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Sulfur mustard (SM), known as the "king of toxic agents," continues to pose a potential danger due to its ability to cause widespread damage, including ongoing corrosive effects. We aimed to determine the rheumatologic markers in SM veterans suffering from severe pulmonary manifestations. The serologic markers, including ANA, anti-DNA, rheumatoid factor (RF), and CRP, between SM-exposed veterans (n = 229) with severe problems and not-SM-exposed residents with no pulmonary disease history (n = 63), 25-30 years after SM exposure were compared. Moreover, SM-exposed veterans were divided into subgroups, including bronchiolitis obliterans, chronic bronchitis, and asthma, based on specialists' diagnoses, and all the data were compared among these clinical subgroups. Autoantibodies were assessed by standard indirect immunofluorescence and/or ELISA. The levels of serum hs-CRP were determined using an immunoturbidometry technique in both the patient and control groups. Statistical analysis was performed using SPSS software. Patients had significantly elevated ANA (P = 0.000), anti-DNA (P = 0.024), RF (P = 0.000), and CRP (P = 0.000) levels compared to the matched control group. These results indicate a possible autoimmune circumstance in this population and suggest the need to follow up the autoimmunity-related markers in all SM-exposed individuals, since they might be a valuable prognostic biomarker for stratifying patients for the future risk of autoimmunity development., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Mustard gas as a chemical weapon has been used in wars and its long-term side effects are substantial in the human body. This study aimed to apply an extension of allostatic load, known as biological health score (BHS), including the wear-and-tear of four physiological systems (endocrine, inflammatory, cardiovascular, and metabolic systems) to estimate biological health caused by sulfur mustard (SM) toxicity., Methods: In this cross-sectional study, serum samples were collected from two distinct groups of male individuals including 1) 236 individuals who had been exposed to SM gas during the Iraq-Iran war in 1987. This group was divided into three subgroups based on their respiratory disorders (19 individuals with asthma, 92 individuals with bronchiolitis obliterans, and 125 individuals with chronic bronchitis); 2) 64 healthy members, at the same range of age and residence, as the non-exposed group. To estimate a modified BHS, 50 blood-derived biomarkers (or their ratios) of the mentioned systems were measured., Results: The SM-exposed group and respiratory disease subgroups exhibited higher BHS than controls (P < 0.05). The endocrine and metabolic systems exhibited higher BHS in the SM-exposed group and its subgroups compared to the control group (P < 0.05). In contrast, the cardiovascular and immune/inflammatory systems did not show significant differences between the groups. Principal component analysis (PCA) identified several key biomarkers, including lymphocyte count, the LDH/lymphocyte ratio, cholesterol levels, and neutrophil count, as major contributors to interpatient variation among individuals exposed to SM and those with related respiratory diseases., Conclusion: The modified multisystem BHS could be useful in the more accurate evaluation of biological health in chronic SM toxicity. The dysregulation observed in the endocrine and metabolic systems underscores the complication of SM toxicity and its extensive consequences on physiological homeostasis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Sulfur mustard (SM) is a chemical warfare agent with well-known severe toxic effects and may cause long-term debilitating injuries. We aimed to evaluate aging and longevity in Iranian SM-exposed survivors using some endocrine and molecular biomarkers for the first time. Dehydroepiandrosterone (DHEA), prolactin (PRL), cortisol, testosterone, and luteinizing hormone (LH) were measured in 289 male SM-veterans and 66 age-matched males using the ELISA method. Leukocyte Telomere Length (LTL) measurement and p16 INK4a expression were measured in the peripheral blood leukocytes of 55 males who were exposed to SM. We found a significantly lower serum DHEAS level and higher serum PRL level in SM-exposed groups (without any related to the severity of lung injuries) compared to healthy controls, but no significant difference in serum levels of cortisol, testosterone, and LH. The molar ratio of DHEAS/cortisol was significantly higher in controls compared to the SM-exposed individuals especially those with severe lung damage. Some biological parameters of allostatic load score such as DHEAS and DHEAS/cortisol ratio significantly decreased long-term after the SM exposure. Additionally, we found that LTL was shorter in SM-exposed veterans rather than unexposed controls while p16 INK4a gene expression significantly increased in these groups. It seems that DHEAS, DHEAS/cortisol ratio, LTL, and p16 INK4a gene expression have changed significantly in favor of cellular senescence in SM-exposed patients. Therefore, it seems that SM exposure increases biological age compared to chronological age in SM-exposed survivors.

Background: COVID-19 spread between and across nearly every country, with considerable negative health consequences. The current study aimed to determine the prevalence of violence and its association with mental health among Iranians older than 15 years in 2020., Methods: Data was collected through National Mental Health Survey on 24,584 Iranians older than 15 years in 2020. were analyzed to determine the prevalence of violence and its association with mental health. Multi-stage sampling method was used, and data on demographic characteristics and domestic-social violence and mental health (GHQ-28) were collected. Data analysis was administered using descriptive statistics and a chi-square test at a 95% level., Results: The mean age of participants was 44.18 ± 16.4 years. The overall prevalence of domestic and social violence was 11.4% and 5.5%, respectively. Verbal violence was the most common type; with 61.8% and 66.8% for domestic and social violence, respectively. A suspected case of mental disorder, female gender, being younger than 25 years, living apart together, unemployment, low education, and history of COVID-19 infection presented a significant association with domestic and social violence (p > 0.05)., Conclusion: In comparison to the previous study in 2015, the prevalence of violence has increased. Therefore, domestic and social violence are the social concerns of Iranian society, indicating the necessity of appropriate interventions, particularly for those suspected of mental disorders and young women with low education levels., (© 2023. The Author(s).)

Background: One of the main concerns of public health is the increasing inequality of health status, which has an adverse effect on people's life., Purpose: The current study aims to analyze the role of socioeconomic inequalities in health-related quality of life (QoL) among Iranian young people in the middle stage of adolescence., Methods: A cross-sectional descriptive study was conducted on 576 young people in the middle stage of adolescence. The samples were selected using the Multi-stage sampling method. Data were collected by a demographic checklist, and KIDSCREEN-52 questionnaire and analyzed by SPSS ver.16. The Health Equity Assessment Toolkit (HEAT) Version 4.0 (beta) was used to assess adolescents' QoL inequalities in terms of socio-economic subgroups., Results: The results show that 27.2 adolescents had low quality of life. The score of physical and autonomy components of QoL was significantly more in male versus school environment in female adolescents. Also, the asset index, father's, and mother's education, and family income in female adolescents, and the assets and family income in male adolescents were significantly related to the quality of life (p < 0.05). The risk of lower QOL in the poorest quintile was 1.12 times more than in the richest quintile. The consideration index of Asset in terms of sex was 4.5 and the modified Gini index was more than 0.5 in females and males., Conclusion: Our findings highlight the significant effects of socioeconomic inequality on the HRQL of Iranian adolescents. Requires a targeted policy approach to reach the poorest quintile for improving the quality of life of adolescents., (© 2023. The Author(s).)

Purpose: To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy., Materials and Methods: Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I-II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water)., Results: The UE condition had significant effects on Overall Stability Index (OSI) (F (2,44)  = 24.899, p < .001), Medial-Lateral Stability Index (MLSI) (F (2,44)  = 4.380, p = .018), Anterior-Posterior Stability Index (F (2,44)  = 6.187, p = .004), and TUG scores (F (2,44)  = 113.372, p < .001). Group was significant for OSI (F (1,22)  = 7.906, p = .010), MLSI (F (1,22)  = 13.113, p = .002), and TUG (F (1,22)  = 36.282, p < .001)., Conclusions: The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs.

Background: Mental disorders are the most common health problems that affect different population groups. According to the national survey in 2015 based on General Health Questionnaire-28 (GHQ-28), 23.44% of Iranians older than 15 years were suspected of having a mental disorder. The study aimed to determine the mental health status of the population over 15 years of age in the Islamic Republic of Iran, one year after the outbreak of COVID-19 in 2020., Methods: The population-based study was performed on 24584 individuals over 15 years of age in Iran between December and February, 2020. The GHQ-28 was completed through telephone interviews. Data were analyzed using descriptive statistics, chi-square test, independent t -test, and multiple logistic regression at 95% confidence level., Results: The results showed that the mean age of participants was 44.18±16.47 years. The prevalence of mental disorders was 29.7%. Mental disorder was associated with female gender (OR=1.195, 95% CI 1.10-1.29), 25-44 years (OR=1.206, 95% CI 1.06-1.36), urban life (OR=1.116, 95% CI 1.04-1.19), illiteracy (OR=1.286, 95% CI 1.11-1.48), being divorced (OR=1.924, 95% CI 1.50- 2.45), and unemployment (OR=1.657, 95% CI 1.40-1.94). Among the participants and their families, 14.7% and 32.3% were infected with the disease, respectively. The COVID-19 mortality rate in their families was 13.2%. The prevalence of mental disorders in infected people (40% vs. 27.3%) and bereaved families (39.6% vs. 35.3%) was more than the non-infected groups., Conclusion: Our results showed that in Iran, the mental health of the general population had a rising trend compared to 2015, especially in people infected with COVID-19 and bereaved families. The observed difference may be due to the prevalence of the COVID-19 epidemic and rapid demographic, social, and economic changes in Iran. Planning to improve mental health in the mentioned population should be considered for the post COVID-19 era., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: Nonalcoholic Steatohepatitis (NASH) results from the accumulation of fatty acids in the liver. The elevated production of pro-inflammatory factors is the reason for the hyper inflammation in NASH. The α-L-Guluronic acid (G2013), a new member of NSAID family, is a plant-originated agent with immunomodulatory properties. The current study investigated the effects of G2013 on inflammatory factors in PBMCs of NASH patients., Methods: PBMCs of 14 NASH patients and 14 healthy controls were isolated and cultured. The patient's cells were treated with low (5 µg/mL) and moderate (25 µg/mL) doses of G2013 alongside the diclofenac optimum dose (3 µg/mL). The expression and secretion levels of variables were assessed by real-time PCR and ELISA, respectively., Results: Findings indicated that the expression levels of TLR4 and NF-κB , as well as the secretion levels of TNF-α and IL-6 cytokines, were significantly elevated in NASH patients compared to healthy individuals. The expression levels of TLR4 and NF-κB were strikingly downregulated in treated cells of patients in both low and moderate doses of G2013. A considerable reduction was obtained in the secretion level of IL-6 using both low and moderate doses of G2013 and in the secretion level of TNF-α using the moderate dose of G2013., Conclusion: The results indicated that G2013 could meaningfully decrease the expression and secretion levels of evaluated factors (TLR4, NF-κB, TNF-α, and IL-6) in PMBCs of NASH cases. Since there is no effective treatment for NASH patients, we hope that G2013 would be a promising immunomodulatory agent in reducing inflammation and improvement of patients.

Background: Ischemic stroke is caused by a sudden neurological defect following a vascular occlusion and elicits a local and systemic inflammation in brain tissue. Interleukin-38 is an anti-inflammatory cytokine associated with ischemic and inflammatory diseases. This study was designed to analyze the effect of tPA therapy on interleukin-38 serum level changes and the serum level of IL-38 in the prognosis of ischemic stroke patients in the next three months., Methods: We enrolled 29 ischemic stroke patients confirmed by a neurologist based on radiologic and clinical manifestation between 2019 September to 2020 February. The patients who had NIHSS more than 6 with no underlying inflammatory diseases were selected for tPA therapy. On admission and 24 h after tPA therapy, the IL-38 serum level was measured by ELISA kit., Results: The results showed that serum levels of IL-38 were significantly increased after tPA therapy (P < 0.001). A remarkable relationship was observed between the modified Rankin Score (mRS) and IL-38 serum changes in response to tPA therapy (P < 0.001). Besides, IL-38 serum changes following tPA were dramatically related to NIHSS at hospitalization (P = 0.007). Also, our analysis posed a positive relation between NIHSS at hospitalization and mRs criteria (P = 0.023). No notable relation has been observed between IL-38 serum levels before and after tPA and mRs (P = 0.601 and P = 0.074, respectively). Furthermore, there was no evidence for the relation between NIHSS at hospitalization and IL-38 levels before and after tPA (P = 0.457 and P = 0.105, respectively)., Conclusion: The results indicate that tPA could meaningfully increase the IL-38 serum level. Also, a negative correlation has been found between IL-38 serum changes in response to tPA and mRS. Since the lower changes in IL-38 serum level result in a poorer prognosis, we conclude that IL-38 serum changes might be a novel early predictor factor for ischemic stroke prognosis., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Self-efficacy is an important psychological and motivational factor in breastfeeding, and it is a valuable framework that predicts breastfeeding outcomes and demonstrates maternal confidence in breastfeeding. The meta-analysis evaluated the effectiveness of educational interventions on improving breastfeeding self-efficacy (BSE)., Methods: The English and Persian databases including Medline, Embase, Cochrane Database of Systematic Reviews (CDSR), PubMed, Web of Science, Scopus, CINAHL, Sid, IRANDOC, and Marg-Iran were systematically searched for studies published from January 2005 to December 2020. The quality of studies was evaluated using the Cochrane risk of bias tool and the heterogeneity by I 2 statistic. The extracted data were analyzed using RevMan 5 statistical software and presented using random effects standardized mean difference (SMD). The funnel plot was used for evaluating publication bias., Results: Results from 40 RCTs showed that educational intervention had a positive effect on the BSE compared with the usual/standard care (pooled SMD = 1.20; 95% CI = 0.75-1.64, p value <0.001). The subgroup analysis indicated that the educational intervention was based on theory, group class format, direct method education, during the first week of postpartum, doing during pregnancy, on primiparous women, and health center setting, and the Asian region has a more effect on BSE than the others., Conclusion: Breastfeeding education is considered an influential factor in the improvement of BSE. It is recommended that breastfeeding education should be continued for several weeks after childbirth for gaining its benefit. The Asian region has a more effect on BSE than the others. Therefore, it is important to add the values in content of education in each country., Competing Interests: No conflicts of interest relevant to this article were reported., (Copyright © 2021 Azam Maleki et al.)

Background: Drug addiction is known as one of the health, medical and social problems of the present century. Beyond the harmful physical and mental consequences for addicts, drug abuse can cause serious social problems. The aim of this study was to evaluate drug and alcohol abuse in individuals aged 15 yr and over in Iran in 2015., Methods: This descriptive cross-sectional study was done on individuals aged 15 yr and older who lived in urban and rural areas of Iran. Overall, 36,600 individuals were selected by systematic and cluster random sampling. The postal code was used to access the samples in 31 provinces of Iran. In each province 1200 individuals (50% men, 50% women) were evaluated. The used instrument was the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and data were analyzed using SPSS software., Results: The results showed 4.6% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.4% used Amphetamine stimulants, 6.1% used Sedative drugs, and 2.6% used Alcoholic beverages on a regular basis. Within the last 12 months, 3.9% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.3% used Amphetamine stimulants, 5.8% used Sedative drugs, and 1.9% used Alcoholic beverages. With the exception of Sedatives drugs men used more drugs than women and residents of rural areas used more opium and its derivatives than other groups of drugs. Based on the provincial distribution, Kerman and Qom used the highest and lowest prevalence percentage of Opium and its derivatives respectively., Conclusion: Overall, 2340000 individuals were addicts used Opium and its derivatives in 2015, therefore, medical and health officials should take all necessary measures to deal with these serious social problems., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Introduction: Sulfur mustard (SM) intoxication produces local and systemic changes in the human body. In this study, the relationship between tear and serum matrix metalloproteinase (MMP)-9 and serum tissue inhibitors of metalloproteinases (TIMPs) are assessed in serious eye-injured SM-exposed casualties., Methods: A group of 128 SM-exposed patients with serious ocular injuries in three subgroups (19 mild, 31 moderate, and 78 severe cases) is compared with 31 healthy controls. Tear and ocular status and serum MMPs and MMP-9/TIMPs complex levels were evaluated using enzyme-linked immunosorbent assay (ELISA)., Results: Serum level of MMP-9 was significantly higher in the SM-exposed group compared to the control group (P = 0.009). Mean serum MMP-9 level in the SM-exposed group with ocular abnormalities was significantly higher than that in the SM-exposed group without ocular abnormalities. SM-exposed people with corneal calcification had significantly higher serum MMP-9/TIMP-1 level compared to the SM-exposed ones without this problem (P = 0.045). The SM-exposed group with severe ocular injuries had significantly higher MMP-9/TIMP-1 than the controls (P = 0.046). The SM-exposed group had significantly lower levels of MMP-9/TIMP-4 complex than the controls (P < 0.001). The SM-exposed group with tear meniscus and fundus abnormality had significantly higher MMP-9/TIMP-4 levels than the SM-exposed group without these problems (P = 0.009 and P = 0.020)., Conclusion: Serum MMP-9 level had increased in SM-exposed groups with ocular problems, while TIMP-1 and TIMP-2 levels had remained unchanged. Serum TIMP-4 drastically decreased in SM-exposed group, which clearly explains the severity of the systemic and ocular damages., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: In recent years, brain functional connectivity studies are extended using the advanced statistical methods. Functional connectivity is identified by synchronous activation in a spatially distinct region of the brain in resting-state functional Magnetic Resonance Imaging (MRI) data. For this purpose there are several methods such as seed-based correlation analysis based on temporal correlation between different Regions of Interests (ROIs) or between brain's voxels of prior seed., Methods: In the current study, test-retest Resting State functional MRI (rs-fMRI) data of 21 healthy subjects were analyzed to predict second replication connectivity map using first replication data. A potential estimator is "raw estimator" that uses the first replication data from each subject to predict the second replication connectivity map of the same subject. The second estimator, "mean estimator" uses the average of all sample subjects' connectivity to estimate the correlation map. Shrinkage estimator is made by shrinking raw estimator towards the average connectivity map of all subjects' first replicate. Prediction performance of the second replication correlation map is evaluated by Mean Squared Error (MSE) criteria., Results: By the employment of seed-based correlation analysis and choosing precentral gyrus as the ROI over 21 subjects in the study, on average MSE for raw, mean and shrinkage estimator were 0.2169, 0.1118, and 0.1103, respectively. Also, percent reduction of MSE for shrinkage and mean estimator in comparison with raw estimator is 49.14 and 48.45, respectively., Conclusion: Shrinkage approach has the positive effect on the prediction of functional connectivity. When data has a large between session variability, prediction of connectivity map can be improved by shrinking towards population mean., Competing Interests: Conflict of interest The authors declared no conflict of interest.

Background and Objective: Aside from direct toxic effects, Sulfur Mustard (SM) induced serum hormone abnormalities may aggravate ocular complaints, including Ocular Surface Discomfort (OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurred vision, foreign body sensation, and pain. The aim of the current study was to investigate the possible association of ocular complaints with serum hormone concentrations in chronic phase of Sulfur Mustard (SM) exposure., Methods: As a part of Sardasht Iran Cohort Study (SICS), 372 SM-exposed patients and 128 non-exposed participants were enrolled. Ocular complaints and ocular surface biomicroscopic conditions and serum hormones were compared., Results: The exposed with tearing group had significantly higher mean serum levels of testosterone and prolactin (ng/mL) than controls (5.75 vs. 4.75, P=0.031; 11.71 vs. 8.42, P=0.009). The exposed with OSD group had significantly higher mean serum levels of prolactin than controls (12.48 vs. 6.90, P=0.002). The exposed with photophobia group had significantly higher mean serum levels of testosterone than the matched exposed (6.25 vs. 5.65, P=0.013). The exposed with blurred vision group had significantly higher mean serum levels of Thyroglobulin (Tg) (ng/mL) than the matched exposed (65.73 vs. 32.6, P=0.003)., Conclusion: Higher mean serum levels of testosterone (in exposed with tearing and photophobia) and prolactin (in exposed with tearing and OSD) may play protective roles against SM effects. Higher mean serum levels of Tg may deteriorate the tear film integrity and optical surface, which causes blurred vision. In the chronic phase of SM toxicity, some ocular surface problems are associated with alterations in the serum concentrations of testosterone, prolactin, and Tg., Competing Interests: The authors report no conflict of interest in this study.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Kohghilouyeh and Bouyerahmad in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Kohghilouyeh and Bouyerahmad in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Yasuj, Dogonbadan, and Dehdasht cities. The General Health Questionnaire-28 (GHQ-28) was used as a screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 16.9% of the subjects showed to be at risk of mental disorders (20.1% of females and 13.4% of males). Urban areas (18.3%) were more at risk of mental disorders compared with rural residents (13.9%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. The results also indicated that mental disorders were more common in certain subgroups; in particular women, those aged 65 years and above, the divorced and widowed, illiterate and retired adults., Conclusion: Our findings suggest that one sixth of the participants are at risk of developing mental disorders. Although the prevalence of these disorders has decreased from 26.2% to 16.9% between 1999 and 2015, it is still of great importance to further promote mental health policies and advocate psychological welfare of those suffering from mental disorders along with their re-empowerment.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Qazvin in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Qazvin in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Qazvin, Alvand, Mohammadieh and Abhar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, 25.8% of the subjects were shown to be at risk of mental disorders (29.5% of females and 22.1% of males). Urban areas (27%) were more at risk of mental disorders compared with rural residents (23.3%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. These disorders were more common in females, age group of 65 and above, people living in rural areas, divorced and widowed, illiterate and unemployed individuals compared with the other groups., Conclusion: The results of this study showed that about a fourth of the people in the province were suspected to have mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Kerman in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Kerman in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Kerman, Jiroft and Bam cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. The analysis of data in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 18.8% of the subjects showed to be at risk of mental disorders (22.9% of females and 14.8% of males). Urban areas (20.2%) were more at risk of mental disorders compared with rural residents (16%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. The results also indicated that mental disorders were more common in certain subgroups; in particular women, those aged 65 years and above, the divorced and widowed, illiterate and unemployed adults., Conclusion: The results of this study showed that one fifth of the samples were suspected of psychiatric disorders and the prevalence of these disorders has decreased from 22.9% in 1999 to 18.8% in 2015; so, it is on the authorities and health managers of the province to maintain the essential elements for continuity of mental health services to people with mental disorders.

Introduction: The main objective of this study was to determine the mental health status of population aged 15 and over in the province of Ardebil in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Ardebil province in Iran. An estimated sample size of 1200 people were chosen using systematic random cluster sampling. Access was provided by the contribution of Geographical Post Office of Ardebil, Pars abad and Germi cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 21.4% of individuals (26.3% of females and 16.5% of males) were suspected of mental disorders. The prevalence of suspected cases of mental disorders was 20.8% in urban and 22.8% in rural areas. The results also showed that somatization and anxiety symptoms were more prevalent than social dysfunction and depression symptoms, and were more common in women than men. The results of this research also showed that the prevalence of suspected cases of mental disorders increased with aging. Such disorders were more common in females, age group of 65 and above, people living in rural areas, divorced and widowed, illiterate and unemployed individuals compared with other groups., Conclusion: The results of this study showed that about one fifth of people in the province were suspected of mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: The main objective of this study was to compare the results of mental health surveys on adult populations of all provinces in Iran, between 1999 and 2015., Methods: This study was an overview of two cross-sectional, descriptive studies that were performed in 1999 and 2015. The study population of these two studies consisted of urban and rural residents of all provinces in Iran. Samples were recruited by systematic random cluster sampling. In both studies, the General Health Questionnaire (GHQ-28) was used to assess mental health status of respondents. Trained psychologists completed questionnaires, and data were analyzed using SPSS software-18., Results: The results showed that in the survey of 1999, 21% of participants suffered from mental disorders (25.9% of females and 14.9% of males). In the survey of 2015, 23.4% of samples were suspected of having mental disorders (27.6% of females and 19.3% of males). The prevalence of mental disorders increased from 1999 to 2014 by about 1.12 fold (1.06 fold in females and 1.3 fold in males). In the survey of 1999, rural residents were more at risk of mental disorders, while in the survey of 2015, urban residents were more prone to mental disorders. In both studies, the risk of suspicion for mental disorders increased with increasing age, and was higher in people aged 65 and above, as well as widowed, divorced and illiterate individuals., Conclusion: The results of this study showed an increase in suspected cases of mental disorders in Iran from 1999 to 2015. Therefore, it is vital for policymakers and health officials to take action in order to improve and maintain mental health status of the people who are at risk in the country.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Sistan and Baluchestan in 2015., Method: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Sistan and Baluchestan province in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Zahedan, Zabol, and Saravan cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 15.1% of individuals (17.2% of females and 13% of males) were suspected of mental disorders. The prevalence of suspected cases of mental disorders was 19% in urban and 13.5% in rural areas. It also showed that somatization and anxiety symptoms were more prevalent than social dysfunction and depression symptoms, and were more common in women than men. The results of this research also showed that the prevalence of suspected cases of mental disorders increased with aging. Such disorders were more common in females, age group of 65 and above, people living in urban areas, divorced and widowed, illiterate and retired individuals compared with the other groups., Conclusion: The results of this study showed that about a sixth of the people in the province were suspected to have mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Zanjan in 2015., Method: This cross-sectional field study was conducted on the residents of both urban and rural areas of the Zanjan province. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of of Zanjan, Abhar and Qeydar. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study showed that using the traditional scoring method, 28.5% of the subjects (32.9% of females and 24.2% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (30%) was higher than the prevalence of these disorders in rural areas (24.8%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and retired individuals compared to the other groups., Conclusion: The results of this study show that more than one quarter of the sample (28.5%) were suspected of mental disorders, and the prevalence of these disorders has increased from 21.3% in 1999 to 28.5% in 2015. Therefore, it is up to the authorities and health managers of the province to take the basic steps to supply, maintain, and preserve the mental health of those in need and promote the mental health of the community.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of North Khorasan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of North Khorasan in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of of Bojnourd, Sfaraien and Shirvan. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study showed that using the traditional scoring method, 22.2% of the subjects (28% of females and 16.4% of males) were suspected of mental disorders. The prevalence of suspected psychiatric disorders in urban areas (23.9%) was higher than the prevalence of these disorders in rural areas (18.3%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and retired people compared to the other groups., Conclusion: The results of this study show that more than one fifth of the sample were suspected of mental disorders. Therefore, health authorities and administrators need to take the principle measures to ensure and maintain the mental health of individuals as well as the evaluation and treatment of patients with mental disorders.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Isfahan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Isfahan in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Isfahan, Kashan and Shahin shahr. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study showed that using the traditional scoring method, 30.6% of the subjects (38.5% of females and 22.5% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (32.1%) was higher than the prevalence of these disorders in rural areas (27%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components in women was higher than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and housewives was higher than other groups., Conclusion: The results of this study show that more than one third of the sample are suspected of mental disorders, and the prevalence of these disorders has increased from 21.3% in 1999 to 30.6% in 2015; therefore, it is up to the authorities and health managers of the province to take the basic steps to supply, maintain, and preserve the mental health of those in need and promote the mental health of the community.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Razavi Khorasan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Razavi Khorasan in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Mashhad, Torbate Jam and Sabzavar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 23.7% of individuals (26.9% of females and 20.6% of males) were suspected of mental disorders. The prevalence of suspected cases of mental disorders was 23.6% in urban and 23.8% in rural areas. It was also shown that somatization and anxiety symptoms were more prevalent than social dysfunction and depression symptoms, and were more common in women than men. The results of this research also showed that the prevalence of suspected cases of mental disorders increased with aging. Such disorders were more common in females, people living in rural areas, divorced and widowed, illiterate, housewives and retired individuals compared with the other groups., Conclusion: The results of this study showed that about a fourth of the people in the province were suspected to have mental disorders and the prevalence rate of mental disorders increased from 7.7% in 1999 to 23.7% in 2015. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: The main objective of this study was to determine the mental health status of population aged 15 and over in the province of Gilan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Fars in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Rasht, Fouman, and Hashtpar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. The analysis of data in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 18% of the studied population (19.3% of the females and 16.6% of the males) were considered as likely cases. The prevalence rate of mental disorders was 18.7% for urban and 17.7% for rural areas. Prevalence rates of somatization and anxiety were higher than social dysfunction and depression and women revealed higher prevalence for these disorders compared with men. It was also shown that the prevalence rate significantly increased with age and was higher in women, people aged 65 and above, urban residents, widowed or divorced, illiterate, and unemployed people., Conclusion: The results of this study showed that about a fifth of the people in the province are suspected to have mental disorders. Comparing the results of the current survey with those of the study conducted in 1999 suggests that the prevalence of mental disorders is on the decrease in this province (from 25.2% in 1999 to 18% in 2015). Therefore, it seems vital that the officials take action in order to improve and maintain mental health status of the people who are at risk.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Hormozgan in 2015., Methods: This cross-sectional field study was conducted on the residents of both urban and rural areas of the Hormozgan province. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Bandar Abbas, Bandar Lengeh and Minab. The 28-item version of the General Health Questionnaire was applied as the tool of screening. The data were analyzed using SPSS, version 18.0 for windows., Results: This study indicates that using the traditional scoring method, 28.2% of study population are highly suspicious for psychiatric disorders (35.4% of females and 21.1% of males). The prevalence of probable psychiatric disorders in urban areas (28.9%) was higher than rural areas (26.5%). The prevalence of probable somatization and anxiety was higher than the prevalence of social dysfunction and depression, and also the prevalence of these disorders was higher in women. The findings of this study show that the prevalence of probable psychiatric disorders has a direct relationship with increasing age and the prevalence of such disorders is higher in women, urban residents, individuals aged more than 65 years, divorced and widowed individuals, illiterate, housewives and unemployed people., Conclusion: The results of this study show that 28.2% of study population (more than a fourth) are suspicious for psychiatric disorders, and the prevalence of these disorders increased from 22.9% in 1999 to 28.2% in 2015. So, health authorities in this province have to do their best for provision, maintenance and improvement of mental health.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Bushehr in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Bushehr province in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Bushehr, Deilam and Borazjan. The 28-item version of the General Health Questionnaire was applied as the screening tool. Data were analyzed using SPSS, version 18.0 for windows., Results: The results of this study showed that using the traditional scoring method, 23.4% of the subjects (29% of females and 14.7% of males) were suspected of mental disorders. The prevalence of suspected psychiatric disorders in rural areas (24.5%) was more than the prevalence of these disorders in urban areas (22.8%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected cases of mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among females, the age group of 65 and older, people living in rural areas, divorced and widowed, students and primary and secondary education than other groups., Conclusion: The results of this study show that more than one fourth of the sample were suspected of mental disorders, and the prevalence of these disorders has increased from 21.3% in 1999 to 23.4% in 2015. Therefore, it seems necessary for the provincial public health authorities to take the needed steps for providing requirements encompassing prevention and promotion of mental health in this area.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Markazi in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Markazi in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Arak, Delijan, and Saveh cities. The General Health Questionnaire-28 (GHQ-28) was used as a screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 computer software., Results: This study showed that using the traditional scoring method, 25.1% of the subjects (31% of females and 18.9% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (25.2%) was higher than the prevalence of these disorders in rural areas (24.8%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and housewives people was higher than other groups., Conclusion: The results of this study show that more than one fourth of the sample were suspected of mental disorders, and the prevalence of these disorders has increased from 18.6% in 1999 to 25.1% in 2015. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: The main objective of this study was to determine the mental health status of population aged 15 and over in the province of East Azarbaijan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of East Azarbaijan in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Tabriz, Sarab and Marand cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. The analysis of data in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 24.9% of the studied population (29.9% of the women and 20.1% of the men) were considered as likely cases. The prevalence rate of mental disorders was 23.1% for rural and 25.7% for urban areas. Prevalence rates of somatization and anxiety were higher than social dysfunction and depression and women revealed higher prevalence for these disorders compared with men. It was also shown that the prevalence rate significantly increased with age and was higher in women, people aged 65 and above, urban residents, widowed or divorced, illiterate, unemployed and housewives people., Conclusion: The results of this study showed that about a quarter of the people in the province were suspected to have mental disorders. Comparing the results of the current survey with those of the study conducted in 1999 suggests that the prevalence of mental disorders is on the decrease in this province (from 25.2% in 1999 to 24.9% in 2015). Therefore, it seems vital that the officials take action in order to improve and maintain mental health status of the people who are at risk.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Lorestan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Lorestan in Iran. An estimated sample size of 1200 people was chosen using the systematic random sampling and the cluster method. Access provided by the contribution of Geographical Post Office of Khorramabad, Aligoodarz, and Kuhdasht cities. The General Health Questionnaire-28 (GHQ-28) was used as a screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software., Results: This study showed that using the traditional scoring method, 36.3% of the subjects (40.8% of females and 31.8% of males) were suspected of mental disorders. The prevalence of suspected psychiatric disorders in rural areas (38.1%) was higher than the prevalence of these disorders in urban areas (35.7%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and housewives people was higher than the other groups., Conclusion: The results of this study show that more than one third of the sample were suspected of mental disorders, and the prevalence of these disorders has increased from 19.7% in 1999 to 36.3% in 2015. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Semnan in 2015., Method: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Semnan province in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Semnan, Garmsar and Shahroud. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study showed that using the traditional scoring method, 14.5% of the subjects (15.8% of females and 13.1% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (15.5%) was higher than the prevalence of these disorders in rural areas (12.1%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than in men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and unemployed people than the other groups., Conclusion: The results of this study showed that about a sixth of the people in the province were suspected to have mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Tehran in 2015., Method: This cross-sectional survey was performed on 1,200 individuals aged fifteen years and older, living in urban, and rural areas of the three main districts of Tehran, Shahriar, and Nasimshahr of Tehran Province. Individuals were enrolled in the study by clustered and systematic randomization. The General Health Questionnaire-28 (GHQ-28) was used for screening for common mental disorders. Those scoring above the cut-off point of the GHQ-28 were considered to be suffering from at least one mental disorder. All data was analyzed using the SPSS-18 software., Results: According to our data, 30.2% of the subjects (34.2% of females and 26.4% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (35.1%) was higher than the prevalence of these disorders in rural areas (18.2%). Scoring above the cut-off point of the GHQ-28 also had a positive correlation with age, especially among those aged 65 years old and above. Somatization and also symptoms of anxiety were more prevalent than social dysfunction and depressive symptoms, and also more prevalent among females compared to males. Being suspected of a mental disorder was also more prevalent among those who had been divorced, widowed, unemployed, and having post-graduate university education., Conclusion: The results of this study show that about one third of our sample population were suspected of suffering from a mental disorder. The prevalence of common mental disorders has increased from 21.2% in 1999 to 31.7% in 2015. Therefore, it is strongly recommended that public health authorities put more effort to ensure necessary requirements encompassing prevention and promotion of mental health of the Iranian population residing in Tehran province.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Chaharmahal and Bakhtiari in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Chaharmahal and Bakhtiari in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Shahre Kord, Farsan and Farrokhshar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. The analysis of data in the current study was carried out using the SPSS-18 software., Results: Using GHQ traditional scoring method, the results showed that 24.9% of the subjects were at risk of mental disorders (26.8% of females and 23% of males). Urban areas (27.1%) were more at risk of mental disorders compared with rural residents (19.1%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. The results also indicated that mental disorders were more common in certain subgroups, in particular females, people aged 65 years and above, the divorced and widowed, illiterate and unemployed adults., Conclusion: Our findings suggest that one fourth of the participants are at risk of developing mental disorders. Although the prevalence of these disorders has decreased from 39.1% to 24.9% between 1999 and 2015, it is still of great importance to further promote mental health policies and advocate psychological welfare of those suffering from mental disorders along with their re-empowerment.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of West Azarbaijan in 2015., Method: This cross-sectional field study was conducted on the residents of both urban and rural areas of the West Azarbaijan province. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Urumia, Salmas and Mahabad. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: Using GHQ traditional scoring method, the results showed that 24% of individuals (29.1% of females and 18.7% of males) were suspected of mental disorders. The prevalence rate of mental disorders was 19.8% for rural and 25.8% for urban areas. Prevalence of somatization and anxiety was higher than social dysfunction and depression and women revealed higher prevalence for these disorders compared with men. It was also shown that the prevalence rate significantly increased with age and was higher in women, people aged 65 and above, urban residents, widowed or divorced, illiterate, housewives, unemployed and retired people., Conclusion: The results of this study showed that about a quarter of the people in the province were suspected to have mental disorders. Comparing the results of the current survey with those of the study conducted in 1999 suggests that the prevalence of mental disorders is on the increase in this province (from 13.5% in 1999 to 24% in 2015). Therefore, it seems vital that the officials take action in order to improve and maintain mental health status of the people who are at risk.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of South Khorasan in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of South Khorasan in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Birjand, Ghayen and Ferdows cities. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: Based on GHQ traditional scoring method, this study showed that 17.1% of the respondents (20% of women and 14.1% of men) were suspected of having mental disorders. The prevalence of suspected individuals for mental disorders was higher in urban areas (18.2%) than rural areas (14.5%). It was also shown that the prevalence of anxiety and somatization symptoms was higher than social dysfunction and depression symptoms, and women revealed higher prevalence for these disorders compared with men. The findings of this study also indicated that the prevalence of suspected cases for mental disorders increased with age. The prevalence of suspected cases of these disorders was higher in women aged 65 and over, divorced, widowed, uneducated and the retired compared to the other groups., Conclusion: The results of this study show that one sixth of the sample population were suspected of mental disorders; therefore, health authorities and administrators need to take the principled measures to ensure and maintain the mental health of individuals as well as the evaluation and treatment of patients with mental disorders.

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Yazd in 2015., Method: This cross-sectional field study was conducted on the residents of both urban and rural areas of the Yazd province. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Yazd, Ardekan and Meybod. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study indicates that through traditional scoring method, 26.7% of study population were highly suspicious for psychiatric disorders (32.1% of females and 21.4% of males). The prevalence of probable psychiatric disorders in urban areas (28.7%) was higher than the prevalence in rural areas (21.3%). The prevalence of probable somatization and anxiety was higher than the prevalence of social dysfunction and depression, and also the prevalence of these disorders was higher in women. The findings of this study show that the prevalence of probable psychiatric disorders has a direct relationship with increasing age and the prevalence of such disorders is higher in women, urban residents, individuals aged more than 65, divorced and widowed individuals, illiterate and unemployed people., Conclusion: The results of this study show that more than one quarter of study population were suspicious for psychiatric disorders and the prevalence of these disorders increased from 11.8% to 26.7% since 1999. So, health authorities in this province have to do their best for provision, maintenance and improvement of mental health.

Introduction: The main objective of this study was to determine the mental health status of population aged 15 and over in the province of Fars in 2015., Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Fars in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Shiraz, Jahrom and Kazeroun. The 28-item version of the General Health Questionnaire was applied as the screening tool. The data were analyzed using SPSS, version 18.0 for windows., Results: This study showed that using the traditional scoring method, 22.5% of the subjects (26.9% of females and 18% of males) were suspected of having mental disorders. The prevalence of suspected psychiatric disorders in urban areas (24.3%) was more than the prevalence of these disorders in rural areas (18.6%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among women, the age group of 65 and older, people living in urban areas, divorced and widowed, illiterate, and retired compared to other groups., Conclusion: The results of this study show that more than a fourth of the sample were suspected of mental disorders, and the prevalence of these disorders has decreased from 22.9% in 1999 to 22.5% in 2015. Therefore, it seems necessary for the provincial public health authorities to take the needed steps for providing requirements encompassing prevention and promotion of mental health in this area.

Background: Mental disorders influence people with a high prevalence and exert remarkable burden on community members. This study was carried out aiming to assess mental health status within the age range category of 15 and above in the Islamic Republic of Iran., Methods: The statistical population of this cross-sectional survey consisted of residents of urban and rural areas in Iranian provinces. An estimated sample size of 36000 people was chosen using systematic random sampling and the cluster method. Access was provided by the contribution of the Geographical Post Office for each province. The GHQ-28 was used as a screening tool for mental disorders. Data analysis was carried out using SPSS-18 software., Results: The results were gathered by the traditional scoring method. A total of 23.44% of samples were suspected of having mental disorders. The prevalence of suspicion for mental disorders was higher in urban (24.55%) than rural areas (20.89%). The prevalence of anxiety and somatization symptoms was higher than social dysfunction and depression symptoms. The outcomes also revealed that the prevalence of suspicion for mental disorders increased noticeably with aging. Suspicion for these disorders was more common in women, divorcees and widows, illiterates, less educated, unemployed and disabled individuals compared with other potential groups of the society., Conclusion: Comparison of the outcomes from this study with the research conducted in 1999, demonstrated an increasing prevalence rate of suspicion for mental disorders. Therefore, it is mandatory for Iranian public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Background: The accuracy of intraoperative diffusion tensor imaging (DTI)–based tractography of the corticospinal tract (CST) is crucial for its use in neurosurgical planning and its implementation in image-guided surgery. To the best of our knowledge, this is the largest prospective correlative study of the intraoperative DTI tractography of the CST and intraoperative direct electrical subcortical stimulation (DESS) of the CST, with application of intraoperative magnetic resonance imaging (iMR)., Objective: To evaluate intraoperatively acquired DTI-based tractography of the CST in correlation with DESS., Methods: Twenty patients with gliomas (grades II-IV) adjacent to the CST were included in this prospective study. Bilateral DTI tractography of the CST was performed pre- and intraoperatively with application of 1.5-T iMRI and the results correlated and compared with the prevailing gold standard of DESS. Sensitivity, specificity, positive predictive value, and negative predictive value were considered to quantify the correlation of DTI tractography with DESS. The intensity of DESS was correlated with the distance from the CST. Moreover, the tissue quality of stimulation points at the wall of the resection cavity was evaluated with 5-aminolevulinic acid. The clinical and volumetric outcomes at postoperative and follow-up periods were also analyzed., Results: The mean ± SD age of the patients was 54.9 ± 12 years. A total of 40 CSTs were reconstructed and 36 stimulations were included at 20 pathological CSTs, resulting in 18 true-positive, 5 false-positive, and 13 true-negative responses. The sensitivity, specificity, positive predictive value, and negative predictive value of DTI tractography to localize the CST were 100%, 72%, 78%, and 100%, respectively. DTI-based tractography correlated well at 86% of DESSs, and a linear correlation was detected between the intensity of DESS and the distance. All of the patients improved clinically, and the mean extent of resection was 97.2%. 5-Aminolevulinic acid was valuable in visualizing tumor infiltration in the false-positive cases, suggesting an infiltration of the CST at stimulation points., Conclusion: CST visualization in the iMRI setting appears to have a high sensitivity in accurately localizing the area of the CST adjacent to the resection cavity in glioma surgery. More prospective studies with a large sample size are needed to further support the results.

Background: Stem cells have been used in several studies with different methodologies to treat patients with ALS., Methods: In this safety and feasibility study, 11 patients with definite or probable ALS according to El Escorial criteria were selected. 3 patients were excluded due to inadequate bone marrow or safety measures after acquisition of bone marrow. Bone marrow stromal cell-derived neural stem cells were injected in C7-T1 spinal cord under general anesthesia. Patients were followed for 12months after injection with manual muscle testing, ALSFRS-R, quality of life changes, pulmonary function test and electromyography., Results: None of the patients had perioperative mortality or major morbidity. One patient had temporary deterioration in lower extremities after injection which improved after a few weeks. In the 12months post-injection, only one patient died due to pulmonary embolism. From the remaining 7 patients, all had a stable course after 4months and 5 were stable for the first 8months post-injection and deteriorated afterwards., Discussion: In this study, intraspinal injection of bone marrow derived neural stem cells appears to be safe. Patients experienced a temporary stabilization for the first few months post-injection and then gradually deteriorated., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Sulfur mustard (SM) is a strong toxic agent that causes acute and chronic health effects on a myriad of organs following exposure. Although the primary targets of inhaled mustard gas are the epithelia of the upper respiratory tract, the lower respiratory tract is the focus of the current study, and upper tract complications remain obscure. To our knowledge there is no study addressing the secretory IgA (S-IgA), C5a, alpha 1 antitrypsin (A1AT) in the saliva of SM-exposed victims. In this study, as many as 500 volunteers, including 372 SM-exposed cases and 128 control volunteers were recruited. A 3 ml sample of saliva was collected from each volunteer, and the level of secretory IgA, C5a, and alpha 1 antitrypsin in the samples were compared between the two groups. The SM-exposed group showed a significantly higher amount of salivary alpha 1 antitrypsin and secretary IgA compared to the control group (p<.006 and p<.018 respectively). The two groups showed no significant difference (p=0.192) in the level of C5a. The results also showed that the level of salivary A1AT is more than that of IgA in severely injured cases. The findings presented here provide valuable insight for both researchers and practitioners dealing with victims of the chemical warfare agent, sulfur mustard. This research indicates that certain branches of the inflammatory processes mandate serious attention in therapeutic interventions., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Respiratory complications are the foremost long term debilitating effects after sulfur mustard toxicity. The underlying immunological mechanisms of sulfur mustard induced lung damage are still poorly understood. The question of the involvement of immunoglobulin classes and subclasses in delayed pulmonary complications induced by SM was addressed in this study as a part of Sardasht-Iran Cohort Study (SICS).In SICS, 372 male participants who were exposed to SM 20 years earlier were compared with 128 unexposed age-matched controls. At the time of study (2007), the clinical evaluations and spirometry was performed for all subjects according to the American Thoracic Society Criteria, and at the same time, the sera were isolated, labeled and aliquots were kept frozen in -80°C. Serum immunoglobulin (Ig) levels including IgM, IgA, IgE, IgG, and IgG subclasses (IgG1, IgG2, IgG3 and IgG4) were measured using quantitative Elisa method. It was found that among immunoglobulin classes and IgG subclasses only IgM and IgG4 were significantly decreased in the peripheral blood of exposed cases. IgM level also positively correlated with FEV1 only in the SM exposed group. These results indicated a weak but significant role for IgA in control of the delayed pulmonary complications. There were no strong correlations between other immunoglobulin classes or IgG subclasses with pulmonary disease severity in sulfur mustard intoxicated subjects. The authors proposed that systemic levels of immunoglobulins do not exert essential roles in severity of delayed pulmonary complications following SM toxicity. However, more studies on local and systemic levels of immunoglobulins in more severe groups are suggested., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Exposure to SM leads to short and long term adverse effects on various organs including the skin. Cherry angioma is one of the late skin disorders in SM exposed individuals. The pathogenesis of abnormal angiogenesis in cherry angioma is not well known but the role of inflammatory mediators and certain hormones, including prolactin, in the regulation of angiogenesis in other diseases has been reported. Alterations in serum levels of prolactin and chemokines in SM-exposed victims and the impact on angiogenesis are indications of the role in SM-induced cherry angioma. As part of the SICS, this study seeks to evaluate the possible association of prolactin and chemokines in the emergence of SM-induced cherry angioma. The serum concentrations of prolactin, IL-8/CXCL8, RANTES/CCL5, MCP-1/CCL2, and fractalkine/CX3CL1 were titrated using sandwich ELISA technique. There was a significant difference in the level of prolactin between the exposed subgroups (with cherry angioma n=72; mean: 10.13) and without cherry angioma (n=268; mean: 13.13, p<0.0096). Median of the serum levels of CCL2 in the exposed patients with cherry angioma was significantly higher than exposed patients without cherry angioma (median=203.5 pg/ml and median=187.10 pg/ml respectively, p=0.035). There was no significant difference in the serum levels of IL-8, RANTES and CX3L1 between the exposed subgroups with cherry angioma and without cherry angioma. This finding serves as a basis for further research on the molecular mechanisms and pathways involved in the pathogenesis of cherry angioma and other related disorders., (Copyright © 2012 Elsevier B.V. All rights reserved.)