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Medical costs (MCs) represent a significant burden on household finances and often lead to economic challenges. This study analyzed the data of 8,993 Iranian households from 2021 collected by the Iranian Statistical Center. Using a marginalized two-part model (MTP) with lognormal and gamma distributions, the relationship between MCs and factors such as age, gender, education, and household characteristics was examined. A two-level structure was applied to account for heterogeneity across provinces, with analyzes performed using R software. The mean annual MC was $180 with high variability (SD = $324.39). The main determinants included family size, residence area, education level, and socioeconomic status. Single households and families with more students had lower MCs. Among the models evaluated, the MTP-Lognormal model (MTP-LN) performed better than the MTP-Gamma model (MTP-G), as it provided better predictive accuracy and better reflected cost differences between province. These results highlight the socio-economic and demographic factors that influence household MCs in Iran. The MTP-LN model provides valuable insights for identifying at-risk groups and developing targeted interventions to reduce the financial burden of healthcare, especially for vulnerable populations. This study emphasizes the importance of tailored interventions to address regional inequalities and promote equitable access to healthcare. [ABSTRACT FROM AUTHOR]

Background: Limited access to conventional treatments for type 2 diabetes mellitus (T2DM) necessitated alternative therapies. Curcumin and Amla, both medicinal plants, exhibited therapeutic properties. Their combination might have yielded synergistic effects, enhancing antioxidant defense, reducing inflammation, and improving glycemic control and lipid profiles more effectively than either agent alone. This approach aimed to develop an intervention for managing T2DM.. Objectives: This study evaluated the combined effects of curcumin and Amla on lipid profiles, glycemic status, inflammation, antioxidant levels, and liver enzymes in patients with T2DM. Methods: This double-blind, randomized controlled trial involved 50 patients with T2DM from the Ahvaz Jundishapur University of Medical Sciences clinic. Participants, aged 25 to 65 years with a BMI of 25 to 34.9, were assigned to receive either two 500 mg capsules of curcumin plus Amla (n = 25) or a placebo (n = 25) daily for 12 weeks. Results: Outcomes assessed changes in glycemic status, Hemoglobin A1c (HbA1c), inflammation, liver enzymes, oxidative stress, lipid profile, blood pressure, body measurements, quality of life, physical activity, and dietary intake. Conclusions: To ensure rigorous control, adherence was monitored through daily contact and three 24-hour food recalls at baseline and at the end of the trial. Only individuals with stable medication regimens for at least three months were included, with regular check-ins confirming no new medications affecting glycemic control or lipid profiles. Random assignment to the intervention or control group minimized bias, with the control group receiving placebo treatment for accurate comparison. [ABSTRACT FROM AUTHOR]

Objective: Given the apparent life-threatening nature of COVID-19, finding an effective treatment is under investigation. Materials and Methods: We assessed effect of shallomin oral syrup (co IranAmin®) as a complementary treatment to improve the clinical outcomes in COVID-19 patients. Patients in the control group received the approved treatment protocol (lopinavir/ritonavir), while those in the intervention group were treated with the oral syrup shallomin in addition to the approved treatment. Clinical status of treated patients was recorded and compared. Results: There were meaningful differences between the two groups regarding shortened length of hospital stay and the recovery time for cough, myalgia, sore throat, and shortness of breath. No side effect occurred in the intervention group compared to the control group in terms of biochemical and hematological factors. Conclusion: It seems that the treatment with shallomin syrup showed remarkable contribution to the recovery of COVID-19 induced symptoms in the patients under lopinavir/ritonavir therapy. [ABSTRACT FROM AUTHOR]

Objentive(s): Physicians are in the frontline of the distribution channel in the pharmaceutical value chain. The prescribing behavior of doctors influences the use of herbal medicines. This study investigated the effect of knowledge, attitude, and social marketing mix on doctors' prescribing behavior of herbal medicines. Methods: The current cross-sectional study was conducted in 2022 in Ahvaz, Iran. Its statistical population included 878 doctors working in medical centers and public and private offices in Ahvaz, and the data were collected using the census method. Data was collected using a self-designed questionnaire to measure the level of knowledge and attitude of doctors and the role of social marketing mix on doctors' prescribing behavior. Descriptive and analytical statistics, including Pearson's correlation, linear regression, t-test, and one-way analysis of variance were used to analyze the data. Results: The results showed a significant relationship between all research variables and doctors' prescribing behavior (p= 0.001), where the attitude showed the strongest positive relationship (r= 0.692). Regression analysis showed that the two factors of attitude and knowledge had a positive effect, and promotion strategy has a negative and inverse effect on doctors' prescribing behavior. Also, a significant relationship observed between doctors' prescribing behavior and gender (p= 0.001) and education level (p= 0.004). Conclusion: Knowledge, attitude, and promotion strategy are predictors of herbal medicine prescribing behavior by physicians. [ABSTRACT FROM AUTHOR]

Introduction: A lack of integration between basic sciences, including physiology, and clinical practice is a problem in medical education that may interfere with clinical reasoning. In this study, we evaluated the attitude of medical students of Ahvaz Jundishapur University of Medical Sciences toward this issue. Methods: A total of 273 clinically active medical students participated in the study, comprising 117 externs, 53 interns, and 103 residents. Externs and interns are medical students with indirect and direct exposure to real patients, respectively, while residents are medical doctors pursuing specialization. The questionnaire included two questions focused on “memory retention of physiology” and “clinical application of physiology.” Results: The percentage of students who reported having a little/fair amount of physiology content in their memory was significantly higher than those who claimed to have much/very much physiology knowledge in their memory: 90.6% (106) versus 9.4% (11) in externs, 84.9% (45) versus 15.1% (8) in interns, and 84.46% (87) versus 15.53% (16) in residents (P<0.001). Additionally, there was a significant increase in the number of students who stated that the loss of physiology knowledge interferes with their clinical reasoning compared to those who did not have such an idea: 81.2% (95) versus 18.8% (22) in externs, 77.36% (41) versus 22.64% (12) in interns, and 78.64% (81) versus 21.36% (22) in residents (P<0.001). Conclusion: Clinically active medical students at Ahvaz Jundishapur University of Medical Sciences recognize the importance of physiology for enhancing clinical performance. They acknowledge that difficulties in remembering this knowledge can have adverse effects on the future practice of doctors. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the effect of breastfeeding on children's growth indices. Materials and Methods: Longitudinal data of children's growth (height, weight, and head circumference) were as a dependent variable and type of nutrition as an independent variable with using multivariate t linear mixed model. Results: The indicated that the height, weight, and head circumference of infants who were fed with breast milk showed a statistically significant difference (P < 0.05) with those of infants receiving formula. Conclusion: Exclusive feeding with breast milk, especially in the first 6 months of life, has a significant impact on the child's growth indicators compared to formula or, or a combination of both. [ABSTRACT FROM AUTHOR]

Background: Since breast cancer is the most common type of cancer in women around theworld, finding newbiomarkers for early diagnosis of breast cancer is invaluable. Objectives: This research assessed them RNA expression of triggering receptors expressed onmyeloid cell 2 (TREM2) and tandem C2 domains nuclear protein (TC2N) genes among Iranian patients with breast cancer. Methods: We acquired 50 samples of cancerous breast tumors and corresponding adjacent non-cancerous tissues from Iranian women. The gene expression of TREM2 and TC2N wasmeasured by quantitative real-time polymerase chain reaction (q-RT-PCR). In addition, the association between TREM2 and TC2N levels with various clinicopathologic characteristics was also investigated. Results: The increased levels of TREM2 and TC2NmRNAs were shown in breast cancerous tissues in comparison with adjacent non-cancerous tissues (P < 0.05). Among the clinicopathological characteristics evaluated, tumor size, necrosis, and lymphatic tissue invasionwere significantly associatedwith high TREM2 expression. A significant relationship was also seen between increased TC2N expression and tumor grade. Sensitivity and specificity were shown at 84% and 94%, respectively, for TREM2 and 72% and 100% for TC2N. Conclusions: The data suggest that TREM2 expression, but not TC2N, could be a suitable biomarker for breast cancer diagnosis. [ABSTRACT FROM AUTHOR]

Background and Objectives: Adenovirus species B, C, D, and E are the most common causes of ocular manifestations caused by adenoviruses. FDA-approved treatment agents for adenovirus infections are not available. Cell-mediated immunity is the major protective mechanism versus human adenoviruses (HAdVs) infection and T cells specific for peptide epitopes from nonstructural proteins can prevent adenoviral dissemination. E1A CR2 region of HAdVs Epitopes predicted for reinforcing cytotoxic T lymphocytes (CTLs) in the EKC patients. Among human adenoviruses E1 protein, four distinct E1A regions had a significantly higher level of homology than the rest of E1A protein. E1A protein inhibits IFN signal transduction. Epitope-based vaccines are designed to have flexible and simple methods to synthesize a vaccine, using an adjuvant to trigger fast immune responses. CTL epitopes were applied to create a multiepitope vaccine. Conserve region1 (CR1) and CR3 have less antigenicity compared to CR2. Additionally, CR3 in HAdV-D8 contains three toxic areas. CR4 similar to the two regions CR1 and CR3 do not show acceptable antigenic properties. Materials and Methods: Bioinformatics’ tools were used to predict, refine and validate the 3D structure of the construct. Effective binding was predicted by protein-protein docking of the epitope vaccine with MHC-I molecules and revealed the safety and efficacy of the predicted vaccine construct. Results: In silico analysis show that rising levels of cytotoxic CD8 + T cells, TH1 cells, macrophages, and neutrophils are linked to IFN-dominant TH1-type responses, which are detected in putative immune individuals. Conclusion: Combined with 3D protein modeling, this study predicted the epitopes of E1A CR2 protein in HAdVs. [ABSTRACT FROM AUTHOR]

Objectives One of the challenges facing societies today is the increased medical expenses of the elderly. Therefore, identifying the factors associated with this increase can help health policymakers control the costs imposed on the elderly and their families. This study aims to identify the factors related to the increase in hospitalization costs of the elderly with circulatory system diseases using the generalized gamma marginalized two-part model. Methods & Materials In this retrospective cohort study, 335 samples were selected by a simple random sampling method from among the older patients of Imam Khomeini and Golestan hospitals in Ahvaz, Iran during 2015-2016 having circulatory system diseases and age ≥60 years. The relationship of age, gender, hospitalization status in intensive care unit (ICU), marital status, admission season, and number of hospitalization days with the increase in treatment costs of the elderly was examined using the generalized gamma marginalized two-part model in SAS 9.4 software. The response variable was the patients' treatment costs. The significance level was set at 0.05. Results The mean age of participants was 70.718.27 years, where 54% were female and 46% were male. The average medical costs in patients admitted to ICU was 3.70 times higher than that in patients who were not admitted to this unit. The odds ratio showed that, for each day of increase in hospital stay, the hospitalization costs of the patients increased by 1.11. The hospitalization costs for older men were 1.67 times higher than in older women. In single patients, it was 2 times higher than in married patients. Moreover, with each year of increase in age (after age 60), the hospitalization costs increased by 0.96. Using the marginalized two-part model, it was found that the variables of age, number of hospitalization days, marital status, gender, and admission to ICU had a significant relationship with the increase in the hospitalization costs of the elderly (P<0.05). Conclusion The burden of hospitalization costs on younger elderly with circulatory system diseases is higher. Older men incur more hospital costs than older women, and single elderly people incur more hospital costs than married ones. The increase in the number of hospitalization days is another factor that can increase the hospitalization costs of the older patients, especially in those admitted to ICU. [ABSTRACT FROM AUTHOR]

Human papillomavirus type 16 (HPV‐16) is one of the most important cause of developing cervical cancer. Therefore, effective epitope‐based vaccine design for HPV‐16 would be of major medical benefit. The aim of our study was to identify B‐ and T‐cell epitopes of HPV‐16 L1 protein. In this study, the HPV‐16 L1 gene was isolated from HPV recovered from five vaginal swab samples using specific primers and finally sequenced. The ExPASy translate tool (http://web.expasy.org/translate/) was used to convert nucleotide sequence into amino acid sequence. Bioinformatic analysis was employed to predict suitable B‐ and T‐cell epitopes and immunogenicity, allergenicity, and toxicity of predicted epitopes were then evaluated. Afterward, the selected T‐cell epitopes were docked using Molegro Virtual Docker software. The two epitopes 207AMDFTTLQA215 and 200MVDTGFGAM208 have showed a very strong binding affinity to HLA‐A0201 and HLA‐B3501 molecules, respectively. Outcome of B‐cell epitope prediction showed that epitope 475KAKPKFTLGKRK ATPTTSSTSTTAKRKK502 contained overlapped epitope, which might be the epitope associated with the production of neutralizing antibody response. Based on this finding, the predicted B‐ and T‐cell epitopes are promising targets for epitope‐based vaccine development against HPV‐16. Further in vivo and in vitro experiments are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Aim: We aimed to assess the association between deficient levels of circulating vitamin D, dietary intake of vitamin D, calcium and retinol, and risk of colorectal cancer in an Iranian population. Methods: In this retrospective case‐control study that was conducted between 2012 and 2015, 278 first incident colorectal cancer cases (colon cancer = 103; rectal cancer = 175), and 278 sex and age matched healthy controls (HCs) were recruited. Serum 25(OH)D, dietary vitamin D, and calcium intake were assessed. Logistic regression was used to estimate the odds ratio (OR) between studied factors and colorectal cancer. Estimates of OR were calculated according to both bivariate analyses based on the matching factors and multivariate analyses, with additional adjustment for potential confounders. Results: A strong inverse linear dose‐response association was seen between serum 25(OH)D and colorectal cancer (P for trend =.002). In comparison to serum 25(OH)D more than 40 nmol/L, lower serum concentrations were significantly associated with an increased OR of colorectal cancer. When analyzing anatomical subsites separately, lower circulating 25(OH)D was associated with higher OR for both colon and rectum cancers. Dietary vitamin D and calcium intake were not associated with colorectal cancer. Interaction analysis between serum 25(OH)D and the amount of calcium intake demonstrated that the lowest level of both factors was associated with an increased OR of colorectal cancer. The highest OR of colorectal cancer that was associated with lowest circulating 25(OH)D was stronger at the highest retinol intakes. Conclusion: This study demonstrated an inverse strong association between 25(OH)D concentration and colorectal cancer in an Iranian population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Numerous factors such as nutrition and diet can affect the quality of sleep of people, especially employees. The aim of this study was to investigate the relationship between university employees' sleep quality and their dietary quality scores (HEI, DII and DASH score). MATERIALS AND METHODS: This cross-sectional study was performed on 211 employees with a mean age of 38.75±11.31. Nutritional status of individuals was determined through the Food Frequency Questionnaire (FFQ) and to assess sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The quality of sleep decreases with increasing Pittsburgh index score. The calculated dietary quality scores include DASH Index, Healthy Nutrition Index (HEI) and Diet Inflammation Index (DII). RESULTS: The results of this study after adjusting for confounding showed a significant positive relationship between DASH diet score and sleep duration (p <0.001). There was a significant negative relationship between HEI score and total score of PSQI (P = 0.003). Also, HEI score had a significant positive relationship with sleep duration in the unmodified and modified models (p <0.001), and a significant negative relationship was seen in unadjusted and modified model between DII score and sleep duration (p <0.001). CONCLUSION: It can be concluded that with increasing the diet quality in employees, the sleep quality also increases. This was the first study in south of Iran that examined the quality of sleep and diet of employees and the result of this study can affect the general health and improve the quality of foods consumed by employees. [ABSTRACT FROM AUTHOR]