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Background Angiopoietin-like 3 (ANGPTL3)-deficiency due to loss-of-function variants are being reported to have a link with triglyceride (TG) level, and high-density lipoprotein cholesterol (HDL-C), and thereby affecting the risk of cardiovascular disease (CVD). Objective In the present study, we examined the association of rs10789117 in the ANGPTL 3 gene locus and the risk of CVD in the group of people who were part of the group of Mashhad-Stroke and Heart-Atherosclerotic-Disorders (MASHAD) cohort. Method 1002 cases with/without CVD following 10 years follow-up were recruited from the MASHAD cohort, followed by DNA extraction and genotyping. The association of the variant with CVD even and lipid profile was assessed using Univariate and Multivariate analysis. Result our data showed that CVD patients after 10 years follow up with AC/CC genotypes have been related to higher risk of CVD events compared to AA genotype (OR = 1.43, 95%CI = 1.01–2.02, P = 0.041) as well as its C allele with CVD risk (OR = 1.32, 95%CI = 1.06–1.72, P value = 0.038). Moreover, we realized that significant association between the variant and serum TG and HDL-C. Conclusion We demonstrated the potential value of g.14079A > C in ANGPTL3 in CVD, indicating further investigations of the emerging biomarker in a multi-center setting as a risk stratification biomarker in cardiovascular disease.

In this study, we examined the effectiveness of Women's Postpartum Sexual Health Program (WPSHP) on Iranian women's sexual health in the postpartum period. A single-blinded randomized clinical trial was conducted in 2016 on 80 postnatal women in Iran. We used the Female Sexual Function Index, Sexual Quality of Life - Female questionnaire and Female Sexual Distress Scale. The intervention group received counseling based on WPSHP. After 28 weeks, the mean score of the Female Sexual Function Index and Female Sexual Quality of Life significantly increased in the WPSH group (

Diabetes mellitus is mostly interrelated to deficiency in wound healing. Low-level laser therapy has been shown to exert reliable effects on the acceleration of wound healing process. This study aimed to determine the potential influence of low-level laser therapy (LLLT) on the healing of extraction sockets in diabetic rats. A total of 24 healthy male Wistar rats were selected for this study. After diabetes induction, the maxillary first molars of all rats were extracted bilaterally. Then, the animals were subjected either to Ga-Al-As laser at 808 nm or to Al-Ga-In-P laser at 660 nm at the right extracted socket every day for the next 14 days. The left sockets served as controls. Rats were sacrificed on the 3rd, 5th, 7th, and 14th days after tooth extraction. The samples were examined by a pathologist. LLLT at 808 nm was able to significantly repress inflammation, improve osteoid formation, and promote vascularization in comparison to the non-treated sockets. LLLT at 660 nm significantly suppressed inflammation and developed vascularization in comparison to the non-treated sockets, but failed to improve osteoid formation in the treated sockets. This study suggests that LLLT could be considered as a reliable treatment for wound healing in diabetic experimental rats.

Aims: Pediculosis is one of the most common health problems in children and especially in girls. This study aimed to investigate the effect of education based on the Health Belief Model using social network messenger on promoting pediculosis preventive behaviors among school girls. Materials & Methods: This quasi-experimental study was conducted in Bojnourd in 2018. 145 students were selected through cluster sampling from 12 schools and randomly divided into the intervention and the control groups. For the intervention group, the training program was implemented for 2 weeks and 3 days each week by uploading videos and educational materials about pediculosis in social network messenger. Data collection tools included a questionnaire based on the Health Belief Model and a demographic questionnaire that were completed by the students before, immediately, and 3 months after the education. The data were analyzed by SPSS 20 and by using Chi-square, Exact Fisher, Mann-Whitney, and ANOVA tests. Findings: Based on the results there was a statistically significant relation among the mean scores of awareness, perceived sensitivity, perceived benefits, perceived barriers and self-efficacy in the intervention group, immediately after the intervention compared to before the intervention (p

Aim of the work: Early cardiovascular disease is an important cause of morbidity and mortality in systemic lupus erythematosus (SLE). The study was designed to assess the relationship between the serum levels of adipokines and atherosclerotic risk factors in SLE patients. Patients and methods: 56 patients and 31 control were included. Serum levels of leptin, adiponectin, traditional and new risk factors for atherosclerosis including plasma glucose levels, lipid profile, high-sensitivity C-reactive protein (hs-CRP), vascular cell adhesion molecule-1 (VCAM-1) and homocysteine were measured. The intima-media thickness (IMT) of the carotid was measured by ultrasonography. The SLE disease activity index (SLEDAI-2k) was assessed. Results: The patients mean age was 30.8 ± 9.9 years, disease duration was 55.7 ± 59.3 months and were 54 (91.5%) females and 5 (8.5%) males. Serum adiponectin levels were significantly lower in patients (3.58 ± 0.4 ng/ml) compared to control (3.9 ± 0.26 ng/ml) (p

Patients with heart failure experience system imbalance and have multiple symptoms. A nurse-led care program based on Johnson’s behavioral system model was used to improve the balance of the behavioral system of heart failure patients. One hundred and fifty patients were randomly assigned into two groups. In the experimental group, the patient’s status was evaluated by a behavioral subsystem assessment tool related to the level of imbalance. The patients in the intervention group received care individually based on their worst subsystem scores over a period of 2 weeks. The results showed significant improvement in restorative, ingestive, eliminative, aggressive/protective, dependency, and achievement ( p < .05) subsystems in the experimental group. However, no significant difference was seen in sexual and affiliative ( p > .05) subsystems.

Background Systemic inflammation is emerging as an important factor in the etiology of psychiatric disorders such as depression and anxiety. Therefore, the inflammatory potential of the diet may also be an etiological factor for these conditions, and this may be estimated by calculating the dietary inflammatory index (DII®) score. We aimed to investigate the association between DII score and incidence of depression and anxiety among a representative sample in northeastern Iran. Methods This cross-sectional study undertook in a sub-sample of 7083 adults aged 35 to 65 years recruited as part of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study population, and after excluding subjects with incomplete data. All participants completed the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II), and a validated 65-item food frequency questionnaire (FFQ). Logistic regression was used to evaluate the association between DII score and depression/anxiety score. Results Of the study participants, 37.1% (n = 2631) were found to have mild to severe depression, and 50.5% (n = 3580) were affected by mild to severe anxiety. After adjusting for confounding factors, in women, the third (OR: 1.41, 95% CI: 1.06–1.88, p-valuesp-values Conclusion There was a significant association between DII score and severe depression among women but not men in this Iranian population. In order to confirm the association between DII food score, depression, and anxiety, further research is required in different populations, and perhaps an intervention study.

Aims: Menopause is one of the most critical periods in women's lives that although it is a physiological event, but it is accompanied by complications that affect women's quality of life. The aim of this study was to determine the prediction of the quality of life of menopausal women based on health literacy and self-efficacy. Instrument & Methods: This cross-sectional descriptive-analytical study was conducted on 400 postmenopausal women referred to comprehensive health centers in Mashhad in 2018 who were selected by random cluster sampling method. The research tool was a 4-part questionnaire including demographic characteristics, test of functional health literacy in adults (TOFLA), Sherer general self-efficacy and quality of life in menopause. Data were analyzed by SPSS 22 software using Kruskal-Wallis, Mann-Whitney, Spearman’s correlation, and linear regression model. Findings: There was a significant correlation between health literacy (r=-0.352) and self-efficacy (r=-0.338) with quality of life (p

BACKGROUND With the obtained advancement in solving health problems, family caregivers are replaced with the care institutions. The accompanying and supporting patients during the disease treatment is very effective in the Iranian culture. AIM This study aims at determining the effect of health intervention based on family-centred empowerment model on health literacy and self-efficacy among caregivers of patients with multiple sclerosis. METHODS In this quasi-experimental study, 70 family caregivers were randomly assigned to the two control and experimental groups, who were evaluated using demographic TOFHLA health literacy and self-efficacy questionnaires. Then, based on training needs in the experimental group, intervention was conducted based on the family-centred empowerment model during one month. The control group received no intervention, and immediately after training and three months after implementing the program, the health literacy and self-efficacy in both the experimental and control groups were re-evaluated. RESULTS Before intervention, mean of health literacy in the experimental group was 57.2 ± 9.15 and 3 months after intervention, it reached 62.45 ± 9.39, (p

In this paper, a mathematical model of fighting against cancer tumor growth by a combination of oncolytic virotherapy and chemotherapy is introduced. In this model, we considered two time delays ?1 and ?2. The time delay ?1 shows the lag of transmission of infection from oncolytic virus to tumor cells. A lot of kind of cancers, symptoms are diagnosed at a late stage and as a consequence the chemotherapy approach start with a lag. Thus, we take this delay into account by presenting the time delay ?2 in the control variable. Therefore, in this study, delay parameters are used for both state and control variables. The Pontryagin minimum principle with delays in both state and control is used to obtain an optimal model for the treatment to minimize the side effect as well as the cost of the treatment.

Background Anthropometric indices such as body mass index (BMI) and percent body fat (PBF) are easily measurable and have been consistently reported to be associated with cardiovascular disease (CVD) and its risk factors. Aims We aimed to compare the association of several CVD risk factors with BMI and PBF to determine which of these adiposity indices had the greater predictive value. Methods and materials Data were derived from the MASHAD cohort study. The cohort was categorised into 4 groups: group 1 (low or normal BMI and PBF, N = 1670), group 2 (low or normal BMI but high PBF, N = 992), group 3 (high BMI and low or normal PBF, N = 837), and group 4 (high BMI and PBF, N = 6245). The best cut-off points were defined by ROC analysis. Results BMI was more strongly correlated with systolic and diastolic blood pressure, serum urate, serum hsCRP, fasting plasma glucose and TC/HDL-C ratio compared to PBF. But BMI was less strongly correlated with three lipid parameters (total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol), Logistic regression analysis showed that BMI was the best predictor for the majority of risk factors, apart from LDL-C in men and LDL-C, TC and non-HDL-C (NHC) in women. ROC analysis showed that BMI had a greater AUC for risk factors other than for SBP, HTN, DM, TC, LDL-C, impaired fasting glucose, non-HDL cholesterol in men and for TC, TG, TC, DBP, HTN, and non-HDL Cholesterol, among female subjects. Conclusions The results suggest that in our population from northeastern Iran, BMI may be a better predictor of several CVD risk factors compared to PBF.

Background: The present study aimed to estimate the survival of HIV-positive patients and compare the accuracy of two commonly used models, Shared Random-Effect Model (SREM) and Joint Latent Class Model (JLCM) for the analysis of time to death among these patients. Methods: Data on a retrospective survey among HIV-positive patients diagnosed during 1989-2014 who referred to the Behavioral Diseases Consultation Center of Mashhad University of Medical Sciences was used in this study. Participants consisted of HIV-positive high-risk volunteers, referrals of new HIV cases from prisons, blood transfusion organization and hospitals. Subjects were followed from diagnosis until death or the end of study. SREM and JLCM were used to predict the survival of HIV/AIDS patients. In both models age, sex and addiction were included as covariates. To compare the accuracy of these alternative models, dynamic predictions were calculated at specific time points. The receiver operating characteristic (ROC) curve was used to select the more accurate model. Results: Overall, 213 patients were eligible that met entry conditions for the present analysis. Based on BIC criteria, three heterogeneous sub-populations of patients were identified by JLCM and individuals were categorized in these classes (“High Risk”, “Moderate Risk” and “Low Risk”) according to their health status. JLCM had a better predictive accuracy than SREM. The average area under ROC curve for JLCM and SREM was 0.75 and 0.64 respectively. In both models CD4 count decreased with time. Based on the result of JLCM, men had higher hazard rate than women and the CD4 counts levels of patients decreased with increasing age. Conclusion: Predicting risk of death (or survival) is vital for patients care in most medical research. In a heterogeneous population, such as HIV-positive patients fitting JLCM can significantly improve the accuracy of the risk prediction. Therefore, this model is preferred for these populations.

BACKGROUND: Pancreatic cancer (PC) is among the most aggressive tumors with a poor prognosis, indicating the need for the identification of a novel prognostic biomarker for risk stratifications. Recent genome-wide association studies have demonstrated common genetic variants in a region on chromosome 9p21 associated with an increased risk of different malignancies. METHODS: In the present study, we explore the possible relationship between genetic variant, rs10811661, and gene expression of CDKN2B in 75 pancreatic cancer patients, and 188 healthy individuals. DNAs were extracted and genotyping and gene expression were performed by TaqMan real-time PCR and RT-PCR, respectively. Logistic regression was used to assess the association between risk and genotypes, while the significant prognostic variables in the univariate analysis were included in multivariate analyses. RESULTS: The patients with PDAC had a higher frequency of a TT genotype for rs10811661 than the control group. Also, PDAC patients with dominant genetic model, (TT + TC), was associated with increased risk of developing PDAC (OR= 14.71, 95% CI [1.96-110.35], p= 0.009). Moreover, patients with CC genotype had a higher expression of CDKN2B, in comparison with TT genotype. CONCLUSION: Our findings demonstrated that CDKN2A/B was associated with the risk of developing PDAC, supporting further investigations in the larger and multicenter setting to validate the potential value of this gene as an emerging marker for PDAC.

Introduction: High blood pressure is a chronic disease that requires long-term treatment; despite being asymptomatic, it leads to fatal complaints and complications. Therefore, the present study was conducted to determine the effect of education based on self-efficacy theory on self-care behaviors of hypertensive self-help groups in comprehensive health service centers in Mashhad in2020. Methods: This study is a quasi-experimental study in which 80 female patients with hypertension were randomly divided into experimental and control groups. The educational intervention was based on the theory of self-efficacy for the experimental group. Data collection tools were a three-part questionnaire including: demographic information and a standard questionnaire of self-efficacy and self-care of blood pressure. Data were analyzed using independent t-test, Mann-Whitney, Chi-square, Fisher's exact test, Friedman test and repeated measures and analysis of covariance by SPSS software version 20 with a significance level of 0.05 Results: There was a significant difference in self-efficacy (P

Introduction The aim of this study was to establish RIs for clinically important markers including superoxide dismutase (SOD), serum copper, zinc, calcium, magnesium, and phosphate in a cohort of healthy Iranian adults. Materials A subsample from MASHAD cohort study was used to assess serum SOD, copper, zinc, calcium, magnesium and phosphate. Serum SOD was measured according to its inhibitory potential of pyrogallol oxidation. Micro‐ and macro‐minerals were measured using flame atomic absorption spectrometry and a BT3000 autoanalyzer, respectively. Sex‐ and age‐specific RIs were then calculated based on CLSI Ep28‐A3 guidelines. Results Reference value distributions for studied parameters did not demonstrate any age‐specific differences that were statistically significant. In addition, sex partitioning was not required for all parameters, apart from serum magnesium, which showed a wider range in females (0.81–1.26 mg/dl) compared with males (0.82–1.23 mg/dl). Conclusion The RIs established in this study can be expected to improve mineral assessment and clinical decision‐making in the Iranian adult population., The aim of this study was to establish RIs for clinically important markers including superoxide dismutase (SOD) and serum copper, zinc, calcium, magnesium and phosphate in a cohort of healthy Iranian adults. Sex‐ and age‐specific RIs were then calculated based on CLSI Ep28‐A3 guidelines. Age and sex partitioning were not required for all parameters, apart from serum magnesium, which showed a wider range in females (0.81–1.26 mg/dl) compared to males (0.82–1.23 mg/dl).

Background The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. Objective To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. Methods A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. Results Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. Conclusion The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.

Background: Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease and all-cause mortality. Zinc (Zn) is an essential trace element for the synthesis, storage, and release of insulin. The relationship between serum Zn and MetS is controversial. In this study we have evaluated whether serum Zn levels are associated with hsCRP level according to MetS phenotypes. Method: A total of 9493 individuals (3768 men and 5635 women) were recruited as part of the Mashhad Stroke and Heart Association Disorder (MASHAD) study. We measured the concentration of serum Zn by flame atomic absorption (Varian AA240FS) and we divided the subjects into quartile of serum Zn. We used SPSS version 18 statistical analyses for all. GraphPad Prism 6 for figures was used.Results: In this study there were significant differences between quartiles of Zn according to sex. The results showed that the level of serum hs-CRP were higher in subjects with metabolic syndrome who also had a serum Zn >95 µg/dl. In subjects with serum Zn Conclusion: Serum hs-CRP concentrations were related to MetS phenotypes. This relationship was modified by serum Zn level. According to the number of MetS components serum Zn levels decreased as the number of MetS component increased, and low serum zinc levels (Q1) showed an overall greater prevalence of MetS.

Vitamin D supplementation has been shown to prevent vitamin D deficiency, but various factors can affect the response to supplementation. Data mining is a statistical method for pulling out information from large databases. We aimed to evaluate the factors influencing serum 25-hydroxyvitamin D levels in response to supplementation of vitamin D using a random forest (RF) model. Data were extracted from the survey of ultraviolet intake by nutritional approach study. Vitamin D levels were measured at baseline and at the end of study to evaluate the responsiveness. We examined the relationship between 76 potential influencing factors on vitamin D response using RF. We found several features that were highly correlated to the serum vitamin D response to supplementation by RF including anthropometric factors (body mass index [BMI], free fat mass [FFM], fat percentage, waist-to-hip ratio [WHR]), liver function tests (serum gamma-glutamyl transferase [GGT], total bilirubin, total protein), hematological parameters (mean corpuscular volume [MCV], mean corpuscular hemoglobin concentration [MCHC], hematocrit), and measurement of insulin sensitivity (homeostatic model assessment of insulin resistance). BMI, total bilirubin, FFM, and GGT were found to have a positive relationship and homeostatic model assessment for insulin resistance, MCV, MCHC, fat percentage, total protein, and WHR were found to have a negative correlation to vitamin D concentration in response to supplementation. The accuracy of RF in predicting the response was 93% compared to logistic regression, for which the accuracy was 40%, in the evaluation of the correlation of the components of the data set to serum vitamin D.

In this study, we aimed to investigate the relationship between the genetic variant of rs696217-ghrelin and fasted lipid profile, indices of obesity, and environmental parameters. Amplification refractory mutation system-polymerase chain reaction (ARMs-PCR) was used for genotyping 1118 individuals recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study. The interaction between the presence of the genetic variant of rs696217-ghrelin and nutritional intake and other major determinants of obesity and lipid profile was examined in the MASHAD study population. Individuals with the TT genotype at the locus had the lowest prevalence of obesity compared to other genotypes among the individuals. No significant relationship was found between the two groups regarding the lipid profile and TT genotype. Furthermore, no significant association was found between dietary intake and the genetic variant of rs696217-ghrelin in the population under study. Individuals with a TT or GT genotype appear to be at a higher risk of obesity, compared to those with a GG genotype. The results of the current study revealed a significant association between the genetic variant of rs696217-ghrelin and obesity; however, this gene did not correlate with the risk factors of cardiovascular diseases and dyslipidemia in the Iranian population.

Background Scavenger receptor class B type 1 (SR-BI) encoded by SCARB1 gene serves as a multifunctional HDL receptor, facilitating the uptake of cholesteryl esters from HDL to the liver. Recent studies have identified the association between the P376L missense mutation of the SCARB1 gene with increased serum HDL-Cholesterol level. However, the contribution of this variant to the development of cardiovascular disease (CVD) remains unclear. Objective We have investigated the association between the P376L polymorphism with the properties of HDL and CVD outcomes in a population sample recruited as part of the Mashhad-Stroke and Heart-Atherosclerotic-Disorders (MASHAD) cohort. Methods Six hundred and fifteen individuals who had a median follow-up period of 7 years were recruited as part of the MASHAD cohort. Anthropometric, biochemical parameters and HDL lipid peroxidation (HDLox) were assessed. Genotyping was performed using TaqMan-real-time-PCR based method. The association of P376L-rs74830766 with cardiovascular-risk-factors and CVD events were evaluated. Results Carriers of the P376L variant were significantly more likely than non-carriers to develop CVD using multivariate analyses adjusted for traditional CVD risk factors defined as: age, sex, BMI, presence of diabetes, or hypertension, positive smoking habit, and total cholesterol (OR: 3.75, 95%CI: 1.76–7.98, p = 0.001). In an adjusted model, there was a two fold increase in cardiovascular endpoints among individuals who were heterozygous for the P376L variant (hazard ratio, 2.08; 95% CI, 1.12-to 3.84, p = 0.02). Although there was no association between the presence of the P376L variant and HDL-C level, serum HDLox, measured as dysfunctional HDL, was 13% higher among carriers of the P376L variant than non-carriers. Conclusion We have found that carriers of the P376L variant possessed higher HDLox and were at increased risk of CVD in a representative population-based cohort, as compared to non-carriers.

Cardiovascular disease (CVD), one of the main mortality causes worldwide is considered to be affected by general oxidative stress and inadequacy antioxidant system. Superoxide dismutase 1 (SOD1), a cytosolic antioxidant enzyme has a key role in neutralizing the excessive prooxidant by scavenging the super oxide anions. SOD1 polymorphic variants exhibit the altered activity properties. In the current study, we are aimed to investigate the association between the SOD1 polymorphism and CVD prevalence. A 6-years case control follow up study was designed to genotype the 526 participants (311 controls and 215 cases) for studying the 50 bp INS/DEL polymorphism at SOD1 promoter gene and analyze their blood lipid profile and anthropometric characteristics. Among the two possible alleles of the SOD1 gene (Wild [W] and Mutant [M]) the meaningful association was detected between the Mutants' frequency and the prevalence of CVD patients (p-value

The dietary inflammatory index (DII) is a novel way of describing diet that has been studied in relation to various health conditions, including cardiovascular disease (CVD) in several populations. We aimed to investigate the association between DII and CVD events among a representative population sample in northeastern Iran. This prospective cohort study was a subsample of 4,672 adults aged 35-65 years, and recruited as part of Mashhad stroke and heart atherosclerotic disorder cohort study population. The DII was computed at baseline according to a 65-item validated food frequency questionnaire. Cox regression was used to determine the association of DII with incident CVD. One hundred twenty-four participants developed CVD (including 24 cases of myocardial infarction [MI], 34 cases of stable angina [SA], and 66 cases of unstable angina [UA]). After adjusting for potential confounding factors, a hazard ratios of 1.06 (95% confidence interval: 0.70-1.60), 1.36 (95% confidence interval: 0.52-3.52), 1.33 (95% confidence interval: 0.60-2.94), and 0.86 (95% confidence interval: 0.48-1.53) were found for total CVD, MI, SA, and UA events, respectively, among the participants with proinflammatory diet (DII ≥ 0) versus those with anti-inflammatory diet (DII < 0). There was no statistically significant association between the DII and total CVD, MI, SA, or UA in this population of middle-aged Iranian men and women.

Background and Objectives: Colorectal Cancer (CRC) is the fourth cancer-related cause of death worldwide. CRC is a multi-stage cancer, which is curable during the early stages of the disease. Therefore, determining the time of cut-point existence could improve treatment planning and help directly allocate resources. This study aims to determine the cut point in the age of CRC diagnosis. Methods: This study, covering the course 1985 to 2012, consisted of 345 colorectal cancer patients registered in Taleghani Hospital, Tehran, Iran and followed up to 2013. The cut-point in the age of CRC diagnosis was obtained using a mixture cure model. The data were analyzed using SPSS and R, V. 20 and 2.15.0, respectively. Results: The results showed that the cut point in the age of CRC diagnosis was 50 years. Based on our estimation, 65% of the patients diagnosed with CRC at or younger than 50 were cured, while 31% of them diagnosed older than 50 were cured, and the younger group had a better survival over the older group. Conclusion: Since access to a cut-point and analysis of created prognostic groups are important in screening and treatment planning, our results suggested that it is better to estimate the cut-point in the age of curable cancers in early stages via survival cure models, and the cure rate would increase by CRC timely screening.

Using cell-based engineered skin is an emerging strategy for treating difficult-to-heal wounds. To date, much endeavor has been devoted to the fabrication of appropriate scaffolds with suitable biomechanical properties to support cell viability and growth in the microenvironment of a wound. The aim of this research was to assess the impact of adipose tissue-derived mesenchymal stem cells (AD-MSCs) and keratinocytes on gelatin/chitosan/β-glycerol phosphate (GCGP) nanoscaffold in full-thickness excisional skin wound healing of rats. For this purpose, AD-MSCs and keratinocytes were isolated from rats and GCGP nanoscaffolds were electrospun. Through an in vivo study, the percentage of wound closure was assessed on days 7, 14, and 21 after wound induction. Samples were taken from the wound sites in order to evaluate the density of collagen fibers and vessels at 7 and 14 days. Moreover, sampling was done on days 7 and 14 from wound sites to assess the density of collagen fibers and vessels. The wound closure rate was significantly increased in the keratinocytes-AD-MSCs-scaffold (KMS) group compared with other groups. The expressions of vascular endothelial growth factor, collagen type 1, and CD34 were also significantly higher in the KMS group compared with the other groups. These results suggest that the combination of AD-MSCs and keratinocytes seeded onto GCGP nanoscaffold provides a promising treatment for wound healing.

Introduction: Parenting is a complex activity, which includes special procedures and behaviors that affect the child's growth. The aim of this study was to determine the effect of educational intervention based on the health action process approach on the parenting skills of girl students’ mothers in Mashhad. Methods: This was a quasi-experimental study conducted on 100 mothers (50test and 50control), who had 10-13 year-old girls. Mothers were selected using cluster sampling method. Data were collected by a questionnaire designed based on the health action process approach. The questionnaire also contained the demographic questions and its validity and reliable were completed before and 2months after the intervention. After completing the questionnaires, data were analyzed by SPSS 16 and descriptive (frequency, percentage, mean, and SD) and analytical tests (Mann-Whitney and Wilcoxon) at the significance level of 0.05. Results: The Chi-square test showed no statistically significant difference between the experimental and control groups in terms of family size, mothers' age category, level of education, and job. The Mann-Whitney test showed that significant difference existed between the experimental and control groups before intervention) P=0.01Z=2.57( only with regard to action planning. Moreover, two months after the intervention, significant differences were observed between the two groups in all constructs. Conclusion: According to the results, the educational intervention based on the structures of the health action process approach can have a positive impact on mother's parenting skills.

Uterine contractions are indicators of labour progress. The relationship between anthropometric indices and types of childbirth has been investigated. One of these indices is referred to as the Cormic Index, which provides an estimation of the sitting height and leg length. This cross-sectional study was performed to determine the relationship between the Cormic Index and the uterine contractions' pattern in the active phase of the first stage of labour. The standing and sitting heights of 150 pregnant women were measured to calculate the Cormic Index. Then, two Cardiotocographic traces were recorded during the 3 to 5 and 6 to 8 centimetres' dilations, by which the uterine contractions' pattern were determined. The mean Cormic Index was 51.84 ± 2.62. The results indicated that the Cormic Index had a positive linear correlation with MTIME (frequency of contractions) in the first monitoring episode and SDTIME (regularity of contractions) in the first and the second monitoring episode, which was significant (

Today, with increasing the lifespan, the importance of health-promoting behavior and paying attention to maintaining individuals' function and autonomy are becoming increasingly evident and regular physical activity is considered as one of the important aspects of healthy lifestyle. This study aimed to apply the theory of planned behavior to predict the intention to do physical activity in the elderly. This study was conducted on the 371 elderly. A three-part questionnaire including demographic, knowledge, and theory of planned behavior questions was used. The views of the elderly were requested directly in this regard. According to the results, the elderly’s mean age was 69 and the sample included 53% women. The behavior intention in this study had a positive significant correlation with all planned behavior theory constructs. The perceived behavior control construct hold the most prediction power regarding the variance of the elderly’s intention of physical activity behavior. The constructs of theory could predict 26.7% of the variance of intention. Based on the results of this study, the theory of planned behavior was successful in predicting the elderly’s intention to do physical activity and the necessity of paying attention to the component is emphasized to teach intention to elderly people, considering the role of the perceived behavior control construct in predicting behavior intention.

Objective Postmenopausal women are at an increased risk of Cardiovascular Disease. We aimed to investigate whether this risk differed between individuals with a naturally occurring and other reasons for menopause within a large population-based Iranian sample. Study Design A total number of 1763 postmenopausal women (defined by amenorrhea for more than a year, or FSH > 30-40 mIU/ml), 900 of them with a natural menopause and 863 of them with other reasons for menopause caused by (hysterectomy without oophorectomy or one side oophorectomy, hysterectomy with oophorectomy or two side oophorectomy without hysterectomy) were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Biochemical and hematological risk factors were measured in all the subjects and the data were analyzed by SPSS software version 20 Results There was a significant difference in the presence of cardiovascular disease in the natural menopause group compared with other reasons for menopause group (p

Background: Heat shock protein 27 (HSP27) is an intracellular chaperone constitutively expressed in many cell types including cardio myocytes and endothelial cells. Circulating levels of HSP27 and anti-HSP27 antibody are higher in patients with CVD. Anti-HSP27 antibody concentrations were also reported to be increased in atherogenesis. We aimed to evaluate serum anti-HSP27 antibody titers in individuals with, or without, MetS in the MASHAD study cohort with large sample size in 6,568 subjects. Methods: Participants with MetS were identified from MASHAD cohort (n=3358) using the IDF criteria, and the control group were those individuals who did not meet these criteria (n=3210). In-house enzyme-linked immune sorbent assay (ELISA) method was used for measuring Anti-HSP27 antibody levels. The two groups were matched for age, sex and smoking habit. Results: As expected, there were significant differences in height (p= 0.004), waist and hip circumference, weight, BMI, systolic and diastolic blood pressure, TGs, TC, HDL-C, Hs-CRP, glucose, with the presence of diabetes mellitus, hypertension, hyperlipidemia (p Conclusion: In conclusion, our results revealed serum anti-HSP27 antibody titers were not statistically different between individuals with and without MetS. However, it is possible that drug treatment may affect antibody titers and confound our findings in this population sample..

The traditional uses of Portulaca oleracea L. (purslane) with anti-inflammatory and anti-cancer activity as well as anti-oxidants properties were expressed previously. This is a double-blind randomized clinical trial to evaluate the protective effects of purslane cream on the nipple fissure.After expressing the goals and methods of the study and obtaining written consent from 86 lactating women with nipple fissure, they were randomly divided into two groups: 43 in purslane cream group and 43 in lanolin ointment group. The score of nipple fissure before the intervention and on the third and eighth day after the study was measured using the Stour scale.The mean score of left and right breast fissures in the group of treatment with lanolin group similar to the group of treatment with purslane cream showed a significant decrease at the third day and eighth day (P=0.001). Mann-Whitney test comparing mean score of the fissure between two groups showed that two groups were homogeneous before the intervention, but there was a significant difference between two groups on the third and eighth days (p 0.001). The recovery process occurred faster in the group of treatment with purslane cream.We showed that the use of purslane cream without any complications could accelerate the repairing of nipple fissure. Based on this clinical trial, purslane cream (2% w/w) can be used as an accelerator for improving the nipple fissure in lactating women.

Background Some materials such as TiO2 display a luminescence property when exposed to X-ray radiation. Therefore, a proper photosensitizer can induce photodynamic effects by absorbing the emitted photons from these materials during radiotherapy. In this way, the problem of limited photo- penetration depth in photodynamic therapy is resolved. In this paper, following the production of a nanopolymer containing TiO2 cores and imprinted for mitoxantron (MIP), the possibility of utilizing its optical and radio properties on two lines of cancer cells were studied. Methods Mitoxantron (MX) was selected as the photosensitizer. The emission spectrum of the nanopolymers synthesized with/without MX was recorded during excitation by 6 MV X-rays. Also, the fluorescence signal of hydroxyl radicals produced into terephthalic acid medium by the nanopolymers were recorded during X irradiation. The percentage of cell survival following irradiation by X-rays was determined for various concentrations of drug agents by MTT assay. The synergistic index and IC50 were calculated to compare the findings. Results The emission spectrum of the nanopolymer reloaded with MX during X-ray irradiation indicated a considerable decline in comparison with the nanopolymer without MX. The level of free radicals produced by nanopolymer was significantly increased during irradiation with X-rays. The highest mean of synergistic indexes was observed in MIP. Conclusion The higher level of hydroxyl free radicals in MIP and lower cell viability in the DFW cell line as well as enhanced treatment efficiency confirm the hypothesis regarding the production of photodynamic effects by synthesized nanopolymer during radiotherapy.

Background The success of assisted reproductive techniques plays a very important role in the quality of life of infertile couples and decreases the negative behavior states of infertility. Objective This study aimed at determining the relationship between psychological coping and adjustment strategies with the success of assisted reproductive technology (ART). Materials and Methods This correlational study was conducted on 204 women visiting Milad Infertility Center in Mashhad during 2015-2016. The research instruments included Fertility Adjustment Scale and Infertility Coping Strategies Scale. The positive result of two pregnancy tests within 48 hours was considered as the success of ART. Results The mean and standard division score of adjustment in the group achieved treatment success (34.3 ± 8.2) exceeded the group failed (33.6 ± 8.8), the difference was not statistically significant (p= 0.381). Also, there was no significant difference between groups in the median and interquartile range of total coping strategies 81 (13) vs. 79.5 (12.25), (p= 0.369). Based on the logistic regression model for one increased transferred embryo, the chance of getting pregnant is 1.3 times, and for each unit increase in FSH level, the chance of ART success decreases 18%. Conclusion The results of this study showed that there is no relationship between psychological coping and adjustment strategies with ART success. However, the number of transferred fetus and tirthday FSH are introduced as factors that are related to the success of ART.

Objectives: The aim of this study was to investigate the diagnostic value of a stress coping scale for predicting perceived psychological traumatic childbirth in mothers. Methods: This cross-sectional study was performed on 400 new mothers (within 48 hours of childbirth). Psychological traumatic childbirth was evaluated using the 4 diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders. Coping was measured using Moss and Billings' Stress Coping Strategies Scale. Results: The overall mean score of stress coping was 29 ± 14.2. There were 193 (43.8) mothers that had experienced a psychological traumatic childbirth. A stress coping score ≤ 30, with a sensitivity of 90.16 (95 CI = 85.1-94.0), and a specificity of 87.44 (95 CI = 82.1-91.6), was determined as a predictor of psychological traumatic childbirth. So that among mothers with stress coping scores ≤ 30, 87 had experienced a psychological traumatic childbirth. Conclusion: Investigating the degree of coping with stress can be used as an accurate diagnostic tool for psychological traumatic childbirth. It is recommended that during pregnancy, problem-solving and stress management training programs be used as psychological interventions for mothers with low levels of stress control. This will ensure that they can better cope with traumatic childbirth and posttraumatic stress in the postpartum stage. © 2019 Korea Centers for Disease Control and Prevention.

It has been shown that increased serum PON1 levels are protective against several disorders. Several single nucleotide polymorphisms (SNPs) of the PON1 gene have been reported to be associated with serum enzyme protein levels and activity.To investigate the association of SNPs of PON1 and serum paraoxonase activity with coronary artery disease (CAD).A total of 601 unrelated patients who underwent coronary angiography including those who hadgt;50% stenosis (N=266) and those withlt;30% stenosis (N=335) were studied. The Paraoxonase gene rs662 and rs840560 SNPs were determined using the ARMS-PCR method and the rs705379 SNP was genotyped using PCR-RFLP analysis. Serum paraoxonase activity was measured using paraoxon as a substrate. A p value of plt;0.05 was considered as significant.Serum paraoxonase activity was not significantly different between the study groups. After adjustment for age, sex, hypertension, diabetes mellitus and dyslipidemia, the GG genotype and co-dominant model of rs662 was positively associated with a positive angiogram (respectively, OR=2.424, 95%CI [1.123-5.233], plt;0.05, OR=1.663, 95%CI [1.086-2.547]). Serum paraoxonase activity was significantly higher in the G allele and GG variant of rs662, A allele and AA variant of rs854560 and C allele and CC variant of rs705379. The haplotype analysis has shown that the ATC haplotype was significantly more prevalent among the angiogram negative group. The analysis between groups indicated that the A allele of rs662 was significantly associated with lower paraoxonase activity in the positive angiogram group (p=0.019).The presence of the G allele of the rs662 single nucleotide polymorphism is independently associated to increased risk of CAD.Tem sido demonstrado que um aumento dos níveis séricos de PON1 é protetor contra vários distúrbios. Foi relatado que vários polimorfismos de nucleotídeo único (SNPs, single nucleotide polymorphisms ) do gene PON1 estão associados a níveis e atividade de proteínas enzimáticas séricas.Investigar a associação de SNPs do PON1 e atividade da paraoxonase sérica com a doença arterial coronariana (DAC).Foram estudados 601 pacientes não relacionados submetidos à angiografia coronária, incluindo aqueles com estenosegt;50% (N=266) e aqueles com estenoselt;30% (N=335). Os SNPs rs662 e rs840560 do gene da paraoxonase foram determinados utilizando o método ARMS-PCR e o SNP rs705379 foi genotipado utilizando análise de PCR-RFLP. A atividade da paraoxonase sérica foi medida utilizando paraoxon como substrato. O valor de plt;0,05 foi considerado significante.A atividade da paraoxonase sérica não foi significativamente diferente entre os grupos de estudo. Após ajuste para idade, sexo, hipertensão, diabetes mellitus e dislipidemia, o genótipo GG e o modelo codominante de rs662 foram positivamente associados a uma angiografia positiva (respectivamente, OR = 2,424, IC 95% [1,123-5,233], plt;0,05, OR = 1,663, IC 95% [1,086-2,547]). A atividade da paraoxonase sérica foi significativamente maior no alelo G e variante GG do polimorfismo rs662, alelo A e variante AA de rs854560 e alelo C e variante CC de rs705379. A análise de haplótipos mostrou que o haplótipo ATC foi significativamente mais prevalente no grupo com angiografia negativa. A análise entre os grupos indicou que o alelo A de rs662 foi significativamente associado à menor atividade da paraoxonase no grupo com angiografia positiva (p=0,019).A presença do alelo G do polimorfismo de nucleotídeo único rs662 está independentemente associada ao aumento do risco de DAC.

Background: Anxiety is one of the most prevalent psychological complications in patients undergoing cardiac catheterization that can be effective on the patients' understanding to do self-care to prevent some complications such as contrast induced nephropathy. The aim of this study was to compare the effect of education by group discussion with videotape on anxiety and contrast induced nephropathy of Coronary catheterization patients. Method: A randomized clinical trial was implemented with 213 patients in three groups at Javad-Al-Aemeh Hospital, Mashhad, Iran, during February to September 2018. An organized educational program was first developed based on an integrative review. The patients were randomly allocated to three groups: group discussion (n=71), film (n=73) and control (n=69) using randomized time blocks. Anxiety was assessed using Spiel Berger Inventory before and 1 hour after the education, before transferring to Cat Lab. The serum creatinine was assessed on arrival, 24 and 72 hours after the procedure. The data were analyzed using ANOVA, Tukey, repeated ANOVA, paired t test and chi square tests by SPSS16. Results: There was no significant difference in mean anxiety between groups before the intervention (P= 0.64), but the anxiety in the videotape group and group discussion decreased significantly after the intervention (pConclusion: Using Group discussion and film screening can be recommended to the community nurses to reduce the cardiac catheterization candidate patient's anxiety and prevent contrast-induced nephropathy.The present study was registered in the Iranian Registry of Clinical Trials with a code of IRCT2016022626776N1.Registration date in IRCT : 2017-07-23, 1396/05/01https://www.irct.ir/trial/22094

Background The efficiency of high‐density lipoprotein (HDL) to efflux cholesterol contributes to the reverse cholesterol transport (RCT) pathway as one of HDL’s proposed functions and depends on the ability of HDL to uptake cholesterol. We aimed to investigate cholesterol uptake capacity (CUC) by a newly developed assay in samples from the MASHAD (Mashhad Stroke and Heart Atherosclerotic Disorders) cohort study. Method The study population comprised 153 individuals developed CVD diagnosed by a specialist cardiologist, over 6 years of follow‐up, and 350 subjects without CVD. We used a modified CUC method to evaluate the functionality of HDL in serum samples. Result The CUC assay was highly reproducible with values for inter‐ and intra‐assay variation of 13.07 and 6.65, respectively. The mean serum CUC was significantly lower in the CVD group compared to control (p = 0.01). Although, there were no significant differences in serum HDL‐C between the groups and there was no significantly association with risk of progressive CVD. Multivariate logistic regression analysis showed that there was a significantly negative association between CUC and risk of CVD after adjustment for confounding parameters (OR = 0.57, 95% CI = 0.38–0.87, p = 0.009). The CUC was also inversely and independently associated with the risk of CVD event using Cox proportional hazards models analysis (HR = 0.62; 95% CI = 0.41–0.94, p = 0.02). We determined the optimum cutoff value of 1.7 a.u for CUC in the population. Furthermore, the CUC value was important in determining the CVD risk stratification derived from data mining analysis. Conclusions Reduced HDL functionality, as measured by CUC, appears to predict CVD in population sample from north‐eastern Iran., Mashhad‐Stroke and Heart‐Atherosclerotic‐Disorders (MASHAD) cohort; 530 healthy individuals, over 6 years of follow‐up,350 individuals without CVD, 153 individuals with CVD. A modified CUC method was used to evaluate the HDL functionality of serum samples. The mean value of serum CUC was significantly lower in the group developed CVD compared to healthy individuals (p = 0.01). multivariate logistic regression analysis showed that there was a significantly negative association between CUC and risk of CVD after adjustment for confounding parameters (OR = 0.62, 95% CI = 0.41–0.94, p = 0.02). The CUC was also independently inversely associated with the risk of a CVD event using Cox proportional hazards models analysis (HR, 0.62; 95% CI, 0.41–0.94, p = 0.02). The CUC value was important in assigning the CVD risk stratification derived from data mining analysis. Reduced HDL functionality, as measured by CUC, appears to predict CVD in our population sample from north‐eastern Iran. CEC: Cholesterol Efflux Capacity; CUC: Cholesterol Uptake Capacity. ​

Objectives: Low back pain (LBP) is one of the most common and most costly work-related musculoskeletal disorders. There are numerous factors that may affect the development of this disease. The aim of this study was to determine the prevalence of low back pain (LBP) and its association with individual, occupational and psychosocial factors among steel industry workers.Methods: For this cross-sectional study, 273 workers in a steel plant were selected by random sampling method. The participants were divided into production (n=168) and administrative (n=105) Workers. Data was collected through in-person interview, physical examination, modified Nordic questionnaire and Osipow questionnaire. Data was analyzed by descriptive statistical methods, chi-square test, t-student،test and logistic regression model using SPSS-20 software. In all statistical analysis P value≤ 0.05 was considered as statistically significant.Results: Despite the young age of participants (39.63±6.32 years) and their short employment duration, the prevalence of LBP was high (38.5%) in this industry. Gender, body mass index, smoking status and total stress score were similar in two groups. No significant relationship was found between LBP and current job status. However, LBP prevalence was significantly associated with age and duration of employment (PConclusion: In our study no association was observed between LBP and the participants' current job status and work- related stress. It appears that life style modifications along with education can decrease the rate of low back pain and its risk factors in employees of this industry.

Background Coronavirus disease 2019 (COVID‐19) pandemic imposes serious problems to health systems around the world and its rapid expansion makes it difficult to serve patients with certain health conditions such as cancer patients which might be at high risk for mortality if they are infected by the severe acute respiratory syndrome coronavirus 2. Aim To compare the outcomes of cancer patients admitted due to COVID‐19 and compare them with data of COVID‐19 infected patients without a history of cancer. Methods In this case‐controlled study, 93 healthy people and 92 patients with malignancy admitted for COVID‐19 were enrolled. The clinical features and laboratory indicators were assessed at the presentation and both groups were followed‐up for treatment options and outcomes prospectively and compared at the level of P ≤ .05. Results COVID‐19 related mortality rate in malignant patients was significantly higher than patients without malignancy (41.3% vs 17.2%, P = .0001). The risk of death increased significantly in patients with malignancy (OR = 8.4, P = .007) and mechanical ventilation (OR = 3.3, P = .034) independent of other variables. Fever (64.5% vs 43.5%, P = .004), chill (35.5% vs 14.1%, P = .001), malaise (49.5% and 30.4%, P = .008), dry cough (51.6% vs 26.1%, P = .0001), and vomiting (17.2% vs 5.4%, P = .012) were reported significantly lower in cancer patients. Conclusion The results suggest that cancer patients who were infected by COVID‐19 may present with atypical symptoms are at higher risk of mortality independent of the demographic data, comorbidities, and treatments.

Background and aim: Premature menopause (PM) is defined by the occurrence of the menopause before the age of 40 years. It is often associated with cardiovascular disease (CVD). The purpose of this study was to explore the relationship between PM-associated genotypes cardio metabolic disorder risk factors. Methods: One hundred seventeen women with PM and one hundred eighty-three healthy women without PM were recruited in this study. DNA was extracted and analyzed using ASO-PCR or Tetra ARMS-PCR. Lipid profiles were also assessed.Results: Multivariate logistic regression analysis showed that individuals with GG vs. TT genotype of the rs1046089 SNP were more likely to have high serum LDL risk (p = 0.03) compared to the control group. There was also a significant association between low serum HDL risk and rs2303369 and rs4806660 SNP genotypes in the PM group. In the PM group, the percentage of those with a high total cholesterol was lower in those with a CC genotype compared to those with a TT genotype (p = 0.03).Conclusion: Some SNPs reported to be associated with PM appear to be independently associated with dyslipidemia. These results may be helpful to identify subjects with PM who may be susceptible to CVD.

Reference Intervals for biochemical markers, such as those comprising the fasted lipid profile vary in different populations and are affected by age, sex, ethnicity, and life style (1, 2). To address this gap for healthy adults living in Iran, we aimed to conduct a study in which normative percentiles of serum total cholesterol, HDL-C, LDL-C and triglyceride were established. Both reference intervals and normative percentiles were determined in this study for the northeastern Iranian population.

BACKGROUND: The development of any society depends on proper planning in various fields such as population and birth control. Fertility control is designed to create a level of population growth appropriate to the resources available and to ensure a good life. Receiving information and education is one of the basic strategies to change the attitude toward fertility and awareness in most people in society. Therefore, this study was conducted to determine the effect of education on knowledge of fertility counseling and attitudes toward fertility control in health workers. MATERIALS AND METHODS: The present study was a randomized clinical trial with a control group that was conducted in the presence of 107 health workers of health centers and community health centers working in Mashhad in 2017. The research units were randomly divided into three groups (webinar training, group discussion training, and control). Research tools were researcher-made questionnaires on attitudes toward fertility and measuring healthy reproductive awareness that all study participants completed at the beginning of the study and 2 weeks after the intervention. Data analysis was performed by the Chi-square, one-way analysis of variance, and independent t-test using the SPSS software version 16. RESULTS: The results of this study showed that at the beginning of the study, all three groups were homogeneous in terms of quantitative and qualitative demographic variables including age, education, work experience, type of employment, and number of family members. The results of Kruskal–Wallis test showed that before the intervention, the three groups did not have a statistically significant difference in terms of mean scores of awareness about fertility counseling (P = 0.77) and attitude toward fertility control (P = 0.523), but this relationship was significant after the interventions. Furthermore, the results of Mann–Whitney intragroup test showed that the scores before and after the intervention were significant in both educational groups (P = 0.001). CONCLUSION: Considering the importance of healthy fertility counseling and the important place of education in promoting awareness and attitude toward healthy fertility, it is recommended to use active educational methods to promote the awareness and attitude of health workers to provide healthy fertility services to couples.

Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), and pulmonary TB is the most prevalent form of the disease worldwide. One of the most concrete actions to ensure an effective TB control program is monitoring TB treatment outcomes, particularly duration to cure, but, there is no strong evidence in this respect. Thus, the primary aim of this study was to examine the possible spatial variations of duration to cure and its associated factors in Iran using the Bayesian spatial survival model. All new smear-positive PTB patients have diagnosed from March 2011 to March 2018 were included in the study. Out of 34,744 patients, 27,752 (79.90%) patients cured and 6992 (20.10%) cases were censored. For inferential purposes, the Markov chain Monte Carlo algorithms are applied in a Bayesian framework. According to the Bayesian estimates of the regression parameters in the proposed model, a Bayesian spatial log-logistic model, the variables gender (male vs. female, TR = 1.09), altitude (&gt, 750 m vs. &le, 750 m, TR = 1.05), bacilli density in initial smear (3+ and 2+ vs. 1&ndash, 9 Basil &amp, 1+, TR = 1.09 and TR = 1.02, respectively), delayed diagnosis (&gt, 3 months vs. &lt, 1 month, TR = 1.02), nationality (Iranian vs. other, TR = 1.02), and location (urban vs. rural, TR = 1.02) had a significant influence on prolonging the duration to cure. Indeed, pretreatment weight (TR = 0.99) was substantially associated with shorter duration to cure. In summary, the spatial log-logistic model with convolution prior represented a better performance to analyze the duration to cure of PTB patients. Also, our results provide valuable information on critical determinants of duration to cure. Prolonged duration to cure was observed in provinces with low TB incidence and high average altitude as well. Accordingly, it is essential to pay a special attention to such provinces and monitor them carefully to reduce the duration to cure while maintaining a focus on high-risk provinces in terms of TB prevalence.