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Background: Salivary cancers are relatively uncommon with important types of head and neck malignancies with poor prognosis in the vast majority of cases. Objectives: Prompt diagnosis and treatment are critical to attaining a good prognosis; hence, recognition of the epidemiological characteristics is worthwhile. Accordingly, in this study, the epidemiological characteristics of cases with salivary sarcoma among Iranian patients were assessed. Methods: In this epidemiological study, 70 consecutive cases with salivary sarcoma in Iran within 22 provinces were assessed from 2009 to 2014. The dataset utilized in this study was sourced from the Iran National Cancer Registry (INCR). These included both parotid (n = 53) and major salivary glands (n = 17). The age, sex, anatomical location, province, and year were the main variables extracted from existing medical data. Results: The present study reports 53 cases of parotid tumor sarcoma, with the mixed tumor exhibiting a predominant malignant component being the most frequently observed pathological subtype. The preponderance of these instances was noted among individuals classified as adults within the working demographic (ranging from 15 to 64 years of age). However, our age-adjusted incidence rate indicates a higher occurrence of salivary gland tumors in individuals above 64. The study reported 17 instances of sarcomas in other major salivary glands, with the malignant type mixed tumor being the most frequently occurring subtype within this group. The gender distribution did not exhibit a statistically significant pattern. Conclusions: Thoroughly, according to the obtained results in this study, it maybe concluded that salivary sarcoma in the Iranian population is usually the mixed malignant tumor subtype and there are similar patterns according to the age and sex in patients with slight male predominance (F/M ratio: 0.75). [ABSTRACT FROM AUTHOR]

Background: Hepatopancreatobiliary (HPB)malignancies are a relatively rare but important type of cancerwith usually poor prognosis. Prompt diagnosis and treatment are crucial to improving the patient's outcome. For this issue, acknowledgment of epidemiological characteristics is helpful. Objectives: In this study, the epidemiological characteristics of cases with HPB sarcoma among Iranian patients were assessed. Methods: In this epidemiological study, 133 consecutive caseswithHPB sarcoma in Iran from2010 to 2014were evaluated, including gallbladder, pancreas, hepatic, pancreatic body and head, and other biliary tumors. Results: Nine gallbladder sarcoma cases were reported between 2010 and 2014, accounting for 6.7% of all HPB sarcoma cases, and leiomyosarcomawas themost common. Atotal of 16patients of pancreatic originwere reportedduring thisperiod,withthehighest rate of 6 cases in 2011; in this sarcoma category,malignant type spindle cell tumor was themost common type accounting for 12.5% of all cases. Ninety-five cases of liver sarcomas were reported generally. Non-specified and desmoplastic small round cell tumors were themost common types. Five cases of pancreatic head sarcomas were reported during 2010 - 2013. There was no predominant tumor type. Five cases of pancreatic head sarcoma were reported during 2010 - 2013. There was no dominant tumor type. About the other biliary tract sites, six patients were reported. Gastrointestinal stromal sarcoma was themost common type. Conclusions: Hepatopancreatobiliary sarcoma in the Iranian population generally has diverse types, and there are different patterns according to the age and sex distribution in patients according to the initial location of the tumor and also their pathological subtypes. [ABSTRACT FROM AUTHOR]

Non-adherence with treatment is a common problem among hemodialysis (HD) patients and was considered as a reliable factor in patients deteriorating, increasing admission chance and inappropriate responding to HD treatment. According to multiple factors related to Non-adherence to HD treatment and its importance in patients' quality of life, this study aimed at a systematic reviewing of Nonadherence with treatment in dialysis patients in Iran. Treatment with adherence status is one of the problems that patient has on dialysis. This study aims at detecting the most important causes of Non-adherence in patients on dialysis according to previous studies. First, all of the studies related to our title were searched using some keywords (dialysis, hemodialysis, adherence, and nonadherence) for English and Persian databases; Iranmedex, Magi ran, SID, Iran doc, Google, Google scholar, PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic that covering the period from 2010 to 2018 was reviewing following a predefined inclusion and exclusion criteria. As a result, 40 papers related to inclusion and exclusion criteria were identified and analyzed. Data were collected according to study features, measures of Nonadherence, prevalence rates and factors related to Non-adherence. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to conduct this systematic review. According the results of present study six main categories were found. The main reasons for Non-adherence with treatment in dialysis patients listed in the papers included: Patient related factors, socioeconomic factors, Psychological factors, Health care related factors, Therapy related factors and Disease-related Factors below is provided for each explanation. Treatment for improving adherence is so important and can play a very significant role to improve the health in patients on dialysis. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the most important aspects of health is social health. Addressing social health and social accountability is possible by education of social determinants of health (SDH) to medical students. The aim of current study is to integrate the SDH variables to patient's history-taking in medical education during clerkship stage as an action research and scholarship in education. Pediatric patients were selected as the target population for this study., Methods: The present study is an action-research including three phases of the program's design, implementation, and evaluation. The present paper reports the results of phase I including the following steps; rapid scoping review and expert panel for development of history-taking form. The goal of this phase was to prepare an SDH checklist for history-taking in the Pediatrics Ward of Firoozabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran. The checklist of history-taking was evaluated in terms of measurability, feasibility, priority, and clarity using a 5-choice Likert scale., Results: According to the results of the scoping review and consensus-based methods, the preliminary version of the program was prepared including the SDH history-taking checklist. A total of 21 items were selected after two expert panel rounds. The overall absolute agreement was 0.704 (95% CI: 0.587 - 0.793) which was significantly higher than 0.5 (P < 0.001). The range of scores was 3.5 - 4.83 (out of five)., Conclusion: We developed a SDH history-taking form including nine domains and 21 items. This form should be piloted and evaluated by an expert panel in the next phases. The present phase of the project proposed a consensus-based program for the imputation of SDH education in the education program of medical students. The reason for the importance of choosing children is that social factors in the group of children can have a greater impact considering the long life ahead and being in the growing age. After the implementation and evaluation phases, this program may be imputed in the medical education curriculum., (© 2024. The Author(s).)

Background: Acute appendicitis (AA) is one of the most common reasons for visiting the emergency room. The lack of proper diagnosis and rapid treatment of AA may lead to severe complications such as intestinal perforation and increased mortality. This study aimed to evaluate the diagnostic accuracy of the Alvarado criteria, ultrasound, and CRP criteria in comparison with their combined use in patients with suspected AA who presented to the emergency room., Methods: In this diagnostic accuracy study, 1411 patients with suspected AA who presented to the emergency department of Firoozabadi Hospital affiliated with Iran University of Medical Sciences and underwent appendectomy from October 2019 to October 2021 were examined. Nine hundred eighty-eight patients were enrolled. All patients were assessed using Alvarado, CRP, and ultrasound. The definitive diagnosis of AA was based on pathological findings and was considered the gold standard. Statistical analyses were performed with STATA VER 11.5. The diagnostic accuracy for each group was compared using the Pearson chi-square test. A value of p < 0.05 was considered statistically significant., Results: The mean age was 29.57 ± 13.66 years. The sensitivity and specificity of Alvarado in the diagnostic accuracy of appendicectomy were 75.2% and 61.3% (CI = 95%), respectively. The sensitivity of ultrasound and CRP for predicting appendicitis was significantly higher than the Alvarado criteria. The diagnostic accuracy for CRP was significantly higher than ultrasound (64.9% vs. 60.7%, P: 0.003). The diagnostic accuracy of the simultaneous use of Alvarado + CRP and CRP + Ultrasound was significantly higher than that of Alvarado + ultrasound. The sensitivity, specificity, and diagnostic accuracy of the simultaneous use of all three criteria together (Alvarado + Ultrasound + CRP) were estimated to be 94.9%, 25.8%, and 81.5% (CI = 95%), respectively, which were significantly higher than the use of other criteria., Conclusion: This study showed that the Alvarado criteria had inadequate diagnostic sensitivity and accuracy for diagnosing acute appendicitis. The diagnostic accuracy of acute appendicitis increases to over 90% using the three Alvarado, ultrasound, and CRP criteria at the same time., (© 2024. The Author(s).)

Non-adherence to treatment is a common problem among hemodialysis (HD) patients and was considered as a reliable factor in patients deteriorating, increasing admission chance and inappropriate responding to HD treatment. According to multiple factors related to Non-adherence with HD treatment and its importance in patients' quality of life, this study aims at a systematic reviewing of Non-adherence to treatment among Iranian dialysis patients. Treatment with adherence status is one of the problems that patients encounter during dialysis. This study aims at detecting the most important causes of Non-adherence in patients on dialysis according to previous studies. First, all of the studies related to our title were searched using main keywords (dialysis, hemodialysis, adherence, and non-adherence) for English and Persian databases; Iranmedex, Magi ran, SID, Iran doc, Google, Google scholar, PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic that covering the period from 2010 to 2018 was reviewing following a predefined inclusion and exclusion criteria. As a result, 40 papers related to inclusion and exclusion criteria were identified and analyzed. Data were collected according to study features, measures of Non-adherence, prevalence rates and factors related to Non-adherence. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to conduct this systematic review. According to the results of present study six main categories were found. The main reasons for Non-adherence with treatment in dialysis patients listed in the papers included: Patient related factors, socioeconomic factors, psychological factors, health care related factors, therapy related factors and disease-related factors.Trying to improve adherence is very important and can play a significant role in increaseing the health status among patients on dialysis.

Clinical studies have shown that hyper-homocysteinemia is a potent independent risk factor for cardiovascular diseases, and many different methods have been investigated for lowering it in hemodialysis (HD) patients. Our study investigated the effect of Vitamin B 12 supplementation on serum homocysteine levels in these patients. This randomized trial was conducted on 140 HD patients. They were randomly distributed by lottery method into two groups: intervention and control. In the intervention group, 100 μg/mL of Vitamin B 12 was intravenously injected two times a week, for eight weeks. No intervention was performed in the control group. Serum levels of homocysteine, hemoglobin (Hb), and hematocrit (Hct) were measured at the beginning and again after eight weeks (2 months) of treatment. About 91% of the patients had hyperhomocysteinemia (serum homocysteine >15 μmol/L). The median baseline levels of serum homocysteine in the intervention and control groups were 31.9 and 26.9 μmol/L, respectively (P = 0.1). After eight weeks, the median homocysteine level reduced significantly in the Vitamin B 12 group to 22.2 versus 28.4 μmol/L in control group (P = 0.006). The mean Hb and Hct also changed significantly during our study (12.3 vs. 11.4 g/dL; P = 0.003 and 37.9 vs. 35.3%; P = 0.02, respectively). Our results demonstrated the existence of a statistical negative relationship between Vitamin B 12 and serum levels of homocysteine. Detailed investigations with larger sample sizes and longer-term use of Vitamin B 12 are recommended.

Introduction: The aim of this study was to compare the effect of continuous care model with routine care on the quality of life among patients who receive a kidney transplant., Materials and Methods: In a randomized clinical trial, 90 kidney transplant patients were selected from 4 hospitals in Tehran, Iran, and were randomly assigned to 2 group. In the experimental group, continuous care model was applied for 3 months and the control group received routine care. The scale scores of the Kidney Transplant Questionnaire concerning quality of life were monthly compared between the two groups., Results: Of 90 patients, 4 in the experimental and 8 in the control group were excluded from the study. Final analysis was performed on 41 in the experimental and 37 in the control groups. No significant difference was found between the two groups in terms of demographic variables. Although the quality of life scores increased in both groups, the mean scores of the experimental group were significantly higher than those in the control group at 1, 2, and 3 months., Conclusions: Continuous care model may improve the kidney transplant patients' quality of life.