Search

For many years, people and even some doctors believed that opium has beneficial effects on cardiovascular disease and diabetes. The effect of opium as a stimulator or inhibitor on the metabolic reg...

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 COVID-19 was discovered in February in China. Due to the high prevalence of the disease, early detection and rapid isolation of patients are the vital points for controlling the outbreak. The purpose of this study was to determine the correct location of chest CT scan in the diagnosis of COVID-19. Main text The current study is a systematic review and meta-analysis. 2959 papers were found in all national and international databases. The study has been reported based on the PRISMA checklist. All analyses were done by CMA Ver. 2 software. The statistical analysis results show that the GGO observation level in the available shape was 46% in CT scan results, and the consolidation observation level in the general form was 33% in CT scan results. Pleural effusion was 7%, and linear opacity observation level was 24% in CT scan results in the general form. The CT scan test sensitivity level was gained 94.7%, and PCR test sensitivity level was achieved as 94.8%. This level was 89% in the early stage. Conclusion The chest CT has about 24% higher diagnostic sensitivity than the PCR test, in the early stage. GGO revealed a declining process and also indicates that GGO is an early symptom of the disease in CT scan. Linear opacity is the reason behind the initial dyspnea in coronavirus suffering patients referring to the medical centers. The extra-pulmonary lesions increase in the last stage of the disease that makes the patient’s worse.

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.

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.

Background: We aimed to estimate the exploratory factor analysis (EFA) of metabolic syndrome components based on variables including gender, BMI, and age groups in a population-based study with large sample size. Methods: This study was conducted on 10663 individuals 40-70 yr old in Phase 1 of the Persian Kharameh cohort study conducted in 2014-2017. EFA of the metabolic syndrome components, including waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein (HDL) and fasting blood sugar (FBS), was performed on all participants by gender, BMI (Body Mass Index), and age groups. Results: EFA results in the whole population based on eigenvalues ​​greater than one showed two factors explaining 56.06% of the total variance. Considering factor loadings higher than 0.3, the first factor included: DBP, SBP, and WC, named as hypertension factor. The second factor also included TG, negative-loaded HDL, FBS, and WC, named as lipid factor. Almost similar patterns were extracted based on subgroups. Conclusion: MetS is a multi-factorial syndrome. Both blood pressure and lipid had a central role in this study and obesity was an important factor in both ones. Hypertension, having the highest factor loading, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.

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.

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.

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.

Introduction: End-stage renal disease (ESRD) is an advanced stage of chronic kidney disease requiring hemodialysis (HD). The long-term efficacy of HD in ESRD patients highly depends on treatment adherence. Objectives: This study aimed to validate the health action process approach (HAPA) questionnaire to predict treatment adherence in HD patients. Patients and Methods:This cross-sectional study was conducted in teaching hospitals in Shiraz during 2018. A total of 220 patients with ESRD under HD were selected using convenience sampling method. Furthermore, the validity, clarity, and comprehensiveness of the questionnaire were validated by a group of patients and experts. Then the exploratory factor analysis (EFA) was performed, and the reliability was determined using Cronbach’s alpha. Internal consistency was assessed using test-retest method (one-month interval) and calculating intra-class correlation coefficient (ICC) index. Results: Content validity index (CVI) and content validity ratio (CVR) were obtained 0.98 and 0.95 respectively indicating adequate content validity. Six constructs (risk perception, action self-efficacy, behavioral intention, planning, maintenance self-efficacy and recovery self-efficacy) were extracted using EFA. These constructs explained 51.4% of total variance. The Cronbach’s alpha of different constructs ranged from 0.68 to 0.82. Furthermore, the ICC ranged from 0.67 to 0.78 indicating an acceptable internal consistency. Conclusion: The HAPA questionnaire is a valid and reliable tool for assessing treatment adherence in HD patients. Further studies are recommended on larger sample sizes and other Iranian populations.

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.

Introduction: Almost one-third of the world’s population is at risk of exposure to tuberculosis (TB) infection. The aim of this study is to describe some patterns of TB in the Babol, Iran, to analyze the current situation and to improve the care of these patients. Methods: This was a cross-sectional study. The data were obtained from medical records pertained to patients with TB of Health Network of Babol County. The variables of interest were demographic characteristics and some clinical patterns. To describe data, indices such as mean ± SD and frequency (percent) was used. Furthermore, analysis of the data was performed by inferential statistical techniques of chi-square, independent samples t-test, and one-way analysis of variance test. Results: Two hundred patients with TB were enrolled. The average age of cases were 47.51 years [standard deviation (SD) = 21.36] and 58.5% of them were males. Age groups of 18-40 and over 60 years old comprised the majority of patients with TB 39.0 and 31.5%, respectively. The median interval time between beginning symptoms and confirmed diagnosis of TB was 56.5 days with interquartile range (IQR) of 56 days. The greatest of the time interval of beginning symptoms and diagnosis belonged to the age group of below 7 years old. The greatest time interval from confirmed diagnosis to treatment pertained to the age groups of 18-40 and 7-18, respectively. In terms of pulmonary TB, 120 (80.0%) were smear positive and 30 (20.0) smear negative. In terms of medicines given to the patients with TB, 181 (90.5%) were completed the treatment and improved, 6 (3.0%) absence of treatment, and 13 (6.5%) died as a result of TB and other causes.Conclusion: This study showed that adults and elderly comprise the highest proportion of TB. The primary prevention and control programs for education and timely referral to the Health Network may be effective in diminishing the morbidity due to TB.

The main incentive in processing fruits such as apple is reduction of losses and gaining added value. In this research, drying kinetics and drying efficiency of Golden Delicious apple slices are investigated using hot air flow and uniform microwave drying. Microwave power levels, 500, 1,000, 1,500, and 2,000 W, air temperatures, 40, 50, 60, and 70°C and air velocities, 0.5, 1, 1.5, and 2 ms−1 were selected. Results revealed that microwave dehydration is highly time-efficient with 80% reduction of processing time, compared to hot air method. Highest value of drying efficiency was found in microwave method and it was reduced by 99% in the case of hot air drying. Energy costs to cover the drying process were decreased by 60% when the microwave method was used. Technically speaking, microwave drying resolves insufficiency of hot air method along with a significant enhancement of drying rate, drying efficiency and energy economy. Practical applications Drying of agricultural commodities is known as a main challenge in the processing industry regarding the waste reduction, longer shelf time, easier transportation, and storage. The main technique in this regard is currently hot air convection method which suffers energy consumption and surface hardening. Reduction of drying time and energy consumption with simultaneous enhancement of drying efficiency and energy economy are well known features in modern drying technologies such as microwave method. However, microwave systems are rarely utilized in industry, because of lack of operating information and high-tech hardware issues. Application of microwave technology in dehydration of apple fruits can result in significant improvement in the processing economy. Volumetric and uniform heating as the primary benefit of microwave drying can be mentioned as an undeniable incentive to producers, processors and industrialists. Additionally, investigation of kinetics of drying is the first step for dryer design or scale-up.

Background: End-Stage Renal Disease (ESRD) is an irreversible impairment of kidney function that leads to permanently dependent on alternative therapies such as hemodialysis, peritoneal dialysis, and renal transplantation. This study aimed to systematically investigate the survival rate of patients with renal transplantation, graft, and its related factors in Iran. Methods: This systematic review and meta-analysis drew on articles indexed in six international and one internal databases (Medline/PubMed, ProQuest, Scopus, Embase, SID, and Web of knowledge) until Nov 2020. The reporting of the present study was performed in terms of PRISMA statement. All analyzes were performed using the STATA software. Results: Overall, 367 titles from 6 databases were evaluated of which 86 articles met the inclusion criteria. According to the random model, the graft survival rate at one, three, five, and 10 years were 92.48%, 85.08%, 79.96% and 68.15% respectively. Additionally, the patient survival rates at one, three, five, and 10 years were 91.27%, 86.46%, 81.17% and 78.15% respectively. There was a significant relationship between the age recipient and three-year graft survival rate (P=0.021). Additionally, there was an inverse and significant relationship between the donor age and 10-year patient survival rate (P=0.011). Conclusion: The patient and graft survival in transplanted kidney patients is comparable with most developed countries.