Search

Objective: During meatotomy procedure for children with meatal stenosis (MS), a straight clamp used as a hemostat on the ventrum of the meatus before incised with scissors for clamping and holding bleeding from the site of operation. The aim of this study was to evaluate the optimum clamping time for meatotomy in children with MS. Materials and methods: All the patients with MS between 2014 to 2019 were enrolled in this retrospective study. Patients with uncircumcised penis, traumatic catheterization, any kind of penile abnormality such as hypospadias or penile curvature, and active urinary tract infection (UTI) were excluded. The indication of meatotomy was a pinpoint meatus that develops with dorsal or lateral deflection of the urinary stream and high-velocity urine flow. During meatotomy procedure, clamping time was examined in different groups such as 2, 3, and 4 minutes. The main symptoms of presentation and ultrasonography (US) findings were recorded and compared between groups. To assess the optimum time clamping, postoperative bleeding was noted carefully in all groups. The success rate was recorded at onemonth postoperative follow-up in the clinic. Results: Of the 120 patients with MS who underwent a meatotomy procedure, there were 40 (33.3%) participants in each group. The main symptoms were painful urination and urine stream deviation that represented in 54 (46%) patients. Bladder wall thickness was the main pre-operation finding in the US which was observed in 67 (55.8%) patients. In comparison between the groups related to clamping time, bleeding was observed and required suturing when clamping was applied for 2 minutes in 4 (3.3%) patients (p = 0.016). With a minimum follow-up of 12 months, no recurrent meatal stenosis was reported. Conclusions: Clamping time for more than 2 minutes may prevent bleeding during and after meatotomy.

Background: Despite the significant role of the Fat Mass and Obesity-Associated (FTO) gene in obesity, the underlying mechanisms are not fully elucidated. Besides, vitamin D deficiency and obesity are mostly seen together, and it can be hypothesized that this nutrient may have an impact in the role of FTO genotype in adiposity.Objective: Thus, this study aimed to investigate the association of FTO rs9939609 gene polymorphism with eating behaviors, eating disorders, and general mental health in overweight adults, considering their vitamin D intake as a mediate confounding factor.Methods: This cross-sectional study was carried out on 197 overweight adults in Shiraz, Iran. Genotyping was performed through amplification refractory mutation system polymerase chain reaction (ARMS PCR). Mental health, vitamin D intake, eating behaviors and disorders were assessed by the validated questionnaires.Results: The risk allele of the FTO rs9939609 polymorphism (A) was significantly associated with a higher risk of eating behavior and mental health disorders (all P < 0.05). After considering vitamin D intake, the AA genotype carriers had significantly higher risks for poorer eating behavior (P = 0.002), mental health (P = 0.007), and general mental health (P = 0.039) compared with the TT carriers if they had insufficient vitamin D intake.Conclusion: In conclusion, these results indicated that the A-allele of the FTO rs9939609 polymorphism may be associated with poorer eating behaviors, mental health, and higher risk of eating disorders. It was also identified that the effect of FTO rs9939609 A risk allele on eating behavior and mental health may be limited to people with insufficient vitamin D intake.

Background & objectives: Depression is a highly prevalent and multifactorial psychological disorder. Fat Mass and Obesity-Associated (FTO) gene and the serum vitamin D level are proposed to be involved in pathophysiology of depression. This study aimed to investigate the interactions between one FTO gene single nucleotide polymorphism, depression, and serum vitamin D level in overweight adults.Methods: One hundred and ninety-seven overweight adults were recruited in this cross-sectional study. FTO genotyping was performed by amplification refractory mutation system polymerase chain reaction (ARMS-PCR). Depression severity was assessed using Beck's depression inventory (BDI-II). Serum vitamin D levels were measured using a direct competitive enzyme-linked immunosorbent assay (ELISA) method.Results: A-allele carriers had higher Beck's depression score (P = 0.03). Multivariate regression models showed a positive association between the A-allele of FTO rs9939609 polymorphism and depression. Serum vitamin D level had no effect on the association between FTO genotype and depression.Conclusion: A-allele of FTO rs9939609 polymorphism might be associated with depression independent of serum vitamin D level. Further longitudinal studies are needed to confirm these results.

Introduction: Finding non-systemic antipyretic option in cancer patients who simultaneously receive several other drugs seems be logical. This study was designed to evaluate complementary therapy with Viola odorata L. oil for fever control in febrile neutropenic children. Methods and Materials: In a randomized placebo controlled clinical trial, 41 febrile children were divided into two groups. Children in the active drug group received viola oil (20 drops) to be rubbed on the peripheral margin of the patient umbilicus. Primary outcome measure of the study was the mean axillary temperature in the 30, 60, and 240 minutes after the intervention. Results: The mean temperature reduced significantly in the viola group after 30 minutes of administration (p =0.005), while there was no significant change in the placebo group (p =1.00). The number of patients who received paracetamol as the rescue treatment was significantly lower in the viola group than that in the placebo group (5 vs. 17, p =0.001). Conclusion: The results of our study showed the safety and efficacy of complementary therapy with Viola odorata L. oil for fever control in febrile neutropenic children during hospital course.

Objectives over the past few years, lifestyle modification has increased the prevalence of major components of metabolic syndrome (MetS), leading to increased risk of non-communicable diseases, especially cardiovascular disease. The present study was aimed to determine the prevalence of MetS and its components and present results according to the major demographic characteristics of the participants in a population-based study. Methods This cross-sectional study was conducted on a total of 10663 subjects aged 40–70 years who participated in phase one of PERSIAN Kharameh cohort carried out between 2014 and 2017. Result According to IDF, ATP III, and an Iranian definition, the prevalence of MetS were reported as 37.00%(36.08–37.92), 33.82% (32.93–34.73), and 33.13% (32.24–34.03), respectively. The most prevalent component of MetS was abdominal obesity (73.59), followed by reduced HDL cholesterol levels (44.83), elevated triglyceride (28.3), fasting glucose (35.34), and high blood pressure (32.64). In addition, the prevalence of MetS were 50.3, 70.4, 68.2, 65.7, and 60.8 among individuals with abdominal obesity, high triglyceride levels, hypertension, impaired fasting glucose, and low HDL-C levels, respectively. Results showed that 90% of the subjects displayed at least one component of MetS, and all MetS components were associated with major demographic characteristics of the study subjects. Conclusions The findings of this study indicate high prevalence of metabolic risk factors among study population. This study with a large sample size would contribute to establishment of efficient interventions and programs aimed at reducing the prevalence of MetS by health staff, supervisors and policymakers.

Farahnaz Joukar,1– 3,* Sara Yeganeh,2,* Mohammadreza Naghipour,1 Soheil Hassanipour,3 Hossein-Ali Nikbakht,4 Fariborz Mansour-Ghanaei1– 3 1Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; 2Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran; 3GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran; 4Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran*These authors contributed equally to this workCorrespondence: Fariborz Mansour-Ghanaei Tel +98(13)33535116Fax +98(13)33534951Email fmansourghanaei@gmail.comBackground: Blood pressure (BP) measurement accuracy is critical to the diagnosis and management of hypertension. The aim of the present study was to validate the Omron HBP-1100-E professional blood pressure measuring device in accordance with the American Association for the Advancement of Medical Instrumentation in Iranian adults.Materials and Methods: Simultaneous blood pressure auscultator measurements were obtained by two observers using mercury sphygmomanometers as a reference, sequentially with a measurement by using the Omron HBP-1100-E device. Absolute device-reference blood pressure differences were categorized into three error categories (within 5, 10, and 15 mmHg), and mean device-reference blood pressure difference (standard deviation) was calculated and evaluated using the American Association for the Advancement of Medical Instrumentation criteria.Results: A total of 85 participants (250 paired readings) were enrolled to the study. 26.8%, 55.6%, and 79.6% of the device-reference blood pressure differences agreed to within 5, 10 and 15 mmHg, respectively, for systolic blood pressure, and 39.6%, 69.2%, and 81.6% of measurements for diastolic blood pressure, respectively, and failed to pass the protocol criteria. The mean device-reference blood pressure difference was 8.0 ± 13.1 mmHg for systolic BP and 2.2 ± 11.3 mmHg for diastolic BP, and was > 5.0 ± 8.0 mmHg (required criteria).Conclusion: Omron HBP-1100-E professional blood pressure monitor is not desirable for measuring the BP for Iranian adults as it overestimates blood pressure in this population.Keywords: validation, electronics, blood pressure monitor, automated devices, American Association for the Advancement of Medical Instrumentation

Background Etiological factors involved in chronic prostatitis (CP) type IIIb and chronic pelvic pain are not sufficiently understood; however, the nervous system has a significant role in the generation and maintenance of chronic pelvic pain. This study was designed to evaluate the sympathetic skin response (SSR) in men with CP type IIIb compared to normal population. Patients and Methods For two years, about 14 patients suffering from CP type IIIb according to NIH-CPSI and 26 healthy control men were enrolled in this study. SSR was performed in all the subjects with a standard method. Bilateral palmar and plantar latency and amplitude of SSR were recorded in response to the median and tibial nerve electrical stimulations. SSR is considered abnormal when the latency is prolonged, and the amplitude reduced. Results SSR latency in the left and right median nerve was significantly prolonged in the patient with CP type IIIb group compared to the control group (p=0.039 and 0.006, respectively). Additionally, the amplitude was reduced in patients with CP type IIIb group compared to the control group in the right tibial nerve (p=0.017). Conclusion Sympathetic skin response may be a helpful diagnostic test for men with chronic prostatitis type IIIb. However, this observation needs to be validated in a large sample cohort study with long-term follow-up.

Objectives Suicide is a conscious act in which the individual deliberately commit and unusual act with the intention of self-harm. The present study aims to examine some epidemiological factors affecting attempted and completed suicide rate during 2012–2016 in NajafAbad, a city in Isfahan province. Methods This is a cross-sectional study. The subjects are 2138 cases involved in suicide attempt during 2012–2016 that gone to Montazeri and Al-Zahra hospital. Chi-square, logistic regression and Cochran–Armitage test was used for data analysis. Result Totally, 1385 (64.8%) patients were female and 47.8% were younger than 24 years of age. The most common method of suicide was medication overdose (91.1%). In multivariable analysis, male gender (OR: 2.67; CI 95% 1.53 to 4.64) was a risk factor for fatal suicide and application of chemical methods (OR: 0.018; CI 95% 0.010 to 0.032) was a protective factor. Results regarding completed suicide trend analysis shows that this trend has had a significant statistical difference in men ( p = 0.019) but in women this trend doesn't statistically significant difference. ( p = 0.209). Conclusions According to the findings of the present study, attempted and completed suicide rate in Najafabad is relatively high compared to other regions in Islamic Republic of Iran. The completed suicide rate was significant in men which achieved its greatest value in 2015. Suicide attempt rate didn't show a significant statistical difference in both men and women.

Objectives The incidence of larynx cancer (LaC) from different areas of Iran were reported. Nevertheless, there is no available systematic reviews in this regard. Therefore, the present systematic review carried out to estimate the incidence rate of LaC among Iranian people. Method This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in October 2017. A search was concluded using Medline/PubMed, Embase, ISI web of knowledge, Scopus, ScienceDirect, and Google scholar for international papers and four national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers. The incidence rate of LaC was calculated using random effect model. Result An aggregate of 166 papers were retrieved in the primary search of the databases. Further screening and advanced refinement of the retrieved studies produced 13 studies totally. The age-standardized rate (ASR) of LaC was 2.70, 95% CI (1.86–3.53) and 0.46, 95% CI (0.31–0.61) in males and females, respectively. Conclusion In comparison to other parts of the world, the incidence of LaC was lower in Iran. Afterwards, further studies are necessary to outline the exact incidence rate and the trend of LaC in Iran.

Background and aim The goal of diabetes management is to enhance the performance of the surveillance system to perpetuate optimal blood sugar, blood pressure and cholesterol levels in the normal values. This paper aimed to identify factors associated with therapeutic target achievement in the control of complications in consequence of diabetes. Methods In this cross-sectional study, a secondary analysis was performed on data obtained in the surveillance center of patients referred to in Makoo city, West Azerbaijan Province. The main interested variables included Fasting Blood Sugar (FBS), HbA1c, triglycerides, cholesterol, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) diastolic and systolic blood pressure, duration of diabetes, family history of diabetes, early and late complications of diabetes, treatment received, history of smoking. Results Average age of the patients with diabetes mellitus, insulin-dependent was 35.43 (SD = 17.25) and in patients of diabetes mellitus 53.37 (SD = 10.89), which was significantly different (p-value = 0.001). Frequency amount of fasting blood sugar in diabetes mellitus, insulin-dependent and diabetes mellitus, type II was 64.30% and 66.0%, respectively. Only 19.0% of patients with diabetes mellitus, insulin-dependent and 13.90% of diabetes mellitus, type II breached to the optimum level of blood glucose control. Conclusions This study found that a considerable proportion of subjects with diabetes mellitus, insulin-dependent and diabetes mellitus, type II did not achieve the goals of care guidelines of Iran on secondary prevention of complications related to diabetes, especially vascular complication.

Hepatocellular carcinoma or liver cancer (LC) is one of most important cancer around the world. There are several reports about LC incidence from various Iranian locations with conflicting results. The present study aimed to accomplish a systematic review to estimate the accurate incidence rate of LC among Iranian people. This systematic review was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist in 2018. A literature search was conducted using international databases (Medline/PubMed, Scopus, ScienceDirect, and Google Scholar) for English papers and national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers which estimated incidence rate of LC in any geographical area of Iran. The incidence rate of LC was calculated using random effect model. Of 171 papers in the primary searches, 15 studies were included by advanced screening and refinement. The age-standardized rate (ASR) of LC was 1.66 (95% CI 1.49–1.83) for males and 1.25 (95% CI 1.12–1.38) for females. The incidence rate of LC in Iran was lower in comparison to other countries. Afterwards, more studies are necessary to outline the accurate incidence rate and the trend of LC among Iranian population.

Background: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children.Materials and methods: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients’ demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group. Results: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041). Conclusions: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

Introduction. The prevalence of metabolic syndrome has increased in recent decades around the world and is currently reaching epidemic levels as it is a major public health and clinical concern. The aim of this study was to evaluate the prevalence of metabolic syndrome and its related demographic factors in a population-based study. Methods. In this cross-sectional study, the target population consisted of 10520 individuals aged 35–70 years in Phase 1 of the Persian Guilan cohort study (Guilan site/Some’e Sara) that was conducted in 2014–2017. Demographic, anthropometric, blood pressure, and biochemical data were used in this study. The IDF definitions were used to diagnose the metabolic syndrome. Results. The prevalence of the syndrome according to IDF and ATP definition was 42.87% (95% CI: 41.92–41.81) and 40.68% (95% CI: 39.74–41.62), respectively. The prevalence of components for central obesity, high triglyceride, HDL cholesterol, blood glucose, and hypertension components was 75.8%, 43.1%, 40.6%, 39.2% and 37.9%, respectively. All demographic variables were related to the syndrome, and among them age, gender, and residence were identified as independent and strong predictive variables in the regression model. More than 92% of the population had at least one component of the syndrome. Conclusion. The results of the study show a high prevalence of metabolic syndrome risk factors. It is essential to educate healthy lifestyle behaviors and further health education in the high-risk groups identified in this study, especially the elderly, women, and rural residents.

Colorectal cancer has a significant impact on patients’ physical, psychological, and social aspects. This study aimed to examine the gender difference in anxiety and depression and its relationship with some of the characteristics of the disease and demographic in the northeast of Iran. In this cross-sectional study, patients with colorectal cancer aged over 18 years who were admitted to hospitals, without considering the disease stage and type of treatment, were enrolled during 2014–2016. The Hospital Anxiety and Depression Scale (HADS) Questionnaire was completed via interview. A total of 303 survivors of colorectal cancer were included in the current analysis, of whom 55.1% (167) were male. The overall frequency of depression was 44.9%, and it was 38.3% and 32.9% for men and women, respectively. The overall frequency of anxiety was 53.4% (50.3% and 57.4% for men and women, respectively). The results showed that compared to men, women (52%) were more likely to report depression (OR = 0.48, 95% CI = 0.22–1.04, P = 0.065); in contrast, men (12%) were less likely than women to report anxiety (OR = 0.88, 95% CI = 0.38–2.03, P = 0.779), which was less than 12% in men. Among other variables, education and employment were identified as independent and strong predictive variables for depression and anxiety. The frequency of anxiety and depression is high among colorectal cancer survivors, especially in women. Therefore, screening for psychological distress is recommended in clinical settings and there is a need to pay attention to women.

Background Metabolic syndrome (MetS) is a major public health concern due to its high prevalence and association with heart disease and diabetes. Artificial neural networks (ANN) are emerging as a reliable means of modelling relationships towards understanding complex illness situations such as MetS. Using ANN, this research sought to clarify predictors of metabolic syndrome (MetS) in a working age population. Methods Four hundred sixty-eight employees of an oil refinery in Iran consented to providing anthropometric and biochemical measurements, and survey data pertaining to lifestyle, work-related stressors and sleep variables. National Cholesterol Education Programme Adult Treatment Panel ІІI criteria was used for determining MetS status. The Management Standards Indicator Tool and STOP-BANG questionnaire were used to measure work-related stress and obstructive sleep apnoea respectively. With 17 input variables, multilayer perceptron was used to develop ANNs in 16 rounds of learning. ANNs were compared to logistic regression models using the mean squared error criterion for validation. Results Sex, age, exercise habit, smoking, high risk of obstructive sleep apnoea, and work-related stressors, particularly Role, all significantly affected the odds of MetS, but shiftworking did not. Prediction accuracy for an ANN using two hidden layers and all available input variables was 89%, compared to 72% for the logistic regression model. Sensitivity was 82.5% for ANN compared to 67.5% for the logistic regression, while specificities were 92.2 and 74% respectively. Conclusions Our analyses indicate that ANN models which include psychosocial stressors and sleep variables as well as biomedical and clinical variables perform well in predicting MetS. The findings can be helpful in designing preventative strategies to reduce the cost of healthcare associated with MetS in the workplace.

Colorectal cancer (CRC) is the second most common cause of cancer-related deaths worldwide. Survival rates are among the most important factors in quality control and assessment of treatment protocols. This study was aimed to assess the survival rate of colorectal cancer in Eastern Mediterranean Region Countries. In the present study we comprehensively searched 6 international databases including PubMed/Medline, ProQuest, Scopus, Embase, Web of Knowledge and Google Scholar for published articles until November 2018. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was applied to evaluate the quality of included studies. The heterogeneity of papers was assessed with the Cochran Test and I-Square statistics. Meta-regression test was performed based on publication year, sample size and Human Development Index (HDI) of each study. Among the total of 1023 titles found in the systematic search, 43 studies were eligible to be included in the present meta-analysis. According to the results, the 1-year, 3-year and 5-year survival rate of patients with Colorectal Cancer was 88.07% (95% CI, 83.22-92.92), 70.67% (95% CI, 66.40-74.93) and, 57.26% (95% CI, 50.43-64.10); respectively. Furthermore, Meta-regressions did not show significant correlations between survival rate and year, sample size or Human Development Index. Survival rates, especially the 5-year survival rate in the EMRO were less than European countries and the USA. Documented and comprehensive evidence-based findings of the present meta-analysis can be used to enhance policies and outcomes of different medical areas including prophylaxis, treatment and health related objectives in colorectal cancer.

Background: Malaria is one of the major human health problems that have become increasingly important in recent decades. Objective: The present study aimed to identify the epidemiological status of malaria in the years 2006–2018 in the southern region of Fars province in southern Iran. Methods: This is a cross-sectional descriptive-analytical study. The study population consisted of all persons with malaria referred to the Center for Disease Control in the four cities of Larestan, Gerash, Evaz and Khonj in the south of Fars province, Southern Iran, between 2006 and 2018. Frequency (%) was used to report descriptive statistics and mean and standard deviation for quantitative variables. The trend of malaria incidence during these years was analyzed using the Cochran Armitage Test. The significance level was considered 5%. Findings: A total of 190 cases of malaria in the period of 2006 to 2018 occurred in the southern region of Fars province; 77.9% were men, more than 95% were Afghans, and most of them were workers. The incidence of malaria in one hundred thousand people per month showed that most of the new malaria cases were in the months of July to October. The peak incidence was in August, with 19.88 cases per 100,000 people. Cochran-Armitage test results showed that this trend was not statistically significant (P = 0.399), despite an almost upward trend in malaria incidence in the south of Fars province. Conclusion: The results of this study showed that the trend of malaria in the south of Fars province was ascending; therefore, increasing surveillance activities to prevent and control malaria in such area is of utmost importance.

Summary Background One of the important issues related to metabolic syndrome is the underlying factor that remains controversial. The purpose of this study was estimating exploratory factor analysis (EFA) to reveal underlying factors that may explain the observed variants of metabolic syndrome (MetS) components in a population-based study. Methods In this cross-sectional study, the target population consisted of 10,520 individuals aged 35–70 years from Phase 1 of the PERSIAN Guilan cohort study conducted between 2014 and 2017. Exploratory factor analysis (EFA) of components of the metabolic syndrome, including waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, triglyceride (TG), high-density lipoprotein (HDL) and fasting blood glucose (f-Glc) was performed across the population as well as by gender. Results EFA results in the whole population based on eigen values > 1 showed two factors that explain 55.46% of the total variance. Taking factor loadings above 0.3, the first factor included systolic blood pressure, diastolic blood pressure, and waist circumference – called the blood pressure factor. Also, the second factor included triglycerides, negative-loaded HDL, and fasting blood glucose, which was named as lipid factor. In terms of gender, the first factor was similar to the whole population pattern, but in the second factor, in addition to the two components of blood lipids, waist size for men and in fasting blood glucose for women was launched. Conclusion Hypertension and lipids were substantial factors, and obesity is an important factor in this study. Hypertension, having the highest factor load, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.

Background: Animal bite due to the risk of rabies is a major public health problem. Rabies is of great importance because of fatalities and economic damage. Objective: This study was conducted to investigate the epidemiological patterns of animal bite in Najaf Abad during the years of 2012 to 2017. Methods: This is a cross-sectional study. All records (4,104) were registered in the registration offices of animal bites during the years of 2012 to 2017 at the rabies treatment centres of Najafabad by census method. Demographic characteristics, animal type and sometime clinical patterns of the wounded were examined. Results: The mean age of the injured was 31.28 ± 15.28 years. Of the 4,104 injured, 3648 (88%) were male and the rest of them were women. In terms of residential area, 3645 people (88%) were in urban areas and the rest were in rural areas in the place of occurrence of bites. Most cases of animal biting occurred in dogs (70.9%) and then cat (24.3%). The most affected part was 51% with shoulder and hand. In this study, the incidence of animal bites is estimated as 100,000 people per year in Najaf Abad in in 2012 it was 206.4, with an increasing trend to 212.9 in 2019 (P < 0.001). Conclusion: The results of the study showed that most cases of animal bites were related to dogs, urban areas and male sex variables. The incidence of animal bites was also increasing. Due to the importance of this disease and its financial losses, it is recommended that prevention methods should be used to control stray dogs, vaccination of domesticated dogs and to raise awareness of the people.

Background: Prostate cancer is one of the most common health issues among men, especially older men. In recent years, incidences of prostate cancer is increasing. Objective: The aim of this study was to provide a comprehensive estimate of the survival of prostate cancer in Asian countries. Methods: We searched five international databases including Medline/PubMed, Scopus, Embase, Web of Knowledge and ProQuest until June 1, 2018. The Newcastle-Ottawa Quality Assessment was used to evaluate the quality of selected papers. The review protocol was registered in PROSPERO (CRD42019117044). Results: A total of 714 titles were retrieved. Thirty-seven studies met the inclusion criteria. Based on the random-effect model one-year, five-year and ten-year survival rate of prostate cancer were 81% (95% CI 77.8–84.2), 61.9% (95% CI 59.5–64.3) and 36.2% (95% CI 9.2–63.2) respectively. Survival rates based on HDI level for five-year were 30.07, 43.43 and 70.84 percent for medium, high and very high levels, respectively. Conclusion: According to the results of our study, the prostate cancer survival rate in Asian countries is relatively lower than in Europe and North America.

Objective To evaluate the accuracy of ultrasonography (US) in measuring the urinary tract stone using non-contrast computed tomography (NCCT) as the standard reference. Patients and methods A total of 184 patients suspected with urolithiasis who had undergone NCCT and US radiologic investigation from 2015 to 2017 were enrolled in this study. The sensitivity, specificity, and stone size measured in US were validated by NCCT. Data of the stone size in US were classified into four groups (0–3.5, 3.6–5, 5.1–10, >10 mm) and then compared with NCCT data. Results In 184 patients, NCCT detected 276 (97.2%) stones, while US could identify 213 (75.5%) stones. Overall sensitivity and specificity of US were 75.4% and 16.7%, respectively. Detection rate of mid and distal ureteral stone was lower than that at other locations. The detection rate increased with the stone size. About 73% concordance was obtained for the stone size measured by US and NCCT (Pearson’s correlation coefficient was 0.841). Factors such as the stone size, amount of hydronephrosis, and weight affected the detection rate of the urinary tract stone using US (P, Video abstract

Background: Self-care of diabetes is an essential part for controlling the disease and improvement of quality of life in type 2 dia betes mellitus (T2DM) patients. This study aimed to analyze the associated factors of quality of life in patients with T2DM in or der to design effective interventions. Methods: This cross-sectional study was conducted on 120 T2DM patients referred to health centers of Chaldoran, West Azer baijan Province, Iran. The quality of life’s questionnaires from World Health Organization and the self-care behaviors’ question naires were used for data collection. Results: The mean age of patients was 46.30% and 53.30% of them were male. Among demographic variables, gender (P=0.002), age groups (P=0.007), and household monthly income (P=0.009) were significantly associated with total quality of life. Also, self-care nutrition (odds ratio [OR], 1.47; P=0.001), self-management of blood glucose control (OR, 1.29; P=0.002), and self-medica tion behavior (OR, 1.18; P=0.030) were identified as factors significantly associated with quality of life. Conclusion: Self-care behaviors were significantly associated with quality of life; among them, the greatest influence was ob served in self-care nutrition behavior. According to the findings of this study, appropriate interventions on self-care behaviors about nutrition can improve the quality of life for T2DM patients.

Desert wheatgrass (Agropyron desertorum L.), tall wheatgrass (Agropyron elongatum L.), and crested wheatgrass (Agropyron cristatum L.) are native cool-season grass species that exhibit potential as a low-input turfgrass. An increased understanding of the biochemical and physiological responses of wheatgrass species and genotypes to salt stress conditions is important for developing genotypes with enhanced tolerance to salinity. The objective of this study was to characterize the physiological and antioxidative properties in 20 Iranian wheatgrass genotypes and to observe their responses to salinity stress during seed germination and seedling growth stage. A completely randomized factorial design was used with two types of factors, four levels of salinity (0, 50, 100, and 150 mm of NaCl), wheatgrass genotypes, and three replicates. In this experiment, the results demonstrated that salinity limits the germination of Iranian wheatgrass genotype seeds. The result of this study showed that among the wheatgrass genotypes, ‘AD1’, ‘AD3,’ ‘AC6’, and ‘FA’ took the shortest average time to germinate. Higher levels of final germination percentage (FGP) were observed in ‘AD2’, ‘AD3’, and ‘AE5’ under salinity stress than other genotypes throughout the experiment. During a prolonged period of study, ‘AD1’ had greater rate of germination (GR) than other genotypes. Out of the 21 genotypes, five genotypes (‘AD1’, ‘AD2’, ‘AD3’, ‘AE5’, and ‘FA’ genotypes) were in the range of “salinity tolerant genotypes” cluster. The ‘AD1’, ‘AD2’, ‘AD3’, ‘AE5’, and ‘FA’ genotypes generally performed better than other genotypes under salinity conditions, mainly through maintaining higher enzymatic activities such as superoxide dismutase (SOD) (EC 1.15.1.1), catalase (CAT) (EC 1.11.1.6), ascorbate peroxidase (APX) (EC 1.11.1.11) and peroxidase (POD) (EC 1.111.1.7), and nonenzymatic antioxidant activities by glutathione (GSH). The ‘AD1’, ‘AD2’, ‘AD3’, ‘AE5’, and ‘FA’ genotypes also had higher proline levels and more of total nonstructural carbohydrates (TNC) content, lower malondialdehyde (MDA) content, and lower hydrogen peroxide content (H2O2).

Background: The aim of this study was to examine the relationship between psychological distress and quality of life (QOL) dimensions in colorectal cancer (CRC) patients. Methods: This cross-sectional study was conducted in the North of Iran. A total of 157 CRC survivors were selected from the registry database and included in this study. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) and QOL was estimated using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ C-30). The association between the patients’ emotional functioning (EF) score on EORTC QLQ-C30 and their HADS scores was analysed through multiple linear regression. Results: In statistical terms, there were significantly negative relationships between EF and HADS-A (anxiety), and between HADS-D (depression) and HADS-T (total score). However, compared with HADS-A, the correlation between HADS-D and other QOL dimensions was significantly higher. By the same token, depression rather than anxiety was more strongly associated with reduced QOL. Conclusions: The EF dimension of the EORTC QLQ-C30 predominantly assesses anxiety; however, depression has a stronger impact on the global QOL of patients than anxiety. Therefore, the use of an additional instrument is recommended for the assessment of depression in outpatients with CRC.

Background: Evidence has shown that colorectal cancer (CRC) survivors, especially women have a lower health-related quality of life (HRQOL). This study aimed to assess the QOL of CRC survivors as well as gender-related differences in the QOL of CRC patients in Northwest of Iran. Methods: This cross-sectional study was conducted in East Azarbijaban. All patients aged ≥18 years, and diagnosed with CRC regardless of its stage and plans for treatment, and also referred to teaching hospitals within a two years’ time frame of 2014–2016, were included in this study. The Persian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was completed for each patient by two trained interviewers. Student t-test and χ2 test were used to analyze Gender differences among patients, clinical-epidemiological characteristics, as well as the scores of QLQ-C30 dimensions. Multiple linear regression models were used to assess the relationship between the score of the EORTC QLQ-C30 questionnaire and gender. Results: Overall 303 patients (166 male, 137 female) with a diagnosis of CRC were included in the study. The mean age of participants was 58.16±13.58 years. The mean scores of physical (b=−14.80, P=0.001) and social functioning (b=−9.14, P=0.038) of women with CRC were more negatively affected than men with CRC. In addition, women had a higher mean score in pain (b=10.74, P=0.022) and fatigue (b=12.53, P=0.007) symptom subscales in comparison to men. Based on the results of multivariate linear regression analysis, gender, occupation, and adjuvant therapy can be considered as the independent and strong predictor factors of functional scale in our CRC patients. Conclusions: Women appear to be more affected than men by impaired physical and social functioning after the development of cancer, and they reported more fatigue and pain than men. Therefore, it might be advisable to consider strategies to improve the HRQOL in women.

Colorectal cancer (CRC) is the second leading cause of cancer deaths. This screening aimed to determine the positivity of the fecal occult blood test (FOBT) and the results of colonoscopy among a medium-risk population in the northern regions of Iran. This cross-sectional study was conducted in 2016 on 924 eligible samples from people over the age of 50. After completing the questionnaire, participants were referred to a laboratory for three immunochemical fecal occult blood tests (IFOBTs). If the result of at least one test was found to be positive, they were submitted to the state hospital for colonoscopy. Results were recorded according to the number of people with CRC, polyps, and other diseases. Among a total number of 897 (97.1%) cases, at least two acceptable samples were sent to the laboratory and in 229 (25.5%) cases, at least one case was IFOBT-positive. Finally, 118 (64.1%) cases were referred to the hospital for colonoscopy; among these, 5 colonoscopies were incomplete, while 113 had complete colonoscopies with 42 healthy subjects, 3 cases of cancer, 28 cases of polyps, and other diseases identified in the remaining patients. Based on the results, the prevalence of positive IFOBT, polyps, and cancer was high. The results of this study will play an important role in establishing a CRC screening program in the country. With reference to the status of the general population, the target group in the country should be reviewed and not limited to the first-degree relatives of patients.

In Iran, cancers are the third leading cause of death, and gastrointestinal cancers are the primary cause of mortality among all the cancers. This study aimed to determine the trend of crude and age-standardized mortality rates (ASMR) for different types of gastrointestinal cancers over an 11-year period in Fars province (Iran). In this study, all the mortality data for gastrointestinal cancers were derived from the Electronic Death Registration System (EDRS) between 2005 and 2015. Subsequently, we calculated the crude and age-standardized mortality rates (ASMR) and their trends for different types of gastrointestinal cancers based on age groups and gender over the study period. A total of 6547 deaths from gastrointestinal cancers were identified, with an average age of 66.0 ± 16.4 years. The crude and age-standardized mortality rates for gastrointestinal cancers were respectively 10.9 and 15.0 per 100,000 population in 2005 which significantly increased to 17.4 and 19.4 per 100,000 population in 2015 (P

Background: Cancer survivors are at greater risk of developing secondary tumours, cardiovascular disease, diabetes, and osteoporosis. A part of this is because they share the similar lifestyle factors. The aim of this study was to examine the prevalence of adverse health behaviours and its determinants among colorectal survivors. Methods: This cross-sectional study was conducted in Babol city located in North of Iran. The pathologic information and demographic characteristics were collected from the population based-cancer registry. Colorectal cancer (CRC) survivors between 2007–2013 were included in this study. A questionnaire includes socioeconomic status, lifestyle behaviours [smoking, physical activity (PA), fruit & vegetable consumption], and clinical factors were completed via home visit by trained interviewers. Results: The majority of CRC survivors were male and were more than 50 years of age, more than half of them resided in urban areas. About 67% of survivors had at least one comorbid condition. In general, the majority of them were not meeting the recommendation for PA (89%), about 87% of them consumed less than 5 daily serving of fruit & vegetable and 14.6% of participants were smoke either cigarette or hookah. Female genders, illiteracy, comorbidities, and place of residency were the most important determinants of having adverse health behaviours. Conclusions: The minority of people with CRC were not meeting the PA or 5-A-day recommendations. It is important to notify the health policy makers and to develop a comprehensive educational program to enhance the adherence to healthy lifestyle recommendation among CRC survivors.

Objective To examine the clinical epidemiology and treatment findings of tuberculosis in Babol, Northern Iran. Methods This cross-sectional study was carried out on medical records of tuberculosis registry pertaining to health center of Babol City, Mazandaran, Iran. The investigated variables included demographic characteristics and some clinical patterns of patients. To present the findings, the descriptive statistics such as mean (and SD) and frequency (%) was used. Analytical statistics was applied by using Chi -square test and independent samples t -test. Results The average age of 200 patients infected with tuberculosis was 47.51 years (SD = 21.36), and 58.5% of the cases were male. In both genders, the highest number of tuberculosis patient was found in 18–38 age group. During the 5-year study period, 95% of the patients received treatment protocol 1 (including new cases with positive smear, negative smear, extra-pulmonary) and in the end of treatment given to patients, 90.5% were improved or treatment period completed. The most important clinical symptoms for referring the patients to the therapeutic centers were cough (75.1%) and fever (60.9%). Conclusions Education and giving information to general population about the most important clinical symptoms of tuberculosis such as fever and cough might be effective in early detection and prevention of Mycobacterium tuberculosis . Then treatment might be effective in decreasing the burden of the disease.

Objective To describe the current situation of animal bites in the Babol County, North of Iran. Methods This was a cross-sectional study based on recently collected data of 3 798 victims bitten (656 females and 3 142 males) from 2010 to 2014 in the Health Center of Babol, Iran. The interest variables in the study included demographic variables, characteristics of animal, some of the time patterns, and some clinical patterns provided to victims. Results The average age of victims was (33.68 ± 17.23) years. The age group with the max proportion (for males, 32.1%; for females, 26.2%) of bites occurred in 18–30 years old group for males and 30–45 years for females. The ratio of male victims to female ones was 4.78. In terms of place of incident, 2 502 (65.9%) cases of animal bites occurred in rural areas. Dogs and cats were the most dominant biters with 3 340 (87.9%) and 395 (10.4%) bites, respectively. For the kinds of biters, 3 643 (95.9%) were pets, 133 (3.5%) were strays and 22 (0.6%) were wild animals. Most of the lesions were on shoulder as well as upper organs (46.9%) and lower organs (41.0%), respectively. Conclusions Since the average age of the subjects with injuries on the head and upper organs was lower than that of victims with other organs injured and since that pet dogs were the major biter, structured monitoring programs that focus on specified target groups in collaboration with other organizations are essential to control the animal bites.

Although there are numerous modalities to evaluate perianal fistula, there is still a need to determine the most sensitive, specific, and accurate modality. This study was conducted to determine the performance characteristics of magnetic resonance imaging (MRI) and contrast-enhanced three-dimensional endoanal ultrasonography (C-3DEAUS) considering surgery as the gold standard. A total of 36 patients who were diagnosed of having anal fistula with 10-MHz hydrogen peroxide-enhanced three-dimensional EAUS underwent MRI followed by surgery. Both of tests were done the day before surgery. Fistula classification was determined with each modality according to Parks’ criteria as inter-sphincteric, trans-sphincteric, extra-sphincteric, or supra-sphincteric and was compared with the surgical findings in all patients. If the accuracy of each modality was at least 85 % compared with the surgery, it was considered as clinically useful. Agreement for the classification of the primary fistula tract was 94.3 % for C-3DEAUS and surgery, 97.1 % for MRI and surgery. Considering a clock face, C-3DEAUS and surgery agreed in location of internal opening in 88.6 % of cases while MRI and surgery agreed in 97.1 %. In detection a collection, agreement between C-3DEAUS and surgery was 82.9 %, and 97.1 % between MRI and surgery. Both methods had almost perfect agreement with surgical findings in the classification of the primary fistula tract but MRI had more agreement in distinguishing other aspects of a fistula and it can be used as the most reliable method for preoperative evaluation of perianal fistulas.

Colorectal cancer (CRC) is one of the most common types of gastrointestinal cancers. This study aimed to determine the demographic characteristics and their relationships with the results of the first screening program for CRC in people over 50 years old in northern Iran.This cross-sectional study was conducted in 2016 on 924 eligible people over 50 years old. Initial screening was done by IFOBT and then colonoscopy was performed if the results were positive. The demographic characteristics of individuals including age, sex, place of residence, marital status, body mass index (BMI) and education level were investigated with the results of the colonoscopy and the test results.The mean age of participants was 59.38 years, and the participation of women (57.0%) and rural residents (54.2%) were higher in the screening program. According to the demographic variables, age was considered as a strong independent predictor variable, so that the prevalence of positive test results was more than 2 times higher in subjects older than 70 compared with subjects aged ≤60 (OR =2.05; 95% CI, 1.18-3.55, P=0.010). Also, the chance of positive test result in the age group ≤55 years old was 23%, with an increase of 64% in the age group above 75 years (P0.001). Among the positive test subjects, 118 cases underwent colonoscopy.The prevalence of IFOBT positivity was increased with age. Therefore, given the aging population of the country, it is recommended to emphasize on the screening of older people in the general population.

Crested wheatgrass (Agropyron cristatum L.) is a cool-season perennial grass, which has demonstrated its potential for use as turfgrass. However, limited information is available on its drought and salinity tolerance. The main purpose of this study was to investigate the changes in the antioxidant defence system and physiological traits of six Iranian crested wheatgrass genotypes under drought and salinity stresses. The experimental design comprised a split plot with water treatments (control well-watered, salinity stress and water stress) as main plots and genotypes as subplots. This study demonstrated the variations in drought and salinity tolerance among crested wheatgrass genotypes. ‘ACSKI’, ‘ACAMI’ and ‘ACDTI’ generally performed better than other genotypes under drought and salinity conditions, mainly by maintaining higher activities of antioxidant enzymes like superoxide dismutase, peroxidase, catalase, ascorbate peroxidase and non-enzyme antioxidants like glutathione, higher proline and total non-structural carbohydrates content. The increased, decreased, and unchanged activities of antioxidant enzymes in the crested wheatgrass genotypes indicates a different forms of metabolism of antioxidant enzymes in response to drought and salinity stress. In general, drought and salinity stress increases the malondialdehyde (MDA) content and hydrogen peroxide (H2O2) content; however, ‘ACSKI’, ‘ACAMI’ and ‘ACDTI’ genotypes could tolerate an increase in MDA content and H2O2 content; therefore, lower levels of MDA content and H2O2 content were observed. The results showed that increasing levels of diamine oxidase and polyamine oxidase have been associated with increasing drought and salinity tolerance. Based on the biochemical and physiological parameters that were evaluated, we concluded that the genotype ‘ACSKI’ was superior in terms of drought and salinity tolerance. This superiority was mainly a result of better enzymatic and non-enzymatic antioxidant defence system and better osmotic adjustment under stress conditions.