neda izadi

This retrospective cohort study explores the long-term effects of different endocrine therapy regimens on mortality, local recurrence, and metastasisin breast cancer patients.

Data from the Referral Cancer Research Center of Shahid Beheshti University of Medical Sciences were analyzed. Records of 2262 histologically confirmed reast cancerb patients with 25 years of follow-up were included. Wecollected patient data, including treatment modalities and details of the endocrine therapy, and conducted statistical analysis to assess treatment outcome associations.

Patients had an average age of 49.45 years, and 99.1% were female. The average tumor size was 2.8 cm, with a 12.3% mortality rate. Positive expression of human epidermal growth factor receptor 2, progesterone receptor, and estrogen receptor was found in 17.3%, 71.8%, and 70.6% of patients, respectively. Tamoxifen was administeredto 1,700 patients, letrozole to 715, and exemestane to 540, with an average endocrine therapy duration of 5.2 years. Letrozole treatment duration (P = 0.001) and lymph node involvement (P=0.028) were independent predictive variables for local recurrence, with longer letrozole therapy associated with lower recurrence.

Estrogen receptor expression and endocrine therapy duration are independent predictive markers for recurrence and mortality. Longer letrozole therapy predicts lower local recurrence. Endocrine therapy duration inversely relates to mortality, recurrence, and local recurrence.

In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19.

This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters.

The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah andHamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces.

In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectivelymitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.

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.

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.

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.

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. 

The accuracy and reliability of noninvasive methods of neonatal jaundice assessment are not completely obvious, including which area of the body is more suitable to estimate actual bilirubin with transcutaneous bilirubinometry (TCB).

This cross-sectional study compares the accuracy of three noninvasive methods for neonatal jaundice estimation included visual estimation, TCB on the forehead, and TCB on the sternum. The mean and standard deviation describe quantitative variables. In addition to analytical analysis, we used the linear regression test to evaluate the association of different variables with the accuracy of TCB as well as paired t test for comparing the TCB results on the sternum with the forehead before and after phototherapy. For all statistical tests, a P value less than 0.05 was considered as significant.

We enrolled 100 neonates with a mean age (±SD, standard deviation) of 6.5±1.9 days (range 2–11 days) in our study. The mean gestational age (GA) of the participants was 38.94 weeks±1.00 w SD, and their mean (±SD) weight was 3302 g (±315.60). The mean (mg/dL)±SD for bilirubin level by clinical estimation of jaundice, TCB on the forehead and TCB on the sternum were 17.35±2.88, 17.23±1.63, and 17.77±1.58, respectively. Also, comparing mean differences before and after phototherapy showed that TCB on the sternum is a good predictor for neonatal jaundice before phototherapy (0.539 vs. 0.348).

TCB on the sternum is more predictive than the forehead, especially before phototherapy, to assess the need for treatment in outpatient settings.

Cancer incidence is a major public health concern and one of the leading causes of premature death worldwide. Therefore, this study was conducted to determine the death rate and years of life lost (YLL) due to cancer in Iran.

In this study, death registration system (DRS) data in Iran was used. The Global Health Estimates (GHE-2016) cause categories and ICD-10 codes (C00-C97 and D00-D48) were assigned for deaths due to cancer. The crude, age-standardized mortality rates (ASMR) via world standard population was measured, and also YLL due to cancer were calculated using standard life expectancy.

The DRS recorded 53,492 deaths due to cancer (58.82% males and 41.18% females). The cancer mortality rate was 66.92 per 100,000 population (77.7 and 55.87 per 100,000 population in men and women, respectively) and ASMR was 96.4 per 100,000 population (115.7 and 77 per 100,000 population for males and females, respectively). The total YLL due to premature death was 736,564 in males, 580,254 in females, and 1,316,818 in both sexes. Death due to stomach cancer, tracheal, bronchus, and lung, leukemia, brain, and nervous system cancer, and breast cancer comprised the largest YLL category among different cancer sites.

Accounting for more than 1,300,000 YLL attributed to cancer, it is a major public health problem in Iran. Therefore, promoting the prevention and control programs and policies are necessary to improve health indicators and since some cancers are preventable, the burden can be reduced by controlling tobacco use, dietary interventions, and promoting physical activity

 The World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak to be a public health emergency and international concern and recognized it as a pandemic. This study aimed to estimate the epidemiologic parameters of the COVID-19 pandemic for clinical and epidemiological help.

 In this systematic review and meta-analysis study, 4 electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar were searched for the literature published from early December 2019 up to 23 March 2020. After screening, we selected 76 articles based on epidemiological parameters, including basic reproduction number, serial interval, incubation period, doubling time, growth rate, case-fatality rate, and the onset of symptom to hospitalization as eligibility criteria. For the estimation of overall pooled epidemiologic parameters, fixed and random effect models with 95% CI were used based on the value of between-study heterogeneity (I2).

 A total of 76 observational studies were included in the analysis. The pooled estimate for R0 was 2.99 (95% CI, 2.71-3.27) for COVID-19. The overall R0 was 3.23, 1.19, 3.6, and 2.35 for China, Singapore, Iran, and Japan, respectively. The overall serial interval, doubling time, and incubation period were 4.45 (95% CI, 4.03-4.87), 4.14 (95% CI, 2.67-5.62), and 4.24 (95% CI, 3.03-5.44) days for COVID-19. In addition, the overall estimation for the growth rate and the case fatality rate for COVID-19 was  0.38% and 3.29%, respectively.

 The epidemiological characteristics of COVID-19 as an emerging disease may be revealed by computing the pooled estimate of the epidemiological parameters, opening the door for health policymakers to consider additional control measures.

The ultimate goal in periodontal treatment is to achieve a functional and anatomical regeneration of lost tissues. Due to the promising outcomes of biologic modifiers in regenerative therapies, this systematic review aimed at evaluating the effects of various biologic modifiers used in intra-bony osseous defects in animal models.

Electronic databases were searched for articles published in March 2010-March 2020 that had evaluated the effect of bio-modifiers used in periodontal intra-bony osseous defects in animal models. Screening was performed based on inclusion/exclusion criteria and SYRCLE tool was used for studies’ quality assessment.

After screening the titles, abstracts, and full-texts, 18 studies were included in qualitative analysis and five studies entered the meta-analysis. According to the configuration of osseous defects, the studies were categorized into three subgroups. Based on histological findings, all these biologic markers significantly enhanced new bone and cementum formation compared to control groups (P<0.001). The meta-analysis showed that biologic modifiers could significantly increase bone regeneration
(1.58 mm, 95% CI: 1.12-2.03, P˂0.001) and cementum regeneration (1.27 mm, 95% CI: 0.84-1.70, P˂0.001) in one-wall osseous defects.

Biologic modifiers namely growth factors could positively affect periodontal regeneration, particularly the cementum and bone in animal models. Further human studies are necessary to address the clinical use of these biomaterials.

The combination of dyslipidemia, obesity, and hyperglycemia can accelerate the progression to cardiovascular disease. Therefore, this study aimed to investigate dyslipidemia and its components across body mass index (BMI) levels among type II diabetic patients.

The data for this cross‑sectional study were extracted from the records of diabetic patients during 2014 to 2015. About 2,300 diabetic patients had been registered, and finally, the records of 2,110 patients which were fully completed were investigated. Dyslipidemia was defined based on the NCEP/ATP III classification of lipid profile. In order to investigate about nonlinear relationship between BMI and dyslipidemia, and its components, restricted cubic spline method was used.

The median age of patients was 55 (IQR = 14) years. 61.11% was females. The median of BMI, triglyceride, cholesterol, HDL‑Chol, and LDL‑Chol were 28.3 kg/m2, 167, 193, 41, and 110 mg/dL in patients, respectively. The prevalence of dyslipidemia was 91.29% (95% CI: 90.05–92.54). Being overweight, diabetic patients were associated with an increased risk of dyslipidemia (OR = 1.87–2.78), hypertriglyceridemia (OR = 1.64; 95% CI: 1.29–2.09), and hypo‑HDL (OR = 1.55; 95% CI: 1.20–2.01). Similarly, obesity also increased the risk of dyslipidemia (OR = 1.94; 95% CI: 1.28–2.95), hypertriglyceridemia (OR = 1.66; 95% CI: 1.29–2.12), and hypo‑HDL (OR = 1.86; 95% CI: 1.41–2.43). The nonlinear dose–response relationship was associated with a significant increase then decrease in the risk of dyslipidemia, hypertriglyceridemia, and hypo‑HDL in men and women as per 1 kg/m2 increase in BMI.

With regards to the result, we know that there is no linear relationship between lipid profiles and BMI, the bell‑shape association between dyslipidemia, hypertriglyceridemia, and hypo‑HDL needs to be further investigated in both diabetic and general population in men and women separately. In addition, for public health section, an appropriate intervention is of most important priorities.

There are significant misconceptions and many obstacles in the way of illuminating the epidemiological andclinical aspects of COVID-19 as a new emerging epidemic. In addition, usefulness of some evidence publishedin the context of the recent epidemic for decision making in clinic as well as public health is questionable. How-ever, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in lesseffective and somehow more harmful decisions for individuals as well as subgroups in general populations ofcountries in the initial stages of this epidemic. Accordingly, our narrative review appraised epidemiological andclinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incuba-tion period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case manage-ment and also successful measures for preventing its spread in some communities.

This study aimed to perform a meta-analysis on the prevalence of metabolic syndrome (MetS) among patients with asthma and to measure the association asthma has with MetS.

The Web of Science, Medline, Scopus, Embase and Google Scholar were searched using the “Asthma”, “Metabolic Syndrome”, “Dysmetabolic Syndrome”, “Cardiovascular Syndrome”, “Insulin Resistance Syndrome”, “Prevalence”, “Odds Ratio”, “Cross-Sectional Studies”, and “Case-Control Studies” keywords. All observational studies reporting the prevalence of MetS among people with and without asthma were included in the study. In the presence of heterogeneity, random-effects models were used to pool the prevalence and odds ratios (OR), as measures of association in cross-sectional and case-control/ cohort studies, respectively.

The prevalence of MetS among patients with asthma (8 studies) and the OR comparing the prevalence of MetS among patients with and without asthma (5 studies) were pooled separately. The pooled prevalence of MetS among patients with asthma was found to be 25% (95% confidence interval (CI): 13%–38%). In contrast, the overall pooled OR for MetS in patients with asthma, compared to healthy controls, was 1.34 (95% CI: 0.91–1.76), which was not statistically significant.

The prevalence of MetS was relatively high in patients with asthma. Furthermore, the odds of MetS was higher in patients with asthma, compared to healthy controls, although this difference was not statistically significant. More original studies among different populations are needed in order to more accurately examine the association between asthma and MetS, as well as the relationship asthma has with the individual components of MetS.

A number of researchers from the Epidemiology Department of the School of Public Health and Safety, Shahid Beheshti University of Medical Sciences and Kerman University of Medical Sciences have attempted to provide us with information related to the novel coronavirus.

This study aimed to estimate the cure proportion and effects of related factors on colorectal cancer in Iranian patients after surgery.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death. The relative survival of CRC varies worldwide given the quality of care, including surgical techniques.

This retrospective cohort study was conducted on 490 patients, aged 20–94 years, with colorectal cancer. All the colorectal cancer patients undergoing surgery in Faghihi hospital, Shiraz University of Medical Sciences were prospectively followed-up for 8 years from 2008 to March 8, 2016. We used parametric cure model (mixture and non-mixture) to estimate the cure proportion and the adjusted hazard ration (HR) for colorectal cancer mortality after surgery. Data were analyzed by the “flexsurvcure” package in R software (version 3.4.2).

The median age of patients was 57.5 (interquartile range =18) years. Specifically, 56.33% of the patients were male. The median time of follow-up in patients was 618 days. The cumulative survival proportion varied from 0.90 to 0.49 which indicated a reduction followed by a flat line in the probability of survival by sex. The flexible survival for adjusted cure proportion (%) was 68.3. Only obesity was associated with a decreased risk of mortality (HR=0.34; 95% CI: 0.12-0.97).

The overall eight-year survival proportion and adjusted cure proportion for CRC were 49% and 68.3%, respectively. Knowing the cure proportion and its related factors in patients with CRC, better services can be provided. Thus, early detection and screening strategies are required to reduce mortality and increase survival of patients.

Different scoring systems based on clinical and laboratory findings are designed for prediction ofshort-term mortality of patients with severe sepsis and septic shock. This study aimed to compare the screeningperformance characteristics of PIRO, SOFA and MEDS Scores in predicting one-month mortality of sepsis pa-tients.

This diagnostic accuracy study was performed on septic shock and severe sepsis patients refer-ring to emergency department of Loghmane Hakim Hospital, Tehran, Iran, from 2017 to 2018. The performanceof MEDS, SOFA, and PIRO models in predicting 30-day mortality of patients was evaluated using discriminationand calibration indices.

200 patients with the mean age of 71.03±15.59 years were studied (61% male).During the 30 days, 66 patients died (mortality rate=33%). The area under the ROC curve of PIRO, MEDS, andSOFA scores were 0.83 (95% CI=0.78-0.89), 0.94 (95% CI=0.91-0.97) and 0.87 (95% CI=0.81-0.92), respectively.Based on Brier, BrierScaled and Nagelkerke’s R2of the models, the best performance in predicting one-monthmortality belonged to MEDS score. C-statistic showed that MEDS score had the highest value in the differentia-tion between the survived and non-survived cases.

This study showed that MEDS score performsbetter than PIRO and SOFA scores in predicting one-month mortality of patients with severe sepsis and septicshock.

The present study aimed to determine the prevalence of HBsAg in Health Care Workers (HCWs) in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries from 2000 to 2016.

In a meta‑analysis study, the databases of PubMed, ISI, Ovid, Scopus, Google Scholar, and Persian databases were searched for relevant articles on the prevalence of HBsAg in HCWs in EMRO and Middle Eastern countries. Homogeneity was assessed based on Cochran’s Q‑test results.

A total of 43 articles (110,179 people) were included. The pooledprevalence of HBsAg in HCWs of EMRO and Middle East countries was found 2.77% (95%CI: 2.64‑2.83). The specific prevalence of HBsAg was 2.84% (95% CI: 2.6‑3.11) in EMRO and 2.22% (95%CI: 2.13‑2.31) in Middle Eastern countries. The highest and lowest prevalence rates of HBsAg among HCWs for countries with more than one study were 6.85% (95% CI: 5.74%–8.16%) in Sudan and 1.00% (95% CI: 0.94%–1.07%) in Turkey, respectively. The trends of HBsAg prevalence among HCWs decreased from 2000 to 2016.

Based on the World Health Organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected in HCWs of EMRO and Middle East countries during 2000–2016.

Context

 The present study aimed to determine the prevalence of HBsAg in pregnant women using available data in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries from 2000 to 2016.

Evidence Acquisition

 Pubmed, ISI Web of Science, ScienceDirect, Ovid, Scopus, Google Scholar, and Persian databases were searched for related articles on the prevalence of HBsAg in pregnant women in EMRO and Middle Eastern countries. Heterogeneity was assessed based on Cochran’s Q-test results. However, since this test may fail to exactly identify true heterogeneity, it was complemented with Higgins and Thompson’s I2.

In general the numbers of 49 articles (89 452 people) were included. Based on available data, the HBsAg prevalence in countries with at least one study conducted in them were 3.2% in Egypt, 1.3 % in Iran, 4.3% in Jordan, 1.5% in Libya, 7.1% in Oman, 2% in Pakistan, 1% in Qatar, 2.6% in Saudi Arabia, 5.6% in Sudan, 4% in Tunisia, 2.8% in Turkey, 1.5% in United Arab Emirates, and 10.8% Yemen.

The available data on the prevalence of HBsAg in pregnant women of EMRO and Middle East countries showed that there was a different pattern of HBsAg prevalence in studied countries. Although there were countries with low prevalence of HBsAg, the lowest frequency in our study was higher than the reported prevalence in developed countries.

Perinatal mortality indicator is a major indicator of health and health assessment that has a direct impact on infant mortality indicator. This study was aimed to determine the rate and causes of perinatal mortality in district of Kermanshah.
In this cross-sectional study, records of perinatal mortality in district of Kermanshah were extracted during 2011-14. Information, including the neonate, data about the mother and indicators of pregnancy and childbirth and the leading cause of death based on ICD-10 was collected. Data were analyzed using mean and standard deviation for quantitative variables and count and percent for qualitative variables by Stata ver.11 software.
Findings: 56.1% of 1236 perinatal death was boy. Most mortality was in low and very low weight and most common underlying disease mother was hypertension. The highest perinatal mortality rate was in 2012 year (12.3 per thousand births) and the lowest in 2014 year (5.7 per thousand births). The most common cause of perinatal death by 87.6% was related to specific disorders originated around the time of birth.
According to the results, emphasizing adequate care during pregnancy and perinatal, more accurately identify and track high-risk women with underlying disease and the prevention of preterm birth and low birth weight babies can be effective in reduction of perinatal mortalities.

Chronic obstructive pulmonary disease (COPD) is an important public health challenge. This report studies the burden of COPD and its risk factors in the Iranian population.

This study has used the data from a study by the Institute for Health Metrics and Evaluation (IHME) on the disability adjusted life year (DALY) of COPD and its risk factors in Iran in 2016.

Based on the IHME results, the DALY was 201.8 per 100 000 population in 1999 and 303.1 per 100 000 population in 2016. About 0.47% of the total estimated DALYs in Iran (1990) were related to COPD. The risk of COPD attributable to tobacco was 140.3 DALYs per 100 000, and air pollution and occupational hazards were responsible for 98.4 and 39.5 DALYs per 100 000 population. In Iran, the DALY of COPD attributable to behavioral and environmental risk factors was 75.7% in 1990 and 91.6% in 2016.

Health policy makers need to have a holistic approach in order to decrease the burden of COPD in the future years. Targeting behavioral and environmental risk factors requires a strong organizational and social commitment to health

Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and signifcant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses.
All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta‑analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015.
The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment.
Due to high prevalence of these disorders among Iranian nurses, providing effective training in the feld of ergonomics and undergoing appropriate exercises are necessary to control it.

Overweight/obesity is increasing in both developing and developed countries. Its socioeconomic determinants have been well studied in developed countries. It has been reported that the family socioeconomic status is associated with overweight/obesity in childhood and adolescence. However, socioeconomic inequality has not been studied sufficiently in developing countries.
This study aimed to determine the status of socioeconomic inequality in overweight/obese high school students and its related factors in Kermanshah, Iran.
Within a cross-sectional study and using stratified cluster random sampling, 1440 students in the academic year of 2015 - 16 were selected from all high schools in Kermanshah, Iran. To collect data, we used a demographic, socioeconomic status, and nutritional status questionnaire. Height and weight of the participants were measured and the status of obesity was determined by calculating body mass index (BMI). The concentration index and a concentration curve were used for the measurement of inequality. We used multinomial logistic regression to investigate the factors associated with obesity. The collected data were analyzed using Stata 11 software.
The mean age of 1445 students participating in the study was 16.35 ± 0.84 years. Of all, 51.63% (746 students) were female and the rest were male. The median of BMI was 20.54 kg/m2 (IQR = 4.32) in female participants, 21.20 (IQR = 4.42) in male participants, and 20.76 kg/m2 (IQR = 4.49) in all the participants. Concerning asset index, Concentration Index for overweight/obesity was 0.09 in girls (95% CI: -0.14 - 0.33), -0.02 in boys (95% CI: -0.14 - 0.09), and 0.01 in the entire participants (95% CI: -0.13 - 0.17). The odds of overweight/obesity in males was 1.81 times higher than that in females; the odds of overweight/obesity in those consuming high-fat food was 1.61 times higher than that of people not consuming high-fat diet.
Overweight/obesity is more prevalent in adolescents with low socioeconomic level; this indicates the shift of the problem to the poorer groups of the community. Predominance of boys and the use of high-fat foods are affecting obesity/overweight; therefore, it must be considered in all health policy interventions.

Remarkably, one of the main causes of years of life lost due to premature death (YLL) is due to road traffic injuries (RTIs), which usually occurs at an earlier age in life.

This study aimed to determine the trend of YLL due to road traffic injuries in Kermanshah Province during the years 2009 - 2014.

This study relied on census data from forensic medicine reports. YLL related to RTIs were calculated according to the global burden of disease (GBD) 2010 guidelines, and the age and sex demographics of the population were obtained from the Governor General’s Office records for 2009 - 2014. The external causes of death were determined using the international classification of diseases (ICD-10) codes. To assess the YLL trend and its significance, negative binomial regression through the use of Stata 11 was implemented.

The mean age of the 3,231 subjects studied was 39.83 ± 21.27 years. A total of 78.4% of the subjects were males. The average number of fatal RTIs in the six-year period was 27.8 per 100,000 persons. The YLL rate was 149,995 (76.5 per 1000) including both sexes. The YLL rates due to premature mortality were 118,393 (119.8 per 1000) for males, and 31,602 for females (32.5 per 1000). The highest YLL rates for both sexes were in the age group of 15 - 44 years. The six-year trend of YLL due to premature mortality was therefore descending; with respect to the incremental period of one year, the YLL decreased by 7% on average (β = - 0.07; CI: - 0.09, - 0.05).

Despite the decrease in the mortality and YLL rates due to TRIs in recent years, these figures are higher global numbers; therefore, there needs to be more serious intervention.

There is some evidence suggesting that Body Mass Index (BMI) may increase plasma lipoprotein levels.
This study aimed to evaluate the possible association between BMI and dyslipidemia among the government staff of Kermanshah.
This descriptive-analytical cross-sectional study was performed on the staff of 13 governmental organizations in Kermanshah (a city located in the west of Iran) in 2012. The staff was recruited using census method. We obtained information of 1496 staff aged 22 - 69 through the standardized stepwise questionnaire for NCDs risk factor surveillance. The staff was then physically examined by trained persons. Finally, their blood samples were obtained.
The prevalence of dyslipidemia was 16.6% in the study group, with the prevalence of 18.2% in men and 7.9% in women. There were also 53% (55.8% in men and 7.9% in women) and 17.8% (17.6% in men and 38.1% in women) prevalence rates for overweight and obesity, respectively. Dyslipidemia was significantly associated with factors such as BMI (P value = 0.004), gender (P value Since dyslipidemia was significantly prevalent among men, fat people, and smokers, a particular attention is crucial to be paid to these groups.

Recognition of factors associated with the knowledge of pregnant women to delivery methods can lead health planners in making decisions. This study aimed to determine willingness of nulliparous pregnant women of their delivery method.
: In this cross-sectional study, the information form includes demographic characteristics as well as sections on the reasons, choice of delivery method, and number of children desired. The forms sent to urban and rural health centers via Nutrition, Population and Family Health Units were available to all nulliparous women within a period of one month. The data were analyzed using Stata 12 software.
The mean age of the 2708 pregnant women were 25.39±5.04 years. 69% and 31% of them considered natural vaginal delivery and cesarean section as delivery method, respectively. Factors related to the selection of delivery method were obtained, education level, employment status, being watched by a specialist, and the place of residence (P According to the percentage of cesarean selection that are greater than the acceptable rate of World Health Organization as well as the priorities obtained in delivery method causes, there needs to be more effort in guiding young mothers to the natural vaginal delivery and eliminating false beliefs and attitudes towards natural vaginal delivery.

Depression is one of the most common secondary effects of HIV / AIDS that affects quality of life and treatment process which accelerates the progression of disease. This study aimed to determine the prevalence of depression and its relationship with quality of life and physical activity in patients with HIV / AIDS. This cross-sectional study was done on 340 people with HIV / AIDS who refers to behavioral health counseling center of Kermanshah province. Using the Beck Depression Inventory, quality of life and physical activity were collected. The data were analyzed by chi-square test, Mann-Whitney, Kruskal-Wallis, t-test, ANOVA and logistic regression analysis. The average age of participants was 38.53± 8.86 years. The average quality of life in the areas of physical health scores was 11.76±2.73, mental health was 11.10±2.70, Social Relations was 12.12±2.86 and environment health was11.16±2.19. Quality of life in mental health area of married individuals were more (11.63 ± 2.76) than singles (10.79 ± 2.60) significantly (p = 0.004). The social area score of married individuals (12.62 ± 2.78) were more than singles (11.71 ± 2.88) significantly (p = 0.002). The prevalence of depression was 61.01% with confidence interval of (55.80 – 66.22) which was more in men (66.04 %) than women (52.03%) (P=0.011). The risk of depression in men versus women's was 2.34 (OR= 2.52; CI=1.22 - 4.48). The findings of this study revealed the high prevalence of depression in people with HIV/AIDS which is notable and it has a role in decreasing the quality of life, particularly in the area of physical health and mental health. Recommending provide appropriate counseling to prevent and reduce depression in this group of people.

Infertility-related stress can be seen as a complex construction including social, sexual and relationship concerns, need for parenthood and rejection of having a childfree life. Infertility can also have an effect on dyadic adjustment. Self-compassion is a procedure of emotional coping to increase self-esteem in infertile women and decrease infertility-related stress. Self-judgment is very weakening and stressful in infertile women. The aim of the present study was to investigate the mediating role of self-compassion and self-judgment in relationship between dyadic adjustment and infertility-related stress among infertile women in Isfahan City, Iran, in 2015.
In this causal-comparative/correlational study, 282 women with primary and secondary infertility diagnosis were selected from the infertility centers of Isfahan city, in 2015, using the convenience sampling method. The participants were asked to complete the questionnaires including Fertility Problem Inventory, Dyadic Adjustment Scale and Self-Compassion Scale (short-form). To analyze the data, the equation model of AMOS (v. 22) was used.
The results revealed that dyadic adjustment had a direct effect on infertility-related stress (P According to the results of the present study, providing a mood regulation therapy (self-compassion and self-judgment) and increase in dyadic adjustment will be useful to decrease infertility-related stress in infertile women.

Context: There is no global consensus on the issue that what dairy subgroups can affect diabetes; thus, this meta-analysis aims to shed light on this matter.
Evidence Acquisition: Main electronic databases such as Web of Science, Scopus, Science Direct, and PubMed, updated to March 2016, were investigated. All original articles from Prospective Cohort and Case-Cohort studies examining the relationship between dairy products subgroups consumption and the risk of diabetes were brought under consideration without any restrictions on age, gender, language, race, and publication year. To validate this study, the STROBE checklist was used. The indices of relative risk and rate ratio were reported using Random Effect Model.
Out of 1391 articles, 13 (covering 421,421 people) were introduced to the current meta-analysis. The findings showed that the consumption of yoghurt and cream has preventive effects on the risk of diabetes: Yogurt: relative risk = 0.74 (95% CI: 0.65, 0.84), rate ratio = 0.66 (95% CI: 0.63, 0.70); Cream: rate ratio = 0.86 (95% CI: 0.82, 0.91). Although the relative risk index showed that milk consumption diminishes the risk of diabetes by 11%, this relationship was not statistically significant: Milk: relative risk = 0.89 (95% CI: 0.82, 0.97), rate ratio = 1.07 (95% CI: 0.93, 1.24). This study also indicated that intake of low-fat milk, ice cream, and cheese has no impact on the incidence of diabetes: Cheese: relative risk = 0.92 (95% CI: 0.82, 1.04), rate ratio = 1.04 (95% CI: 0.93, 1.16); Low-fat milk: rate ratio = 0.93 (95% CI: 0.76, 1.14); Ice cream: rate ratio = 1.05 (95% CI: 0.93, 1.18).
Due to the scarcity of studies related to some dairy subgroups, it is not possible to make a final judgment about their effects on the risk of diabetes; therefore, more studies need to be conducted on this issue.