نیره اسماعیل زاده

The delay in the diagnosis of tuberculosis by providing the basis for the transmission of the infection is considered a big challenge in front of the effort to eliminate tuberculosis in the world, and the border cities of Afghanistan are at greater risk. This study was conducted with the aim of determining the delay in the diagnosis of pulmonary tuberculosis and its related factors in the southeast of Razavi Khorasan province.

In this descriptive and analytical study, the data of 256 pulmonary tuberculosis patients from the cities of Taibad, Khaf, Bakherz, Freeman, and Sarkhes were collected by census method and analyzed with SPSS software.

There were 156 (60.9%) female and 100 (39.1%) male patients with a mean (median) age of 22±53 (58) years. 244 patients (95.3%) were Iranian. 76 patients (29.7%) had contact history with positive smear patients. 197 (77%) of patients were identified and treated with a delay of more than 28 days. The median delay during the studied years was 36 days. The median diagnosis delay in the age groups, cities and years studied showed a statistically significant difference.

The median delay in the diagnosis of pulmonary tuberculosis patients was 36 days. Planning for active case finding among contacts, targeted case finding in middle-aged groups and women, and implementing syndromic surveillance at border entries can help reduce the delay in diagnosis and decrease the adverse outcomes of the disease.

Bovine tuberculosis (BTB) is a disease with high economic relevance.

This study aimed to determine a fast alert surveillance system for bTB before the outbreak in the epidemic region of Iran.

This cross-sectional study was conducted using the Auto-Regressive Integrated Moving Average (ARIMA) model for monthly bTB detections (reactors). These reactor cases result from the positive Tuberculin Purified Protein Derivative (PPD) test on cattle farms for the period between April 2007 and March 2019 in Razavi Khorasan province. Autocorrelation functions (ACF) and partial autocorrelation functions (PACF) plots were used to determine model parameters. The Akaike Information Criteria (AIC) were employed to select the best-fitted model. The root mean square error (RMSE) was applied for the evaluation of the models. Then, the best-fitted model was hired to predict the cases for 12 oncoming months. The data were analysed by STATA (ver. 14) software with a significant level at P≤0.05.

ARIMA (3, 0, 3) 12 was introduced as a recommended fitted model according to white noise residual test (Q=22.87 and P=0.98), lower AIC (541.85), and more precise model RMSE (1.50). However, the forecast values were more than the observed values.

The application and interpretation of ARIMA models are straightforward, and may be used as immediate tools for monitoring systems. However, we proposed an Auto-Regressive Integrated Moving Average with Exogenous Input (ARIMAX) model with some measurable exotic factors such as economic fluctuations, climate changes, and pulmonary tuberculosis to introduce a more precise and accurate model for the fast alert surveillance system.

Each year، 10 million people are faced with cancer and about 6 million of them die throughout the world. This study aimed at investigating the geographical distribution of cancer and its environmental risk factors in Iran.

The present study was mapping the available data collected from the reports of Iranian Center for Disease Control (Cancer Bureau) regarding the frequency of 10 common cancers (stomach، esophageal، colorectal، bladder، lung، CNS، lymphoma، prostate، ovarian، and breast) as their age-standardized incidence rate (ASR) for each province in between 2005 and 2006 using ArcGIS 9. 3. The published information about environmental risk factors was also gathered based on reviewing available public sources of digital databases including Scopus، Pubmed and Persian sources of IranMedex، Iran DOC، SID، and magiran، as well as through hand searching of books and manuals using keywords.

Geographically، the incidence of certain cancers varied in different regions of Iran. Between 2005 and 2006، the estimated ASR of cancers was 102. 4 and 117. 3 per 100،000 among females and males، respectively. The ASR of cancer was higher in the north than in the south of Iran. This difference is possibly due to the methods of registry and difference in the site. Lifestyle، infectious agents، environmental exposures، and constitutional factors are risk factors that have been attributed to certain types of cancer.

Development، establishment، and implementation of Comprehensive National Cancer Control Program should be the first priority for health policy-makers. Given its nationwide distribution، Iranian Army can provide substantial assistance in collection and analysis of data on cancer in case of access to a record and control system of cancer.

Disability is the most important determinants of disease course، treatment and rehabilitation outcomes and consequently the quality of life in patients with multiple sclerosis. The aim of the present study was to determine the relationship of disability and quality of life in multiple sclerosis patients. This cross-sectional study was performed on 325 patients referred to the physiotherapy unit of the Multiple Sclerosis Society of Iran (Tehran). Data collection tools were MSQOL-54 questionnaire for evaluating quality of life and Expanded Disability Status Scale (EDSS) for assessing the degree of disability. Data analysis was performed through SPSS16 and using t-test، chi-square test and linear regression. Mean age of patients was 39. 1± 10. 4 years. Among 14 domains of quality of life، the highest score was related to pain (67. 8 ± 25. 7) and the least was related to role limitations due to physical problems (31 ± 17. 1). Linear regression model showed significant negative effect of disability on both physical and mental health domains of quality of life (P <0. 001). The present study showed the association between disability and factors such as age of disease onset and gender and quality of life in multiple sclerosis patients. Therefore supportive care to reduce disability and maintain patients’ functions at the highest possible level، particularly in women and patients with later age of disease onset، in order to improve the quality of life is recommended.