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Introduction: Cancer is projected to become the primary cause of death in the 21st century. Although childhood cancer is relatively rare, it remains a significant contributor to mortality among children. This study examines the geographical distribution of childhood cancer incidence in Iranian provinces using data from the National Cancer Registry between 2014 and 2018., Materials and Methods: This registry-based study analyzed data from 14,711 children under 20 diagnosed with common childhood cancers, sourced from the Iranian National Population-based Cancer Registry for the period 2014-2018. The age-standardized incidence rates (ASR) were calculated using direct standardization methods and reported per 1 million person-years. Spatial autocorrelation measures, including global and local indices such as Moran's I and Getis-Ord's G, were employed to identify high-risk and low-risk areas, assess overall spatial dependence, and pinpoint specific clusters and hotspots of incidence rates., Results: ASR for childhood cancer in Iran was 119.56 per 1 million individuals aged 0-19 years. Boys had a higher ASR (129.98) than girls (107.68). Childhood cancer cases increased from 2765 in 2014 to 3354 in 2018, with leukemia as the most common type, followed by brain and nervous system, lymphoma, bone, and connective and soft tissue cancers. Spatial analysis identified high-risk clusters in central Iran (Isfahan, Yazd, Tehran) and low-risk clusters in the northeast (Kermanshah, West and East Azerbaijan, Kurdistan)., Conclusion: This study highlights high childhood cancer incidence in Iran, particularly among boys and in central regions, with elevated leukemia rates. These findings call for targeted prevention strategies and further research to address geographic and gender disparities and to improve care programs., Competing Interests: Declaration of Competing Interest Authors have no conflicts of interests to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Reinfection with SARS-Cov-2 after recovery can occur that most of them don't require hospitalization. The aim of this study is estimation of out-patient COVID-19 reinfection and recurrence rates and its associated factors among Iranian patients with history of confirmed SARS-Cov-2 infection and hospitalization., Methods: This study is a retrospective cohort conducted from May 2021 to May 2022 in Iran. The national Medical Care Monitoring Center (MCMC) database, obtained from the Ministry of Health and Medical Education, includes all information about confirmed COVID-19 patients who are hospitalized and diagnosed during the pandemic. Using probability proportional to size sampling from 31 provinces, 1,532 patients over one years of age with a history of hospitalization in the MCMC data are randomly selected. After that, interviews by phone are performed with all of the selected patients using a researcher-made questionnaire about the occurrence of overall reinfection without considering the time of infection occurrence, reinfection occurring at least 90 days after the discharge and recurrence (occurring within 90 days after discharge). Univariate and multivariable Cox regression analyses are performed to assess the factors associated with each index. All of the analyses are performed using Stata software version 16., Results: In general, 1,532 phone calls are made, out of which 1,095 individuals are willing to participate in the study (response rate ≃ 71%). After assessing the 1,095  patients with a positive history of COVID-19, the rates of non-hospitalized overall SARS-Cov-2 reinfection, reinfection and recurrence are 122.64, 114.09, and 8.55 per 1,000 person-years, respectively. The age range of 19-64 years (aHR:3.93, 95%CI : 1.24-12.41) and COVID-19-related healthcare worker (aHR: 3.67, 95%CI: 1.77-7.61) are identified as risk factors for reinfection, while having comorbidity, being fully vaccinated, and having a partial pressure of oxygen (PaO2) ≥ 93 mmHg during the initial infection are identified as factors that reduce the risk of non-hospitalized reinfection., Conclusion: Reinfection due to COVID-19 is possible because of the weakened immune system for various reasons and the mutation of the virus. Vaccination, timely boosters, and adherence to preventive measures can help mitigate this risk., (© 2024. The Author(s).)

Introduction: Reinfection and hospital readmission due to COVID-19 were significant and costly during the pandemic. This study aimed to assess the rate and risk factors of SARS-Cov-2 reinfection, recurrence, and hospital readmission, by analyzing the national data registry in Iran., Methods: This study was a retrospective cohort conducted from March 2020 to May 2021. A census method was used to consider all of the possible information in the national Medical Care Monitoring Center (MCMC) database obtained from the Ministry of Health and Medical Education; the data included information from all confirmed COVID-19 patients who were hospitalized and diagnosed using at least one positive Polymerase Chain Reaction (PCR) test by nasopharyngeal swab specimens. Univariate and multivariable Cox regression analyses were performed to assess the factors related to each studied outcome., Results: After analyzing data from 1,445,441 patients who had been hospitalized due to COVID-19 in Iran, the rates of overall reinfection, reinfection occurring at least 90 days after the initial infection, recurrence, and hospital readmission among hospitalized patients were 67.79, 26.8, 41.61, and 30.53 per 1000 person-years, respectively. Among all cases of hospitalized reinfection (48292 cases), 38.61% occurred more than 90 days from the initial SARS-Cov-2 infection. Getting infected with COVID-19 in the fifth wave of the disease compared to getting infected in the first wave (P<0.001), having cancer (P<0.001), chronic kidney disease (P<0.001), and age over 80 years (P<0.001) were respectively the most important risk factors for overall reinfection. In contrast, age 19-44 years (P<0.001), intubation (P<0.001), fever (P<0.001), and cough (P<0.001) in the initial admission were the most important protective factors of overall reinfection, respectively., Conclusion: Reinfection and recurrence of COVID-19 after recovery and the rate of hospital readmission after discharge were remarkable. Advanced or young age, as well as having underlying conditions like cancer and chronic kidney disease, increase the risk of infection and readmission., Competing Interests: The authors declare that they have no competing interests.

Background: This study examined the difficulties and obstacles faced by healthcare professionals in implementing Iraq's national plan for hepatitis B virus (HBV) control. This research aims to offer valuable insights into the intricacies of HBV control efforts and identify key areas for improvement., Methods: In this qualitative study, semi-structured interviews were conducted with a purposive sample of 10 physicians, representing diverse medical specialties and healthcare settings, including experts in the fields of medical sciences. Data analysis was conducted using MAXQDA software, version 24 (VERBI Software GmbH, Berlin, Germany) to identify recurring themes and gain insights into the challenges encountered during the implementation of the national plan., Results: Ten physicians participated in the study, providing insights into challenges and barriers hindering the effective implementation of Iraq's national plan for HBV control. Consensus among participants highlighted challenges such as resource constraints, inadequate infrastructure, population ignorance, and vaccine refusal. Documentation challenges, including inaccuracies in reporting HBV-associated mortality, were also noted. Barriers to successful implementation included poor public awareness, inadequate education for healthcare providers, and funding shortages. Unmet needs highlighted the necessity for unified protocols, surveillance systems, and international training programs. The improvement strategies proposed by participants emphasized raising awareness, supporting primary healthcare centers, and enhancing funding allocation., Conclusion: This study underscores significant challenges in implementing Iraq's national plan for HBV control, with barriers ranging from resource constraints to communication barriers. Healthcare professionals advocate for targeted interventions, collaborative efforts, and policy measures to address these challenges effectively. The findings contribute to the evidence base for enhancing HBV control efforts in Iraq and emphasize the importance of tailored approaches to public health interventions., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Postgraduate Education Council of the Faculty of Public Health and Safety (PHS) at Shahid Beheshti University of Medical Sciences (SBMU) issued approval (IR.SBMU.PHNS.REC.1404.044). We have obtained approvals from the relevant institutions, as described earlier, to collect data that had been previously collected. Our evaluation focused on the program's process, without involving any application (not applicable) to humans or human tissues. Additionally, a formal letter of approval has been obtained from the Research Committee at the National Center for Training and Human Development, Iraq Ministry of Health (MOH) with the approval ID: IRAQ.MOH.FORM NUMBER 04/2012. DECISION NUMBER:24. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jalal et al.)

Background and Aim: Provision of timely healthcare for children under 5 years of age specially children with congenital hypothyroidism and also regular monitoring of growth through measuring weight, height and head circumference have been of great importance. The aim of this study was to make a comparison between healthy children and children with congenital hypothyroidism in regard to health-care coverage in Iran. Materials and Methods: This study was conducted in five provinces in different geographical areas of Iran in 2015. 240 children with congenital hypothyroidism and 240 healthy children were entered into the study. Children with congenital hypothyroidism were selected randomly from the national registere database. The children in the control group were matched with the children with hypothyroidism in regard to age, gender and place of residence. Anthropometric indices including weight, height and head circumference of the children of less than 3 years of age were recorded as the health care indices. STATA software version 13 was used for data analysis. Results: The mean percentage of measurement and record of weight, height and head circumference in children below 3 years of age with congenital hypothyroidism were 82.1, 78.7 and 55.4%, respectively. The mean percentage of measurement and record of weight, height and head circumference in healthy children (control group) below 3 years of age were 82.2%, 80.9 and 55.1%, respectively. There was a statistically significant difference between the two groups in relation to the percentage of height measurement (P =0.02). Conclusion: According to the results of this study, percentage of measurement and record of the anthropometric indices in Iranian children of less than 3 years of age is low. More attention to the measurement and record of these physical growth indices in children of less than 3 years of age specially children with congenital hypothyroidism who need regular follow up, is essential.

Hepatitis B virus (HBV) infection remains a significant global public health challenge, leading to considerable morbidity and mortality. Implementation of effective strategies and novel initiatives is necessary to control and eliminate HBV. To identify the key approaches and actions used worldwide for HBV control and elimination, we conducted a comprehensive scoping review. We searched various sources, including PubMed, Scopus, Web of Science, Google Scholar, the official websites of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and relevant articles and reports published in the past decade. Our inclusion criteria focused on studies that reported on strategies for HBV control and elimination, provided evidence of their effectiveness, and assessed their impact on public health outcomes. We included 16 articles in our review, which highlighted a range of strategies, such as universal HBV vaccination, prevention of mother-to-child transmission, mass screening programs, and treatment of chronically infected individuals. These strategies have shown promising results in reducing HBV transmission rate, improving health outcomes, and making progress toward HBV elimination. Moreover, several challenges, including limited access to care, low awareness, stigma, and funding constraints, hinder the effectiveness of elimination programs. The findings underscore the importance of sustained efforts and investment in comprehensive strategies for HBV control and elimination. It is crucial to address barriers to care and enhance public awareness to achieve the goal of eliminating HBV as a public health threat by 2030., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Jalal et al.)

Introduction: This study assessed the incidence and severity of side effects associated with coronavirus disease 2019 (COVID-19) vaccination among healthcare workers registered with the Medical Council of the Islamic Republic of Iran., Methodology: A retrospective cohort study was conducted on the healthcare workers focusing on the side-effects of COVID-19 vaccines from March to June 2021. Data were collected using online questionnaires. Multivariable logistic regression was used to assess the association between side effects of the vaccines and demographic variables, comorbidities, vaccine type, and history of COVID-19., Results: Out of 42,018 people who were included, 55.85% reported at least one side effect after receiving the first vaccine dose. 4.59% of those with side effects sought diagnostic intervention or were referred to treatment centers. Multivariable logistic regression indicated that being a woman, higher education, having a history of COVID-19 infection, and having comorbidities increased the risk of side effects. The AstraZeneca vaccine significantly increased the risk of side effects compared to the Sputnik vaccine, while the Sinopharm vaccine decreased this risk. The risk of developing a side effect decreased with age. The risk of moderate and severe side effects was significantly associated with gender, younger age, comorbidities, and a history of COVID-19 infection. Moderate and severe side effects were less reported by those who received the Sinopharm vaccine., Conclusions: Clinical complications after COVID-19 vaccination, directly or indirectly caused by the vaccines, are common. However, the benefits of COVID-19 vaccines greatly outweigh the risk of reversible side effects, especially among the high-risk population., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Hassan Roudgari, Koorosh Etemad, Manoochehr Karami, Farideh Mostafavi, Sahar Sotoodeh Ghorbani, Kosar Farhadi Babadi, Elham Rahimi, Niloufar Taherpour, Seyed Mahmood Fattahi Masoom, Masoud Habibi, Hossein Kermanpour, Reza Laripour, Omid Manoochehri, Mohammad Raeeszadeh, Alireza Salimi, Babak Shekarchi, Ali Tajernia, Mohammad Reza Zafarghandi, Alireza Zali, Afshin Zarghi, Seyed Saeed Hashemi Nazari.)

Abstract: Gangliosidosis is one of the hereditary metabolic diseases caused by the accumulation of Gangliosid in the central nervous system, leading to severe and progressive neurological deficits. Regarding phenotype, GM1 and GM2-Gangliosidosis are divided into Infantile, Juvenile, and Adult., Materials & Methods: In this study, thirty-seven patients with GM1 and GM2-Gangliosidosis were referred to the neurology department of Mofid Children's Hospital in Tehran, Iran, whose disease was confirmed from September 2019 to December 2021. This study assessed age, sex, and developmental status before the onset of the disease, clinical manifestations, brain imaging, and electroencephalography., Results: 97.20% of patients were the result of family marriage. Approximately 80% of juvenile patients were developmentally normal before the onset of the disease. Developmental delay was more common among infantile GM1-Gangliosidosis than infantile GM2-Gangliosidosis, but in total, more than 50% of GM1&GM2-Gangliosidosis patients had reached their developmental milestone before the onset of the disease. With the onset of disease symptoms, 100% of patients regressed in terms of movement, 97.20% of them mentally, and 75% of them had seizures during the disease. The most common clinical findings were cherry-red spot, Mongolian spot, macrocephaly, organomegaly, hyperacusis, and scoliosis. The most common brain imaging findings included bilateral thalamus involvement, brain atrophy, PVL, and delayed myelination. The most common finding in electroencephalography was background low voltage with abnormal sharp waves., Conclusion: This study concluded that most of the patients are the result of family marriage, and most of the juvenile patients are developmentally normal before the onset of the disease. In addition, more than 50% of infantile patients reach their developmental milestones before the onset of the disease. The most common clinical findings of these patients are seizures, cherry-red spot, macrocephaly, hyperacusis, Mongolian spot, and bilateral involvement of the thalamus., Competing Interests: The authors declare that they have no conflicts of interest regarding the research presented in this manuscript., (© 2023 The Authors.)

Objectives: Therapeutic plasma exchange (TPE) is a plasmapheresis procedure whose Safety data for pediatric neuro-immunological disorders (PNID) is confined. The present research documents TPE's safety and feasibility data in these conditions., Materials & Methods: The current study involved six distinct groups of patients with PNID undergoing TPE: neuromyelitis optic spectrum disorder (NMOSD), autoimmune encephalitis (AIE), acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), Guillain-Barre syndrome (GBS), and optic neuritis (ON). This study documented complications related to each TPE process. In addition, TPE's efficacy was studied in these patients., Results: The present study recorded adverse effects in 18 patients with PNID that received 121 TPE cycles: five cycles (4.13%) in MS, three (2.48%) in AIE subgroup, one (0.82%) in ADEM, and two (1.65%) in GBS. No severe complications were observed among the patients., Conclusion: Patients with PNID tolerated therapeutic plasma exchange, which was a safe process., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Authors.)

This study aimed to examine the impacts of single and multiple air pollutants (AP) on the severity of breast cancer (BC). Data of 1148 diagnosed BC cases (2008-2016) were obtained from the Cancer Research Center and private oncologist offices in Tehran, Iran. Ambient PM 10 , SO 2 , NO, NO 2 , NO X , benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene, and BTEX data were obtained from previously developed land use regression models. Associations between pollutants and stage of BC were assessed by multinomial logistic regression models. An increase of 10 μg/m 3 in ethylbenzene, o-xylene, m-xylene, and 10 ppb of NO corresponded to 10.41 (95% CI 1.32-82.41), 4.07 (1.46-11.33), 2.89 (1.08-7.73) and 1.08 (1.00-1.15) increase in the odds of stage I versus non-invasive BC, respectively. Benzene (OR, odds ratio = 1.16, 95% CI 1.01-1.33) and o-xylene (OR = 1.18, 1.02-1.38) were associated with increased odds of incidence of BC stages III & IV versus non-invasive stages. BC stage I and stage III&IV in women living in low SES areas was associated with significantly higher levels of benzene, ethylbenzene, o-xylene, and m-xylene. The highest multiple-air-pollutants quartile was associated with a higher odds of stage I BC (OR = 3.16) in patients under 50 years old. This study provides evidence that exposure to AP is associated with increased BC stage at diagnosis, especially under premenopause age., (© 2024. The Author(s).)

Purpose: To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran., Methods: This population-based cross-sectional study was performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement., Results: Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16; P < 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63; P < 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001)., Conclusion: Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Rhabdomyolysis is a potentially life-threatening condition induced by diverse mechanisms including drugs and toxins. We aimed to investigate the incidence of rhabdomyolysis occurrence in intoxicated patients with psychoactive substances. In this review, three databases (PubMed, Scopus, Web of Science) and search engine (Google Scholar) were searched by various keywords. After the screening of retrieved documents, related data of included studies were extracted and analyzed with weighted mean difference (WMD) in random effect model. The highest incidence of rhabdomyolysis was observed in intoxication with heroin (57.2 [95% CI 22.6-91.8]), amphetamines (30.5 [95% CI 22.6-38.5]), and cocaine (26.6 [95% CI 11.1-42.1]). The pooled effect size for blood urea nitrogen (WMD = 8.78, p = 0.002), creatinine (WMD = 0.44, p < 0.001), and creatinine phosphokinase (WMD = 2590.9, p < 0.001) was high in patients with rhabdomyolysis compared to patients without rhabdomyolysis. Our results showed a high incidence of rhabdomyolysis induced by psychoactive substance intoxication in ICU patients when compared to total wards. Also, the incidence of rhabdomyolysis occurrence was high in ICU patients with heroin and amphetamine intoxication. Therefore, clinicians should anticipate this complication, monitor for rhabdomyolysis, and institute appropriate treatment protocols early in the patient's clinical course., (© 2023. Springer Nature Limited.)

Background: The prevalence of psychoactive substance use is increasing worldwide and identifying adverse effects of these types of drugs is necessary in intoxicated patients., Objective: We aimed to investigate the association of psychoactive substance intoxication with their adverse effects on the functioning of the bodily organs., Methods: This was a single-center study between March 2019 and April 2022 on intoxicated patients with psychoactive substances. Inclusion criteria were intoxication with alcohol, opioids, and stimulants, and having available results of laboratory biomarkers. Demographic and clinical data of patients at the time of admission as well as during hospitalization were reviewed, retrospectively. Data were analyzed using a generalized linear mixed model in R software and the Adjusted Odds Ratio (AOR) was estimated., Results: A total of 800 hospitalized patients in the ICU ( n  = 400) and general ward (n = 400) were divided into two groups of intoxicated with alcohol (n = 200) and opioids or stimulants (n = 200). Liver (AOR = 0.15, p  = 0.033; AOR = 0.13, p  = 0.007) and kidney (AOR = 0.46, p  = 0.004; AOR = 0.24, p  = 0.021) dysfunction occurred less in the ICU and general ward, respectively, in opioids or stimulants intoxication compared to alcohol. Cardiovascular dysfunctions occurred more in opioids or stimulants intoxication compared to alcohol in both ICU (AOR = 10.32, p  < 0.0001) and general ward (AOR = 4.74, p  < 0.0001)., Conclusion: Kidney dysfunctions had a greater effect on mortality compared to other dysfunctions. During the follow-up, the incidence of dysfunctions increased in those intoxicated with opioids or stimulants. Men experienced more liver and kidney dysfunctions as well as mortality, but psychoactive substance experience was a protective factor in cardiovascular dysfunctions and mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Amanollahi, Shadnia, Mehrabi and Etemad.)

Background and Objective: Acquired immunodeficiency syndrome (AIDS) is a definition of dysfunction of immune system in human that is induced by infection with a virus named human immunodeficiency virus (HIV). The most high risk group in HIV infected people are intravenous drug users (IDUs) with unsafe sex. This study was conducted to evaluate knowledge and attitude of IDUs with unsafe sex about AIDS and relation with socioeconomic levels in Golestan province in North of Iran. Materials and Methods: This Cross-Sectional study was conducted on 134 IDUs in Golestan province during 2007. Samples were chosen by a random systematic method. Data was collected with interview by standard questionnaire. Data was analyzed by SPSS-16 and One-way ANOVA,T-test student, Kruskal-wallis, Mann-Whitney U and Kendall tests. Results: This study showed that 36.6% of samples had moderate knowledge about AIDS and 49.3% of them had negative attitude about AIDS. 67% of subjects had education between 6-12 years, 44.8% were married and 53% were jobless and without income. Level of knowledge had a significant relation with age (P

Background: Renal dysfunction is one of the adverse effects observed in methamphetamine (MET) or tramadol abusers. In this study, we aimed to review articles involving intoxication with MET or tramadol to assess the occurrence of renal dysfunction., Methods: Two researchers systematically searched PubMed, Scopus, Web of Sciences, and Google Scholar databases from 2000 to 2022. All articles that assessed renal function indexes including creatine, Blood Urea Nitrogen (BUN), and Creatine phosphokinase (CPK) in MET and tramadol intoxication at the time of admission in hospitals were included. We applied random effect model with Knapp-Hartung adjustment for meta-analysis using STATA.16 software and reported outcomes with pooled Weighted Mean (WM)., Results: Pooled WM for BUN was 29.85 (95% CI, 21.25-38.46) in tramadol intoxication and 31.64(95% CI, 12.71-50.57) in MET intoxication. Pooled WM for creatinine in tramadol and MET intoxication was respectively 1.04 (95% CI, 0.84-1.25) and 1.35 (95% CI, 1.13-1.56). Also, pooled WM for CPK was 397.68(376.42-418.94) in tramadol and 909.87(549.98-1269.76) in MET intoxication. No significance was observed in publication bias and heterogeneity tests., Conclusion: Our findings showed that tramadol or MET intoxication is associated with a considerably increased risk of renal dysfunction that may result in organ failure., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Different countries throughout the world have adopted non-pharmacologic interventions to reduce and control SARS - CoV-2. In this systematic approach, the impact of non-pharmacologic interventions in management of COVID-19 pandemic was assessed., Methods: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, systematic search was carried out on the basis of a search strategy on PubMed, Web of Science, Scopus, and WHO databases on COVID-19. The impact of travel ban, personal protective equipment, distancing, contact tracing, school closure, and social distancing and the combined effect of interventions on COVID-19 were assessed., Results: Of the 14,857 articles found, 44 were relevant. Studies in different countries have shown that various non-pharmacological interventions have been used during the COVID-19 pandemic. The travel ban, either locally or internationally in most of the countries, movement restriction, social distancing, lockdown, Personal Protective Equipment (PPE), quarantine, school closure, work place closure, and contact tracing had a significant impact on the reduction of mortality or morbidity of COVID-19., Conclusion: Evidence shows that the implementation of non-pharmacologic interventions (NPIs), for this study suggests that the effectiveness of any NPI alone is probably limited, thus, a combination of various actions, for example, social distancing, isolation, and quarantine, distancing in the workplace and use of personal protective equipment, is more effective in reducing COVID-19., Competing Interests: The authors declare that they have no competing interest.

Background: Clinical registries facilitate medical research by providing 'real data'. In the past decade, an increasing number of disease registry systems (DRS) have been initiated in Iran. Here, we assessed the quality control (QC) of the data recorded in the DRS established by Shahid Beheshti University of Medical Sciences in Tehran, the capital city of Iran, in 2021., Methods: The present study was conducted in two consecutive qualitative and quantitative phases and employed a mixed-method design. A checklist containing 23 questions was developed based on a consensus reached following several panel group discussions, whose face content and construct validities were confirmed. Cronbach's alpha was calculated to verify the tool's internal consistency. Overall, the QC of 49 DRS was assessed in six dimensions, including completeness, timeliness, accessibility, validity, comparability, and interpretability. The seventy percent of the mean score was considered a cut-point for desirable domains., Results: The total content validity index (CVI) was obtained as 0.79, which is a reasonable level. Cronbach's alpha coefficients obtained showed acceptable internal consistency for all of the six QC domains. The data recorded in the registries included different aspects of diagnosis/treatment (81.6%) and treatment quality requirements outcomes (12.2%). According to the acceptable quality cut-point, out of 49 evaluated registries, 48(98%), 46(94%), 41(84%), and 38(77.5%), fulfilled desirable quality scores in terms of interpretability, accessibility, completeness, and comparability, however, 36(73.5%) and 32(65.3%) of registries obtained the quality requirement for timeliness and validity, respectively., Conclusion: The checklist developed here, containing customized questions to assess six QC domains of DRSs, provided a valid and reliable tool that could be considered as a proof-of-concept for future investigations. The clinical data available in the studied DRSs fulfilled desirable levels in terms of interpretability, accessibility, comparability, and completeness; however, timeliness and validity of these registries needed to be improved., (© 2023. The Author(s).)

Combining augmented reality (AR) and physicalization offers both opportunities and challenges when representing detailed historical data. In this article, we describe a framework where mobile AR supplements views of 3-D prints of historical locations with interactive functionality and small visual details that the prints alone cannot display. Since seeing certain details requires bringing the camera close to the physical objects, the resulting camera frames may lack the visual information necessary to determine objects' positions and accurately superimpose the overlay. We address this by enhancing tracking of 3-D prints at close distances and employing visualization techniques that allow viewing small details in ways that do not interfere with tracking. To demonstrate these techniques, we apply our framework to the preservation of two heritage sites that represent large real-life areas containing smaller details of interest.

Introduction: Although the lungs are the main target of coronavirus disease (COVID-19), infection is also associated with a high rate of extra-pulmonary complications. This study aimed to evaluate the one-year incidence of long-term COVID-19 complications among the nursing staff., Methods: This study is a retrospective longitudinal study. All nursing staff working in public hospitals affiliated with Shahid Beheshti University of Medical Sciences who had been affected with COVID-19 were included in the study via convenience sampling method. The patients were recruited from 20 th February 2020 to 20 th March 2021., Result: 1762 nursing staff with a mean age of 35.08 ± 8.02 (Range: 22-66) years were studied (73.5% female). The results showed that among those who reported at least one type of complication, the duration of complications was significantly longer than 1 week and the median was 8 weeks. The findings demonstrated that complications occurred in 65% of infected females. For men, this rate was 62.3%. Generalized pain, anxiety disorders, and skin complications were among the complications that were significantly more common in women than in men. Additionally, the incidence of anosmia, ageusia, anxiety disorders, and skin complications was significantly higher in younger people than in older people. The comparison of complications revealed that nurses were significantly more likely than other occupations to experience respiratory complications, anosmia and ageusia, generalized pain, and skin complications and that outpatients experienced significantly more complications than hospitalized patients., Conclusion: The one-year cumulative incidence of long-term complications in nursing staff with COVID-19 was 64.3%. The most common complications were respiratory complications, generalized pain, anosmia, and ageusia, respectively., Competing Interests: The authors have no conflict of interest to declare

Background: Annually, over 131000 new cases of cancer have been identified in Iran, with an increasing trend that is predicted to grow by 40% by 2025. The most important contributing factors to this increase are the improvement of the health service delivery system, increased life expectancy, and the aging of the population. The aim of this study was to develop Iran's "National Cancer Control Program" (IrNCCP)., Methods: The present study is a cross-sectional study that was conducted in 2013 using the method of reviewing studies and documents and focused group discussions and a panel of experts. In this study, the available evidence related to cancer status and its care in Iran and other countries, as well as national and international upstream documents, were reviewed and analyzed. Then, by analyzing the current situation in Iran and other countries and conducting stakeholder analysis with the strategic planning approach, the IrNCCP was developed with a 12-year horizon consisting of goals, strategies, programs, and performance indicators., Results: This program has 4 main components, including Prevention, Early Detection, Diagnosis and Treatment, and Supportive and Palliative care, as well as 7 supporting components including Governance and policy-making, Cancer Research, Developing facilities, equipment, and service delivery network, Providing and managing human resources, Providing and managing financial resources, Cancer information system management and registry, and Participation of NGOs, charities, and the private sector., Conclusion: Iran's National Cancer Control Program has been developed comprehensively with cross-sectoral cooperation and stakeholder participation. However, like any long-term health intervention, strengthening its governance structure both in terms of implementation and achievement of expected goals and evaluation and modification during the implementation of the program is essential., Competing Interests: The authors declare that they have no competing interests., (© 2022 Iran University of Medical Sciences.)

Objective: Leukaemia is one of the most common cancers and may be associated with exposure to environmental carcinogens, especially outdoor air pollutants. The objective of this study was to investigate the association of ambient air pollution and leukaemia in Tehran, Iran., Design: In this retrospective cohort study, data about the residential district of leukaemia cases diagnosed from 2010 to 2016 were inquired from the Ministry of Health cancer database. Data from a previous study were used to determine long-term average exposure to different air pollutants in 22 districts of Tehran. Latent profile analysis (LPA) was used to classify pollutants in two exposure profiles. The association between air pollutants and leukaemia incidence was analysed by negative binomial regression., Setting: Twenty-two districts of Tehran megacity., Participants: Patients with leukaemia., Outcome Measures: The outcome variables were incidence rate ratios (IRR) of acute myeloid and lymphoid leukaemia across the districts of Tehran., Results: The districts with higher concentrations for all pollutants were near the city centre. The IRR was positive but non-significant for most of the air pollutants. However, annual mean NOx was directly and significantly associated with total leukaemia incidence in the fully adjusted model (IRR (95% CI): 1.03 (1.003 to 1.06) per 10 ppb increase). Based on LPA, districts with a higher multiple air-pollutants profile were also associated with higher leukaemia incidence (IRR (95% CI): 1.003 (0.99 to 1.007) per 1 ppb increase)., Conclusions: Our study shows that districts with higher air pollution (nitrogen oxides and multipollutants) have higher incidence rates of leukaemia in Tehran, Iran. This study warrants conducting further research with individual human data and better control of confounding., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Congenital anomalies are one of the major public health problems and one of the leading cause of infant mortality and morbidity. We aimed to investigate some factors associated with infant mortality due to congenital anomalies in several provinces of Iran., Methods: This case-control study was conducted on 2199 women referring health centers of nine provinces of Iran 2015-2018. Cases were defined as mothers with infant death due to congenital anomalies, and control group comprised of mothers with live birth or infant deaths due to other causes (n=1986). The descriptive data were expressed as percentage and frequency. Factors associated with infant death due to congenital anomalies were evaluated and analyzed at 95% confidence level by logistic regression analysis., Results: The multiple logistic regression analysis reveal that history of cesarean delivery [OR:2.13 ;95%CI (1.58-2.87)], maternal age [OR:1.94 ;95%CI (1.31-2.86)])], area of living [OR: 1.69;95%CI (1.22-2.33)], maternal smoking during pregnancy [OR: 1.41; 95%CI (1.02-1.95)], consanguineous marriage [OR:1.53;95%CI (1.12-2.08)], also low birth weight [OR: 3.09; 95%CI (2.23-4.30)] were significantly associated with infant death due to congenital anomalies., Conclusion: Identification of factors associated with congenital anomalies has been shown to reduce treatment costs and medical complications of neonates. Therefore, genetic counseling and educational programs for high-risk women, and prenatal screening are essential to identify and prevent factors contributing to congenital abnormalities., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests., (Copyright © 2022 Zolfizadeh et al. Published by Tehran University of Medical Sciences.)

Purpose: To evaluate the effect of inherited retinal dystrophies (IRDs) on vision-related quality of life (VRQoL) among IRDs' patients in Iran., Methods: This cross-sectional study was conducted on 192 patients with different types of IRDs who were randomly selected from registered patients in the Iranian National Registry for Inherited Retinal Dystrophy (IRDReg®). All ophthalmic findings were collected based on the recorded data in IRDReg®. Moreover, the eligible participants were interviewed to fill out the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) to assess their VRQoL. Ordinal logistic regression was used to evaluate the possible association of the different clinical and nonclinical factors such as demographic information, socioeconomic status, and visual function with VRQoL., Results: The overall mean of a composite score of VRQoL was 45. All subscales obtained from the NEI VFQ-25 questionnaire except general health, mental health, and ocular pain had a significant negative correlation with logMAR best corrected visual acuity (BCVA) and near visual acuity variables. There was a statistically significant relationship between VRQoL and factors like age (odds ratio [OR] = 0.91, 95% confidence interval [CI]: 0.87-0.94), employment status (OR = 1.37, 95% CI: 1.05-4.74), logMAR BCVA (OR = 0.31, 95% CI: 0.19-0.49) and normal color vision (OR = 1.92, 95% CI: 1.74-5.01)., Conclusion: The VRQoL of patients with IRDs in this study was low. BCVA could be an indicator to show VRQoL., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Current Ophthalmology.)

Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy that significantly affects perinatal outcomes., Objective: The aim of this study was to determine the prevalence of GDM and its relation with the incidence of stillbirth, preterm birth, macrosomia, abortion and cesarean section (C-section) delivery in pregnant women., Methods: This cross-sectional study was conducted on 3675 pregnant women in 11 provinces across Iran. Cluster sampling was used to select samples from mothers covered by health plans in 11 provinces of Iran. Prevalence of adverse pregnancy outcomes, including preterm delivery, type of delivery, macrosomic preterm birth, miscarriage, stillbirth, infant death, and birth weight were measured, using family record and face-to-face interviews. Data were analyzed by logistic regression, using STATA14.2 software., Results: About four percent of Iranian pregnant women had GDM during pregnancy. Prevalence of C-section was significantly higher in diabetic women than in the non-diabetic ones (53.19 vs 46.81, respectively, P < 0.001). Abortion in diabetic mothers was more than twice that of the non-diabetic mothers (P < 0.001). In the adjusted logistic regression model, the odds of stillbirth in mothers with GDM were 1.8 (95% CI: 1.11, 2.91, P = 0.018) times higher than that of the non-diabetics. The odds of macrosomia in diabetic women was about 7 times higher than the non-diabetic women (95% CI: 2.81, 17.14, P < 0.001). The odds of GDM had an increasing trend according to the BMI (p < 0.001). The risk of GDM were significantly lower, according to the daily physical activity (PA) (p < 0.001)., Conclusion: The GDM prevalence has a decreasing trend in Iran. It increases the adverse pregnancy outcomes such as stillbirth, neonatal deaths, macrosomia, preterm birth, abortion and C-section delivery. As, some of these consequences like macrosomia are not treatable, thus early prevention is very crucial., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2021 Pacini Editore SRL, Pisa, Italy.)

Background: Many factors contribute to the spreading of hospital-acquired infections (HAIs)., Objective: This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method., Methods: In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs., Results: The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected., Conclusions: The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system., (©Neda Izadi, Koorosh Etemad, Yadollah Mehrabi, Babak Eshrati, Seyed Saeed Hashemi Nazari. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 07.12.2021.)

Background and Objectives: The present study aims to determine the cumulative incidence rate of acute lymphoblastic leukemia (ALL), the degree of spatial autocorrelation and clustering of ALL, the hotspot and coldspots of ALL and geoclimatic conditions affecting the incidence of ALL in Iran and to draw a comparison between global and local regression models., Materials and Methods: In this ecological study, an exploratory-etiologic multiple-group method has been adopted to investigate all children under 15 years of age with ALL in Iran during 2006-2014. Data analysis was performed using Mann Whitney U, Pearson correlation coefficients (PCCs), Global Moran's I, Optimized hotspot analysis (OHSA), Global Poisson regression (GPR), Geographically Weighted Poisson Regression (GWPR) at a significant level of α = 0.05., Results: The cumulative incidence rate of ALL was estimated at 21,315 per 100,000 Iranian children under 15 years of age. The value of Global Moran's I index was estimated 0.338 and significant (<0.001 P-value). Coldspots were observed in north and northwest of Iran and hotspots were identified in south, southwest and mid-east of Iran. In the present study, Max Temperature of Warmest Month (MTWM) and Direct Normal Irradiation (DNI) were risk factors and Precipitation of the Coldest Quarter (PCQ) and Altitude (AL) were protective factors in the incidence of ALL, even though the non-stationarity of local coefficients and local t-values was clear. GWPR, by capturing and applying spatial heterogeneity and spatial autocorrelation, had a greater performance and goodness of fit than GPR., Discussion: ALL has created spatial clusters in Iran. The incidence of ALL is the result of synergistic interaction between environmental, infectious, geographical and genetic risk factors. It is recommended to use of local models in ecological studies., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Colorectal cancer is one of the most common cancers in the world. This study aimed to determine the relationship between risk factors and the incidence of colorectal cancer in Urbanization levels in Iran., Methods: This was a population-based study. Urbanization levels were determined using the census data of the Statistical Center in 2012. Data on risk factors for colorectal cancer were obtained from the information provided by the Iranian Non-Communicable Disease Control Center and the incidence of colorectal cancer from the data from the National Cancer Registry System. Negative binomial regression analysis was used to determine the relationship between colorectal cancer risk factors and urbanization levels with colorectal cancer incidence. For statistical analysis, SPSS and Stata software were used. A significant level of P ≤0.05 was considered., Results: The relationship between urbanization levels and risk factors with the incidence of colorectal cancer, nutrition Status, tobacco use, and body mass index were not significant. There was a significant relationship between physical activity and incidence at different levels and between levels of urbanization and incidence rate, indicating a lower incidence rate of colorectal cancer at lower levels of urbanization., Conclusion: Colorectal cancer incidence is higher at higher levels of urbanization than lower levels. The difference between regions in terms of urbanization can have in flounce on access to facilities, health service, and counseling opportunities to modify the risk factors and access to proper screening and follow-up care., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests., (Copyright © 2021 Enayatrad et al. Published by Tehran University of Medical Sciences.)

BACKGROUND: Neonates are too vulnerable that low birth weight (LBW) and preterm birth can easily threaten their lives. Demographic, social and environmental factors as well as health care are contributing factors for LBW. The study was conducted in 10 provinces of Iran to investigate the association between LBW and mother's diseases. METHODS: A case-control study was conducted in 10 provinces of Iran on 2580 mothers (712 cases and 1868 controls) referred to public health care centers. We used a questionnaire to collect data. For univariate analysis we used chi-square test and for multivariable analysis we used logistic regression model. RESULTS: LBW was significantly associated with living in rural area (OR = 1.4 CI: 1.14–1.71), having body mass index (BMI)<18 (OR = 1.48 CI: 1.14–1.92), being a housewife (OR = 1.65 CI: 1.07–2.53), having high blood pressure (OR = 1.91 CI: 1.26–2.88), and having pregnancy without testing for diabetes (OR = 1.91 CI: 1.44–2.54). Minor thalassemia, hypothyroidism, oral health care and headache were not significant predictors for LBW. CONCLUSION: In this study, we observed that place of residence, BMI before pregnancy, mother's occupation and gestational diabetes were significant predictors of LBW. It is necessary to improve women's awareness about prenatal health care before pregnancy to avoid LBW. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is spreading rapidly and has affected millions of people worldwide. Comorbid diseases have complicated the course of infection and increased mortality. Myasthenia gravis (MG) affects the neuromuscular junctions (NMJs) and can compromise respiratory muscle action, leading to worse clinical outcomes in individuals infected with the COVID-19 theoretically. In this study, the aim is to assess the pattern of COVID-19 infection in patients with MG based on several factors. Methods: This was a prospective cohort study following 150 patients with MG over a six-month period. The patients were monitored for the development of signs and symptoms of the COVID-19 infection. Results: Comparison of the patients infected with COVID-19 with MG and those not infected was performed independently based on age, duration since MG diagnosis, status of thymectomy, and current clinical status of MG disease. Data analysis did not reveal increased susceptibility or increased severity of COVID-19 illness based the criteria assessed. Conclusion: COVID-19 related deaths and susceptibility were not related to age, thymectomy status, and disease duration in patients with MG., (Copyright © 2021 Iranian Neurological Association, and Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

The β-thalassemias are a group of genetic disorders defined by decreased levels of functional hemoglobin (Hb). In light of pivotal improvements in patient survival, the load of consistent treatment harms patients' quality of life (QOL). This study aimed to determine the QOL in patients with β-thalassemia (β-thal) in Iran and identify associated factors. This cross-sectional study was conducted among 1240 patients with β-thal. Data for this study were obtained from the General, the TranQol (Transfusion-dependent QoL) Standard, and the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. The univariate and multivariable linear regression was used in STATA version 14 to identify factors related to QOL. Overall, the QOL score was 103 ± 21.96, and adults had a higher score than children under 15 years old. Emotional health had the highest score (39.96 ± 11.54), and sexual activity in adults (1.87 ± 2.08) and activities related to education in children (10.43 ± 7.46) had the lowest. The multivariable linear regression analysis showed that the age, gender, age of blood transfusion initiation, Hb level, number of underlying diseases, and social support level by family and community significantly impact QOL. In exchange for an increase in comorbidities, patients' QOL decreased by 86.0% [odds ratio (OR) = 0.14, 95% confidence interval (95% CI): 0.04-0.45]. Many factors affecting the QOL can be controlled, so social support, increased Hb levels, regular and timely blood transfusions, and treatment can improve the thalassemia patients' QOL.

Background : The most common drug, illegally used in Iran is opium. The treatment of people with substance use disorder is one of the most important strategies in reducing its burden. The aim of this study was to investigate the effect of different increasing and decreasing opium treatment coverage on the patterns of abstinence, transition to heroin dependence and mortality, over 30 years. Methods: This study was a dynamic compartmental modeling conducted in three stages: 1) presenting a conceptual model of opium dependence treatment in Iran, 2) estimating model's parameters value, and 3) modeling of opium dependence treatment and examining the outcomes for different treatment coverage scenarios. The input parameters of the model were extracted from the literature, and secondary data analysis, which were finalized in expert panels. Results: The number of opium dependence will increase from 1180550 to 1522063 [28.93% (95% CI: 28.6 to 29.2)] over 30 years. With a 25% decrease in coverage compared to the status quo, the number of deaths will increase by 459 cases [3.28% (95% CI: 0.91 to 5.7)] in the first year, and this trend will continue to be 2989 cases [15.63% (95% CI: 13.4 to 17.9)] in the 30th year. A 25% increase in treatment coverage causes a cumulative decrease of heroin dependence by 14451 cases [10.1% (95% CI: 9.5 to 10.8)] in the first decade. Conclusion: The modeling showed that the treatment coverage level reduction has a greater impact than the coverage level increase in the country and any amount of reduction in the coverage level, even to a small extent, may have a large negative impact in the long run., (© 2021 The Author(s).)

Lung cancer is the most rapidly increasing malignancy worldwide with an estimated 2.1 million cancer cases in the latest, 2018 World Health Organization (WHO) report. The objective of this study was to investigate the association of air pollution and lung cancer, in Tehran, Iran. Residential area information of the latest registered lung cancer cases that were diagnosed between 2014 and 2016 (N = 1,850) were inquired from the population-based cancer registry of Tehran. Long-term average exposure to PM 10 , SO 2 , NO, NO 2 , NO X , benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene (BTEX), and BTEX in 22 districts of Tehran were estimated using land use regression models. Latent profile analysis (LPA) was used to generate multi-pollutant exposure profiles. Negative binomial regression analysis was used to examine the association between air pollutants and lung cancer incidence. The districts with higher concentrations for all pollutants were mostly in downtown and around the railway station. Districts with a higher concentration for NOx (IRR = 1.05, for each 10 unit increase in air pollutant), benzene (IRR = 3.86), toluene (IRR = 1.50), ethylbenzene (IRR = 5.16), p-xylene (IRR = 9.41), o-xylene (IRR = 7.93), m-xylene (IRR = 2.63) and TBTEX (IRR = 1.21) were significantly associated with higher lung cancer incidence. Districts with a higher multiple air-pollution profile were also associated with more lung cancer incidence (IRR = 1.01). Our study shows a positive association between air pollution and lung cancer incidence. This association was stronger for, respectively, p-xylene, o-xylene, ethylbenzene, benzene, m-xylene and toluene.

Background: Although dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to examine the prevalence of not receipt dental care and also determinants of that during pregnancy., Materials and Methods: This population-based study was conducted on 4071 mothers in 10 provinces of Iran, during 2014-2015. We calculated the prevalence of not receipt of dental care, and reasons for nonreceipt of care. We used logistic regression to estimate odds of nonreceipt of care by demographics variables. In the analyses, the level of statistical significance was set at P < 0.05., Results: Overall, 54.70% of women had no dental visit during pregnancy. In mothers who had a history of stillbirth, neonatal death and live birth, the prevalence of not receipt dental care during pregnancy were 54.56%, 48.92%, and 58.76%, respectively. The logistic regression analyses showed that parity second-to-fourth birth than first birth (odds ratio [OR] 1.37 confidence interval [CI] 95% 1.17-1.59, residence in rural (OR 1.68 CI 95% 1.45-1.95), and not intended pregnancy (OR 1.32 CI 95% 1.03-1.68) associated with not received dental care during pregnancy., Conclusion: Most pregnant women in this study received insufficient dental care. The need for dental care during pregnancy must be promoted widely among women of reproductive age, and family barriers to dental care should be addressed., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or non-financial in this article., (Copyright: © 2021 Dental Research Journal.)

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan-Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death. Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors., (Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Context: Exposure to bio-aerosols in a variety of environments has been of great interest due to the health effects on humans. Hospitals can be the reservoir of these biological agents because of the presence of infectious patients; which can lead to hospital infections and various occupational hazards. In this way, we assessed bacterial contamination in two teaching hospitals in Tehran., Aims: Our purpose in this study assessment of bacterial pathogens and their antibiotic resistance in the air of different wards of selected teaching hospitals in Tehran., Settings and Design: In this study, sampling was done according to NIOSH 0800., Methods and Material: This descriptive study was carried out in the different sections of two hospitals in Tehran. A total of 180 air samples were evaluated according to NIOSH 0800. In each section sampling was performed on the culture media in three stations including primary room, end room, and nursing position then the number of colonies counted. The zone of inhibition was measured in antibiotic disks to determine antibiotic resistance of samples., Statistical Analysis Used: Data analysis was performed using SPSS version 21. Initially, the data were normalized using the Kolmogorov-Smirnov test. The difference between the two hospitals was achieved with Mann-Whitney U test for un-normal distribution data., Results: Bacterial contamination in hospital 2 was significantly higher than the hospital 1( P < 0.001). The median number of colonies in hospital 1 was 129.87 (87.46-268.97) CFU/m 3 and 297.97 (217.66-431.85) CFU/m 3 for hospital 2. Bacterial contamination in the all of stations in hospital 2 and 87% of samples in hospital 1 was higher than the acceptable range of ACGIH (75 CFU/m 3 )., Conclusions: High bacterial contamination may be related to a lack of hygiene management and poor ventilation system. It seems effective infection control processes, appropriate ventilation systems and supervision systems should be improved., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Occupational and Environmental Medicine.)

Background: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran., Methods: For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of "hospital-ward-month"), and then, the last observation carried forward method was used to replace the missing data., Results: The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran's hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area., Conclusions: HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

Background: The aim of present study is to determine the spatial-temporal epidemiology of acute lymphoblastic leukemia (ALL) in Iranian children., Methods: This ecological study was performed using an exploratory mixed design. The study population consists of 3769 children with ALL who were reported in the National Cancer Registry Program of Iran from 2006 to 2014. Data analysis was conducted using Mann-Whitney U, joinpoint regression analysis, Global Moran's I and Anselin Local Moran's I., Results: The average annual incidence rate of ALL was 2.25 per 100000 children under 15 years of age during the study period, which was 1.37 times higher in males. The average annual percentage change (AAPC) of the disease was 7.1%, which is higher than that of developed countries. The incidence of ALL was higher in spring and summer and its peak incidence was at the age of 2-5. Spatial autocorrelation of the ALL was 0.358 and significant ( P value <0.001). The high-risk cluster of ALL was identified in Fars and Kohgiluyeh and Boyer-Ahmad provinces and the low-risk cluster in Kermanshah, Zanjan and Kurdistan provinces., Conclusion: The incidence of ALL is on rise in Iranian children and appropriate healthcare services are required to prevent new cases of this disease in high-risk areas., (© 2021 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.)

Objective: Sleep disturbance during pregnancy is one of the most common maternal complaints. Not only does it play a crucial role in a mother's life, but also it comes with a multitude number of complications. This study aimed at assessing the association between sleep disturbance in pregnancy and maternal and child outcomes. Materials and methods: This was a multicenter cross-sectional study, conducted on pregnant women across 11 provinces in Iran in 2018. Sleep disturbance as a composite variable was defined using the principal component analysis based on five questions. Abortion, anemia in the first and third trimester, gestational diabetes, gestational age, glucose tolerance test (GTT), fasting blood sugar (FBS), mode of delivery, low birth weight and stillbirth were defined as study outcomes. Results: Totally, 3675 pregnant women enrolled in the study. Most of the participants (84.5%) reported that their sleep duration is less than 8 hours per day. The prevalence of sleep disturbance was 20.7% (95% CI: 19.1, 22.3). After adjusting for maternal age, education, job, place of residency and physical violence, sleep disturbance would increase the odds of abortion (p=0.009), anemia in both first (p=0.001) and third (p=0.003) trimester, gestational age (p=0.049), abnormal FBS (p=0.015) and cesarean section (p<0.001). Conclusion: Regarding the effect of sleep quality on maternal outcomes, planning and implementing a suitable intervention in the context of primary health care is necessary. Increasing the awareness of mothers, health workers and medical personnel about the suitable quality and quantity of sleep during pregnancy is of great importance., (Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)