flare-ups was significantly higher, but no gender-based differences were observed (p<0.001 and p=0.071, respectively). The second vaccine dose resulted in a higher number of symptom flares compared to the first dose (9.30% vs. 3.0%, p < 0.001). No significant differences were observed between patients experiencing flare-ups after the first dose and the second dose in terms of the number of involved joints (p=0.321) and the time gap from vaccination to symptom recurrence (p=0.526). No patients required hospitalization, and prednisolone dosage adjustments effectively managed symptoms. Conclusion: The occurrence of flare-ups was relatively low after the Sinopharm COVID-19 vaccination in RA patients undergoing treatment with DMARDs during remission. The majority of these flares were mild and no hospitalizations were required. [ABSTRACT FROM AUTHOR]

Deep vein thrombosis (DVT) is a prevalent vascular disease characterized by pelvic and limb deep vein thrombophlebitis, and it has a high incidence in traumatic patients. Contrary to older studies, recent research has reported that recanalization in DVT is not a slow process. The present study aimed at the comparative examination of DVT recanalization with Doppler ultrasound in different intervals following treatment with heparin or enoxaparin. This prospective study was conducted on all traumatic patients hospitalized in Imam Reza Hospital of Kermanshah, Iran, with the clinical and sonographic diagnosis of DVT in limb veins. Doppler ultrasound was performed two weeks, one month, and three months following treatment in order to examine recanalization. Data were analyzed using statistical tests in SPSS16 at the significance level of <0.05. Based on Doppler ultrasound, a significant difference was found between the degree of recanalization in patients aged <45 years and those aged >45 years, between male and female patients, and between different DVT locations (P<0.05). After three months of treatment with heparin and enoxaparin, the degree of recanalization was increased in DVT. Moreover, it was found that Doppler ultrasound is a useful tool for the diagnosis of recanalization in patients with DVT. [ABSTRACT FROM AUTHOR]

Introduction: Rivers react to subsidence at their baseline by cutting and digging topographic features. The development of an upstream incision is often accompanied by a steep fracture called a river break (Loget & Van Den Driessche, 2009). The presence of river breaks in a geographical landscape is an indication of a steady-state in river systems. Therefore, the presence of knickpoints shows the system instability. The study of knickpoints can be used in the field of studies related to the evolution of valleys, identification of tectonic active areas and rock outcrops, river surface changes, erosion and sedimentation, and geomorphological changes in river systems. The basin studied in this study is located in the Qaleh Shahrokh-Chelgard area in the northeastern part of Chaharmahal and Bakhtiari province, Iran. The reason for selecting this basin is the extensive activities of the Zagros fault along the northwest-southeast and the existence of a hydrographic network affected by the trend of faults and the potential for knickpoints. Methodology: In this study, the locations of knickpoints were detected from the Radiometrically TerrainCorrected (RTC) model which is extracted from the active microwave sensor ALOS PALSAR with a spatial resolution of 12 meters (Logan et al., 2014) as input data to the MATLAB executive toolbox called Tec DEM. Tec DEM is an executable toolbox in MATLAB software and uses a Digital Elevation Model (DEM) as input for morphotectonics in the basin. Tec DEM tool can be used in a variety of fields in the analysis of surface anomalies, drainage network and surface dynamics of basins, production of base maps, incisions (local roughness), vertical dissection and drainage density of basins and sub-basins, determination of turning points or knickpoints, hypsometric analysis and slope and concavity index of canal profiles (Shahzad & Gloaguen, 2011). The determination of knickpoints according to the shape of the longitudinal profile of the river is done semi-automatically. In this study, these points in the study areas were investigated according to field observations. In this study, geological variables and geomorphic variables related to knickpoints were used to identify the knickpoints. Information layers including geology, distance from the fault, distance from the boundary of geological formations, surface roughness index, fractal dimension, base surfaces, local roughness, and the vertical dissection as predictor variables and the layers of knickpoints as the prediction variables were used for modeling. For geological and tectonic studies of the region, geological maps of 100,000 sheets of Chadegan and Fereydunshahr and 250,000 sheets of Shahrekord were used. A total of 8 raster layers were used to analyze and predict the possibility of the presence of a knickpoint in the study area. Since 8 layers have different units and are not suitable as direct input for logistic regression, the input parameters were normalized in the range of 0 to 1. Nominal layers, such as geological data, became sequential variables between 0 and 1. All of these layers were then resampled as a network format with a cell size of 195*195 m using the nearest neighbor method, to allow all layers to be combined. Then, a matrix of square cell structure was prepared for the study area. It consisted of a matrix of 273 rows and 273 columns representing a total of 39,650 cells. Of these, 74 cells were identified as knickpoint points. These areas were identified with code 1 (presence of knickpoint) and the rest of the cells that did not have knickpoints were recorded with code 0 (absence of knickpoint). Discussion: The probabilistic relationship of the presence of a knickpoint as one of the important results of the research was obtained by the logistic regression method. This relationship predicted the probability of the presence of knickpoints based on geological and geomorphic variables. The probability map of the knickpoints in the study area was obtained based on the statistical relationship. According to the results, there is a possibility of river knickpoints in the southwestern regions and parts of the northeastern Basin. The results of the probability ratio test to determine the statistical significance of each of the independent variables in the proposed model showed that the geology and the distance from the boundaries of the geological formations in the model were significant. The results of the Yuden index for the training dataset, validation, and test data were equal to 0.72, 0.76, and 0.66, respectively, which indicated the accurate information on the probability status of knickpoint points, especially for the test data of the model. The results of the Kappa agreement coefficient for training, validation, and test data were also equal to 0.62, 0.73, and 0.60, respectively, which indicated the agreement of both methods with the observed values of knickpoints. Conclusion: The results of this study showed that at the boundary of lithology, because of the presence of joints and cracks due to differences in the type of rocks, the probability of the presence of river break was more than other parts of the region. Although the presence of some relatively high slope knickpoints indicated active tectonics in that area, in the present study, the effect of the fault system or active tectonics in the formation of knickpoints was not statistically significant. Particularly, the reduction of local roughness index and baselines was associated with less tectonic activity, but in this study, the appearance of knickpoints has been associated with a decrease in these two factors. [ABSTRACT FROM AUTHOR]

Context: Preventive orthodontic treatments are performed in the primary or mixed dentition period and provide a proper development of occlusion to avoid dentofacial anomalies.Aims: This study aims to evaluate the Baby-Risk of Malocclusion Assessment Index (ROMA) index regarding ease of use, reproducibility, and the epidemiological assessment of major orthodontic problems in children aged 4-6-year-old in Kerman (Iran) kindergartens.Setting and Design: This cross-sectional study was conducted on 1000 children aged 4-6 in Kerman (Iran) kindergartens, selected by cluster sampling, and data were collected using the Baby-ROMA index.Methods: After recording a demographic data collection form, the clinical examination of the teeth was carried out by a dental student. The data were analyzed with SPSS 18 using t-test, analysis of variance, Chi-squared test, and Mann-Whitney test at a significance level of P < 0.05.Results: In this study, the most common cause of malocclusion was dental caries (7.5%), followed by crossbite (6.1%). Furthermore, 31.6% of the subjects had one type of malocclusion, and 20.5% needed monitoring the occlusion before the growth spurt, while 11.1% needed immediate orthodontic treatment (mostly 6-year-old children). Moreover, 15.3% of the subjects had systemic problems; 3.4% had craniofacial, 22% had dental, and 2% had functional problems. The prevalence of class I canine relationship in the right canines was 82.32%, with 82.5% on the left side. The prevalence of open bite was higher in females with thumb-sucking habit.Conclusion: The Baby-ROMA index presented good reliability and ease of use for evaluating early orthodontic treatment needs in primary and mixed dentition periods. [ABSTRACT FROM AUTHOR]

Traffic congestion in urban areas is a challenging issue in transportation planning. Policy options have been proposed to evaluate the impacts of interventional action through change detection or before–after studies. In this research, low-cost traffic image data collected by smartphone-based application have been employed and the impact of new congestion charging scheme (CCS) upon congestion within congestion charging zone (CCZ) as well as the entire network in Tehran, the capital of Iran has been investigated. Applying statistical tests indicated the significance of change in congestion within CCZ by applying the new CCS. Differential Moran's I as spatial autocorrelation index specified the spatial patterns of congestion between the critical time of changing the scheme on weekdays (17:00–19:00) and weekend (6:00–13:00) after implementing the new CCS. The approach in this paper can be used with a low-cost appropriate instrument to monitor the probable change in traffic congestion by introducing any new scheme or sudden change. [ABSTRACT FROM AUTHOR]

Background: Nurses play a key role in providing patient safety. It is known that patient safety requires the improvement of patient safety culture, which can be a difficult process. One of the current challenges of hospitals is to explore the ways to improve patient safety culture. Organizational citizenship behaviors are one of the factors, which can develop organizational culture including safety culture; however, its role is not well established. Methods: In this cross-sectional study, a stratified random sample of 214 nurses was selected from a largest teaching hospital in west of Iran. The institutional research board approved the study protocol. Data were collected using three self-report questionnaires: demographic information; hospital survey on patient safety culture (HSPSC); and organizational citizenship behaviors questionnaire. Data were analyzed using Spearman's correlation coefficient test in SPSS (α < 0.05). Results: Organizational citizenship behaviors were found to be at an intermediate level (56.84 ± 16.22). However, some of its dimensions, including sportsmanship, civic virtue, and courtesy, were at weak levels (< 50%). The mean percentage of positive responses to the patient safety culture was 49.00 ± 14.01. The patient safety culture had significant positive correlations with organizational citizenship behaviors (r = 0.349, P = 0.001) and dimensions of altruism (r = 0.255, P = 0.001), civic virtue (r = 0.434, P = 0.001), and courtesy (r = 0.214, P = 0.001). Conclusion: Our findings proposed the hypothesis that OCB has a statistical significant impact on PSC. Low levels of civic virtue, sportsmanship and courtesy behaviors may be indicative low nurses' interest in participating in organizational affairs and nurses' low attention to measures that prevent harm to their organization. It is recommended that nursing managers focus more on these dimensions, identifying influintioal factors and taking appropriate management measures to promote these behaviors. If our findings are confirmed in future studies, nursing managers can consider the development of organizational citizenship behaviors as one of the managerial approaches for promoting a patient safety culture. [ABSTRACT FROM AUTHOR]

Objectives: Upper crossed syndrome (UCS) can exert adverse effects on rehabilitation after a coronary artery bypass graft (CABG). Hence, the present study aimed to investigate the effects of stretching exercises on UCS in women undergoing CABG. Materials and Methods: The present quasi-experimental study was carried out on 30 women in Shahid Madani hospital of Tabriz, Iran. According to a similar study, the participants were selected through a convenience sampling method and randomly assigned to two groups of A and B. Those in group A participated in an 8-week intervention of stretching exercises (3 sessions per week) in accordance with the existing protocol. The data were statistically analyzed using analysis of covariance, the dependent t test, and the Wilcoxon test at the significance level of 0.05. Results: The results indicated a significant difference between the two groups in terms of kyphosis angle (P=0.001) and forward head angle (P=0.019) after the intervention. The data analysis also showed that stretching exercises had no significant effect on the improvement of angles of left and right shoulders (P=0.109 and P=0.111) respectively. Conclusions: The study findings suggest that corrective and stretching exercises might improve head forward posture and kyphosis angle, but do not affect shoulder angle. [ABSTRACT FROM AUTHOR]

Background Cutaneous Leishmaniasis (CL) is an important infection with a high incidence rate. The spatiotemporal dynamics of this disease is mainly determined by three main components of parasite, reservoir and vector. Climatic factors can significantly affect its incidence through their impact on these components. Materials and Methods: The present study aimed to assess the effects of climatic changes on the incidence rate of CL in Mashad, Iran. To this end, first different phases of drought were identified through Standard Precipitation Index (SPI). Then the relationship between the incidence of CL and these phases was analyzed with non-parametric Kruskal-Wallis test and Dunn-Bonferroni test at a significance level of 95%. Results: The results of the non-parametric Kruskal-Wallis test on the incidence of CL in the three phases of drought showed a significant relationship between them. Dunn-Bonferroni test showed that the incidence of CL was significantly higher during the years with severe drought as compared to years with normal rainfall. The significant increase in the mean incidence of CL during severe drought can be attributed to limited food sources available to the vectors, which are mostly rodents. Conclusion: Scarcity of food sources during drought makes rodents, as the main vector of the disease, to seek food and be more exposed to sandflies. That is how the incidence of CL increases. [ABSTRACT FROM AUTHOR]

Mobile applications are increasingly presented by service providers to fulfill the users’ tendency for mobility and access to services from anywhere and anytime; thereby, service platforms and a long range of tasks from banking to gaming are enabled by this technology. Although different companies offer a growing number of mobile services for potential users, only a few of them become popular and are perceived to be useful from the users’ viewpoint. The purpose of this research is to investigate the factors, which directly or indirectly influence mobile applications’ adoption by users. In other words, this study investigates the decision making process of users considering different factors such as subjective norms, attitude, perception and quality. Employing analytical approach in the literature review led to the development of a comprehensive model covering influential factors from different theories such as TPB and TAM as well as system quality, information and service quality approach. Incidentally, 39 hypotheses were developed and classified into nine different groups based on the originated theories. The model and hypotheses were tested by a sample of 1348 potential mobile application users in Iran and the data were analyzed through structural equation modeling techniques. Different internal and external variables were investigated, among which the effect of satisfaction on intention to recommend, the trace of trust on subjective norms and the influence of perceived ease of use on perceived behavioral control were more potent. In addition to offering a few suggestions for mobile application providers and marketers, this research proposes an integrated model of influential variables from different perspectives for scholars. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of couples are infertile with the male factor explaining approximately 50% of the cases. One of the main genetic factors playing a role in male infertility is Y chromosomal microdeletions within the proximal long arm of the Y chromosome (Yq11), named the azoospermia factor (AZF) region. Recent studies have shown there is a potential connection between deletions of the AZF region and recurrent pregnancy loss (RPL). The aim of this study is to examine this association by characterizing AZF microdeletions in two infertile groups: in men with non-obstructive infertility and in men with wives displaying RPL. Materials and Methods: In this is a case-control study, genomic DNA was extracted from 80 male samples including 40 non-obstructive infertile men, 20 males from couples with RPL and 20 fertile males as controls. Multiplex polymerase chain reaction was used to amplify 19 sequence tagged sites (STS) to detect AZF microdeletions. Differences between the case and control groups were evaluated by two-tailed unpaired t test. P<0.05 were considered statistically significant. Results: Only one subject was detected to have Y chromosome microdeletions in SY254, SY157 and SY255 among the 40 men with non-obstructive infertility. No microdeletion was detected in the males with wives displaying RPL and in 20 control males. Y chromosome microdeletion was neither significantly associated with non-obstructive infertility (P=0.48) nor with recurrent pregnancy loss. Conclusion: Performing Testing for Y chromosome microdeletions in men with non-obstructive infertility and couples with RPL remains inconclusive in this study. [ABSTRACT FROM AUTHOR]

Context: Diminished hip-abductor strength has been suggested to increase the risk of noncontact lateral ankle sprains. Objective: To determine prospectively whether baseline hip-abductor strength predicts future noncontact lateral ankle sprains in competitive male soccer players. Design: Prospective cohort study. Setting: Athletic training facilities and various athletic fields. Patients or Other Participants: Two hundred ten competitive male soccer players. Main Outcome Measure(s): Before the start of the sport season, isometric hip-abductor strength was measured bilaterally using a handheld dynamometer. Any previous history of ankle sprain, body mass index, age, height, and weight were documented. During the sport season (30 weeks), ankle injury status was recorded by team medical providers. Injured athletes were further classified based on the mechanism of injury. Only data from injured athletes who sustained noncontact lateral ankle sprains were used for analysis. Postseason, logistic regression was used to determine whether baseline hip strength predicted future noncontact lateral ankle sprains. A receiver operating characteristic curve was constructed for hip strength to determine the cutoff value for distinguishing between high-risk and low-risk outcomes. Results: A total of 25 noncontact lateral ankle sprains were confirmed, for an overall annual incidence of 11.9%. Baseline hip-abductor strength was lower in injured players than in uninjured players (P = .008). Logistic regression indicated that impaired hip-abductor strength increased the future injury risk (odds ratio = 1.10 [95% confidence interval = 1.02, 1.18], P = .010). The strength cutoff to define high risk was -33.8% body weight, as determined by receiver operating characteristic curve analysis. For athletes classified as high risk, the probability of injury increased from 11.9% to 26.7%. Conclusions: Reduced isometric hip-abductor strength predisposed competitive male soccer players to noncontact lateral ankle sprains. [ABSTRACT FROM AUTHOR]

Background: Iran and its neighboring countries represent four world regions with unique cultures and geography. Skin diseases span a wide diversity of etiologies including infectious, inflammatory, autoimmune, vascular, neurogenic, and oncologic. The Global Burden of Disease Study (GBD) 2015 measures the burden from skin diseases in 195 countries. Methods: Epidemiologic data were collected from literature review, survey data, and hospital inpatient/outpatient claims data. These raw data entered modeling using a Bayesian meta-regression tool, DisMod MR-2.1, which yielded prevalence estimates by age/sex/location/ year. Prevalence estimateswere combined with disability weights to yield years lived with disability (YLDs). YLDs are combined with years of life lost (YLLs), from mortality estimates, to yield disability-adjusted life years (DALYs). DALYs were obtained for 16 skin conditions and both sexes in Iran and 15 surrounding countries. The sociodemographic index (SDI) for each country was also correlated with skin disease DALY rate using the Pearson coefficient (r) with two-tailed p-value. Results: There was no significant correlation between individual skin diseases and SDI. Acne and dermatitis caused the greatest burden and BCC the lowestburden ofskin diseases in Iran and the other15countries. SCC and BCCwere responsible forthe largestdiscrepancy by sex, with higher burden in males compared to females. Conclusion: Skin diseases, particularly dermatitis and acne, cause considerable burden in Iran and surrounding regions. Objective and transparentepidemiologic data such asGBD hasthe potential to inform and impactmanyfacetsofhealthcare, research prioritization, public policy, and international partnerships. [ABSTRACT FROM AUTHOR]

Background: Tooth extraction causes an open wound in the soft and hard tissues. During the inflammatory phase of the healing process, a large amount of free radicals are produced and cause oxidative stress, which leads to tissue damage and delayed wound healing. Thus, in this study, we evaluated the effect of tert-butylhydroquinone (TBHQ), as an antioxidant, on the healing process of tooth sockets in rats. Materials and Methods: To conduct this experimental study, male Wistar rats (n = 42) were divided into two groups. In each case, one upper second molar was extracted under general anesthesia. After the extraction, the tooth sockets of the experimental group were treated with a 0.02% TBHQ solution (0.1 ml) while the same volume of distilled water placed in the sockets of the control group. On days 3, 7, and 21 postoperatively, 7 rats from each group were euthanized, and histological slides were prepared from their tooth sockets. The prepared slides were examined histopathologically using a light microscope and compared using an independent two-sample t-test. The significance level was set at 0.05. Results: In the experimental group, a statistically significant (P = 0.003) increase in granulation tissue was observed on day 3, in comparison to the control group. The extent of bony trabeculation was also significantly higher in the TBHQ-treated group than in the control group on day 21 (P < 0.001). Conclusion: Considering the limitations of an experimental study, it can be concluded that TBHQ may enhance the healing of the hard tissue in the tooth sockets. [ABSTRACT FROM AUTHOR]

Objective: Drug Craving could be defined as a subjective motivational state associated with a strong desire to consume drugs. Craving is a subjective phenomenon; therefore, self-report (subjective) craving measures are usually referenced. Two well-known questionnaires for measurement of drug craving severity are Desire for Drug Questionnaire or DDQ (for instant craving) and Obsessive Compulsive Drug Use Scale or OCDUS [for craving in a period of time (periodic craving), usually one week]. In this study, we evaluated the content-related validity of these questionnaires for Persian-language speaking crystalline-heroin abusers. Methods: After translation by two different groups, back translation and retranslation process of the DDQ and OCDUS questionnaires were achieved by an expert team in English language; we used them for evaluation of instant and periodic craving among 131 male crystalline-heroin abusers. Then, both DDQ and OCDUS questionnaire's scores were subjected to an exploratory principal components factor analysis (PCA). The criterion for factor extraction was an eigenvalue equal to or more than 1. Results: The factor analysis of DDQ and OCDUS led to three factors for DDQ and four factors for OCDUS; each group of factors together explained 62% and 65% of the common factor variance, respectively. There was no significant correlation between different DDQ and OCDUS components and demographic factors. Nevertheless, approximately all of the seven OCDUS and DDQ components were significantly correlated to each other. Conclusion : The Persian version of DDQ and OCDUS questionnaires could be considered as valid and reliable instruments for evaluation of drug craving in male crystalline-heroin Persian-language speaking abusers. [ABSTRACT FROM AUTHOR]

Background: Neuropsychological manifestations are present in 60% of patients with Systemic Lupus Erythematosus (SLE) among which cognitive dysfunction is the most common. This study aims to determine the prevalence of cognitive disorders in SLE patients, and the relationship between cognitive disorder domains and depression and anxiety. Methods: In this cross-sectional study, 54 patients with SLE and 48 healthy subjects were included. Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and Trail Making Test part A (TMT-A) were used to screen for cognitive impairments. All subjects were evaluated with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) to determine depression and anxiety as probable confounding variables. Results: The mean MMSE scores in SLE and control group patients (26.12 ± 3.58 and 28.01 ± 1.99, respectively) were significantly different (P = 0.001). The sub-scores in all areas assessed with MMSE were lower in SLE patients; however, it was only significant in the areas of orientation, recall and language (P < 0.05). SLE patients showed a significantly poorer performance in TMT compared to healthy controls (P= 0.01). The CDT according to the Watson scoring system showed significant difference between the two groups (P= 0.03). The Sunderland scoring system also indicated poorer performance in the SLE group, but the difference was not significant. Conclusion: Our study showed that cognitive disorders are more than 3-fold higher in SLE patients compared to normal subjects. The most impaired domains include orientation, Memory (recall), Language, Executive function, and psychomotor speed. Anxiety and depression are mostly correlated with domains included in the MMSE test. [ABSTRACT FROM AUTHOR]

Introduction: Current evidence is inconsistent about the association between dietary protein intake and risk of pancreatic cancer (PC). The aim of this study was to evaluate the association between total intake of major dietary protein sources and risk of PC in a large prospective study in Golestan Cohort Study (GCS). Methods: We examined the association of total intake of major dietary protein sources with risk of PC in the 50,045 participants (20,855 men and 28,255 women) of the GCS in northeastern Iran. Participants were aged 40 and older at baseline and actively followed from 2004 to the present time. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire that was administered at baseline. Cox proportional hazards models were used to estimate Multivariable hazard ratios with 95% confidence intervals (Cl). Results: During 383,630 person-years of follow-up, 54 cases of pancreatic cancer were ascertained. There was only a statistically significant inverse association between risk of PC for the second versus lowest fertile of plant based protein intake in the first and multivariable models (HR95%,27. = Cl = .12-64, HR = .28, 95% Cl = .12 -.65 respectively); however, this association was not significant anymore when comparing the highest fertile with the lowest one, in the first and multivariable models (HR = .49, 95% Cl = .19-1.24, HR = .52, 95% Cl = .20-1.34 respectively). Conclusion: In this large prospective cohort, we did not observe any clear and consistent evidence for an association between main dietary protein intakes and the risk of PC. Examining the method of cooking is recommended in future studies. [ABSTRACT FROM AUTHOR]

We analyzed spatial and temporal patterns in temperature extremes from 31 stations located throughout Iran for the period 1961 to 2010. As with many other parts of the globe, we found that the number of days (a) with high maximum temperatures was rising, (b) with high minimum temperatures was rising, and (c) with low minimum temperatures was declining; all of these trends were statistically significant at the 0.05 level of confidence. Population records from 1956 to 2011 at the station locations allowed us to reveal that the rate of human population growth was positively related to the increase in the number of days with high maximum temperatures and negatively related to days with low maximum temperatures. Our research shows a number of identifiable anthropogenic signals in the temperature records from Iran, but unlike most other studies, the signals are stronger with indices related to maximum, not minimum, temperatures. [ABSTRACT FROM AUTHOR]

Background: Because of the increasing usage of waterpipe globally, we need to know more about the different factors related to waterpipe and cigarette smoking. Therefore, the present study aims at gaining more insight on waterpipe and cigarette smoking based on perceived parental reaction and appeal and repellent of smoking among adolescents. Materials and Methods: A cross-sectional survey entitled "Isfahan Tobacco Use Prevention Program" (ITUPP) was conducted among 5,500 adolescents in Isfahan Province, Iran in 2010 using a self-administered anonymous questionnaire. Demographic factors, cigarette and waterpipe smoking status, appeal and repellent of smoking, perceived parental reactions, and the main reasons behind the increase in waterpipe smoking were measured. Chi-square, univariate logistic regression, and multiple logistic regression were used. For all analyses, we defined statistical significance a priori with a two-tailed alpha of 0.05. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 15. Results: 50% of the sample was female and 89% lived in urban areas. The average age of the respondents was 14.37 ± 1. 70 years. While a majority of cigarette smokers (70.9%) were waterpipe smokers, only 35.7% of waterpipe smokers smoked cigarettes. The incidence of smoking was high in those who expected less extensive parental reaction with odds ratio (OR) = 1.89 [95% confidence interval (CI): 1.35-2.63] (P < 0.001) among cigarette smokers and OR = 2.75 (95% CI: 2.16-3.50) (P < 0.001) among waterpipe smokers. "Taste" was rated the most attractive feature by waterpipe and cigarette smokers 2.83-fold (95% CI: 2.06, 3.90) (P < 0.001). Most waterpipe smokers compared to nonsmokers believed that the main reason behind waterpipe popularity was habit. Conclusion: The factors related to waterpipe smoking were different from those in cigarette smoking; so we need to implement different interventions to overcome the surging usage of tobacco use. [ABSTRACT FROM AUTHOR]

Background: Studies have shown controversial effects of obesity on major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). We sought to investigate the impact of the body mass index (BMI) on the mid-term outcome following successful PCI. Methods: Between March 2006 and August 2008, 3948 patients underwent successful elective PCI in Tehran Heart Center, Tehran, Iran, and were retrospectively included in this study. Patients who underwent PCI on the same day as the occurrence of myocardial infarction were excluded. The demographic, procedural, in-hospital, and follow-up information of these patients was extracted from the PCI Data Registry of our institution. The patients were divided into three groups: normal weight (No. 1058, BMI < 25 kg/m2 age = 58 ± 10 years); overweight (No. 1867, 25 ≤ BMI < 30 kg/m2, age = 57 ± 10 years); and obese (No. 1023, BMI ≥ 30 kg/m2, age = 56 ± 10 years). MACE included death, myocardial infarction, target vessel revascularization, and target lesion revascularization. Results: Compared with the other patients, the obese individuals were significantly younger and more frequently female, had a higher ejection fraction, and more frequently presented with hypertension, diabetes, and hyperlipidemia. There was no association between the BMI and the angiographic and procedural findings in the univariate analysis. While no difference was found in the rate of in-hospital death between the groups, the number of the obese patients undergoing emergent cardiac surgery was marginally different in the univariate analysis (p value = 0.06). At 9 months' follow-up, MACE had occurred in 92 (2.3%) patients and cardiac mortality was 9 (0.2%). After adjustments for confounders, no significant difference was observed in terms of MACE between the BMI groups. Conclusion: The BMI had no significant effect on the rate of MACE at 9 months' follow-up in our study population. Interventionists' recommendations for patients undergoing PCI should, therefore, not be significantly influenced by the BMI status. [ABSTRACT FROM AUTHOR]

The interaction of genetic and dietary factors, as an area of CVD research, has been explored poorly. The aim of the present study was to examine the interaction of dietary patterns and three genetic variants of APOA1 and APOC3, both independently and in combination, relative to the risk of the metabolic syndrome (MetS) in Tehranian adults. In the present matched, nested case–control study, 414 subjects with the MetS and 414 controls were selected from the participants of the Tehran Lipid and Glucose Study. Dietary patterns were determined by factor analysis. APOC3 (rs5128 3238C>G) and APOA1 (rs670, − 75G>A and rs5069,+83C>T) SNP were genotyped by the conventional PCR followed by the restriction fragment length polymorphism technique. Overall, three major dietary patterns were extracted: healthy dietary pattern (HDP); Western dietary pattern (WDP); fat–sweet dietary pattern (FSDP). The A and T allele carriers of the APOA1 SNP had a greater risk of developing the MetS in the highest quartile of WDP scores (OR 3·22, 95 % CI 1·21, 8·58, Pinteraction= 0·03). Compared with other genotype combinations, the combined effect of APOC3/APOA1 (CC/GA+AA/CT+TT) genotypes showed a further increase in the risk of the MetS in the highest quartile of WDP scores (OR 1, 2·49, 8·73, 6·32, Ptrend< 0·001, Pinteraction= 0·003). A significant interaction was found between the quartiles of FSDP scores and the APOA1 diplotype (GA+AA/CT+TT). OR for these genotype carriers were 1, 0·65, 0·57 and 0·22 (Ptrend= 0·006) in the lowest to the highest quartile of FSDP scores when compared with the other combined genotypes (Pinteraction= 0·03). Our findings suggest that the WDP and FSDP are associated with APOA1 and APOC3 SNP in relation to the risk of the MetS. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Pseudomonas aeruginosa is one of the most common nosocomial pathogens with high mortality rates. Organisms such as Pseudomonas aeruginosa have the ability to develop high level MDR (Multi drug resistance). The MexAB-OprM system is one of the largest multi-drug resistant efflux pumps with high levels of expression and the first finding of the RND (Resistance-nodulation-division) family in P. aeruginosa. AIM: For better understanding of the antibiotic resistance mechanism in P. aeruginosa, this study was conducted to determine the expression of the genes encoding these efflux pumps in 100 strains of P. aeruginosa isolated from patients admitted to various hospitals in Hamadan using quantitative Real-Time PCR (qRT-PCR). METHODS: This study examined 100 strains of P. aeruginosa isolated from patients admitted to various hospitals in Hamadan. Then, 31 samples were selected based on collected specimen type and their antibiotic susceptibility pattern; i.e., the samples with reduced susceptibility to antibiotics, particularly carbapenems. Antibiotic disk diffusion method was performed for aminoglycoside, quinolone and carbapenem. Furthermore, MIC method was performed for ciprofloxacin, gentamicin and imipenem. Finally, qRT-PCR was used for determining the efflux pump genes expression. RESULTS: Among eight selected antibiotics, the greatest resistance was to levofloxacin (61.2%, n = 19) and the lowest one to imipenem (9.6%, n = 3). All isolates (100%, n = 31) exhibited efflux pump MexAB-OprM genes but different expression was observed in different strains. The result of gene expression indicated that significant differences in expression of MexR (P value = 0.003), OprD (P value < 0.001), and MexB (P value = 0.026) genes. In addition, there was high level of MexR gene expression in bacteria that leads to reduced expression of MexA, MexB, and OprM. The OprD gene was presented in all strains but different expression has been observed. CONCLUSION: Identifying the bacterial resistance mechanisms is very complicated. Although efflux pump MexAB-OprM plays an important role in antibiotic resistance in P. aeruginosa, because of acting the efflux pumps on antibiotics in a non-specific manner, it is elusive to consider or describe an antibiotic resistance based on the presence or absence of an efflux pump. [ABSTRACT FROM AUTHOR]

BACKGROUND: Polymorphism of CYP2C19 gene is one of the important factors in pharmacokinetics of CYP2C19 substrates. Omeprazole is a proton pump inhibitor which is mainly metabolized by cytochrome P450 2C19 (CYP2C19). The aim of present study was to assess omeprazole hydroxylation index as a measure of CYP2C19 activity considering new variant allele (CYP2C19*17) in Iranian population and also to see if this activity is sex dependent. METHODS: One hundred and eighty healthy unrelated Iranian individuals attended in this study. Blood samples for genotyping and phenotyping were collected 3 hours after administration of 20 mg omeprazole orally. Genotyping of 2C19 variant alleles *2, *3 and *17 was performed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and semi-nested PCR methods. Plasma concentrations of omeprazole and hydroxyomeprazole were determined by high performance liquid chromatography (HPLC) technique and hydxroxylation index (HI) (omeprazole/ hydroxyomeprazole) was calculated. RESULTS: The CYP2C19*17 was the most common variant allele in the studied population (21.6%). Genotype frequencies of CYP2C19*17*17, *1*17, and *2*17 were 5.5%, 28.8% and 3.3% respectively. The lowest and the highest median omeprazole HI was observed in *17*17 and *2*2 genotypes respectively (0.36 vs. 13.09). The median HI of omeprazole in subjects homozygous for CYP2C19*1 was 2.16-fold higher than individuals homozygous for CYP2C19*17 (P < 0.001) and the median HI of CYP2C19*1*17 genotype was 1.98-fold higher than CYP2C19 *17*17 subjects (P < 0.001). However, subjects with CYP2C19*2*17 (median HI: 1.74) and CYP2C19*1*2 (median HI: 1.98) genotypes and also CYP2C19*1*17 (median HI: 0.71) and CYP2C19*1*1 (mean HI: 0.78) did not show any significantly different enzyme activity. In addition, no statistically significant difference was found between women and men in distribution of CYP2C19 genotypes. Furthermore, the hydroxylation index of Omeprazole was not different between women and men in the studied population. CONCLUSION: Our data point out the importance of CYP2C19*2 and CYP2C19*17 variant alleles in metabolism of omeprazole and therefore CYP2C19 activity. Regarding the high frequency of CYP2C19*17 in Iranian population, the importance of this new variant allele in metabolism of CYP2C19 substrates shall be considered. [ABSTRACT FROM AUTHOR]

Objective: Sleep complaints are common among Iranian chemically-injured veterans. The growing body of research has investigated (in) equalities between such subjective complaints and objective sleep records. Moreover, sleep complaints are associated with depressive symptoms. Depressive symptoms, also, have been frequently reported in chemically-injured veterans. Therefore, the purpose of this pilot study was to investigate the relationship between perceived sleep quality, polysomnographic measures and depressive symptoms in Iranian veterans with chemical injuries. Methods: In this pilot study, 35 Iranian veterans with chemical injuries complaining of a sleep problem were selected. Initially, participants were evaluated via all-night polysomnography, then, they completed the research questionnaires. Collected data were analyzed using Pearson correlation coefficients. Results: Data analyses showed that there was no significant correlation between many of self-reposted variables and polysomnogaphic recordings, however, remarkable relationships were found between the Pittsburgh Sleep Quality Index and the Beck Depression Inventory scores. Conclusion: The findings indicated that sleep complaints of chemically-injured veterans are not equivalent to objective sleep disturbances, however, these complaints are largely associated with level of depression. This study emphasizes the important role of mood in sleep evaluation. Further, the findings suggest using a combination of both subjective and objective measures for accurate assessment of sleep quality in Iranian veterans with chemical injuries (i.e., multimethod approach). [ABSTRACT FROM AUTHOR]

The article cites a study which surveyed the causes and results of eye removal surgery in Yazd, Iran. The study reviewed the profile of 102 patients who had underwent eye removal surgery in the Shahid Sadoughi hospital during the last 10 years. The study found that the two most common causes of eye enucleation were trauma and painful blin eye.

Background: The study of the association between genotype and phenotype is of great importance for the prediction of many diseases and pathophysiological conditions. The relationship between angiotensin-converting enzyme (ACE) gene insertion/ deletion (I/D) polymorphism and pathological processes such as coronary artery disease (CAD) has been investigated previously with discordant results. This study was designed to determine the association between ACE gene I/D polymorphism and CAD in an Iranian population. Methods: A total of 1050 individuals who were referred to Tehran Heart Center for coronary angiography were recruited. Six hundred seventy-six CAD-positive patients (documented by coronary angiography and Gensini scores higher than 6) and 374 CAD-negative patients were evaluated for ACE gene I/D polymorphism via the Polymerase Chain Reaction Amplification method. The patients' age, sex, smoking status and its duration as well as familial history of CAD, hypertension, and diabetes mellitus were recorded. Results: Five hundred four (74.6%) of the CAD-positive patients were male, and the mean age of this group was 60 (60 ± 10). In the CAD-negative individuals, the mean age was 56 (56 ± 10) and 196 of them were male (52.4%). After the analysis of all the groups and gender subgroups, neither genotype nor allele frequency was significantly different between the CAD-positive and CAD-negative groups (p values for genotypes and allele frequencies were 0.494 and 0.397, respectively). Conclusion: ACE gene I/D polymorphism was not associated with an increased risk of CAD in an Iranian population. [ABSTRACT FROM AUTHOR]

Objective: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode . Methods: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to determine the frequency of bipolar episodes. Results: Considerable proportion of patients (53.9%) previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003) and current mixed mood symptoms (p<0.0001) Conclusion: Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders. [ABSTRACT FROM AUTHOR]

Background and Objective: Cutaneous leishmaniasis is one of the zoonosis disease which is transmitted by sand fly and has been considered as one of the most important health problems in Iran. This study was designed to assess the status of cutaneous leishmaniasis in Gonbad Kavoos, North of Iran. Materials and Methods: This descriptive-analytical retrospective study was performed on the two groups consist of: 1799 patients (995 men and 804 women) referred to health centers of Gonbad Kavoos in Golestan Province North of Iran during 2009-11. Also 278 men and 271 women were selected randomly in one of the villages for the assessment of acute and scar wounds. Patient's characteristics such as age, sex, habitat, number and sites of ulcer(s), month and years of incidence were registered. Data were analyzed using SPSS-13 and Chi-Square test. Results: From 1799 under care patients, 995 cases (55.3%) were males and 804 cases (44.7%) were females (P<0.05). 1542 patients (85.7%) resided in rural areas, while 257 (14.3%) lived in urban areas (P<0.05). The most frequent age group was 0-9 years old (43.3%) (P<0.05). Hands were the most common sites of ulcer (42.3%) and 37.9% of the patients with one ulser. The highest prevalency of disease was observed in months of October and November (68.4%) 4% and 78.6% of subjects selected from villages were presented with acute wound and scar, respectivley. Conclusion: This study showed that Cutaneous leishmaniasis in 2010-11 was dispersed in Gonbad- Kavoos a city in North of Iran. The endemicity situation of this disease in this area is hypoendemic. [ABSTRACT FROM AUTHOR]

Background: The Insomnia Severity Index (ISI) is a short subjective questionnaire which helps physicians in making decisions about patients suffering from insomnia. The present study was an attempt to test the reliability and validity of the Iranian version of the ISI and to measure the correlation between ISI items and polysomnography results in chronic insomnia patients. Methods: Two groups responded to the Persian translation of four questionnaires; ISI, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and General Health Questionnaire (GHQ). The first group consisted of 135 patients diagnosed with chronic insomnia, and the second group was comprised of 55 normal people. After completing the questionnaires, the insomniac patients underwent standard overnight polysomnography. Results: The internal consistency demonstrated by Cronbach's alpha coefficient was above 0.8 for both groups. The Intra-class correlation coefficient was above 0.7 after two weeks for both groups. The correlations between ISI, PSQI, ESS, and GHQ were high. In addition, close correlations were found between scores obtained from the ISI questionnaire items in insomniac patients with corresponding polysomnographic variables. Conclusion: The Iranian version of the ISI is a reliable and valid instrument. It is a valuable short and first-line questionnaire for insomnia research and clinical work. [ABSTRACT FROM AUTHOR]

Background: This study ascertained the effects of soy, in the forms of textured soy protein (TSP) and soy nuts, on lipid profiles, apolipoproteins, inflammatory and prothrombotic markers, and blood pressure in elderly women diagnosed with metabolic syndrome (MetS). Methods: This was a 12-week parallel, randomized, controlled trial conducted in rural health centers of Babol, Iran. Participants were 75 women, ages 60-70 years, who were diagnosed with MetS. Subjects were randomized to one of the following 3 groups: i) soy nut (35g/d), ii) TSP (35g/d), and iii) control. Blood biochemical markers measured at baseline and at the end of the study included: triglyeerides (TG), cholesterol, HDL-C, LDL-C, VLDL-C, ApoB100, ApoAl, C-reactive protein (CRP), and fibrinogen. Results: Soy nuts significantly improved LDL-C, VLDL-C, and ApoB100levels (P < 0.05), while fewer, significant improvements were observed in these variables in the TSP group compared to mean changes from baseline (P < 0.001 ). Similar results were found for ApoAl in the treatment groups (P < 0.01 ). Serum total cholesterol (TC) decreased significantly in the treatment groups compared with the control group (P < 0.005). Differences from the control group in terms of TG, HDL-C, fibrinogen, CRP, and blood pressure were not significant. Conclusion: Both forms of soy improved lipid profiles. The group that consumed soy nuts had greater improvement than the TSP group. Therefore, moderate daily intake of soy may be a safe, inexpensive, and practical method to improve the risk of cardiovascular disease (CVD) and reduce the need for medical treatment. [ABSTRACT FROM AUTHOR]

Background: Discharge against medical advice (DAMA) is a relatively common problem worldwide. We sought to determine the prevalence of and reasons for DAMA among inpatients of our cardiac center. Methods: From a total of 20289 discharges from our cardiac teaching hospital, 992 (4.9%) patients at a minimum age of 18 years were cases of DAMA. After excluding 49 cases due to missing data, we retrospectively analyzed our prospectively collected data from 943 patients, who were DAMA cases. Patients' characteristics, including demographic details, reason for discharge, insurance status, and length of stay before discharge, were examined. Results: The mean age of the study patients was 60.7 ± 13.0 (range, 18-94 years) with a male-to-female ratio of 2.1/1. Lack of consent to surgery or other invasive procedures was the reason cited for DAMA in 31% of the patients, followed by personal or family issues (17%). No reason for DAMA was reported in 26 (2.8%) of the patients. Women compared to men were more likely to cite "lack of consent to surgery or invasive procedures" as the reason for DAMA (p value = 0.005), whereas men more prevalently stated "personal or family issues" as the reason for DAMA (18.7% vs. 12.7%, p value = 0.022). Conclusion: The most frequent self-reported reason for DAMA in our cardiac patients was lack of consent to surgery or invasive procedures. This may be because of fear of undergoing invasive procedures such as revascularization. Explaining the stages of a given invasive procedure to patients and comparing its risks versus benefits may lessen impulsive decision-making and DAMA. [ABSTRACT FROM AUTHOR]

Background: In preparation for pandemic H1N1 or H1N1 influenza (H1N1) it is necessary to identify factors associated with mortality of patients with H1N1 and hospital admissions to intensive care unit (ICU) of patients diagnosed in 2009 with H1N1. Objectives: To describe the clinical and epidemiological features associated with 2009 H1N1 mortality and ICU patient admissions to Masih Daneshvari Teaching Hospital, Iran. Methods: A retrospective cross-sectional study was conducted among patients with mortality and admissions to ICU with confirmed H1N1. Demographic, clinical, laboratory, radiological findings, and epidemiologic data were abstracted from medical records, using a standardized datasheet. Results: From June through December 2009, 20 out of the 46 confirmed hospitalized patients with confirmed H1NI were admitted to the ICU and 7 (15%) died. Among various variables, opium inhalation (P = 0.01), having productive cough, hemoptysis, chest pain, confusion, and loss of consciousness were significantly related to ICU admission (P < 0.05). Pleural effusion (P = 0.006), elevated liver enzymes, as well as CPK and LDH level were significantly relevant to ICU admission (P < 0.05). Delayed antiviral treatment was more common among patients who died and the elderly. Discussion: Patients who were admitted to ICU with confirmed H1N1 included the following risk factors: delayed initiation of antiviral therapy, history of opium inhalation and symptoms including; productive cough, hemoptysis, chest pain, confusion, and loss of consciousness. The mortality rate in the study population was high but compares favorably with other recent published studies. [ABSTRACT FROM AUTHOR]

Background: Nowadays, developed junctional rhythm (JR) that occurs during slow-pathway radiofrequency (RF) catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) has been focused upon as a highly sensitive surrogate end point for successful radiofrequency ablation. This study was conducted to assess the relationship between the presence and pattern of developed JR during the RF ablation of AVNRT and a successful outcome. Methods: Seventy-five patients aged between 14 and 88 who underwent slow-pathway RF ablation due to symptomatic AVNRT were enrolled into the study and received a total of 162 RF energy applications. Combined anatomic and electrogram mapping approach was used for slow-pathway RF ablation. The ablation procedure consisted of 60-second, 60 °C temperature-controlled energy delivery. After each ablation pulse, successful ablation was assessed according to the loss of AVNRT inducibility via isoproterenol infusion. Four different patterns were considered for the developed JR, namely sparse, intermittent, continuous, and transient block. Success ablation rate was assessed with respect to the position, pattern, and number of junctional beats. Results: Successful RF ablation with a loss of AVNRT inducibility was achieved in 43 (57.3%) patients using 119 RF energy applications (73.5%). JR developed in 133 of the 162 (82.1%) applications with a given sensitivity of 90.8% and low specificity of 41.9% as an end point of successful RF ablation, with a negative predictive value of 62.1%. The mean number of the developed junctional beats was significantly higher in the successful ablations (p value < 0.001), and the ROC analysis revealed that the best cut-off point of the cumulative junctional beats for identifying accurate AVNRT ablation therapy is 14 beats with 90.76 % sensitivity and 90.70% specificity. There were no significant differences in terms of successful ablation rates according to the four different patterns of JR and its positions (p value=0.338, p value=0.105, respectively) in the univariate analyses. Conclusion: JR is a sensitive but non-specific predictor of the successful RF ablation of AVNRT. Nevertheless, according to the results, its specificity could increase with the presence of more than 14 cumulative junctional beats. Although the development of JR during slow-pathway RF ablation seems not to be reliable as a success end point, its absences could be a marker of requiring more energy application to ablate the slow pathway. [ABSTRACT FROM AUTHOR]

Background and purpose: Despite edidemiologic similarity of multiple sclerosis worldwide, prevalence shows considerable variability. According to Kurtzke, Iran is considered to have a low prevalence. In this study, we wanted to estimate the prevalence period and Indicate Epidemiologic aspect of MS in Mazandaran Province, North of Iran. Materials and methods: A cross- sectional Registered case Study Conducted in 2007 on all definite MS Patients that live and reside within Mazandaran, as well as being a member of the Mazandaran MS Society. 582 difinite patients (161 men and 421 woman) were identified. The patients were Viu interview and questionnaire to record demographic and Case related information. According to the national Sensius Reports, the population of Mazandaran was 2,893,087. Results: The mean (SD) age of the participants was 34.3 (9.4) years. The MS period pervalence was 20.1 per 100,000 (95% confidence interval (CI) 18.7-22.1). The Female/male ration was 2.6 and MS rates were highest among 3rd decade. Visual and sensory disturbance were the most common initial persontations with prevalence of 40.1 %( 95% CI: 38.5-42.9 ) and 34.2% ( 95% CI: 32.8 - 36.1), respictively. Conclusion: Mazandaran is in medium MS prevalence area. This is in clear contrast with background hypothesis, but other epidemiologic indices were almost pursuant with pervious information. [ABSTRACT FROM AUTHOR]

Background: The Consolidated Standards for Reporting of Trials (CONSORT) statement is a device to standardize reporting and im- [ 1 prove the quality of controlled trials. The aim of this study is to determine the quality of controlled clinical trial reports by national peer-1 reviewed journals in Iran. i Methods: In a cross-sectional study, we evaluated clinical trial reports by national peer-reviewed Iranian journals between 2008 and 2010 by CONSORT2010. The sample was selected from Iran Medex. The proportion of adherence to each item of the CONSORT checklist was assessed for each clinical trial. The reliability of evaluation by reviewers was calculated by Pearson correlation coefficient, and was deter- i mined to be 0.73 - 0.89, with a significance level of P < 0.01 between reviewers. Results: A total of 509 articles published in 80 peer-reviewed national journals were evaluated. The average adherence of evaluated randomized controlled trials (RCTs) to the 37 items of the CONSORT statement was 43.8%. The mean CONSORT score significantly differed across each year of publication. None of the articles mentioned the location where the full trial protocol could be accessed. Conclusion: The quality of reporting RCTs published in national peer-reviewed journals needs significant improvement as the majority did not adhere to CONSORT guidelines. It is necessary for the editors of Iranian journals to consider CONSORT criteria for evaluation of all future RCTs [ABSTRACT FROM AUTHOR]