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Background: Cystic echinococcosis (CE) is a parasitic and zoonotic infection, recognized globally as aneglected disease, with significant morbidity and mortality rates, especially in low-advantaged countries. Weaimed to evaluate the recurrence rate after hydatid disease surgery in Fars Province, Iran.Methods: A retrospective design was used to examine the data collected from Nemazee and Shahid FaghihiHospitals, Shiraz, southern Iran, over eight years, from 2011 to 2019. The research was conducted in 2023.The study extracted the following data from hospital records: demographic characteristics, paraclinicalfindings (such as sonography and CT scan), organ involvement, cyst number and size, surgical procedure, cystcomplications, intraoperative or postoperative complications, and recurrence rate.Results: The study included 303 patients, of whom recurrence occurred in 36 (11.9%). Intra or postoperativecomplications were associated with recurrence (P=0.001). In the recurrent cases, the most common intraoperativecomplication was anaphylactic shock (P=0.001), and the most common postoperative complicationswere unresolved pneumothorax and empyema (P=0.001). There was a significant association betweenrecurrence and complicated cysts (P=0.001). There was no significant difference between the organ involvedand the complicated cyst in the recurrence (P=0.50). There was no association between increasing the cyst’ssize and the chance of the recurrence rate. There was a significant relationship between recurrence and thenumber of cysts in the affected organ (P=0.001). There was a significant association between using no scolicidalagents and recurrence (P=0.001), and no antiparasitic drugs were used in only one (2.7%) patient (P=0.3240).There was no significant association between recurrence and duration of admission (P=0.193).Conclusion: Intra or postoperative complications (anaphylactic shock, unresolved pneumothorax, andempyema), complicated cysts, the number of cysts in the affected organ, and injecting of no scolicidal agentswere significantly associated with recurrence. Recurrence may have many reasons, such as insufficient drainage(incomplete peri-cystectomy and minute spillage of cyst contents), missing hidden cysts (numbered cysts),rupture or spillage of the cysts, and inadequate medical treatment.

Background: Cystic echinococcosis (CE) is a parasitic disease caused by the larval stages of taeniid cestodes of the genus Echinococcus which is considered a neglected disease of public health worldwide. CE primarily affects the liver and demonstrates distinctive radiological findings in computed tomography and ultrasonography. Surgery is considered the mainstay of CE treatment. Case presentation: The patient was a 17-year-old man who was admitted to the Emergency Department of Shahid Faghihi Hospital affiliated with the Shiraz University of Medical Science with dull right upper quadrant abdominal pain, loss of appetite, abdominal distention, and fullness. Abdominal computed tomography (CT) scan revealed a giant hepatic cyst measuring about 24 × 20 × 15 cm in the RHL with a pressure effect on the right kidney, pancreas, and bowel loops and another smaller one measuring 9× 8 × 8 cm in the left liver lobe. Semi-chevron incision was done and the patient underwent partial precystectomy with capitonnage and omentoplasty. Our case was the 5th rank according to the size of the recorded published cases in the literature.Conclusion: When dealing with a huge liver cyst, a high index of suspicion for echinococcal etiology becomes important in endemic areas like Iran. The choice of treatment for giant hepatic cysts substantially seems to be radical surgery by surgical ablation in general to mitigate the mortality and morbidity rate, because they are at risk of rupture, anaphylaxis, and so forth.

Abstract Background Leishmaniasis, a disease caused by a protozoan, causes numerous deaths in humans each year. After malaria, leishmaniasis is known to be the deadliest parasitic disease globally. Direct visual detection of leishmania parasite through microscopy is the frequent method for diagnosis of this disease. However, this method is time-consuming and subject to errors. This study was aimed to develop an artificial intelligence-based algorithm for automatic diagnosis of leishmaniasis. Methods We used the Viola-Jones algorithm to develop a leishmania parasite detection system. The algorithm includes three procedures: feature extraction, integral image creation, and classification. Haar-like features are used as features. An integral image was used to represent an abstract of the image that significantly speeds up the algorithm. The adaBoost technique was used to select the discriminate features and to train the classifier. Results A 65% recall and 50% precision was concluded in the detection of macrophages infected with the leishmania parasite. Also, these numbers were 52% and 71%, respectively, related to amastigotes outside of macrophages. Conclusion The developed system is accurate, fast, easy to use, and cost-effective. Therefore, artificial intelligence might be used as an alternative for the current leishmanial diagnosis methods.

Background: Neonatal jaundice, amongst the most prevalent neonatal ailments with a prevalence of 60%, is defined as elevated serum levels of bilirubin. Phototherapy is the cornerstone for treating neonatal jaundice. The effect of phototherapy on magnesium serum levels is not well studied. Therefore, through this review article, we aim at assessing changes of serum magnesium levels during phototherapy. Material and Methods: In this systematic review article, domestic databases of University Jihad, Civilica, and university journals in addition to PubMed database are searched without time limit. Studies which assessed the effect of phototherapy on serum magnesium level were reviewed and the results were reported. All articles were separately reviewed by two authors. Results: Two hundred and twenty-two articles were extracted from the mentioned databases. Applying the inclusion and exclusion criteria, 14 articles were selected for thorough assessment. As shown in most of these studies, phototherapy had a significant effect on decreasing serum magnesium levels in neonates. Only one study did not show any significant effect. Most studies have not evaluated demographic and clinical variables in decreasing serum magnesium levels. Conclusion: There is a significant relationship between phototherapy and serum magnesium levels. Considering the role of NMDA receptor and its stimulatory effect in brain damage due to hypoxia and hyperbilirubinemia and the importance of magnesium in its inhibition, the body increases the extracellular magnesium levels during neonatal jaundice to prevent brain damage. It is concluded that after phototherapy, and therefore resolution of hyperbilirubinemia, serum magnesium level is reduced.

Objectives: Urolithiasis is a common condition with a high recurrence rate associated with serious complications. Moreover, it imposes a great financial burden on patients and the healthcare system. Studying its prevalence and associated factors are of great importance. We aimed to study the frequency of patients admitted to Shiraz hospitals because of urinary stones. Study Design: In this cross sectional study, three hospitals of Shiraz city, which are the referral centers for urological problems selected and all patients that admitted with impression of urolithiasis, were investigated Methods: In this study, the information of 1420 patients was collected during 2013 based on the consensus method. The collected information included age, sex, place, time and duration of admission, family history of diseases, the characteristics of urinary stones, and received treatments. Results: The male-to-female ratio was 1.96:1 with mean±SD age of 47.5±17.3 years. Most patients were 40-60 years old. The incidence rate of urolithiasis ranged from 22.2% to 27.8% in different seasons (P>0.05). Mean duration of hospitalization was 3.8±3.3 days and 37.7% of patients had another associated medical disease. Most stones were located in the kidney (49.2%) and ureter (39.4%). Composition of 70.8% of pure stones was calcium oxalate and 18.7% were staghorn type. Hematuria was the most prominent paraclinical finding (78.3%) and the most used method of treatment was lithotripsy procedures (72%) and 11.1% of patients underwent open surgery. Conclusion: Based on the current research, a significant percentage of patients had urinary stones that highlights the role of effective treatment and follow-up.

Background: Due to the increasing rate of cervical cancer screening, and the importance of teachers and faculties in changing the perspective of population on this issue, the present study was carried out to evaluate knowledge base, attitude and performance of teachers and faculty members in relation to cervical cancer screening test. Objectives: This study attempted to evaluate the knowledge, attitude and performance of teachers and faculty members on cervical cancer screening test in Shiraz, Iran. Patients and Methods: The present cross-sectional survey was conducted on a community with high education level. The study was carried out on a sample of 417 randomly selected subjects involving 206 participants from high school teachers and 211 faculty members. Stratified random sampling method was used proportionate to the size, of the main population in each group. P value 0.05 was considered for estimating sample size. Valid and reliable questionnaires were completed via face to face interview. Data were analyzed using SPSS Software version 13. Results: Mean score of knowledge (4.78 ± 0.71) was higher in faculty members than female teachers (4.21 ± 1.16). There was no statistically significant difference in mean scores of knowledge (P value = 0.748) and attitude (P value = 0.704) between teachers of different age groups. Mean score of knowledge (P value = 0.001) and attitude (P value = 0.009) was significantly different among faculty members with different academic degrees. Although academics had higher Knowledge and attitude, the mean score of performance among teachers (18%) was higher than faculty members (16.6%). Conclusions: This study showed that in regard to screening of cervical cancer, there is no acceptable knowledge, attitude and performance level among faculty members and teachers in different zones of Shiraz.

Background: Teachers and university faculty members can play key role in raising the awareness and knowledge of the populations and potentially change their attitude and behavior regarding CRC. Thus considering the important role played by this group and regarding the increasing rate of CRC, the present study attempted to evaluate the basic knowledge of high-school teachers and university faculty members and their attitude and practice in connection with CRC screening test. Objectives: The aim of this study was to compare the knowledge, attitude and practice about Colorectal Cancer Screening between University Faculty members and High School teachers in Shiraz, Iran. Materials and Methods: This cross-sectional study comprised 832 subjects with high education level. Use of a sample size formula indicated the need for at least 770 participants; a population goal was set at 831 individuals. The study involved 424 males (212 high school teachers and 212 faculty members) and 417 females (206 high school teachers and 211 faculty members). Stratified random sampling method was carried out proportionally to population size in each group. Questionnaires were completed via face to face interview. Data were analyzed using SPSS.V.13. Results: Mean scores for knowledge of male faculty members (3.47 ± 1.39) and female teachers (4.09 ± 1.51) were greater than female faculty members (2.36 ± 1.28) and male teachers (2.65 ± 1.96). Male faculty members had higher mean scores for attitude (3.00 ± 1.61) than that of female teachers (3.00 ± 2.09). A significant difference was observed in mean knowledge scores (P = 0.001) of female teachers with different academic degrees, but not in regard to attitude (P = 0.89). Conclusions: This study showed no acceptable level of knowledge, attitude and practice about screening of colon cancer among faculty members and teachers from different areas of Shiraz. This calls for further attention paid by health professionals and other authorities concerned with regard to providing the population under study with necessary information about colon cancer screening.

Background: Computerized preventive screening software is a cost effective intervention tool to address non-communicable chronic diseases. Shiraz Smart Screening Software (SSSS) was developed as an innovative tool for qualified screening. It allows simultaneous smart screening of several high-burden chronic diseases and supports reminder notification functionality. The extent in which SSSS affects screening quality is also described. Methods: Following software development, preventive screening and annual health examinations of 261 school staff (Medical School of Shiraz, Iran) was carried out in a software-assisted manner. To evaluate the quality of the software-assisted screening, we used quasi-experimental study design and determined coverage, irregular attendance and inappropriateness proportions in relation with the manual and software-assisted screening as well as the corresponding number of requested tests. Results: In manual screening method, 27% of employees were covered (with 94% irregular attendance) while by software-assisted screening, the coverage proportion was 79% (attendance status will clear after the specified time). The frequency of inappropriate screening test requests, before the software implementation, was 41.37% for fasting plasma glucose, 41.37% for lipid profile, 0.84% for occult blood, 0.19% for flexible sigmoidoscopy/colonoscopy, 35.29% for Pap smear, 19.20% for mammography and 11.2% for prostate specific antigen. All of the above were corrected by the software application. In total, 366 manual screening and 334 software-assisted screening tests were requested. Conclusion: SSSS is an innovative tool to improve the quality of preventive screening plans in terms of increased screening coverage, reduction in inappropriateness and the total number of requested tests.

During the human history, there was a great struggle against illness and pain, and physicians have always been vanguard in this fight, but some physicians, in addition to treating patients, have been doing their actual duty, namely the maintenance of human health. In the ancient medical history resources, issues of health protection have been shown to be one of the most significant subjects of medical science. Naseri’s view on health maintenance is one of medical resources, in which principles of health protection have been expressed, entitled “setteye zaroorieh”. The following literature is an overview of Iranian knowledge in the field of preventive medicine and Old Iranian physician’s attention to this important issue. Undoubtedly, similar studies can provide new incentives for modern physicians to address this medical field and may help to achieve health promotion goals and also can reduce excessive costs of health care and increase the life expectancy in communities.

Background: The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran. Methods: In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. Results: Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking 2 years. Almost half of those surveyed (48.9%) smoked 20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. Conclusions: Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

Background: The study of the mortality patterns in each country helps to improve proper programming to reduce the number of deaths. Our effort was to study the frequency of unnatural deaths from 2006 to 2010. Methods: In the present cross-sectional research carried out to study the cases of unnatural deaths in Fars province between 2006 and 2010, all documents related to unnatural deaths in Fars Forensic Medicine Registry (FFMR) were investigated. Information about the deceased, including age, gender, education, and type of accident, was extracted and analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: The findings indicated that during the five-year period studied a total number of 10079 unnatural deaths occured. During the study period, unnatural deaths had a decrease. The most recurring cause of death was traffic accidents (38%), with the death caused by substance abuse (19.2%) and burns (9.5%) the second and the third leading causes of death. Of all deaths, 81% of the deceased were male. The highest frequency of deaths occurred in the age group of 20 to 29 years. Also, the highest number of deaths belonged to individuals with primary and middle school education (52%). Conclusion: The number of unnatural deaths decreased as the time went by. Unnatural deaths were more frequent in males and in young people and happened more in people with lower education. Implementation of correct policies and appropriate programs focusing on these high risk groups could lead to considerable prevention of unnatural deaths.

Background: A healthy lifestyle is important because of its long-term benefits; however, there is a paucity of information concerning health choices among Iranians. We evaluated personal health behaviors, attempts to change unhealthy behaviors, and factors affecting attempts at change. Methods: The design of this cross-sectional study was to assemble a representative cadre of> 18-year-old adults in Shiraz, Iran, using a multistage cluster sampling technique. Validated questionnaires collected participant's demographic information, such as weight, height, cigarette smoking history, physical activity, and attempts at lifestyle changes during the previous year. To determine predictors of attempts to change unhealthy lifestyle and to identify confounders, we applied single and multivariable logistic regression methods, respectively. A confidence interval of 95% was calculated for each odds ratio. Results: The prevalence of attempts to change unhealthy lifestyle was 42%, 64.8%, and 27.8%, respectively, for losing weight, being more physically active, and smoking cessation. Unemployment, low levels of education, and decreased socioeconomic status have important roles in attempts to change lifestyle conditions. Low socioeconomic status was a risk factor for quitting smoking. Occupation (unemployed/homemaker) and low level of education were two significant factors for being more physically active. Conclusions: The prevalence of inadequate physical activity and being overweight or obese was considerable in Shiraz, Iran. Attempts to change unhealthy lifestyle were less than ideal. Social determinants of health factors including unemployment and low levels of education and socioeconomic status play important roles in attempts to change current lifestyles.