naeimeho ssadat asmarian

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection, especially among sexually active individuals.

This study aimed to determine the prevalence of HPV infection among males and females in Southern Iran. Although previous studies have explored HPV prevalence in various provinces across Iran, this research is unique as the first to examine a four-type sample within this region.

This cross-sectional study involved a sample of residents from Southern Iran, comprising 82 females (71.9%) and 32 males (28.1%), aged between 13 and 74 years, most of whom were sexually active. The main focus of the research was to investigate HPV infection across various anatomical sites in both healthy women and those with external genital warts (eGW).

The anatomical sites assessed included the oral, anal, vaginal, and urinary areas. Out of the total sample, 79 individuals (69.3%) tested positive for HPV. Within this group, 65 individuals (81.3%) were from the eGW group, while 14 individuals (41.2%) belonged to the normal population. A statistically significant difference (P ≤ 0.1) was observed in the prevalence of HPV in oral samples between the two groups. In the eGW group, 61 participants were positive for low-risk HPV (LR-HPV) genotypes, and 4 tested positive for HPV-18. Among the normal population, 14 individuals tested positive for LR-HPV genotypes. Notably, a higher proportion of positive HPV results—approximately 29%—was identified in anal and urinary samples compared to vaginal samples from females in the normal population.

Significant differences in HPV prevalence were noted between individuals with eGW and those in the normal population. Overall, the prevalence of HPV among eGW individuals was approximately twice that of the normal population across the four anatomical sites. Further research is warranted to better understand the association between HPV infection, eGW, and various sociodemographic factors.

Acute renal colic has been challenging and has brought many concerns for physicians and patients for centuries. This study aimed to evaluate the analgesic effect and safety of a combination of papaverine and ketorolac against ketorolac and placebo in treating acute renal colic.

This randomized clinical trial was performed in patients with renal colic from May 2018 to May 2020 in Ahvaz, Iran. Patients with colic pain due to sand or kidney stones underwent clinical examination. The pain intensified based on the visual analog scale (VAS) and the patients’ need for rescue analgesia are considered as primary outcomes at various times after treatment. Patients were equally divided into two groups: A (ketorolac plus papaverine) and B (ketorolac plus placebo) by block balanced randomization method. Student t test, the Chi square, and ANOVA tests were used for statistical analyses, which were performed by SPSS 19.0. P<0.05 was considered significant. 

A significant difference was observed in 280 patients (140 patients in each group) in pain intensity between both groups at 45 and 60 min. VAS scores in groups A and B were 5.08±1.23 and 5.56±1.11 in 45 min and 3.35±1.47 and 3.92±1.31 in 60 min (P=0.001, P=0.002), respectively. In subgroup analysis, the VAS score significantly decreased after taking the drug for middle and proximal ureteral stones at 45 and 60 min (P<0.001). Rescue analgesics were required in 7 (5%) and 21 (15%) patients in groups A and B, respectively (P=0.005). Side effects were similar in the two groups.

In this study, ketorolac, along with papaverine, was effective in acute renal colic control, and combination therapy with ketorolac and papaverine was associated with reduced use of other rescue analgesics.Trial registration number: IRCT20190217042738N1.

Post-dural puncture headache (PDPH) is the most common complication following spinal anesthesia among parturients undergoing cesarean section surgery. The purpose of this study was to evaluate the effectiveness of acetaminophen and caffeine in preventing PDPH.

This double-blind, randomized clinical trial was conducted on 96 obstetric women, who were candidates for elective cesarean section. Following the randomization of participants into two groups, participants in the intervention group received tablets of acetaminophen (500 mg)+caffeine (65 mg), and participants in the control group received placebo tablets orally 2 hours before spinal anesthesia induction and then every 6 hours after surgery up to 24 hours. All parturients were evaluated for frequency and intensity of PDPH every 6 hours until 24 hours after surgery and then 48 and 72 hours after surgery. Overall satisfaction during the first 72 hours of postpartum was evaluated. The data were analyzed using SPSS software. P<0.05 was considered statistically significant.

Participants in the intervention group were 70% less likely to experience PDPH after spinal anesthesia (OR=0.31 P=0.01, 95% CI [0.12-0.77]). They also experienced significantly milder headaches 18 hours, 48 hours, and 72 hours later. Participants in the intervention group reported higher levels of satisfaction at the end of the study (P=0.01). No side effects related to the intervention were reported.

Prophylactic administration of acetaminophen+caffeine decreases 70% the risk of PDPH and significantly attenuates pain intensity in obstetric patients who underwent spinal anesthesia for cesarean section.

Guillain-Barre Syndrome (GBS) is the most prevalent acute peripheral polyneuropathy disorder. The disparities between populations and variations in the major risk factors highlight the importance of country-specific studies. This study aimed to report clinical characteristics and outcomes of ICU-admitted patients with GBS in an academic medical center in Iran.  The data were collected retrospectively from all patients with GBS admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences, (Shiraz, Iran), between March 2016 to March 2021. Specialized neurological information and the Acute Physiology and Chronic Health Evaluation (APACHE II) score were recorded. The SPSS software was used to analyze the data. The analyzed data were reported as numbers and percentages, or mean±SD, or median(Interquartile)  The study included 132 GBS patients, with an average age of 47.87±15.4 years and a male-to-female ratio of 1.69:1. More than half of the patients (58.5%) were classified as having an axonal disease. In patients with axonal illness, 51.4% of patients had lower limb powers<3, while only 36% of those had the demyelinating disease. This group also required mechanical ventilation more frequently (54% vs. 46%) and for a longer duration (26 [9–37] vs. 10 [1–61]) days. Pneumonia and sepsis were each observed in 16% of patients, and 12% developed a urinary tract infection. The most common type of GBS was acute inflammatory demyelinating polyneuropathy (AIDP). Only 6 (3.8%) patients died. The axonal type of GBS was more frequent, and these patients required mechanical ventilation more frequently and for a longer duration than those in other electrophysiological categories.

The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.

This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants’ American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.

Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.

In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.Trial registration number: IRCT2013081614372N1.

There have been few studies on the effect of Kegel exercises on the treatment of functional constipation in children. Hence, the present study investigated the add-on role of Kegel exercises in children with functional constipation. This clinical trial was conducted on children with functional constipation, according to Rome IV, who were referred to the pediatric department of Imam Reza Clinic (Shiraz, Iran) in 2022. The sample consisted of 64 children who were randomly assigned to either the intervention or the control groups. In the control group, a pediatrician administered conventional therapy, including diet training, defecation training, and polyethylene glycol (PEG) syrup (0.7 g/Kg daily). In the treatment group, in addition to conventional therapy, a pediatrician taught Kegel exercises to the child both verbally and in writing in the presence of their parents. To investigate the effectiveness of the intervention, frequency of defecation, defecation time, assistance used for defecation, incomplete emptying, unsuccessful defecation, abdominal pain, and painful defecation were selected as the outcomes. Independent sample t test was used for continuous variables. Categorical variables were reported as frequency and percentages. To examine the difference in categorical outcome variables, Wilcoxon (pre and post), Chi square, and Fisher exact tests were used. Data were analyzed using SPSS software version 21. P<0.05 were considered statistically significant. Twenty-seven (88.4%) patients in the Kegel exercise group reported a defecation time of less than 5 min, while only 12 (37.5%) patients in the control group reached this time, and this difference was statistically significant (P=0.001). Moreover, patients in the treatment group showed significant improvements in terms of incomplete emptying of stool, unsuccessful defecation, abdominal pain, and painless defecation (P=0.001, P=0.001, P=0.001, P=0.037, respectively). After intervention, the use of laxatives, digits, or enemas to assist defecation was not significantly different between the groups (P=0.659). Kegel exercise was an effective adjunctive treatment for pediatric functional constipation.Trial registration number: IRCT20230424057984N1.

Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days.  A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved.

 One-lung ventilation (OLV) is often required to facilitate surgical exposure. Hypoxemia is a common disorder during thoracic surgery.

 We studied whether changing from the supine to the lateral position during OLV and two-lung ventilation (TLV) in thoracic surgery would affect positions on arterial oxygen pressure (PaO2) in two groups of smokers and nonsmokers.

 This single-blinded prospective observational pilot study was conducted on patients who underwent thoracotomy under general anesthesia. The effect of lateral and supine PaO2 was investigated in 15 patients with a history of smoking (≥ 40 packs/year) and 15 patients without. The data were analyzed via descriptive and inferential statistics in SPSS v. 19.

 Arterial oxygen pressure did not significantly differ between the two groups in the supine TLV (P = 0.98), supine OLV (P = 0.16), lateral TLV (P = 0.06), and lateral OLV (P = 0.31). However, the PaO2 level was higher in smokers than in nonsmokers (except during supine TLV). Changing the position from supine to lateral caused a relative decrease in PaO2 (except during TLV in smokers) during TLV and OLV. This reduction in PaO2 levels was less in smokers (72.12) than in nonsmokers (95.28). Oxygen saturation (SpO2) levels were the same in all positions regardless of whether they were a smoker or nonsmoker.

 Changing the position from supine to lateral had no significant effects on PaO2 and SpO2 levels in smoker and nonsmoker patients during OLV and TLV in thoracic surgery.

Several adjuvants, added to local anesthetics, were suggested to induce an ideal regional block with high-quality analgesia. The purpose of this study was to evaluate the particular blocking properties of low-dose bupivacaine in combination with meperidine and fentanyl in spinal anesthesia during Cesarean sections. A randomized, double-blind clinical trial was conducted at Hafez Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from February 2015 to February 2016. A total of 120 pregnant women, who underwent spinal anesthesia during elective Cesarean section were enrolled in the study. Based on block-wise randomization, the patients were randomly assigned to three groups, namely “B” group received 2 mL bupivacaine 0.5% (10 mg), “BM” group received 8 mg bupivacaine and 10 mg meperidine, and “BF” group received 8 mg bupivacaine and 15 µg fentanyl intrathecally. The block onset, the duration of analgesia, and the time of discharge from the post-anesthesia care unit (PACU) were all assessed. Data were analyzed using SPSS software version 21, and P<0.05 were considered statistically significant. The mean duration of motor blocks in the B group (150 min) were significantly higher than the BM (102 min) and BF (105 min) groups (P<0.0001). In both the BM and BF groups, the duration of sensory and motor blocks was the same. The length of stay in the PACU was significantly longer in the B group (P<0.001) than the BM and BF groups. When meperidine or fentanyl was added to bupivacaine, the duration of the analgesia lengthened (P<0.001).  Intrathecal low-dose spinal anesthesia induced by bupivacaine (8 mg) in combination with meperidine and/or fentanyl for Cesarean section increased maternal hemodynamic stability, while ensuring effective anesthetic conditions, extending effective analgesia, and reducing the length of stay in PACU.Trial Registration Number: IRCT2015013119470N14.

This meta-analysis was conducted to summarize the comparative effect of Vitamin E and N-acetyl cysteine (NAC) on oxidative status, including total antioxidant capacity (TAC), total oxidative stress (TOS), oxidative stress index (OSI), and hemoglobin (Hb) in patients with TDT.

This systematic review and meta-analysis was done according to the PRISMA checklist. We searched databases including Web of Science (ISI), Scopus, Medline (via PubMed), and Embase. Meta-analysis was done using Stata statistical software version 16.0.

Finally, four randomized-controlled trials (RCT) for Vitamin E and three RCTs for NAC were included. Our meta-analyses and review showed a significant increase in the weighted mean differences (WMD) of Hb and a significant decrease in the WMD of TOS and OSI in children subgroup of Vitamin E. Also, based on the results of the review in the NAC group, a significant increase in the WMD of Hb and a significant decrease in the WMD of TOS and OSI were found in children.

Vitamin E showed a beneficial effect on improving anemia in TDT children. Moreover, both NAC and Vitamin E seems to be effective antioxidant supplements in children with TDT. More well-designed randomized, controlled trials for the effect of NAC and Vitamin E in TDT patients are recommended with more focus on the essential influencing factors on the oxidative status in these patients.

 Chronic immunity to hepatitis A (HA) is largely influenced by environmental factors, such as socioeconomic indicators, public health conditions, and access to safe water. In the past two decades, Iran has witnessed improvements in socioeconomic status, increased urbanization, enhanced health education, improved access to safe drinking water sources, and better public health conditions. However, these changes have not been uniform across all regions of Iran, and varying epidemiological situations are expected.

 This study aimed to delineate the pattern of HA chronic immunity across different regions of Iran using geographical information system (GIS) mapping.

 The study included a total of 3255 individuals who tested positive for anti-hepatitis A virus (anti-HAV) immunoglobulin G (IgG). This study analyzed factors such as place of residence, marital status, age, and gender to explore possible relationships. Univariate and multivariable analyses were conducted to identify independently associated factors for HA. A locally weighted scatterplot smoothing (LOWESS) multivariate model was developed using a backward stepwise approach. Geographical variations in the prevalence of HA chronic immunity in the general population of Iran were assessed to understand spatial effects and risk factors. A Bayesian spatial model was employed to identify the spatial pattern of HA chronic immunity prevalence, using OpenBUGS version 3.2.3.

 The prevalence of HAV immunity was higher in regions with mild semi-dry climates (aPR = 2.37, 95% confidence interval [CI] = 2.30 - 3.33, P< 0.001), medium semi-dry climates (aPR = 1.37, 95% CI = 1.14 - 1.63, P< 0.001), dry climates (aPR = 1.13, 95% CI = 0.9 - 1.4), and ultra-dry climates (aPR = 1.79, 95% CI = 1.05 - 2.98, P = 0.033), compared to semi-humid climates. Other variables did not exhibit a significant relationship with HA chronic immunity. The GIS analysis map revealed that immunity to HA was generally lower in the capital cities of Iran’s provinces. However, most central regions of Iran exhibit medium endemicity; nevertheless, higher immunity to HA was observed in border areas and coastal regions, particularly in the northern part of the country.

 Different regions of Iran display distinct patterns of HAV endemicity, influenced by the country’s climatic diversity.

To compare clinical and paraclinical similarities between trauma patients with positive RT-PCRtests (PCR+ve) and the RT-PCR negative ones (PCR -ve). This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groupswere compared regarding (para) clinical values. Multivariable binary logistic regression analysis investigatedthe variables predicting COVID-19 and the mortality rate. Both groups were similar regarding the clinical findings and comorbidities (p>0.05). PCR+ve grouphad lower lymphocyte count (1.41 [1.45] vs. 1.66 [1.61], p=0.030), CPK level (411 [928.75] vs. 778 [1946.5].p=0.006) and CRP level (17 [42.5] vs. 24 [50.75], p=0.004). However, none of these findings were significant inthe multivariable analysis. Finally, PCR+ve group had increased odds of death (OR=2.88; 95% CI=1.22-7.41). Unlike our primary hypothesis, the study failed to mark any significant (para) clinical featuresguiding us to detect COVID-19 earlier in trauma patients. Moreover, the PCR+ve group is at increased mortalityrisk. A larger, multicentric prospective study should be designed to address this issue.

SARS-CoV-2 is a novel virus that caused the recent global pandemic. Health care workers (HCWs), especially hospital staff, are at a higher risk of infection by this virus than the general population. In this study, anti-SARS-CoV-2 IgG antibodies were assessed in hospital workers.

This prospective seroconversion-based cohort study assessed chronic immunity against covid-19 in the staff of two hospitals, the main referral hospital and a general hospital in Shiraz, south of Iran. A valid and reliable checklist was filled out for each available staff member willing to participate in this study through a face-to-face interview. Furthermore, the titer of anti-covid-19 IgG was measured by ELISA twice; in July 2020 after the second wave of COVID-19 and in February 2021 after the third wave in IRAN.

One hundred forty (65%) of the 214 members who participated in both stages of this consideration were from the COVID-19 referral healing center, and 74 (35%) were from the common clinic. Twelve (5.6%) of staff members had anti-SARS-CoV-2 IgG antibodies, including 10 (7.1%) from the referral healing center and 2 (2.7%) from the common healing center (P = 0.23). In the second measurement (second overview), 79 (36.9%) of members had IgG antibodies; 58 (41.4%) from the primary hospital and 21 (28.3%) from the second healing center (P = 0.039). Cruel of the IgG titer within the first study and the referral clinic was 0.8 ± 0.3 compared to 0.15 ± 0.42 within the common clinic (P = 0.001). These figures were 3.05 ± 4.58 and 1.74 ± 3.53 in both clinics and within the second overview separately (P = 0.003). IgG levels were significantly higher in the second overview compared to the first (P < 0.0001).

During the third wave of COVID-19, a significant proportion of hospital staff developed COVID-19 IgG, especially in the referral hospitals for COVID-19. As a result of their higher and chronic exposure to COVID-19 patients than the general hospital staff, the titer of IgG in the referral hospital staff was also higher. However, the seroconversion rate between the two waves was 1.8 times in the general hospital staff compared to the referral hospital, possibly due to less conservative precautions against covid-19 among them. Even after receiving the anti-covid-19 vaccination, it is important to monitor the immunity of hospital staff to covid-19 and to adhere strictly to standard precautions.

The coronavirus disease 2019 (COVID-19) has become the leading source of pneumonia outbreaks in the world. The present study aimed to compare the condition of intensive care unit (ICU) and non-ICU COVID-19 patients in terms of epidemiological and clinical features, laboratory findings, and outcomes in three cities across Iran. In a cross-sectional study, 195 COVID-19 patients admitted to five hospitals across Iran during March-April 2020 were recruited. Collected information included demographic data, laboratory findings, symptoms, medical history, and outcomes. Data were analyzed using SPSS software with t test or Mann-Whitney U test (continuous data) and Chi square test or Fisher’s exact test (categorical variables). P<0.05 was considered statistically significant. Of the 195 patients, 57.4% were men, and 67.7% had at least one comorbidity. The prevalence of stroke, chronic obstructive pulmonary disease, and autoimmune diseases was higher in ICU than in non-ICU patients (P=0.042, P=0.020, and P=0.002, respectively). Compared with non-ICU, ICU patients had significantly higher white blood cell (WBC) count (P=0.008), cardiac troponin concentrations (P=0.040), lactate dehydrogenase levels (P=0.027), erythrocyte sedimentation rates (P=0.008), and blood urea nitrogen (BUN) (P=0.029), but lower hematocrit levels (P=0.001). The mortality rate in ICU and non-ICU patients was 48.1% and 6.1%, respectively. The risk factors for mortality included age>40 years, body mass index<18 Kg/m2, hypertension, coronary artery disease, fever, cough, dyspnea, ST-segment changes, pericardial effusion, and a surge in WBC and C-reactive protein, aspartate aminotransferase, and BUN.  A high index of suspicion for ICU admission should be maintained in patients with positive clinical and laboratory predictive factors.

Postoperative pain is a common expected problem. Appropriate medications are important to control pain, especially in breast cancer surgery with a high rate of postoperative acute and chronic pain.

This study aimed to evaluate the effect of intraoperative infusion of dexmedetomidine on acute and chronic pain after simple mastectomy.

This is a double-blind clinical trial study which included 110 eligible patients for simple mastectomy from Shahid Faghihi Educational and Medical Center in Shiraz between October 2018 and May 2019. The patients were randomized into two groups of intervention who were received intraoperative dexmedetomidine 0.4 μg/kg/h, and control group who were received the same amount of placebo (normal saline 0.9%). The severity of acute and incidence of chronic pain were assessed with VAS of pain, and brief pain inventory (BPI), and the number of analgesics (Apotel, Morphine) that patients received in first 24 hours were recorded postoperatively. Collected data were analyzed, and P-values of less than 0.05% were considered statistically significant.

Here, 110 patients (55 people in each group) were met the inclusion criteria of the study. Based on the result of this study, the mean VAS score of pain in the intervention group (0.96 ± 0.14) was significantly lower than the control group (4.44 ± 2.25) (P < 0.001). Although the incidence of chronic pain was different between the two groups after three months, this difference was not statistically significant (P = 0.871). Moreover, the number of requests and the amount of analgesia (Apotel and Morphine) in the first 24 hours after surgery in patients in the intervention group was significantly less than patients in the control group (P < 0.001). Also, the time of the first request for analgesia (Apotel, Morphine) in the patients of the intervention group was significantly longer than the control group (P-value = 0.036).

According to the finding of this study, the use of dexmedetomidine during simple mastectomy reduces pain, decreases, and delays in requirement of analgesia at the first 24 hours post-operation. However, it did not have a significant effect on chronic pain.

Hepatitis A virus (HAV), the most common cause of acute viral hepatitis, afflicts millions of people and causes the loss of thousands of lives annually.

This study aimed to detect the seroprevalence of anti-HAV IgG in Fars province, Iran.

This cross-sectional study was conducted using multi-stage cluster random sampling from 12 cities and 24 villages. All age groups, excluding infants (≤ 1-year-old), were included in this study. A valid checklist consisting of demographic and sanitation items and questions about the transmission routes of HAV were filled out for each individual. In the case of children, interviews were performed with one of the parents. Furthermore, anti-HAV IgG was detected by enzyme-linked immunosorbent assay (Dia.pro kits, Italy) on 3 cc of the blood sample of each participant. Data were analyzed using univariate and multivariate (binary logistic regression) tests by SPSS. We applied both World Health Organization (WHO) and age at mid-point of population immunity (AMPI) protocols for HAV endemicity classification. In addition, the geographical variation of hepatitis A chronic immunity was analyzed by the Bayesian spatial model. OpenBUGS program was used to estimate parameters, and ArcGIS was used to display the results on a map.

A total of 547 participants with an age range of 1 - 82 years, mean age of 33.07 ± 15.1 years, and female to male ratio of 1.1 were studied. Overall, 380 (69.5%) individuals had anti-HAV IgG, and 124 of 282 (44%) adults ≤ 30 years old had HAV immunity. AMPI was 25 years old. Being married (OR = 10.7), non-Fars ethnicity (OR = 2.8), knowledgeable about HAV (OR = 2.2), and employed (OR = 1.7) were the strongest determinants of anti-HAV seropositivity. Southern cities of Fars province, which have a hot climate, had the highest prevalence of HAV immunity.

Fars province is a very low and intermediate HAV endemic area based on WHO and AMPI protocols, respectively. High-risk groups, such as patients with chronic liver diseases or coagulopathy, travelers to highly-endemic areas, intravenous drug abusers, and homosexuals, should be given priority in the HAV vaccination program. However, the strategy of HAV vaccination should be tailored to subsequent cost-effectiveness studies and national HAV vaccination strategy.

Information on the pattern and trend of mortality with regards to sex and location gives us a detailed insight into the population health which is an essential component in policy debates to improve the health system. The purpose of this study is to explore and compare the mortality pattern in the west and east of Iran. To assess the spatial patterns, we used disease mapping and spatial dependency with first-order neighborhood structure. Incorporating neighborhood structure with Bayesian method assisted us in using smooth standardized mortality ratios (SMR). Mean overall smooth SMRs in the west and east were 1.005 and 0.998, respectively, and mortality trend in these two regions were approximately smooth. The most favorable conditions were associated with females in the east and females in the west had a higher risk of death. The health system in Iran has been effectively improved and with recent essential health policies, it is expected to see a negative trend in mortality rates in the near future.

Individualized Medical Nutrition Therapy (IMNT) is recommended as a part of glycemic control in hospitalized diabetic patients. However, it is provided only for a small number of patients. This study aimed to compare the effects of IMNT and Consistent Carbohydrate Meal-Planning (CCMP) on glycemic control, energy, and carbohydrate and protein intake in hospitalized diabetic patients.

This randomized clinical trial was conducted on 164 hospitalized diabetic patients. The patients were randomly selected from internal wards of Namazi hospital, Shiraz, Iran from September 2016 to October 2017. They were allocated to IMNT or CCMP groups using simple randomization for four days. Blood glucose was measured before each meal and at bedtime. A 24-h food recall was also completed to measure the energy and carbohydrate and protein intake during the study. The data were analyzed using independent sample t-test and repeated measures ANOVA via the SPSS software, version 19.

The results showed a significant decrease in the IMNT group compared to the CCMP group regarding the mean blood glucose level measured prior to breakfast, lunch, dinner, and bedtime during the first, second, third, and fourth days of the study (p=0.025, p=0.030, p=0.002, and p=0.011, respectively). Besides, mean peak and nadir of glucose level (p=0.042 and p=0.036, respectively) and the means of energy, carbohydrate, and protein intake were significantly increased in the IMNT group compared to the CCMP group.

IMNT could help to control the blood glucose. In addition, it could improve energy and nutrients intake, which might play a role in patient recovery.

Recurrent pregnancy loss (RPL) is a heterogeneous condition with the prevalence of more than 1% among women of reproductive age, which is defined as the occurrence of more than two miscarriages. Immune-mediators, cytokines, determine the role of immune cells in response to tissue incompatibility conditions. Colony stimulating factor 3 (CSF3) is a cytokine affecting the expression of other cytokines such as IL-4, and suppressing the immune response against semi-allograft embryo. This study was done for the first time on the association of the rs1042658 polymorphism at 3’UTR of the CSF3 gene with the susceptibility to recurrent pregnancy loss, supposing the effect of it on the expression level and stability of the CSF3 gene transcript.
122 RPL women and 140 healthy fertile women as a control group were enrolled in this case-control study. Genotype distribution of the selected polymorphism was evaluated by T-ARMS PCR method and the results were analyzed by logistic regression test.
comparison of the genotypic frequencies in the 3'UTR of the CSF3 gene in patients and controls resulted in the statistically significant difference in the incidence of pregnancy loss in order to the protection effect of the genotypes carrying T allele was observed between two groups (p Findings showed significant relationship between rs1042658 polymorphism and the risk of recurrent pregnancy loss, which can affect the susceptibility of the condition.