Iranian Journal of Public Health
Volume:53 Issue: 3, Mar 2024

Patients with benign prostatic hyperplasia are generally treated holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP). Therefore, it is important to analyze the several surgical procedures used for benign prostatic hyperplasia in terms of their role, effectiveness and safety.

We conducted a meta-analysis by searching databases of PubMed, Google Scholar, and Web of Science. Finally, we selected 10 papers including 2,456 patients treated with of thulium laser and holmium laser in the surgical treatment of benign prostatic hyperplasia. We did the analysis using RevMan 5.0 with the selected studies until 26 October 2023.

ThuLEP resulted in a smaller reduction in haemoglobin (MD: -0.22, 95%CI -0.32 to -0.13, P<0.001) and a shorter hospital stay (MD: -0.29, 95%CI -0.38 to -0.20, P <0.001). During the postoperative follow-ups, only the IPSS (MD: -0.03; 95%CI -0.11 to -0.06; P 0.58) at the six-month showed statistically significant differences.

ThuLEP has greater security and faster growth than HoLEP.

Uropathogenic Escherichia coli is a major cause of urinary tract infections (UTIs). This systematic review and meta-analysis was conducted to determine the prevalence of antibiotic-resistant uropathogenic E. coli among Iranian children with confirmed bacterial UTIs from 2012 to 2022.

A systematic review was performed by searching PubMed, Scopus, Google Scholar, Web of Science, MagIran, Iranian Scientific Information Database, IranMedex, and Iranian Research Institute for Information Science and Technology. The antibiotic-specific pooled prevalence estimates were calculated by applying a random-effects model. Freeman-Tukey Double Arcsine transformation was applied. I-squared statistic, and Cochran’s Q test were computed and meta-regression was conducted on latitude of sampling location.

The literature search retrieved 2159 articles, among which 19 articles were included. The highest antibiotic resistance was related to doxycycline, ticarcillin-clavulanic acid, cefazolin, cefuroxime, and amoxycillin-clavulanic acid, 59%, 57%, 54%, 53%, and 52%, respectively. Meta-regression on the latitude was statistically significant for nitrofurantoin (P=0.05).

Resistant uropathogenic Escherichia coli strains were observed in the majority of confirmed bacterial UTIs among Iranian children. The most effective antibiotics for uropathogens were colistin, meropenem, and imipenem.

The prevalence of pelvic organ prolapse is varied in different countries. For validating the results of numerous studies on the prevalence of Pelvic organ prolapse in the world, a meta-analysis study seems necessary to provide an accurate and valid prevalence for planners and researchers in this field. Therefore, we aimed to investigate the worldwide prevalence of pelvic organ prolapse using the meta-analysis method.

By using valid keywords, searching was done in ISI Web of Science, PubMed, Scopus, and Medline databases, and 22 articles were selected based on inclusion criteria between 2009 and 2021. The quality of articles was checked using The Joanna Briggs Institute (JBI) checklist. Meta-analysis was performed on collected data using Comprehensive Meta-Analysis Software (CMA, Version 2). Meta-analysis of data was done with a random-effects model. The heterogeneity of the study was checked using the I2 index. Publication bias was assessed by the Egger test and funnel graph.

The overall prevalence of included studies was 30.9% (95% confidence interval: 24.4-38.2%), (P<0.001, heterogeneity I2=99.8%). Meta-analysis of subgroups in studies that used a questionnaire to estimate the prevalence rate showed the prevalence was 25.0% and in the studies used the physical examination was 41.8%.

Studies carried out in different parts of the world have examined the prevalence of pelvic organ prolapse using different tools. Since some cases are asymptomatic, especially in the low stage of prolapse, physical examination of pelvic organ prolapse should be considered an essential tool in evaluating pelvic organ prolapse.

Several studies have evaluated the effects of lavender essential oil on the anxiety of hemodialysis (HD) patients, but most of them did not estimate the pooled effect size. The current systematic review and meta-analysis was conducted to evaluate the effects of lavender on anxiety and fatigue among HD patients.

Eligible studies were selected based on the PRISMA steps and protocol. Literature was retrieved from PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engines until Sep 2022. The risk of bias and analysis were evaluated using version 2 of the Cochrane risk-of-bias tool and STATA v.14 software, respectively. Effect sizes were pooled using random effect models.

Nine studies were included. Lavender oil significantly reduced the average anxiety of HD patients compared to the control group (SMD: -2.51, 95% CI: [-3.56, -1.45], Z=4.67, P<0.001, I2 :89.9%). Also, it significantly reduced the average fatigue compared to the control group (SMD: -1.56, 95% CI: [-2.49, -0.63], Z=3.29, P=0.001, I2:92.2%). Subgroup analysis indicated controversial results regarding session frequency and drop number of lavender oil.

Using Lavender oil significantly reduced fatigue and anxiety in HD patients.

Cadmium, a toxic heavy metal, experienced a surge in production during the 20th century due to the rise of nickel-cadmium batteries, metal plating, and plastic stabilizers. Exposure to cadmium primarily occurs through the consumption of contaminated food, such as vegetables and grains, as well as drinking water or inhaling polluted air. The objective of this study was to investigate the relationship between cadmium exposure and the incidence of prostate cancer using a systematic review and meta-analysis approach.

This research involved searching and retrieving observational and experimental studies conducted until May 2022 from various databases, including ISI Web of Science, Cochrane, Science Direct, Scopus, PubMed, and Google Scholar. Data analysis was performed using Stata 15 statistical software.

The initial search yielded 794 articles, which were subsequently reduced to 427 articles after eliminating duplicates. Following the application of inclusion and exclusion criteria, a total of 16 studies were included in the meta-analysis. The odds ratio of prostate cancer compared to the first quartile of exposure in the second quartile was 1.03 (0.95-1.12), in the third quartile it was 1.12 (0.99-1.26) and in the fourth quartile of exposure was equal to 1.16 (0.79-1.70). Regarding the investigation of the probability of the occurrence of publication bias, the results of Begg's and Egger's tests were not statistically significant.

Although exposure to cadmium leads to an increase in the chance of prostate cancer, this chance increase was not statistically significant.

Multiple Myeloma (MM) is a neoplastic hematologic disorder caused by the excessive proliferation of plasma cells and leads to bone lesions, anemia, and kidney failure. No definite etiology has been proposed for MM, but several environmental and genetic risk factors have been implicated so far. Exposure to pesticides, benzene, and organic solvents like methyl chloride have been considered a potential risk factor. Asbestos, ionizing radiation, and wood dust exposure have also been associated with MM. As MM is a relatively rare condition, the number of studies is insufficient, and in many studies, only a few study participants recall exposure to any agents. Therefore, establishing a definite risk factor is cumbersome and further studies with large study samples are needed. By recognizing these occupational risk factors, clinicians can encourage employees to reduce their exposure as more as possible and implement precautionary measures. In this review, we highlighted the current research on the potential association between occupational exposures and MM. Because of these studies, new regulations with the goal of occupational exposure reduction are anticipated in the future.

As Korea rapidly enters a super-aged society, interest in depression, a change in psychological function that occurs with aging, is increasing. Although previous studies have suggested a relationship between depression and cognitive decline in older adults, they have not clarified how cognitive decline leads to depression. We aimed to examine the mediating effects of digital information utilization ability (DIUA) and interpersonal contact (IC) in the relationship between cognitive function and depression in older adults.

This descriptive cross-sectional study used data from the 2020 Korean Elderly Survey. The participants were 9,920 seniors aged 65 years and older. Descriptive statistics, t-test, and one-way ANOVA correlation analysis were performed using SPSS 24.0 and the dual mediation effect was analyzed using PROCESS Macro for SPSS v.3.5 model 6.

Depression had a negative correlation with cognitive function (r=-.26, P<.001), DIUA (r=-.20, P<.001), and IC (r=-.13, P<.001). Cognitive function was positively correlated with DIUA (r=.40, P<.001) and IC (r=.08, P<.001). There was a positive correlation between DIUA and IC (r=.10, P<.001). Finally, the mediating effect of cognitive function on depression through the dual parameters of DIUA and IC was also statistically significant (B=.-001, 95% CI [-.002, -.001).

The depression caused by cognitive decline can be reduced by improving older adults’ ability to use digital information and interact with others. Therefore, social interventions to increase the interpersonal contact of older adults is required, and education programs for improving older adults’ ability to utilize digital information may be developed to increase indirect contact using digital devices as well as direct contact.

Most of the people with Down syndrome have short stature compared to general population. There is also a high prevalence of overweight and obesity, mainly in the adolescence and in the adult life. The aim of this study was to compare some anthropometric parameters, heart rate and blood pressure of children with Down syndrome and those with normal development. Down syndrome is among the most commonly classified categories of mental sub normality, with the incidence at birth being around 1: 700 and 1: 750 in live births in most countries worldwide, with the risk of increasing with mother’s age.

The sample consisted of 82 children, 32 with Down syndrome and 50 healthy children, male, aged 14-15 yr from the population of Kosovo in 2022. There were no health problems present in the healthy children.

About 53% of children with Down syndrome have normal body mass, 15.62% are overweight, and 21.8 are obese. In terms of blood pressure, Down syndrome children have higher systolic pressure (121.94mm/hg), sd ±21.69 than healthy children (111.18mm/hg, sd ±10.88).

Children with Down syndrome had significantly higher body mass index, heart rate, and systolic pressure at rest compared to healthy children. However, after short physical activity, healthy children exhibited greater diastolic pressure than children with Down syndrome.

Chronic obstructive pulmonary disease (COPD) has become a global public health problem due to its high mortality. So there is an urgent need to find an effective treatment

The targeting relationship among circABCB10, miR-130a and PTEN was predicted by  the targetscan database. The lung condition was detected by CT(Computed Tomograph). The expression levels of circABCB10, miR-130a and PTEN in lung tissues were determined by qRT-PCR. The COPD model was established by stimulating normal and silenced 16HBE cells in circABCB10 genes with cigarette smoke extract (CSE) at different concentrations. qRT-PCR was conducted for the expression levels of circABCB10, miR-130a and PTEN, WB for the expression levels of apoptotic proteins,ELISA for the content of inflammatory factors,and CCK8 for the effect of CSE on the proliferation of cells.

CircABCB10 expression increased in lung tissues from patients with COPD and in 16HBE cells treated with CSE. The stimulation on cells with CSE increased the expression of inflammatory factors, while knocking down circABCB10 could reverse this response. The inflammatory response to the knockdown of circABCB10 was reversed by miR-130a inhibitor, which increased the expression of c-caspase 3. The targetscan database predicted the target factor downstream miR-130a was PTEN. Transfecting OE-PTEN reversed the inflammation of knocking down circABCB10, and increased the apoptosis and inflammation.

CircABCB10 can cause the inflammatory response by targeting miR-130a/PTEN axis, which is a mechanism that may lead to the occurrence and development of COPD.

Physical education in schools improves students’ health, physical strength, and lifelong physical engagement. Therefore, participation must be encouraged. This study aimed to investigate the relationship between emotional responses and participation satisfaction, word-of-mouth (WOM) praise, and WOM activity in students participating in school sports. Few studies have considered WOM praise and activity separately. This study addresses this gap in the literature.

In 2023, a survey of total of 345 students in Gyeonggi-do, Korea, was conducted using convenience sampling. Data processing included factor analysis to verify validity and reliability, correlation analysis, confirmatory factor analysis, and structural equation modeling to test the hypotheses.

The results confirmed a relationship between the emotional responses of students and satisfaction with participation. The emotional responses (ventilation [P<0.001], sense of dominance [P<0.001]) significantly affected participation satisfaction, and the latter had a possible causal relationship with WOM praise (P<0.001) and activity (P<0.001).

The emotional responses of school sports participants were related to participation satisfaction, WOM praise, and WOM activity. Participation satisfaction significantly affected WOM praise and WOM activity. Therefore, to contribute to students’ lifelong health, school sports programs should be developed and implemented to induce positive emotional responses, ensure students’ participation in school sports, and improve their future quality of life.

Fine particulate matter (PM2.5), an important component of ambient air pollution, induces significant adverse health effects. MitoQuinone (MitoQ), a mitochondria-targeted antioxidant, has been reported to play a protective role in various diseases. However, the roles of MitoQ in PM2.5 induced pulmonary toxicity remains to be elucidated.

All the experiments were performed at Higher Educational Key Laboratory for Translational Oncology of Fujian Province, Putian City, China in 2023. Pulmonary epithelial cells (A549) were pretreated with 4 µM MitoQ for 2 h and exposed to PM2.5 for 24 h. Cell viability was tested through CCK8 assay. Oxidative stress state and active mitochondria was used to study MitoQ’s effect on PM2.5 induced injury, and cell apoptosis was measured using a flow cytometer and analyzed by Bcl-2 family.

MitoQ pretreatment significantly relieved a decreased cell viability, subsequently, MitoQ alleviated ROS production and prevented the reduction of T-AOC and GSH and increased the expression of NF-E2-related factor 2 (Nrf2) and p62 in A549 cells exposed to PM2.5. MitoQ restored the decreased mitochondrial dysfunction and dynamics disorder and inhibited activated mitochondrial-mediated apoptosis induced by PM2.5. Furthermore, the decreased ratio of Bcl-2/Bax and expression of Mcl-1 and the enhanced expression of Caspase-3 were reversed by MitoQ pretreatment.

MitoQ might be regarded as a potential drug to relieve PM2.5 induced pulmonary epithelial cells damage.

Health indicators are often used for a variety of purposes, including program management, re-source allocation, monitoring of country progress, performance-based payment, and global reporting.Real pro-gress in health towards the United Nations Millennium Development Goals and other national health priorities is vitally dependent on stronger health systems. We aimed to analyse the progress of “birth related indicators” of selected countries of Balkan and Eastern Europe and to forecast their values in the future.

This research report article represents a descriptive data analysis of selected health indicators, ex-tracted from European Health for All database (HFA-DB) and EuroStat. Indicators of interest were analysed for 17 countries in observational period from 1990 to 2019. The data were analysed usinga linear trend estimate and median operation and interquartile range 25th–75th percentile were used for better comparison of each country. Forecasting analysis to year 2025 was performed by combining Excel analysis and SPSS program.

Number of all live births to mothers aged under 20 is decreasing in almost all examined countries,while live births to mother over 35 is mostly increasing. Total fertility rate is also mainly decreasing in almost all countries of interest for our investigation, as well as the crude birth rate.Estimated infant mortality per 1000 live births is decreasing in all observed countries.

Population aging is becoming more pronounced, while current birth-related indicators have nega-tive tendencies; this problem will obviously continue over time.

We aimed to explore the epidemiological trends and characteristics of undernutrition among children and adolescents aged 7~18 years in Macao from 2005 to 2020 to provide insights into the improvement of nutritional status among the youth in Macao, China.

Based on the data collected from the Citizen Physical Fitness surveillance sessions in Macao in 2005, 2010, 2015, and 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was calculated.

In 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was 12.11%. Among them, the rates of stunting, moderate or severe wasting, and mild wasting were 0.63%, 5.25%, and 6.23%, respectively. The prevalence of undernutrition among boys (13.81%) was higher than that among girls (10.06%). Mild wasting was the main form of undernutrition among students. From 2005 to 2020, the prevalence of malnutrition showed a decreasing trend (P<0.05), but there was a rebound in 2020 from 2015, mainly because it may be caused by the COVID-19 pandemic in 2020. The prevalence of undernutrition among children and adolescents in Macao was lower than that in Mainland China (P<0.01).

The detection rates of undernutrition showed a decreasing trend from 2005 to 2020. In the post-pandemic era, Macao should undertake more effective measures in areas such as promoting balanced nutritional intake, increasing physical activity levels, enhancing school physical education, and incorporating mental health education. These efforts are essential for further reducing the prevalence of undernutrition among children and adolescents.

The regulation of p21 in the pyroptosis of cartilage cells still needs to be further clarified. We aimed to explore the regulation of p21 on the pyroptosis of cartilage cells and to reveal the improvement of osteoarthritis.

Chondrocytes were collected and isolated from patients with osteoarthritis (average age 58.64 ± 4.32) in Xuzhou Third People's Hospital, China in 2019, and healthy volunteers (average age 58.23 ± 3.91) were enrolled as the control group. mRNA expression levels of p21 and pyroptosis-related proteins (NLRP3, ASC, total caspase1 and cleaved-Caspase1) were detected by Western blot and real-time PCR. Cell activity, total number of cells and number of dead cells were calculated with CCK-8, MTT. And the regulation of p21 on the pyroptosis of cartilage cells was verified with overexpression and knockdown of p21 in cartilage cells.

In cartilage cells of patients with osteoarthritis, the transcription and translation levels of pyrolysis-related genes (NLRP3, cleaved-caspase 1, and ASC) significantly increased (P<0.01). p21 expression was up-regulated and positively correlated with the changing trend of pyrolysis-related proteins (P<0.01). Overexpressing p21 genes in normal cartilage cells significantly increased the expression of pyrolysis-related proteins (P<0.01).

The pyroptosis of cartilage cells is causally related to the process of osteoarthritis, and can be regulated by transcription factor p21, which is a potential therapeutic target for osteoarthritis.Osteoarthritis

Soil is an appropriate substrate for the storage and transmission of oocytes of Toxoplasma gondii. Ingestion of soil contaminated with T. gondii oocysts is a major transmission route of human and animal toxoplasmosis. The present study was carried out to investigate soil contamination with T. gondii oocysts in urban and rural areas of Guilan Province, northern Iran.

Overall, 208 soil samples were collected from 16 cities and villages in Guilan Province, northern Iran from Oct 2020 to Nov 2021. Soil samples were investigated using modified sucrose flotation technique. Real-time polymerase chain reaction was used to detect presence of T. gondii DNAs in the samples. Positive samples were further analyzed using nested polymerase chain reaction for GRA6 gene. Moreover, six selected positive samples were used for amplifying and sequencing of the GRA6 gene.

Overall, 31 samples were positive for T. gondii with frequency of 14.9% and ranging from 10.9% in rural areas to 16.3% in urban areas. Statistical analysis showed significant differences between the seasons (P=0.003). The phylogenetic analysis illustrated that our six sequences were similar and closely related to Type I strain of T. gondii.

Results showed relatively high levels (14.9%) of T. gondii oocytes in soil samples of Guilan Province, northern Iran, which provided essential data for the effective prevention and control of toxoplasmosis in the region.

We aimed to investigate two polymorphisms, rs8106922 and rs157580 of TOMM40 in Alzheimer's disease (AD).

In the present case-control research, we collected blood samples from 117 AD patients and 130 controls from Alzheimer's Hospital, residents of Tehran, Iran during the winter 2020 to autumn 2022. Following extraction of DNA, Genotyping of TOMM40 polymorphisms rs8106922 and rs157580 were examined by sequencing and ARMS/PCR approaches. We compared distributions of genotypes in both patient and healthy groups using the Chi-Square test.

Regarding rs157580, a statistically significant difference was observed in the GA genotype frequency between patient and healthy groups, in both univariate and multivariate modes with these results that have come respectively, and it can be regarded as a protection factor P<0.05).. No significant difference was observed in the frequency of A and G alleles between patient and healthy groups. Besides, concerning rs8106922, the AG genotype frequency in research groups in both univariate and multivariate cases, with these results that have come respectively was significantly different (P=0.003) & (P=0.009). Regarding GG genotype, a statistically significant difference was observed between the patient and healthy groups in both univariate and multivariate cases, respectively (P=0.419) & (P=0.425). Significant differences were observed in the G allele frequency for rs8106922 in the healthy and patient groups (P=0.007), it can be regarded as a potential protective factor.

It is possible to consider the TOMM40 gene as one of the potential genes concerning Alzheimer's disease.

Gastrointestinal cancers can cause major health problems globally since their burden is increas-ing in many countries. We aimed to investigate the trend of years of life lost due to gastrointestinal cancers in Fars Province, southern Iran during the 2004-2019.

In this cross-sectional survey study, we obtained the information regarding all deaths due to gastro-intestinal cancers in Fars Province from the electronic population-based death registration system (EDRS).Years of Life Lost(YLL) was calculated using the YLL template of 2015 by the WHO. To examine the trend for different years, join point regression based on the log-linear model was used. Joinpoint regression analysis describes changing trends over successive periods of time and the increasing or decreasing rate within each period.

During the years of 2004-2019, 9742 deaths due to gastrointestinal cancers occurred in Fars Prov-ince. 6013 (61.72%) cases were male and 3729 (38.28%) cases were female (Male / Female Sex Ratio: 1.61). Overall, 4152 cases (42.63%) were due to gastric cancer and 2112 cases (21.68%) were due to liver cancer. Total years of life lost due to premature death from gastrointestinal cancers during the 16-year study period was 73565 yr (2.33 per 1000 persons) in men, 52766 yr (1.71 per 1000 persons) in women, and 126331 yr (2.02 per 1000 persons) in both sexes.

Among all cancers, the highest mortality rates in both sexes belong to gastric cancer. This study showed the trend of YLL rate of malignant neoplasms of liver and intrahepatic bile ducts, esophagus, oral cavity, and colon cancer were increasing in both sexes, however, the trend of YLL rate for malignant neo-plasms of the small intestine was decreasing in both sexes. Variation of GI cancers patterns and trends around the Fars Province indicated that a more comprehensive control plan is needed to control these variations

Hospital refrigerators as essential food storage can be important source of food contamination. We aimed to investigate the frequency and antibiotic susceptibility of the pathogenic bacteria in three hospital refrigerators in Tehran.

This study was performed on 254 samples, collected from 60 refrigerators of the various wards of three hospitals, A, B, and C, in Tehran, Iran from 2020 to 2021. Following isolation and identification of isolates, the antibiotic susceptibility pattern was determined. PCR-based assays were used to screen the presence of antibiotic resistance genes of resistant isolates.

From 254 collected samples, 236 samples (92.9%) were contaminated. Most strains were isolated from refrigerators with poorly cleaned, temperatures above 8 °C in non-critical wards. Most bacteria belonging to Enterobacteriaceae (68.8%), followed by Staphylococcus (11.9%), and Enterococcus (10.6%), while the frequency of non-Enterobacteriaceae isolates was 8.9%. The highest antibiotic resistant bacteria were in extended spectrum beta-lactamase (ESBL) 9.7%, vancomycin-resistant enterococci (VRE) 5.3%, methicillin-resistant S. epidermidis (MRSE) 0.4%, and methicillin-resistant S. aureus (MRSA) 0.4%, respectively. The blaOXA-48, blaCTX, and bclaTEM genes were found only in 10% of Enterobacteriaceae isolates. The blaOXA-51 gene was found in all non-Enterobacteriaceae isolates. The vanA and mecA genes were detected in antibiotic-resistant Enterococcus and Staphylococcus.

Our findings suggests major concern about cross-contamination and the emergence of antibiotic-resistant isolates as a potential health threat with hospital refrigerators origin. More attention to hospital refrigerators cleaning is necessary to prevent foodborne diseases and nosocomial infections.

We aimed to identify the factors contributing to human error in hospital emergency departments using scientific methods.

We used the Fuzzy Analytical Network Process (FANP) and Success Likelihood Index Method (SLIM) to investigate human reliability in 54 hospital emergency departments in 15 provinces of Iran from 2021 to 2022.

The study classified 17 general factors affecting human errors in hospital emergency departments. Organizational (0.349), occupational (0.330), and personal factors (0.320) had the most significant impact on human error. Based on a matrix of paired comparisons for nine emergency tasks using the probability of success index method, "checking test results and diagnosis" had the highest probability of error when referring patients to intensive care or discharge. Although the study prioritized patients, there was still a cumulative probability of human error before disease diagnosis at 0.01332, highlighting the need for further training to minimize these risks.

The FANP and SLIM were effective in identifying the factors contributing to human error in hospital emergency departments. Doctors and nurses working in these departments require more knowledge, experience, and responsibility to avoid errors. By identifying factors influencing the occurrence of human error and finding solutions to reduce risks, hospitals can improve the quality of their care and prevent errors.

A significant share of medical care, primary health care, and health-related education and research in Iran is provided by the Ministry of Health and its affiliated universities of medical sciences. We aimed to identify a set of key metrics for monitoring their efficiency in the four areas of medical care, primary health care, education and research.

A combination of scoping review, expert panel and Delphi method was used. First, the relevant keywords were searched in the appropriate databases between 2000 and 2020. The final extracted indicators then reviewed, reduced and refined through the expert panel meetings. The last metrics were established following a three-stage Delphi study.

Out of 2327 studies, 155 were selected following the different screening stages of scoping review. After summarizing and refining the indicators via several expert panel meetings and the Delphi method, a total of 36 key indicators were considered appropriate for measuring efficiency of the health system, 23 of which were for the sub-systems of public health (4 indicators), medical services (10 indicators), education (4 indicators) and research (5 indicators) and 13 indicators for the whole system efficiency.

The set of indicators presented representing both the technical and allocative efficiency, might be a reliable basis for designing information systems and management dashboards for periodic monitoring of health system efficiency at national, regional and local levels.

We aimed to investigate  miR-21-5p inhibition effect on lncRNA-XIST expression and apoptosis status of MCF-7 cells.

The MCF-7 cells were cultured and transfected by the anti-miR-21-5p oligonucleotide and expression of miR-21-5p, lncRNA-XIST, apoptosis-associated genes (bax and p53) and one miR-21-5p-unrelated lncRNA (BC200) was assessed by RT-qPCR. Furthermore, cell viability checked by MTT assay and apoptosis and cell cycle in transfected cells were detected by flow cytometry. Also, bioinformatics analysis on the transcriptome data confirmed that the lncRNA XIST might have a critical role in breast cancer (BC) cell apoptosis through ceRNAs mechanism and possible regulatory interactions with miR-21-5p.

Expression of miR-21-5p and lncRNA-XIST was significantly down- and up-regulated respectively (P<0.05). However, there was no significant change in lncRNA-BC200 expression. Also, the expression of bax and p53 upraised significantly (P<0.05). In transfected cells, MTT and flow cytometry assays reported a highly significant decrease and increase in viability and apoptosis respectively.

Inhibition of miR-21-5p resulted in significant upregulation of lncRNA-XIST and apoptosis-associated genes bax and p53, which led to the induction of apoptosis in MCF-7 cells. Therefore, more investigations may provide a valuable target for studies on molecular therapies for BC.

Cancer stem cells (CSCs) substantially influence the development of colorectal cancer (CRC), metastasis, relapse, and resistance to therapy. Ibuprofen and hyperthermia can be effective in the treatment of cancer. Herein, we evaluated the effects of hyperthermia and ibuprofen on the isolated-CSCs of CRC.

This experimental study was conducted between Sep 2020 and Jan 2022 at the Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Iran. A non-adhesive culture system was used to isolate CSCs from HT-29 cells. To confirm the stemness nature of isolated-CSCs, the expression of stemness genes and protein markers was evaluated by quantitative Real-time PCR (qRT-PCR) and flow cytometry assay. The isolated-CSCs were treated with hyperthermia and ibuprofen. The cell viability was determined by MTT assay and trypan blue staining. The expression of stemness, proliferation, Wnt signaling pathway and apoptosis genes was assessed by qRT-PCR.

CSCs were isolated within 14 days. The expression of CD-133 marker and OCT3/4, C-MYC, KLF4, and NANOG genes in isolated-CSCs was higher than HT-29 cells (P<0.05). Cell viability of treated-CSCs were considerably reduced (P<0.05). Hperthermia reduced the expression of OCT3/4, NANOG, PCNA, WNT1 and CTNNB1 genes and increased the expression of P53, BAX, and KLF4 genes (P<0.05). Ibuprofen decreased the expression of OCT3/4, BCL2, NANOG, PCNA, WNT1, and CTNNB1 genes and increased the expression of P53, BAX, and KLF4 genes in treated-CSCs (P<0.05).

Hyperthermia and ibuprofen treatment demonstrate an inhibitory effect on colorectal CSCs. However, using combination therapy is remaining to be tested.

There were contradictory reports about the relationship between neck circumference (NC) and thyroid status. This study aimed to compare the NCs of Korean adults with or without thyroid disease.

The data of 8,198 subjects (aged 40–80 yr) that participated in the 2019-2020 Korean National Health and Nutrition Examination Survey were subjected to analysis. NCs were measured by trained staff to an accuracy of ±0.1 cm with a tape measure. Multiple logistic models were used to assess the prevalence of thyroid disease by NC level among men and pre- and postmenopausal women.

Approximately 5% of subjects had a history of thyroid disease. In contrast to men and postmenopausal women, premenopausal women with a larger NC had a significantly higher prevalence of thyroid disease (P-value=0.025).

A large NC is significantly associated with thyroid disease among premenopausal Korean women.