Search

Aim: This study aims to correct undercounts in cancer data before initiating a population-based cancer registry program, employing an innovative Bayesian methodology. Background: Underestimation is a widespread issue in cancer registries within developing countries. Methods: This secondary study utilized cancer registry data. We employed the Bayesian approach to correct undercounting in cancer data from 2005 to 2010, using the ratio of pathology to population-based data in the Golestan province as the initial value. Results: The results of this study showed that the lowest percentage of undercounting belonged to Khorasan Razavi province with an average of 21% and the highest percentage belonged to Sistan and Baluchestan province with an average of 38%. The average age-standardized incidence rate (ASR) for all provinces of the country except Golestan province was equal to 105.72 (Confidence interval (CI) 95% 105.35-106.09) per 100,000 and after Bayesian correction was 137.17 (CI 95% 136.74-137.60) per 100,000. In 2010 the amount of ASR before Bayesian correction was 100.28 (CI 95% 124.39-127.09) per 100,000 for women and 136.49 (CI 95% 171.20-174.38) per 100,000 for men. Also, after implementing the Bayesian correction, ASR increased to 125.74 per 100,000 for women and 172.79 per 100,000 for men. Conclusion: The study demonstrates the effectiveness of the Bayesian approach in correcting undercounting in cancer registries. By utilizing the Bayesian method, the average ASR after Bayesian correction with a 29.74 percent change was 137.17 per 100,000. These corrected estimates provide more accurate information on cancer burden and can contribute to improved public health programs and policy evaluation. Furthermore, this research emphasizes the suitability of the Bayesian method for addressing underestimation in cancer registries. It also underscores its pivotal role in shaping the trajectory of future investigations in this field. [ABSTRACT FROM AUTHOR]

Background: Knowledge, attitudes, and practices (KAP) studies are widely used in public health. This study aimed to investigate and compare KAP among patients with coronary artery disease (CAD) and premature coronary artery disease (PCAD) regarding cardiovascular disease (CVD). Methods: This cross-sectional study was conducted on 100 PCAD patients and 100 CAD patients in a general hospital in Tehran, Iran, between April and October 2022. A valid questionnaire was utilized to gather information, and descriptive analysis and logistic regression were employed for analysis using SPSS, version 23. Results: This study involved 100 CAD and 100 PCAD patients with average ages of 68.09±7.20 and 50.20±7.65 years, respectively. Men accounted for 58% of the PCAD group and 73% of the CAD group. The PCAD group had a higher level of knowledge and exhibited a more positive attitude toward CVD than the CAD group (P=0.007 and P<0.001, respectively). The PCAD patients and those with a family history of chronic diseases had a higher level of knowledge (P=0.045 and P=0.27, respectively) and showed a more positive attitude (P=0.030 and P<0.001, respectively). However, participants with a self-reported history of chronic diseases and those who were employed exhibited a less positive attitude. Occupation was associated with nutritional and smoking status (P=0.037). Conclusion: Higher levels of knowledge and more positive attitudes regarding CVD were observed; still, the study population's behaviors were unsatisfactory. Educational interventions are needed to promote positive health behaviors, emphasizing the link between knowledge and risk reduction and decreased CVD and mortality rates. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to detect relationships among quality of life (QoL) and anxiety and demographic factors in patients with celiac disease (CD). Background: CD is a type of autoimmune small intestine diseases caused by gluten ingestion. In Iran, the prevalence of CD is considered to be 1% in the general population. As physical problems and behavioral disorders of CD can lead to a reduction in QoL. Methods: This cross-sectional study was performed on 533 patients with Celiac Disease from 9 cities of Iran. Data collected were analyzed by SPSS version 22. Quality of life and anxiety respectively evaluated by (GHQ-28) and SAS questionnaires. Predictors of quality of life (sex, age, age of diagnosis, city of life, education level, family history of celiac, occupation and anxiety) were tested by multiple linear regression. Results: Our results showed a significant relationship between poor quality of life and anxiety (correlation= -0.143, P=0.001). The mean of the quality of life index in celiac diseases was 126.2±30.4 and women had a lower quality of life than men (P=0.003) importantly in emotions and worries scores. There was no significant difference between male and female in terms of anxiety level. Conclusion: According to the results, both quality of life and anxiety correlated together and women seem to suffer more than men from celiac disease. Therefore, greater attention to women who have celiac disease are suggested. [ABSTRACT FROM AUTHOR]

Objective: The actual impact of the pandemic on COVID-19 specific mortality is still unclear due to the variability in access to diagnostic tools. This study aimed to estimate the excess all-cause mortality in Iran until September 2021 based on the national death statistics. Results: The autoregressive integrated moving average was used to predict seasonal all-cause death in Iran (R-squared = 0.45). We observed a 38.8% (95% confidence interval (CI) 29.7%–40.1%) rise in the all-cause mortality from 22 June 2020 to 21 June 2021. The excess all-cause mortality per 100,000 population were 178.86 (95% CI 137.2–220.5, M:F ratio = 1.3) with 49.1% of these excess deaths due to COVID-19. Comparison of spring 2019 and spring 2021 revealed that the highest percent increase in mortality was among men aged 65–69 years old (77%) and women aged 60–64 years old (86.8%). Moreover, the excess mortality among 31 provinces of Iran ranged from 109.7 (Hormozgan) to 273.2 (East-Azerbaijan) per 100,000 population. In conclusion, there was a significant rise in all-cause mortality during the pandemic. Since COVID-19 fatality explains about half of this rise, the increase in other causes of death and underestimation in reported data should be concerned by further studies. [ABSTRACT FROM AUTHOR]

Aim: Description of the inflammatory bowel disease natural history in Tehran province. Background: Inflammatory bowel disease (IBD) is a non-homogeneous disorder with an unpredictable natural history that impairs a patient's quality of life over the course of their life. As a result, providing evidence for efficient patient management is critical. Methods: In this case series study, 198 IBD patients who were visited in our clinic at least three times routinely from Oct 2015 to May 2020 were included. Then, two panel-based approaches, the Multi-State Model (MSM) and random-effect ordered logistic, were used to deduce the clinical course of IBD, which included remission, mild, moderate to severe, and surgical states. Results For ulcerative colitis (UC), women had a slightly poorer condition for remission but better for moderate to severe and a faster transition from moderate to severe to mild (HR=1.490, 95% CI: 1.02-2.16) compared to men. For Crohn's disease (CD), they had a better condition for remission but a slightly poorer condition for the severe state and higher transition from mild to moderate to severe (HR=1.221, 95% CI: 0.4713.22) than men. Oral 5-ASA had better efficacy in people with remission and/or mild states but not for those with moderate to severe states, especially in CD (mild to moderate to serve, HR=1.526, 95% CI: 0.59-3.89). Immunosuppressive drugs were better for patients with lower disease severity, especially with UC (mild to remission, HR=1.258, 95% CI: 0.75-2.09). Conclusion: Panel approaches have the potential efficacy to tackle the unpredictable clinical course of IBD (UC/CD). Hence, we highly recommend that our findings be included into the Iranian routine clinical environment of IBD and/or that related studies be conducted in Iran and other regions to gain a better understanding of the natural history of IBD. [ABSTRACT FROM AUTHOR]

Background: The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD).Methods: To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches.Results: In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high-income Asia-Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively.Conclusions: Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data. [ABSTRACT FROM AUTHOR]

Introduction: The disease related to the coronavirus disease 2019 (COVID-19) has now been a pandemic throughout the world. Although the epidemiological studies and clinical trials are utilized to find standard measures and medicines to prevent and control COVID-19, addressing the mental health and psychology of the people who may be at risk of the disease may also be effective to find comprehensive methods to better overcome this pandemic. This study aimed at investigating the mental status of both the general population and healthcare personnel during this pandemic in Iran. Methods: Using a cross-sectional design, a sample of 296 medical staff and 532 people living in Tehran city of Iran were included in the study. The assessment was performed by Depression, Anxiety, and Stress scale short-form (DASS-21). Two groups were matched in terms of some demographical factors such as age, gender, and marital status. Analysis of covariance (ANCOVA) was utilized to perform comparisons between the two groups. Results: Both samples of the general population and medical staff had high levels of stress, anxiety, and depression. The mean score of anxiety and depression among medical staff was higher than that of the general population (P < 0.001). There was no significant difference between the two groups in terms of stress level. Conclusion: It seems both the Iranian general population and healthcare personnel are under mental pressure caused by COVID-19, indicating an urgent need for intervention and using preventive measures to control the negative impacts of the diseases on the psychological well-being of these people. Further studies in other regions affected by the disease may provide more evidence in this regard. [ABSTRACT FROM AUTHOR]

In the current highly competitive airline market, many companies have failed due to their low revenue rates. For this reason, many of them have to develop strategies to increase their revenue. In this study, we develop revenue management (RM) strategy for the Iranian airline industry. More specifically, we present a mathematical model that considers some conditions not studied in previous research in order to provide a more realistic RM modeling of airlines that fits well for the special characteristics of Iranian Airways. A binary differential evolution algorithm is employed to solve the model due to the stochastic nature of data and the NP-hardness of the considered problem. To generate maximum revenue among the six types of airplanes that fly the four capital cities of Iran, the airline under investigation is advised to operate only 21 flights to those cities and cancel the rest of the flights. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused serious psychological problems, including panic attack, anxiety, stress, and depression. The main objective of this study was to measure the prevalence and compare the severity of this psychological distress among four groups of an Iranian population. Method: In a cross-sectional survey, the mental health status of four groups of an Iranian society including community population, patients with COVID-19, medical staff, and medical students were investigated by the self-report questionnaire of Depression, Anxiety, and Stress Scale (DASS). DASS-21 questionnaire and the demographic data sheet were filled out by the participants. All statistical analyses were done using R version 3.6.1 software. P-values less than 0.05 were considered as statistically significant. ANOVA test was used to compare the severity of stress, anxiety, and depression between the four study groups. Results: Of the 886 participants in this survey, 554 (62.5%) were men and 332 (37.5%) were women, and the mean ± standard division of age was 40.91 ± 10.7 years. Among these participants, 241 (27.2%) were selected from community population, 221 (24.9%) were patients with COVID-19, 217 (24.5%) were medical staff, and 207 (23.4%) were medical students. The mean score of stress, anxiety, and depression in medical students and patients with COVID-19 was significantly higher than in medical staff and community population (P < 0.05). Overall, the anxiety score in men was higher than that in women (27.4 ± 4.6 vs. 26.48 ± 4.8, P = 0.006), and unmarried participants had a significantly higher depression score compared with the married group (27.5 ± 4.8 vs. 26.7 ± 4.6, P = 0.023). In addition, the score of depression was higher in female medical staff (27.08 ± 4.6 vs. 25.33 ± 4.3, P = 0.011) and community population (26.6 ± 4.3 vs. 25.3 ± 4.3, P = 0.02) than in male. Conclusion: COVID-19 patients and medical students in contact with these patients were at a high risk for mental illness due to lower experience compared with professional medical staff and community population. Continuous surveillance and monitoring of psychological distress for outbreaks should become a routine part of preparedness efforts worldwide. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to evaluate two supply chain resilience key elements of vulnerability and capability in the automotive industry. Design/methodology/approach: We propose a fuzzy approach for statistical hypothesis testing and analyze two research hypotheses by synthesizing the results of a questionnaire given to 44 companies in the Iranian automotive industry. Findings: The results indicate that the automotive industry in Iran should: (1) resist five elements of vulnerability, i.e. "external pressures," "sensitivity," "connectivity," "supplier/customer disruptions," and "resource limits," and (2) embrace nine elements of capability, i.e. "flexibility in order fulfillment," "capacity," "efficiency," "visibility," "adaptability," "recovery," "dispersion," "organization," "market position" and "security" to achieve greater resiliency elasticity in the supply chain. Originality/value: This is the first study on the supply chain resilience vulnerabilities and capabilities in the Iranian automotive industry. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer (GC) has been considered as the 5th most common type of cancer and the third leading cause of cancer-associated death worldwide. The aim of this historical cohort study was to evaluate the survival predictors for all patients with GC using the Cox proportional hazards, extended Cox, and gamma-frailty models.Methods: This historical cohort study was performed according to documents of 1695 individuals having GC referred to three medical centers in Iran from 2001 to 2018. First, most significant prognostic risk factors on survival were selected, Cox proportional hazards, extended Cox, gamma-frailty models were applied to evaluate the effects of the risk factors, and then these models were compared with the Akaike information criterion.Results: The age of patients, body mass index (BMI), tumor size, type of treatment and grade of the tumor increased the hazard rate (HR) of GC patients in both the Cox and frailty models (P < 0.05). Also, the size of the tumor and BMI were considered as time-varying variables in the extended Cox model. Moreover, the frailty model showed that there is at least an unknown factor, genetic or environmental factors, in the model that is not measured (P < 0.05).Conclusions: Some prognostic factors, including age, tumor size, the grade of the tumor, type of treatment and BMI, were regarded as indispensable predictors in patients of GC. Frailty model revealed that there are unknown or latent factors, genetic and environmental factors, resulting in the biased estimates of the regression coefficients. [ABSTRACT FROM AUTHOR]

Background: The main aim of the present study was to map the real high risk regions of gastric cancer (GC) using corrected data for misclassification error in all Iranian provinces. Method: In this cross-sectional study, the data were extracted from the reports of Ministry of Health and Medical Education and previous studies on correcting GC registered data including 30 provinces in 2008. The information about socioeconomic factors was extracted from the statistical centers of Iran. To estimate the model parameters, the Bayesian approach was used with regards to spatial correlation due to adjacent effects. Results: The southern and northern provinces were introduced as high-risk regions and the central provinces were introduced as low-risk regions. The mean household income was inversely associated with the risk of GC. Conclusion: The real high-risk regions of GC in Iran are the north and south border provinces which should be considered by health policy makers. It is also necessary to correct misclassified registered data which can lead to seduction in health service allocation. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate the association between serum levels of interleukin IL-1, IL-6, IL-8 genes as well as interferon (IFN)-γ and the risk of celiac disease (CD). Background: The role of serum cytokine levels in the pathophysiology of CD is still an open field to be explored. Methods: This case-control study was performed on 110 patients with CD and 46 healthy controls referring to Taleghani Hospital, Tehran, Iran. Expression levels of IL-1, IL-6, IL-8, and IFN-γ were assessed by enzyme-linked immunosorbent assay (ELISA) kits. Results: The Bayesian intervention odds ratio (OR) and Highest Posterior Density (HPD) interval were 1.133 (95% credible interval 1.018- 1.269), 0.947 (95% credible interval 0.898 - 0.996) and 1.004 (95% credible interval 1.001- 1.009) for IL-1, IL-6, and IL-8 respectively. Conclusion: The serum level of IFN-γ has no effect on the risk of CD, but given the OR and the HPD interval obtained for serum levels of IL-1, IL-6 and IL-8, with one unit increase in IL-1 serum, the risk of CD grows by 1.13 times while one unit increase in IL-6 serum reduces the risk of CD by 15%. Finally, regarding IL-8, the risk of CD increases by 0.004 times with a unit increase in IL-8 serum. [ABSTRACT FROM AUTHOR]

Background/aim: The Y-chromosome mainly consists of heterochromatin regions that have a father-to-son inheritance. Short tandem repeat polymorphic (STRP) markers distributed all over the chromosome provide the opportunity for investigations in forensic medicine and ancestral lineage studies. Due to the existence of wide varieties of geographical and ethnic groups in Iran, studying Y-STRP markers is necessary for further applications. Here we investigated the provinces of Mazandaran and Gilan for the first time. Materials and methods: Samples included 119 and 90 unrelated males from Mazandaran and Gilan, respectively. Using a PCR amplification kit, 17 Y-STRP markers were amplified and genotyping was conducted by capillary electrophoresis. Allele frequency, haplotype diversity (HD), and haplotype discrimination capacity (DC) were calculated. The populations were compared together and to neighboring countries including Afghanistan and Azerbaijan by FST index. Results: A total of 204 unique haplotypes were observed. No uniqueness was observed between the two provinces. HD was 0.9993 and 0.9998 in Mazandaran and Gilan, respectively. DC was 0.9666 and 0.9888 for Mazandaran and Gilan, respectively. DYS385b and DYS391 had the most and least polymorphic content in both provinces, respectively. There was not a significant difference between these two provinces (FST = 0.0006 and P = 0.00) and neighboring countries. Conclusion: The results highlight the effectiveness of these Y-STRP markers for male discrimination in the north of Iran. Using additional markers along with extended sample size would provide a better opportunity for removing matched haplotypes and introducing the best polymorphic markers in this specific population. [ABSTRACT FROM AUTHOR]

Background: The first-degree relatives (FDRs) of patients with colorectal cancer (CRC) are at a 2 to 3-fold increased risk of developing the disease compared with the general population. Objectives: This study aimed to determine the relationship between the lifestyle of colorectal cancer patients' FDRs and their compliance in colonoscopy screening test. Methods: This cross-sectional study conducted on FDRs of patients with colorectal cancer in one educational hospital, Tehran, Iran in duration 2018. A total of 114 patients' FDRs were consulted face to face by preventive medicine specialist and data collecting forms were fully completed. Three months later the FDRs were followed for undergoing colonoscopy screening test or decision to do it soon. Next, the relationship between lifestyle [BMI (body mass index), cigarette smoking, diet, physical activity], socioeconomic status (job, income, health insurance), and comorbidities with a tendency to participate in colonoscopy screening program assessed. In multivariable logistic regression analysis, predictor factors for colonoscopy screening in FDRs were investigated. The data were analyzed using SPSS V. 18 software and the significance statistically was P < 0.05 in the all tests. Results: Overall, 57% of FDRs undergone colonoscopy tests up to time of study or they were tended to do it soon. In multivariable logistic regression, age <50 years old (P = 0.01, OR = 1.08,95%CI: 1.01-1.8), higher income (equal and more than 20 million Rials) (P < 0.001, OR = 2.5,95%CI: 1.8-11), appropriate physical activity (≥ 150 minutes weekly) (P < 0.001, OR = 5.2,95%CI: 4.6-17.5) and normal diet (intake of carbohydrate, fat, protein, fruit and vegetables) (P = 0.006, OR = 3.02, 95%CI: 2.9 - 6.6) were the predictor factors to compliance the FDRs for participation in colonoscopy screening program. Conclusions: Although in this study there was an association between lifestyle of FDRs and the compliance rate of colonoscopy screening test but according to the vulnerability of the relatives, more research in this field should be carried out. [ABSTRACT FROM AUTHOR]

Aim: To estimate the number of confirmed cases and the rate of death and also to investigate the cause of death in Italy, Iran and South Korea in the next month. Background: Growing number of confirmed and deaths cases from the coronavirus worldwide, particularly in Italy, Iran and South Korea, has resulted concerns about the future of these countries and their deterioration. Also the European region is likely to face more casualties due to the delay in the virus reaching most of its regions and, of course, as the trend continues. Methods: We conducted a simulation in both current and ideal situation for the next month to predict the death rate and examine the reason for the difference in Italy, Iran and South Korea individually. If we assume the cultural and political factors and age pyramids distribution are similar across regions, the differences are mainly due either to the heavier health-care burden owing to the larger population or to the medical facilities diversities. Results: Our results for Italy showed higher death number, but the rate would be more for Iran. South Korea is also expected to have a smaller increase in the number of confirmed cases and deaths compared to Iran and Italy by the next month. Conclusion: Given the prevailing conditions around the world and the increasing number of casualties, it is essential that all countries, especially those with fewer days of involvement, shall do their best to avoid major losses and damages. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a heterogeneous disease that occurs in different parts of the gastrointestinal system. Objectives: This study aimed at analyzing the effects of risk factors on survival and cure fraction of patients with CRCin a population of Iranian patients, using parametric non-mixture cure rate model. Methods: This retrospective cohort study was conducted at Shiraz University of Medical Sciences on 512 patients with CRC. Patients were followed-up for 8 years, from January 2009 until February 2017. Stepwise selection and parametric non-mixture cure rate model were used to find the risk factors of survival in patients with CRC. Akaike information criteria was used to identify the best parametric non-mixture cure rate model in this study. Results: Staging III (OR = 0.41, 95% CI: 0.19 - 0.90, P = 0.026), staging IV (OR = 0.15, 95% CI: 0.04 - 0.50, P = 0.002), Perineural invasion (OR = 0.41, 95% CI: 0.21 - 0.92, P = 0.007), and lymph node ratio (OR = 0.94, 95% CI: 0.51 - 0.82, P = 0.002) had significant effects on cure fraction and survival of patients with CRC. Conclusions: Perineural invasion, Lymph node ratio, and American Joint Committee on Cancer (AJCC) staging should be assessed as an important factor in modeling survival analysis of patients with CRC. Patients who were in advanced stages of CRC should have received treatment and appropriate therapies given their shorter survival rates. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is a highly prevalent cancer across the world, which is associated with significant mortality. Therefore, special attention must be paid to the prevention and care of this fatal disease. The present study aimed to evaluate the effective methods to prolong the survival of colorectal cancer patients and determine the influential factors in their longevity using the exponentiated Weibull statistical model. Methods: Medical records of 446 colorectal cancer patients referring to Taleghani Hospital in Tehran, Iran during 1985 - 2013 were reviewed. The exponentiated Weibull model is an extended version of the Weibull model, which is used to investigate the survival of colorectal cancer patients and assess the influential factors in their survival and longevity. We also compared the model with the Weibull-exponential model for better practice. Results: Mean survival rate of the patients was 4.52+0.182 years. According to the exponentiated Weibull model, age at diagnosis was the only significant influential factor in the survival of colorectal cancer patients (P= 0.002). Other factors such as gender, tumor size, family history of colorectal cancer, tumor site, and body mass index had no significant effects on the survival of these patients. The proposed model was considered superior to theWeibull-exponential model due to the lower Akaike's information criterion. Conclusions: According to the results, age of colorectal cancer patients at the time of diagnosis is the most important influential factor in increasing their survival and reducing the mortality rate. Therefore, it is recommended that proper care be provided for the elderly patients with colorectal cancer, especially at the onset of the disease. [ABSTRACT FROM AUTHOR]

The objective of this meta-analysis was to determine the prevalence of depressive symptoms and suicidal behaviors among high-school students in Iran. A comprehensive search strategy was conducted in the following original databases: PubMed, Web of Science (ISI), Scopus, Psycinfo, and national databases, including the Scientific Information Database (SID) and MagIran, from January 1988 through January 2023. Studies that reported the prevalence of depressive symptoms and suicidal behaviors among high school students in Iran were included. Two investigators extracted all relevant data independently. For deriving mean prevalence rates, random-effects meta-analyses were used. We assessed the quality of studies by the Joanna Briggs Institute (JBI). Total of 67 studies (45,798 participants) were included in the syntheses on depressive symptoms and suicidal ideation. For depressive symptoms, the mean prevalence rate was 48 % (40 %, 55 %). 2804 participants were enrolled for assessing of the prevalence of suicide ideation, and the mean prevalence rate was 21 % (6 %, 36 %). The meta-analysis pooling of the prevalence estimates of suicide attempts was 18 % (15 %, 20 %). Approximately half of the high school students experience depressive symptoms and, astonishingly, one in five high school students experiences suicidal ideation, so to identify strategies for preventing and treating depressive symptoms and suicidal behaviors in this special population, further research and policymaking are urgently needed. • Depression, which affects 4% to 8% of adolescents, is the world's leading cause of life years lost with a highprevalence around maturity • Suicidal ideation, suicide planning, and attempting suicide are different stages of suicidal behavior among high schools. • The mean prevalence rate of depression and suicide ideation were 48% and 21% respectively. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the impact of diabetes and hypertension on colorectal cancer (CRC) mortality. Background: One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias. Methods: One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias. Results: The effect size with ignorance misclassification bias was 0.78 for diabetes and 0.94 for hypertension respectively which both of them were not significant. After adjusting the misclassification and performing the robust Bayesian analysis, we arrived at region (0.27, 3.4) for OR of diabetes and (0.21, 2.31) for hypertension. Conclusion: our study demonstrated that diabetes and hypertension increase the risk of mortality in CRC patients, using robust Bayesian analysis and misclassification in diagnosis these two exposure could change or confound the results of this association. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to obtain more accurate estimates of the liver cancer incidence rate after correcting for misclassification error in cancer registry across Iranian provinces. Background: Nowadays having a thorough knowledge of geographic distribution of disease incidence has become essential for identifying the influential factors on cancer incidence. Methods: Data of liver cancer incidence was extracted from Iranian annual of national cancer registration report 2008. Expected coverage of cancer cases for each province was calculated. Patients of each province that had covered fewer cancer cases than 100% of its expectation, were supposed to be registered at an adjacent province which had observed more cancer cases than 100% of its expected coverage. For estimating the rate of misclassification in registering cancer incidence, a Bayesian method was implemented. Beta distribution was considered for misclassified parameter since its expectation converges to the misclassification rate. Parameters of beta distribution were selected based on the expected coverage of cancer cases in each province. After obtaining the misclassification rate, the incidence rates were re-estimated. Results: There was misclassification error in registering new cancer cases across the provinces of Iran. Provinces with more medical facilities such as Tehran which is the capital of the country, Mazandaran in north of the Iran, East Azerbaijan in north-west, Razavi Khorasan in north-east, Isfahan in central part, and Fars and Khozestan in south of Iran had significantly higher rates of liver cancer than their neighboring provinces. On the other hand, their neighboring provinces with low medical facilities such as Ardebil, West Azerbaijan, Golestan, South and north Khorasans, Qazvin, Markazi, Arak, Sistan & balouchestan, Kigilouye & boyerahmad, Bushehr, Ilam and Hormozgan, had observed fewer cancer cases than their expectation. Conclusion: Accounting and correcting the regional misclassification are necessary for identifying high risk areas of the country and effective policy making to cope with cancer. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to estimate the economic burden of celiac disease (CD) in Iran. Background: The assessment of burden of CD has become an important primary or secondary outcome measure in clinical and epidemiologic studies. Methods: Information regarding medical costs and gluten free diet (GFD) costs were gathered using questionnaire and checklists offered to the selected patients with CD. The data included the direct medical cost (including Doctor Visit, hospitalization, clinical test examinations, endoscopies, etc.), GFD cost and loss productivity cost (as the indirect cost) for CD patient were estimated. The factors used for cost estimation included frequency of health resource utilization and gluten free diet basket. Purchasing Power Parity Dollar (PPP$) was used in order to make inter-country comparisons. Results: Total of 213 celiac patients entered to this study. The mean (standard deviation) of total cost per patient per year was 3377 (1853) PPP$. This total cost including direct medical cost, GFD costs and loss productivity cost per patients per year. Also the mean and standard deviation of medical cost and GFD cost were 195 (128) PPP$ and 932 (734) PPP$ respectively. The total costs of CD were significantly higher for male. Also GFD cost and total cost were higher for unmarried patients. Conclusion: In conclusion, our estimation of CD economic burden is indicating that CD patients face substantial expense that might not be affordable for a good number of these patients. The estimated economic burden may put these patients at high risk for dietary neglect resulting in increasing the risk of long term complications. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prognosis factors of survival in patients with colorectal cancer in presence of competing risks, using generalized Weibull distribution, and to compare the results of Weibull modelas well as semi parametric models. Methods: A total of 1462 patients with colorectal cancer, registered in cancer registry center of research institute of gastroenterology and liver disease (from 2004 to 2015), Taleghani hospital, Tehran, Iran entered this study. Death and the causes of death were confirmed via telephone contact to patients' families. The demographic and clinical features included age at diagnosis, sex, family history of CRC, body mass index (BMI), tumor size and tumor site extracted from hospital documents. Generalized Weibull distribution, Cox regression analysis and Fine-Gary model were used to assess the prognosis of CRC survival. The analysis was carried out using R software version 3.0.2. P value less than 0.05 were considered significant. Results: Overall, 1060 CRC patients with completed data were included in the analysis. 58% were men and the mean ± SD of age at diagnosis was 53.67 ± 0.46 years. The mean ± SD of survival time was 56.96 ± 1.46 with median = 45.5 months. 380 patients (35.5%) died from CRC and 49 patients (4.6%) died from other causes of death, such as myocardial infarction, stomach cancer, liver cancer etc. Generalized Weibull model with competing risk analysis and other models indicated age and BMI as the prognosis. Conclusions: This study indicated age and BMI as the prognosis, using a generalized Weibull model with competing risk analysis. Also according to the survival curve estimation, generalized Weibull model with competing risk has a better fit to the data, compared to Weibull model. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify the effect of podcasting on Iranian learner's motivation and attitude. The participants consisted of 60 male students including 30 participants for the experimental group and 30 for the control group. All of them were studying in the second junior high school in Shahed school in Semnan, Iran. Their age ranged from 13 to14. The researchers randomly selected Shahed school from a list of all junior high schools inSemnan province. In addition, data were collected by using a questionnaire and an interview. In the present study, the researchers used Nelson's proficiency test for homogenizing the learners.Moreover, theresearchers collected the data through one questionnaire and an interview as data gathering instruments and podcasts and 'Prospect 2' book as instructional materials. A 46-item motivation questionnaire focused on evaluating English learners' beliefs and attitudes in Iran. A 7-item researcher-made interview was conducted with 10 participants. The main purpose of this interview was to investigate the effect of podcasting on the learners' attitude.The results of data analysis revealed that the application of podcasts as a motivational teaching strategy significantly benefited the experimental group to show a higher mean on classroom motivation. It also revealed that the application of podcast changes the learners' motivation positively. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the association between survival of patients with colorectal cancer and prognostic factors in a competing risk parametric model using Weibull distribution. Background: The prognosis of colorectal cancer is relatively good in terms of survival time. In many prognostic studies, patients may be exposed to several types of competing events. These different causes of death are called competing risks. Methods: Data was recorded from 372 patients with colorectal cancer who registered in the Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences (Tehran, Iran) from 2004 to 2015 in a retrospective study. Analysis was performed using competing risks model and Weibull distribution. Software used for data analysis was R, and significance level was regarded as 0.05. Results: The result indicated that, at the end of follow-up, 111 (29.8%) deaths were from colorectal cancer and 14 (3.8%) deaths were due to other diseases. The average body mass index (BMI) was 24.61(SD 3.98). The mean survival time for a patient in 372 was 62.05(SD 48.78) month with median equals to 48 months. According to competing-risks method, only stageIII ( HR, 1.69; 95% CI, 1.246-2.315 ), stageIV( HR, 4.51; 95% CI,2.91-6.99 ) and BMI( HR, 0.96; 95% CI, 0.96-0.975) have a significant effect on patient's survival time. Conclusion: This study indicated pathologic stage(III,IV) and BMI as the prognosis, using a Weibull model with competing risks analysis, while other models without the competing events lead to significant predictors which may be due to over-estimation. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. There have been several studies reporting the proximal tumor shift, especially in Western countries. In the present study, we investigated the clinicopathologic and 0 anatomical distributions of colorectal tumors in Iranian CRC patients. Materials and Methods: In this retrospective cohort study, 258 patients with CRC from 2008 to 2013 were evaluated. Comparison of variables was performed using Pearson's chi-square test and Fisher's exact test depending on the nature of the data. Results: A total of 258 patients including 124 (48.1%) females and 134 (51.9%) males enrolled in this study. The majority of cancers were detected in the rectosigmoid, i.e., 98 (38%) followed by the left colon, i. e., 84 (32.6%) and the right colon, i.e., 76 (29.5%). In the present study, we observed the significant association between metastases, adjuvant therapy, family history, and history of inflammatory bowel disease (IBD) with tumor, node, and metastasis (TNM) staging (P < 0.001). In univariate analysis, there was a strong association between overall survival (OS) and stage II CRC (P = 0.03). However, the predictive value was lost in multivariate analysis (P = 0.145). Conclusion: Unlike the majority of previous studies on Iranian CRC patients, we observed a considerably higher occurrence of right-sided colon cancers (84 versus 76). Although this phenomenon did not reach the statistical significance rate, based on recent studies on Iranian population including the present one, the pattern of anatomical distribution of colorectal tumors has been changed toward the proximal colon. This requires an urgent need to provide other strategies and complementary detecting approaches in order to identify proximal tumors in Iranian CRC patients. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to evaluate the time trend of Helicobacter pylori (H. pylori) prevalence and presence of intestinal Metaplasia over the period of seven years among gastritis Iranian patients. Background: H. pylori is the major causal factor in chronic gastritis. Its acquisition leads to a chronic, usually lifelong, inflammation of the gastric mucosa, which may gradually progress to atrophy with intestinal metaplasia in a significant proportion of infected individuals. Patients and methods: H. pylori and intestinal Metaplasia data among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran's Taleghani Hospital in Iran from 2008 to 2014, was examined by sex and age group. The patients were divided into six age groups (16-30, 30-40, 40-50, 50-60 and >70). The chi-square test was used to compare the qualitative variables. Results: The overall prevalence rate among patient with H. pylori infection was 83.5% (12406/14860) and 11,394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with severe gastritis was significantly higher (P<0.05) compared to mild and moderate gastritis. In addition, the prevalence of H. pylori decreased with age and has been declined in recent years. The presence of intestinal metaplasia increased with age (P<0.05). Conclusion: The results of this study showed that the prevalence of H. pylori infection in Iranian population has been declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and gastritis. There is no association between sex and infection, however in contrast with the most studies its prevalence decreased with age. [ABSTRACT FROM AUTHOR]

Background: Cancer is the third most common cause of death in Iran, the leukemia cancer is one of the most important causes of cancer mortality. Regarding cancer mortality, data would be important to monitor the program screening effects, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was mortality rates evaluating, then leukemia cancer trends among the Iranian population within almost a period of a decade, i.e. from 1995 to 2004. Methods: National death Statistic Reported by Ministry of Health and Medical Education (MOH&ME) from 1995 to 2004, stratified by age group, sex, and cause of death, have included in this study. Leukemia cancer has expressed as the annual mortality rates/100,000, in general, and/or per gender, and age group. Results: The general mortality rate of leukemia cancer has slightly increased within the mentioned study period, from 0.44 to 2.54, then leukemia cancer mortality has often seen in men more than women. Conclusion: The mortality rate of leukemia has significantly increased throughout Iran. Associated risk factors with leukemia have headmost identified for their prevention and control. So, future studies to reveal leukemia risk factors among the Iranian population would be crucial in order to control its burden. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the relationships between workplace spirituality, organizational citizenship behavior (OCB), and affective organizational commitment among nurses, and whether affective commitment mediates the relationship between workplace spirituality and OCB. Methods: In the present correlational study, a cross-sectional design was employed, and data were collected using a questionnaire-based survey. Based on the random sampling, 305 nurses were chosen and questionnaires were distributed among respondents in four public and general hospitals located in Kerman, Iran. To analyze the data descriptive statistics, Pearson coefficient, simple and multiple regression, and path analyses were also conducted. Findings: Workplace spirituality has a positive influence on nurses' OCB and affective commitment. Workplace spirituality explained 16% of the variation in OCB, while it explained 35% of the variation in affective commitment among nurses. Moreover, affective organizational commitment mediated the impact of workplace spirituality on OCB. Conclusions: Workplace spirituality predicts nurses' OCB and affective organizational commitment. It emphasizes benefits from the new perspective of workplace spirituality, particularly among nurses who need to be motivated in their work. Clinical Relevance: This study illustrates that there are potential benefits owing to the positive influence of workplace spirituality on OCB and affective commitment among nurses. Managers of nursing services should consider workplace spirituality and its positive influence on nurses' outcomes in order to improve their performance and, subsequently, the healthcare system. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the epidemiology of GERD base on population study in Tehran providence. Background: Gastro-esophageal reflux disease (GERD) is a common and chronic problem. Recent reports from developing countries indicate increment in the incidence and prevalence of the disease over the past. Patients and methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran. Participants completed a valid gastro-esophageal reflux Questionnaire. The questionnaire included personal and family characteristics such as age, gender, and educational status. In addition, interviewers asked them regarding 10 GI symptoms. Results: Altogether 18180 individuals participated in this cross-sectional study. The mean ± SD age of participant was 38.7±17.1 and 9072 (49.9%) were women. The prevalence of GERD was 8.85 (8.43-9.26). There was significant relationship between age, sex, marital and educational status with GERD. GERD symptoms were more common in women, older people, individuals with low education and married people. There was overlap between GERD, irritable bowel syndrome (IBS) and uninvestigated dyspepsia (UD). Conclusion: According to our finding although the prevalence of GERD in our population is less than other studies, this prevalence is increasing in recent years. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to describe the occurrence of self report bloating and related factors in patients with irritable bowel syndrome (IBS). Background: Bloating symptoms are common in patients with IBS and have significant impact on normal daily function. Patients and methods: This study was a community-based cross-sectional survey that conducted using a valid questionnaire base on Rome III criteria. Univariate analysis was used for investigation about distribution of self reported bloating according to demographic and psychological factors in irritable bowel syndrome patients. Results: Out of 18180 subjects under study, 198 cases met criteria for the diagnosis of the irritable bowel syndrome according to criteria ROME III and 61.6% reported bloating symptoms. Bloating symptoms were more prevalent among patients with intermittent symptoms and diarrhea than in patients with constipation. Catastrophic events and depression were independent risk factors for bloating. Conclusion: Findings of this study support the clinical impression regarding the high prevalence of bloating symptoms in patients with irritable bowel syndrome. Further studies are needed to understand the role of physiological and psychological factors and their interaction in development of bloating in irritable bowel syndrome patients. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of constipation and its associated factors using Rome III criteria in Iranian population. Background: Due to the appearance of Amoxicillin-resistant H. pylori strains all over the world, the decreased efficacy of conventional Amoxicillin-containing treatment regimens has become a matter of concern. Patients and methods: A cross-sectional study conducted in Tehran province from May 2006 to December 2007, including 18180 adult persons. In the first part of interview, characteristics and gastrointestinal symptoms were considered Those who reported at least one symptom referred for the second interview consisted of questions about different gastrointestinal disorders based on Rome III criteria. Results: 6.33% of interviewees reported constipation and 2.41% had functional constipation (3.5% women and 1.3% men). The prevalence of constipation increases in the group older than 50 years. Constipation was more common in none or low educated than educated groups. Conclusion: It can be concluded that constipation has a less common prevalence in the general Iranian population. Women, older, obese, married and low education subjects are more likely to suffer from constipation. [ABSTRACT FROM AUTHOR]

The author discusses how misclassification in reported new cancer cases among provinces in Iran remains a potential problem for achieving a full registry in each territory.

Background: The prevalence of irritable bowel syndrome (IBS) is relatively high, but up to now, no population based study in Iran has used the ROME III criteria. The aim of the present study was to determine the prevalence of IBS by using the ROME III criteria in the adult population of Iran. Methods: A face to face survey was conducted in a large area of the Tehran province. IBS was diagnosed by using a validated questionnaire based on the ROME III criteria. Results: The study population comprised 18,180 participants, with a female to male ratio of 1. 15.3% of participants complained of gastrointestinal (GI) symptoms, while the prevalence of IBS was estimated to be 1.1% (139 women, 59 men, p=0.000). IBS patients were more likely to be married, and older. The most common presenting symptoms of IBS were abdominal pain that was relieved by defecation (94%), change in fecal consistency (78%), and change in bowel frequency (70%). Constipation was predominant in 52% of IBS cases, diarrhea was predominant in 18%, and 8% experienced intermittent diarrhea and constipation. Conclusion: The prevalence of IBS is relatively low in the Iranian adult population according to the ROME III criteria. The most probable reasons are the specificity of ROME III criteria and the characteristic low prevalence of GI symptoms in the study population. [ABSTRACT FROM AUTHOR]

Abstract: Background and study aims: The aim of this study is to present the mortality trends of oesophageal cancer (EC) in the Iranian population, to provide updated information regarding time trends for this cancer. Patients and methods: We analysed the national death statistics reported by the Iranian Ministry of Health and Medical Education from 1995 to 2004. EC [International Classification of Diseases (ICD-9); C15] were expressed as the annual mortality rates/100000, overall, by sex and by age group (<15, 15–49 and ⩾50years of age) and age standardised rate (ASR). Results: The age standardised mortality rate of EC increased dramatically during the study period. EC mortality was higher for males and the mortality rate also increased with age. Conclusion: This study provides a comprehensive projection for the burden of death due to EC, indicating that the trend of EC mortality dramatically increased in the recent decade. [Copyright &y& Elsevier]

Aim: The aim of this study was to provide quantitative estimations of the burden of death in term of years of life lost (YLL) due to colorectal cancer (CRC) in Iran and a temporal trend analysis. Background: Colorectal cancer is the third most common cause of cancer-related deaths in the world. YLL is a tool for quantifying the burden of disease according to mortality rates. The aim of this study was to provide quantitative estimations of the burden of death in term of YLL due to colorectal cancer in Iran and a trend analysis. Patients and methods: National death Statistic Reported by the Ministry of Health and Medical Education (MOH&ME) from 1995 to 2003, stratified by age group, sex, and cause of death were included in this analysis. YLL for CRC were expressed as the annual rates per 100,000 of the general population, gender and age group. Results: The general rate of YLL for CRC increased during the years under study from 4.52 to 32.20 per 100,000 of the general population and YLL mortality was higher for older aged males. Conclusion: Our study confirms a temporal trend of increasing YLL due to CRC. Currently there is a low rate of CRC screening in Iran. We recommend that in Iran screening be started, at least in families with a history of CRC, in order to reduce the mortality and burden of CRC in the future. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate relation between demographic factors and hospitalization in gastrointestinal disorders. quantile regression was used to analyze the predictors of duration of staying in hospital for patients with GI disease. Methods: This study was designed as a retrospective cross-sectional survey included all consecutive gastrointestinal (GI) patients admitted over one year period in a random selected hospital group located in Tehran metropolitan in 2006. Residence, age, sex and type of GI disorders were analyzed respectively using quantile regression. Results: A total of 6405 patients with GI disorders were included in the study, There were 3633 men (56.7%) and 2772 women (43.3%). Type of diseases was a significance predictor for length of staying at hospital in quantile regression analysis. Age was significant only in second quartile and sex was not assessed as a predictor at all. Conclusion: The results have demonstrated that duration of hospitalization for inpatients with GI cancers was longer than other groups and quantile analysis drawn a good picture of predictors for length of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Inequity in megacities is a real concern in public health perspective. Tehran is a megacity with more than 8 million population that is divided into 22 regions (counties) with considerable diversity in socioeconomic status. On the other hand, spatial cluster detection is an important tool in disease surveillance for identifying areas of elevated risk and generating hypotheses about disease or mortality etiology. The present research aims to identify high or low-risk clusters for five non-communicable leading causes of death in 22 regions of Tehran province. Methods: Cause-specific mortality rates were extracted from Behesht-e-Zahra registry system for Tehran province in 2011. Spatial scan statistic was chosen as the most common method in spatial cluster detection to detect clusters with elevated risk of death. Given the observed and expected number death in each region, a log likelihood ratio (LLR) criterion was used to test whether a cluster is significant. Result: Two high-risk and two low-risk clusters were detected for each cause of death. All these clusters were statistically significant with P values less than 0.05. Mapping these clusters shows substantial differences between regions in Tehran. For mortality due to ischemie heart diseases, cerebrovascular diseases, hypertensive diseases, respiratory diseases, and stomach cancer, the high-risk clusters concentrated in the southern half of Tehran and low-risk clusters were in the northern half of Tehran. In the most situations, regions 2, 3, and 5 seemed to have lower rates of death compared with other regions. On the other hand, regions, 16,19, and 20 were in the high rate clusters. Conclusion: There was substantial disparity between regions of Tehran for five non-communicable causes of death studied in this article. Identifying factors affecting the observed differences is useful to set effective preventive interventions and can be investigated in future researches. [ABSTRACT FROM AUTHOR]

Intestinal microsporidiosis is known as an opportunistic infection in immunocompromised patients. The current study aimed to investigate intestinal microsporidia infection in human subjects with/without immunodeficiency. Totally, 600 stool samples were collected from immunocompromised (254) and immunocompetent (346) subjects. DNA extraction was performed and the SSU rRNA and the ITS genes were amplified to detect and characterize microsporidia and the relevant genotypes. Phylogenetic trees were drawn using MEGA7 software to illustrate the correlation between isolates. From 600 enrolled subjects, 283 and 317 were male and female, respectively. The average age ± SD of all tested subjects was 28.85 ± 26.92. The results of PCR demonstrated the presence of E. bieneusi and Encephalitozoon sp., among 10/600 (1.67%) and 26/600 (4.33%) of samples, respectively. Accordingly, E. bieneusi was seen among 4/346 (1.15%), 1/53 (1.88%), 3/124 (2.42%), and 2/63 (3.17%), and Encephalitozoon sp., was detected from 17/346 (4.91%), 3/53 (5.36%), 4/124 (3.22%) and 2/63 (3.17%) of healthy subjects, RA patients, cancer patients, and transplantation recipients, respectively. Statistical significant correlation was not seen between the presence of microsporidia and age, gender, stool appearance, and geographical region. Molecular analysis showed that all E. bieneusi were the genotype D. Phylogenetic tree demonstrated no classification according to the presence/absence of immunodeficiency, geographical locations and presence of diarrhea. The high prevalence of Encephalitozoon sp., in comparison to E. bieneusi in this study suggested the importance of this genus alongside with E. bieneusi in Iran. In addition, predominance of the genotype D highlighted the wide distribution of this genotype in Iran. • Microsporidia infection were investigated among immunocompromised and immunocompetent subjects. • E. bieneusi and Encephalitozoon sp., were seen among healthy subjects and immunocompromised patients. • Phylogenetic classification regarding the clinical symptoms and geographical locations was not seen. • All E. bieneusi were the genotype D and clustered within E. bieneusi group 1. [ABSTRACT FROM AUTHOR]

Context: Patients with inflammatory bowel disease (IBD) were found to have the higher intestinal expression of Angiotensin-Converting Enzyme2 (ACE2) that could consequently increase susceptibility to COVID-19 infection. Objective: This study reports the outcomes of COVID-19 infection in a large cohort of IBD patients. We compare levels of serum ACE and IFN-α between COVID19 patients with and without IBD. We performed a cross-sectional retrospective multicenter study. Methods: We enrolled patients with IBD screened for SARS-COV-2 in six medical centres in Iran from June to November 2020. The blood samples were drawn to measure COVID-19 IgM and IgG, and serum levels of sACE2, sACE1, and interferon-α, regardless of suspicious symptoms have done the molecular test. Results: A total of 534 IBD patients were included in the study. Of these, 109 (20.0%) cases had detectable IgG and IgM against SARS-CoV-2. sACE2 levels were higher in IBD patients than controls, whereas ACE1and IFN-α levels were similar among groups.

Background: Colorectal cancer (CRC) screening and detecting it at an early stage is an effective way to decrease mortality from CRC. Colonoscopy, considered the gold standard (GS) for diagnosing the disease in many countries, has several limitations. Therefore, the main focus of this literature is to investigate the ability of combining candidate gut microbiota for early diagnosis of CRC, both in the presence and absence of GS test outcomes., Methods: We analyzed the data derived from a case-control study, including 83 screening colonoscopies conducted on subjects aged 18-92 years in Tehran, Iran. The candidate gut microbiota including, ETBF, Enterococcus faecalis, and Porphyromonas gingivalis were quantified in samples using absolute qRT PCR. The Bayesian latent class model (LCM) was employed to combine the values from the multiple bacterial markers in order to optimize the discriminatory ability compared with a single marker., Results: Based on Bayesian logistic regression, we discovered that family history of CRC, physical activity, cigarette smoking, and food diet were all significantly associated with an increased risk of CRC. When comparing ETBF and E. faecalis to P. gingivalis, we have observed that P. gingivalis exhibited greater predictive power in detecting high-risk individuals with CRC. As such, the sensitivity, specificity, and the area under the receiver-operating characteristics curve of combining ETBF, E. faecalis, and P. gingivalis were 98%, 96%, and 0.97, respectively., Conclusions: This study suggests that the combined use of the three markers markedly improves classification performance compared to pairwise combinations, as well as individual markers, both with and without GS test outcomes. Noticeably, the triple composition of the fecal markers may serve as a reliable non-invasive indicator for the early prediction of CRC., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background:  Coronavirus infection can induce the production of inflammatory cytokines leading to acute respiratory distress syndrome (ARDS) and death. It is well-established that interferons (IFNs) are essential in regulating the immune response, thus their effects of IFNs on COVID-19 patients should be subject to investigation. This study aimed to investigate the effects of IFN-α alone or in combination with remdesivir in hospitalized COVID-19 patients., Material and Methods:  A multicentre, retrospective study was conducted on COVID-19 patients admitted to three hospitals in Tehran, Iran, from March 20, 2020, to March 18, 2021. The unadjusted and adjusted effects of IFN-α on COVID-19 outcomes were investigated through propensity score matching (PSM) to achieve a 1:1 balanced dataset., Results: Among 4,782 patients, 3,764 were eligible for the study, including 1,704 patients (45.27%) receiving at least one treatment with IFN-α and 2,060 controls not receiving IFN-α. After PSM, 851 IFN-α patients and 851 controls were recruited in the PSM analysis with a median age of 60.8 (standard deviation [SD]: 16.2 and 60.9 [SD: 17.4]), respectively. The PSM results showed no significant difference between the survival curves of the IFN-α group and the control group (p=0.340). However, the unadjusted impact of IFN-α on the risk of mortality was statistically significant (p=0.043, hazard-ratio: 0.86; 95% confidence interval [CI]: 0.75-0.99). Also, the combination of IFN-α and remdesivir had no significant benefit (HR: 89, 95% CI: 0.74-1.34)., Conclusion: Our findings indicate that subcutaneous administration of IFN-α, with or without remdesivir, does not have any significant impact on COVID-19 mortality and ICU admission. Future clinical trials considering the time, subtype, and form of IFN-α administration are warranted to investigate the potential therapeutic effects of IFN-α on COVID-19.

We aimed to propose a mortality risk prediction model using on-admission clinical and laboratory predictors. We used a dataset of confirmed COVID-19 patients admitted to three general hospitals in Tehran. Clinical and laboratory values were gathered on admission. Six different machine learning models and two feature selection methods were used to assess the risk of in-hospital mortality. The proposed model was selected using the area under the receiver operator curve (AUC). Furthermore, a dataset from an additional hospital was used for external validation. 5320 hospitalized COVID-19 patients were enrolled in the study, with a mortality rate of 17.24% (N = 917). Among 82 features, ten laboratories and 27 clinical features were selected by LASSO. All methods showed acceptable performance (AUC > 80%), except for K-nearest neighbor. Our proposed deep neural network on features selected by LASSO showed AUC scores of 83.4% and 82.8% in internal and external validation, respectively. Furthermore, our imputer worked efficiently when two out of ten laboratory parameters were missing (AUC = 81.8%). We worked intimately with healthcare professionals to provide a tool that can solve real-world needs. Our model confirmed the potential of machine learning methods for use in clinical practice as a decision-support system., (© 2023. The Author(s).)

Background: Colorectal cancer (CRC) has been regarded as one of the most frequently diagnosed malignancies among the leading causes of cancer-related morbidity and mortality globally. Diagnosis of CRC at the early-stages of tumour might improve the survival rate of patients. The current study sought to determine the performance of fecal Fusobacterium nucleatum (F. nucleatum) and Streptococcus bovis (S. bovis) for timely predicting CRC., Methods: Through a case-control study, the fecal sample information of 83 individuals (38 females, 45 males) referring to a hospital in Tehran, Iran was used. All patients underwent a complete colonoscopy, regarded as a gold standard test. Bacterial species including S. bovis and F. nucleatum were measured by absolute quantitative real-time PCR. The Bayesian univariate and bivariate latent class models (LCMs) were applied to estimate the ability of the candidate bacterial markers in order to early detection of patients with CRC., Results: Bayesian univariate LCMs demonstrated that the sensitivities of S. bovis and F. nucleatum were estimated to be 86% [95% credible interval (CrI) 0.82-0.91] and 82% (95% CrI 0.75-0.88); while specificities were 84% (95% CrI 0.78-0.89) and 80% (95% CrI 0.73-0.87), respectively. Moreover, the area under the receiver operating characteristic curves (AUCs) were 0.88 (95% CrI 0.83-0.94) and 0.80 (95% CrI 0.73-0.85) respectively for S. bovis and F. nucleatum. Based on the Bayesian bivariate LCMs, the sensitivities of S. bovis and F. nucleatum were calculated as 93% (95% CrI 0.84-0.98) and 90% (95% CrI 0.85-0.97), the specificities were 88% (95% CrI 0.78-0.93) and 87% (95% CrI 0.79-0.94); and the AUCs were 0.91 (95% CrI 0.83-0.99) and 0.88(95% CrI 0.81-0.96), respectively., Conclusions: Our data has identified that according to the Bayesian bivariate LCM, S. bovis and F. nucleatum had a more significant predictive accuracy compared with the univariate model. In summary, these intestinal bacteria have been highlighted as novel tools for early-stage CRC diagnosis., (© 2022. The Author(s).)

Background: The outbreak of coronavirus disease 2019 (COVID-19) dates back to December 2019 in China. Iran has been among the most prone countries to the virus. The aim of this study was to report demographics, clinical data, and their association with death and CFR., Methods: This observational cohort study was performed from 20th March 2020 to 18th March 2021 in three tertiary educational hospitals in Tehran, Iran. All patients were admitted based on the WHO, CDC, and Iran's National Guidelines. Their information was recorded in their medical files. Multivariable analysis was performed to assess demographics, clinical profile, outcomes of disease, and finding the predictors of death due to COVID-19., Results: Of all 5318 participants, the median age was 60.0 years, and 57.2% of patients were male. The most significant comorbidities were hypertension and diabetes mellitus. Cough, dyspnea, and fever were the most dominant symptoms. Results showed that ICU admission, elderly age, decreased consciousness, low BMI, HTN, IHD, CVA, dialysis, intubation, Alzheimer disease, blood injection, injection of platelets or FFP, and high number of comorbidities were associated with a higher risk of death related to COVID-19. The trend of CFR was increasing (WPC: 1.86) during weeks 25 to 51., Conclusions: Accurate detection of predictors of poor outcomes helps healthcare providers in stratifying patients, based on their risk factors and healthcare requirements to improve their survival chance., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Hamidreza Hatamabadi et al.)

Background: The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results., Research Design: In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative, and suspected cases., Results: A total of 25,481 cases (14,791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative, and suspected cases were 20.55%, 9.97%, and 7.31%, respectively. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups., Conclusions: Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests.