negar rezaei

Sustainable rural development will not be achieved without considering the importance of developing entrepreneurial behaviors of rural women, which should be on the agenda of rural planners and policymakers. So, the main purpose of this research was to presenting a model for the development of entrepreneurial behavior among rural women entrepreneurs in Ravansar township. The current research was conducted using the qualitative approach and grounded theory research method. The studied community included all the experts in the field of the studied subject, and the participants were selected using purposeful and theoretical sampling methods. Data collection tools included individual in-depth interviews, group discussions, document review and note-taking. The results showed three categories of causal conditions (including economic-financial and individual-personality factors), contextual conditions (including social, communication-informational, managerial and cultural factors) and intervening conditions (including political-legal, supportive, educational-promotional and marketing development) play a role in the development of the entrepreneurial behavior of rural women entrepreneurs, and these factors provided the context for the adoption of some strategies, which subsequently had various consequences, such as the development of rural women's entrepreneurship and finally moving towards sustainable rural development. Based on the results, in order to realize the development of rural women's entrepreneurial behavior, all related societies should provide the context for rural women's entrepreneurial activities with a systemic view. It is recommended to promote and develop the entrepreneurial culture of rural women among relevant communities.

 Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI).

 The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website.

 Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five.

 This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures.

This study presents estimates for type 2 diabetes mellitus (T2DM) burden and attributable risk factors in Iran from 1990–2019, using data from the 2019 Global Burden of Disease study.

This study reports prevalence, incidence, death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) of T2DM in Iran, by sex, age, and province, from 1990 to 2019. We also present the T2DM burden attributable to risk factors. Results are reported in absolute number and age-standardized rates.

Overall, the burden of T2DM had increased greatly since 1990. In 2019, the T2DM incidence and prevalence cases were 291,482 (a 374% increase) and 5,035,012 (a 417% increase) respectively. Moreover, the number of death and DALYs were 14,191 (a 488% increase) and 716,457 (a 417% increase) respectively. DALYs and YLDs in women were consistently higher than men were, whereas women experienced slower increases in YLLs from 1990 to 2019. The age-standardized DALYs rate increased for all Iranian provinces during study period. High body-mass index, ambient particulate matter pollution, and low physical activity remained the three major attributable risk factors in all provinces in 2019.

T2DM constitutes a major health burden in Iran. The remarkable upsurge in the T2DM burden represents an ongoing challenge, given the rapidly aging population in Iran. Thus, integrated and multi-sectoral actions that decrease exposure to risk factors and improve the prevention and early diagnosis are needed.

Smoking is a modifiable risk factor for six of the eight leading causes of death. Despite the great burden, there is lack of data regarding the trend of cigarette smoking in Iran. We described the national and provincial prevalence of cigarette smoking and its 12-year time trend utilizing six rounds of Iranian stepwise approach for surveillance of non-communicable disease (STEPS) surveys.

We gathered data from six STEPS surveys done in 2005, 2007, 2008, 2009, 2011, and 2016 in Iran. To estimate the data of missing years, we used two separate statistical models including the mixed model and spatio-temporal analysis.

The overall prevalence rate of cigarette smoking was 14.65% (12.81‒16.59) in 2005 and 10.63% (9.00‒12.57) in 2016 in Iran. The prevalence of cigarette smoking in 2005 and 2016 was 25.15% (23.18‒27.11) and 19.95% (17.93%‒21.97%) for men and 4.13% (2.43‒6.05) and 1.31% (0.06-3.18) for women, respectively. The prevalence of smoking in different provinces of Iran ranged from 20.73% (19.09‒22.47) to 9.67% (8.24‒11.34) in 2005 and from 15.34% (13.68‒17.12) to 6.41% (5.31‒7.94) in 2016. The overall trend of smoking was downward, which was true for both sexes and all 31 provinces. The declining annual percent change (APC) of the prevalence trend was -2.87% in total population, -9.91% in women, and -2.08% in men from 2005 to 2016.

Although the prevalence of smoking had a decreasing trend in Iran, this trend showed disparities among sexes and provinces and this epidemiological data can be used to modify smoking prevention programs.

Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present.

In addition to the three main steps of this survey, including questionnaires, physical measurements, and laboratory assessments, we adapted the survey with the situation caused by the COVID-19 pandemic, by adding to various aspects of study phases and changing some scientific and executive procedures in this round of STEPS survey in Iran. These changes were beyond the initial novelties embedded within the survey before the pandemic, by refining the study protocol benefiting from the previous experiences of the STEPS survey.

By amending the required changes, we could include a total of 27874 individuals in the first step of the survey. This number was 27745 and 18119 for the second and third steps. Comparing the preliminary results with the previous nationwide surveys, this study was highly representative on both national and provincial levels. Also, implementing the COVID-19 prevention and control strategies in all stages of survey led to the least infection transmission between the study investigators and participants.

The novel initiatives and developed strategies in this round of Iran STEPS survey provide a state-of-the-art protocol for national surveys in the presence of an overwhelming catastrophe like the COVID-19 pandemic and the triggered limitations and shortages of resources.

The most recent emerging infectious disease, coronavirus disease 2019 (COVID-19), is pandemic now. Iran is a country with community transmission of the disease. Telehealth tools have been proved to be useful in controlling public health disasters. We developed an online self-screening platform to offer a population-wide strategy to control the massive influx to medical centers.

We developed a platform operating based on given history by participants, including sex, age, weight, height, location, primary symptoms and signs, and high risk past medical histories. Based on a decision-making algorithm, participants were categorized into four levels of suspected cases, requiring diagnostic tests, supportive care, not suspected cases. We made comparisons with Iran STEPs (STEPwise approach to Surveillance) 2016 study and data from the Statistical Centre of Iran to assess population representativeness of data. Also, we made a comparison with officially confirmed cases to investigate the effectiveness of the platform. A multilevel mixed-effects Poisson regression was used to check the association of visiting platform and deaths caused by COVID-19. 

About 310 000 individuals participated in the online self-screening platform in 33 days. The majority of participants were in younger age groups, and males involved more. A significant number of participants were screened not to be suspected or needing supportive care, and only 10.4% of males and 12.0% of females had suspected results of COVID-19. The penetration of the platform was assessed to be acceptable. A correlation coefficient of 0.51 was calculated between suspected results and confirmed cases of the disease, expressing the platform’s effectiveness.

Implementation of a proper online self-screening tool can mitigate population panic during wide-spread epidemics and relieve massive influx to medical centers. Also, an evidence-based education platform can help fighting infodemic. Noticeable utilization and verified effectiveness of such platform validate the potency of telehealth tools in controlling epidemics and pandemics.

The prevalence of tobacco smoking and its burden on societies is not homogenous at the national and district levels. This nationwide study aimed to investigate current inequalities in the prevalence of smoking at the district level and the association of smoking behaviors with gender, wealth, education, and urbanization in Iran. Study design: A cross-sectional study.

This study was conducted by analyzing the data of the STEPS survey 2016 with 30,541 participants. The small-area estimation method using the Bayesian spatial hierarchical multilevel regression model was employed to generate district-level prevalence of all types of smoking by gender. The inequalities between the groups by wealth, education, and urbanization were investigated via concentration index.

The prevalence rates of current daily cigarette smoking were found to be at the range of 4.6-40.9 and 0-4.5 among men and women, respectively. Current daily cigarette smoking was higher in men than in women: 19.0 (95% CI: 9.5-28.7) vs 0.7 (95% CI: 0-6.9). Women with lower wealth, education, or urbanization were more likely to smoke tobacco or be exposed to secondhand smoking. On the other hand, men with higher wealth or education indices were more likely to smoke tobacco. Men with lower wealth, education, or urbanization were more likely to be exposed to secondhand smoking.

The smoking behavior varied significantly at the district level in Iran. Gender, wealth, education, and urbanization were determinants of smoking prevalence.

High risk blood transfusions can cause a lot of financial and psychological burden to the community. The prevalence of Hepatitis B is useful for evaluating the blood products' safety and donor selection methods. We aimed to predict the prevalence of hepatitis B in Iranian blood donors from 2000-2016.

Positive cases of hepatitis B from 2006 to 2014 were collected from Iranian Blood Transfusion Organization. This database was classified according to the age, provinces, and type of donation. Data was not existed in all subnational levels and all years, therefore, for predicting the hepatitis B prevalence, two separate, Spatio-temporal and mixed model (GLMM) were developed.

At the national level, the hepatitis B prevalence declined from 0.69 (0.51 to 0.90) in 2000 to 0.27 (0.21 to 0.33) in 2016. In first-time, regular, and repeated donors, this prevalence declined from 2.31 (1.74 to 2.31), 0.26 (0.19 to 0.34), and 0.51 (0.38 to 0.68) in 2000 to 0.87 (0.69 to 1.09), 0.09 (0.07 to 0.12), and 0.19 (0.14 to 0.24) in 2016. At the provincial level, the highest and lowest prevalence in 2016 was observed in North Khorasan and Gilan. With increasing age, the average prevalence of hepatitis B, increased.

Prevalence of hepatitis B in Iranian blood donors has been reduced significantly over 17 years, but still new cases of hepatitis B are reported. By precise monitoring the donor selection process and implementing more sensitive laboratory screening, we can reduce the risk of new infectious agents.

Platelet microparticles are microvesicles derived from platelets. Today, with the use of nanoparticles in cancer treatments, many limitations of traditional drug delivery methods are reduced. Doxorubicin, a chemotherapeutic drug available for the treatment of many cancers, has fluorescent properties and can be detected by fluorescent imaging in tissues. Aim of this study is to compare different drug loading methods into platelet microparticles.

In this experimental study, the platelet concentrates were taken on their fifth day from Iranian Blood Transfusion Organization. Then platelet microparticles were extracted from those concentrated platelets in several centrifugation stages.  Fluorescent microbeads with one-micrometer size and anti-CD41/61 antibody were used to determine the size and identity of microparticles, respectively. Doxorubicin was loaded at 10 µg/ml on platelet microparticles using three methods of incubation, cell-penetrating peptide, and Sonication. Using the auto-fluorescence property of Doxorubicin, the rate of drug loading on platelet microparticles was measured by flow cytometry method.

Results

In terms of size, 95% of the total population of microparticles was less than one micrometer. The expression levels of CD41 and CD61 were 92.39% and 80.03%, respectively. The average fluorescence light intensities calculated in each of the incubation, sonication, and CPP methods were determined to be 79.09% ± 11.37, 47.48% ± 25.12, and 56.69% ± 23.24, respectively. 

Conclusions  

As the incubation method has higher loading percentage, it could be an effective method for loading drug in platelet microparticles. Furthermore, the use of this method can be considered for clinical studies.

Bleeding assessment tools are key components in the evaluation of patients suspicious for bleeding disorders. The exact determination of the normal ranges of ISTH-BAT (International Society on Thrombosis and Hemostasis –Bleeding Assessment Tool) in the healthy population is a crucial step for determining who needs to be referred for further coagulation laboratory examinations. We aimed to determine the normal range of ISTH-BAT and simultaneously evaluate the Von Willebrand disease (VWD) diagnostic panel tests in a healthy Iranian group.

ISTH-BAT as well as prothrombin time, activated partial thromboplastin time, factor VIII clotting assay, von Willebrand factor (VWF) antigen, VWF ristocetin cofactor assay, ristocetin induced platelet agglutination, and blood group typing were assessed for 25 normal adults without any bleeding symptoms or a known coagulation disorder.

In the 25 studied subjects (13 men, 12 women), the range of bleeding score was 0-6 in women and 0-5 in men; however, since the scores were lower than 2 in most (68%) cases, the interquartile range (IQR) was used for normalizing the data. The ISTH-BAT normal range was found to be 1-4 in women and 0–2 in men.

According to this result, the ISTH-BAT cut-off for abnormal bleeding score was ≥5 in adult women and ≥3 in adult men. These data may be valuable in the routine practice of clinicians and adult hematologists in our country for the assessment of individuals with suspected bleeding disorders.

Non-Communicable Diseases (NCDs) are the major cause of premature death and disability due to diseased globally, imposing a heavy burden on the health systems. Four main categories of NCDs are cardiovascular diseases, neoplasms, diabetes, and chronic respiratory diseases. Iran, the second greatest country in the Middle East Region, has been through an important transition period of communicable diseases toward NCDs in the last decades. One of the effective approaches to control NCDs is implementation of population-based studies and interventions, trying to reduce risk factors and incidence of NCDs through investigations in the populations. Endocrinology and Metabolism Research Institute (EMRI) and Non-Communicable Diseases Research Center (NCDRC) are the pioneers trying to study and control various NCDs during the last decades in Iran. In this review, we are going to inspect some of the major completed and ongoing projects of this research institute to highlight valuable efforts to reduce burden of NCDs in Iran, and make a successful example for national and regional public health policy makers and authorities.

Hepatitis B infection is the major risk factor for liver cancer in Iran. There is no comprehensive population-based study on the prevalence of hepatitis B by regional distribution. Moreover, systematic reviews of hepatitis B prevalence lack knowledge of some regions. We aimed to estimate the prevalence of hepatitis B and its temporal trends over 17 years by sex, age and geographical distribution.

We used the Iranian Blood Donors data in addition to systematic reviews on population-based studies at national and provincial levels and statistical methods (A two-stage spatio-temporal model and crosswalk approach) to address the missing points of hepatitis B prevalence among the general population. The direct age-standardized approach was applied using Iran’s national population in 2016.

At national level, age-standardized hepatitis B prevalence in Iran decreased from 3.02% (95% uncertainty interval; 2.26 to 3.96) in 2000 to 1.09% (95% uncertainty interval; 0.85 to 1.37) in 2016, with a total -64.84% change. Hepatitis B prevalence was more than 1.3 times greater in males than females in 2016. Overall, the prevalence of hepatitis B increased with increasing age. At provincial level, in 2016, the province with the highest prevalence had a nearly 11-time greater rate compared to the lowest prevalence. The declining annual percent change (APC) of the prevalence trend varied between -11.53% to -0.5% at provincial level from 2000 to 2016. Only one province did not witness a downward trend in which the APC was 0.5% (95% UI:0.47-0.54).

The downward trend in prevalence of hepatitis B infection indicates the effectiveness of strategies and preventive measures adapted in Iran. Nevertheless, we need to eradicate this infection. In this regard, re-evaluating preventive measures, especially in high-risk age groups of the population, is recommended

The origin and function of human leukocyte antigen (HLA) class I molecules on platelets are still highly arguable. Given the differences in the results of the previous studies in this regard, the lack of research in recent years, and the clinical importance of HLA class I molecules, the absorption capacity of platelets for soluble HLA class I molecules was studied in this investigation.

In this experimental study, HLA-A2 antigen was purified from a B cell precursor leukemia cell line (Nalm-6) by cell membrane protein solubilization and usage of HLA-A2 affinity column. Platelet concentrates (PCs) were received from Tehran Blood Transfusion Center. Eighteen bags of HLA-A2-negative PCs were prepared randomly and treated with various concentrations of the purified HLA antigen (100, 500, and 1000 ng/ml) for 48 to 72 hours. Subsequently, the HLA-A2 levels were evaluated on platelets by flow cytometery technique. Data were evaluated using repeated measure ANOVA.P-values less than 0.05 were considered significant.

The results of this study showed that the purified protein was an HLA molecule (HLA-A2).  After the treatment of platelets and HLA molecules, platelets inability was shown for the attracting of HLA molecules. This finding was true in both media of RPMI and plasma. The differences between the case (HLA-treated platelets) and control (untreated platelets) were not significant (p-values> 0.05).

Platelets were unable to significantly adsorb exogenous HLA antigens from their environment. Further studies are needed to unravel the nature and origin of HLA molecules on platelets.

Nowadays, electroconvulsive therapy (ECT) is considered as an effective treatment for psychological disorders. The ECT, and induced seizure, stimulates cardiovascular system through parasympathetic system and then sympathetic stimulation. Therefore, heart rate and blood pressure increase significantly to the extent that may cause ischemia and coronary diseases in high-risk patients. In the current study, the effects of two different doses of labetalol treatment on hemodynamic changes during ETC were compared.

The current cross-sectional randomized clinical trial study was conducted on 36 patients underwent two sessions of ECT. Each time, they were randomly treated with one of the labetalol doses of 0.2 or 0.4 mg/kg. Furthermore, all the patients were treated with 0.5 mg/kg succinylcholine and 2 mg/kg sodium thiopental. Blood pressure, heart rate, oxygen saturation, recovery duration, time of spontaneous respiration return following ECT, and dose-related complications were recorded in two groups and compared.

Comparison of two groups presented no statistical differences regarding mean arterial, systolic, and diastolic blood pressure; while nausea and vomiting occurred less in low-dose-treated group (P = 0.020).

 Both doses of 0.2 and 0.4 mg/kg labetalol could make a stable hemodynamic without affecting the quality and duration of the seizure in negative manner; but low dose of labetalol was accompanied with fewer adverse effects.

Cancer, a common disease in adulthood, is a rare albeit slowly increasing condition among children. Currently, limited data are available on the incidence, prevalence, and mortality of these diseases in many regions, including developing countries. Herein, we are reporting national and sub-national estimates on deaths due to childhood cancers between 2000 and 2015 in Iran. Cancer mortality rates were estimated using the national death registration system’s data after addressing its incompleteness and misclassification, using demographic (complete birth history and summary birth history) and statistical analysis (spatiotemporal, Gaussian process regression, and generalized linear mixed models). We included data from cemeteries of two cities (Tehran and Isfahan) that were not included in the death registration system. We used census data and household expenditure and income surveys for data on population and other covariates used in the modeling. The overall age-standardized death rate (ASDR) of childhood cancers have decreased by 69.52% (80.67–49.71) in Iran (equal to an annual percent change of -3.63 [-4.53– -2.24]), declining from 12.24 (95% UI: 10.52–14.49) in 2000 to 3.73 (2.8–5.29) deaths per 100000 in 2015. This decrement was equal to an annual percent change of 4.35% over these years. Leukemia, brain, and nervous system malignancies accounted for about 66% of all cancer-related mortalities among children and adolescents in 2015, which had a 10% increase compared to 2000. Moreover, trends at the sub-national level showed that the highest and lowest ASDR of childhood cancers ranged from 2.12 to 4.99 across provinces of Iran in 2015. Although the overall mortalities have decreased, there is still inequality in the distribution of the recorded deaths. This inequality should be addressed with the improvement of the quality of care and better access to pediatric hospitals and oncologists in these areas.

Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 days due to the destructive effects of platelet storage lesion (PSL) and bacterial contamination. Although prolonged storage of platelets (PLTs) at 4°C reduces the likelihood of bacterial contamination and PSL levels, it is accompanied by an increase in the clearance rate and changes in the surface markers of PLTs. The goal of this study was to evaluate the effects of sodium octanoate (SO) as a stabilizer on PLTs during storage at 4°C. In this experimental study, PCs were divided into three portions and stored for 5 days at 3 different conditions, including 20-24°C, 4°C temperature, and 4°C in presence of SO. PLTs enumeration was performed using an automated hematology analyzer. To measure the metabolic activity and survival rate of PLTs, the water-soluble tetrazolium salt (WST-1) assay was performed. The activity of lactate dehydrogenase enzyme (LDH) was measured by a biochemical analyzer. Additionally, the levels of PLT glycoprotein Ibα (GPIbα) and CD62P (P-selectin) were measured on PLTs by flow cytometry technique. PLTs count was higher in SO-treated (4°C) PLTs than two other studied samples. Additionally, the viability was higher in the SO-treated PLTs than that in other groups. LDH amount was lower in the SO-treated PLTs than that in other groups (P>0.05). GPIbα expression was significantly higher in SO-treated PLTs than that other groups (P0.05). SO could modulate the effects of cold temperatures on PLTs. Furthermore, we found that the survival of platelets was better maintained in the presence of SO at 4°C.

Due to increasing the importance of natural antioxidants because of their positive effects on human health and enhancing preservation of food products, and on the other hand, some unexplained effects of synthetic antioxidants, using and replacing of natural antioxidants is considered widely nowadays. The purpose of this study was to identify the potentials of Ferulla Persica extract as a native and novel source of antioxidants and polyphenols. In this research, the optimization of extraction conditions from the leaf of Ferulla Persica was studied by response surface methodology (RSM) at 3 temperature levels (20, 40 and 60 °C), three time levels (2, 3 and 4 hours) and three levels of water to ethanol ratio (50, 75 and 100%). RSM was used to evaluate the effect of different optimization processes on extraction efficiency, antioxidant activity and total phenolic content. Based on the results of optimization, a second-order polynomial model was designed to optimize the extraction conditions as the best model. the optimum conditions of extraction were in the solvent ratio of 79.58% at 20 °C during 2 hours. In these conditions, the optimum point has yield of 17.61%, EC50 equal to 87.20 (μg/ml) and TPC of 140428.0 (mg GAE/g).

Gestational weight gain during pregnancy is supposedly associated with the increased risk of some adverse outcomes. Thus, assessing the trend of gestational weight gain and its associated risk factors for each population may reduce the related harms. We examined the trend of gestational weight gain and some of its associated risk factors in a sample of Iranian pregnant women.

From five health centers in Isfahan, 458 pregnant women were selected through a multi-stage sampling method. The gestational weight gain was measured nine times during pregnancy. The latent growth curve model was used to investigate the trend of gestational weight gain and a random effects model was used to identify the factors affecting gestational weight gain during pregnancy.

The mean weight at the baseline was 58.7 ± 0.1 kg. It increased by a mean of 301 ± 0.0 grams per week. The pre-pregnancy weight (p<0.001) and parity (p<0.001) had a significant indirect effect, and motherchr('39')s height (p=0.028) had a significant direct effect on gestational weight gain. Motherchr('39')s age showed no significant effect on weight gain during pregnancy.

More than 50% of our sample had an abnormal weight gain. Thus, according to the criteria proposed by the American Institute of Medicine (IOM), it is vital to promote the knowledge of women and health care providers and raise their awareness about the determinants of abnormal gestational weight gain and their consequences.

Liver cancer is a highly lethal cancer with 5 year survival rate of about 18%. This cancer is a leading cause of death in many countries. As there is not a comprehensive population base study on liver cancer mortality rates by cause in national and provincial level in Iran. We aimed to estimate the liver cancer mortality rate, its patterns, and temporal trends during 26 years by sex, age, geographical distribution, and cause.
We used the Iranian death registration system (DRS), in addition to demographic and statistical methods, to address the incompleteness and misclassification and uncertainty of death registration system to estimate annual liver cancer mortality rate. Direct age standardized approach was applied using Iran national population 2015 as a standard population to facilitate the comparison between the provinces.
Liver cancer age standardized mortality rate in Iran increased by more than four times from 1.18 (95% uncertainty interval; 0.86 to 1.61) deaths per 100,000 person in 1990 to 5.66 (95% uncertainty interval; 4.20 to 7.63) deaths per 100,000 person in 2015. Male to female age adjusted mortality ratio changed from 0.87 to 1.82 during the 26 years of the study. With increasing age, liver cancer mortality rate increased in both sex and all provinces. At provincial level, the province with highest mortality rate have 2.96 times greater rate compare to the lowest. Generally, about 71% of mortality at national level is due to hepatitis B and C infection.
In order to reduce liver cancer mortality rate, it is recommended to control main risk factors including chronic hepatitis infections. Because of the growing rate of mortality from liver cancer, augmenting life expectancy, and increasing number of the elderly in Iran, policy makers are more expected to adopt measures including hepatitis B vaccination or hepatitis C treatment.

Platelet-rich plasma (PRP) is a human plasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties.
The aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections.
Patients and In this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women’s hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance.
At the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5% reduction in the PRP group; 72% in the control group) (P It seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors.

The first step in educational planning is identifying and prioritizing the educational needs. The initial point is needs assessment. Therefore, the aim of this study was needs assessment and determining priorities in health education of youth covered by the Health Departments of Iran University of Medical Sciences.
The research method was descriptive and 2842 youth aged 18 to 29 years were enrolled from areas under coverage of Iran Medical University. Two-stage sampling was used: First cluster sampling from health centers and then random sampling of young people. The sampling tool was a questionnaire prepared by the Ministry of Health and descriptive statistics were used.
The most important need for health education in all centers is teaching life skills (4.47 ± 3.34). The period of examination needs to be established or reevaluated in primary health care services (1.38 ± 0.57). The most required health consult is consulting on skills before marriage (2.82 ± 1.89). In most cases, the preferred educational training is listed through family.
Solving the problems of young people in society is the duty of every health care system. To do this, it is needed to identify problems according to available resources and priorities. For each priority, educational programs should be specified. In this process, the consensus of all stakeholders on the priority list of programs is documented.