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Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, Iranian households have experienced a decline in dairy product consumption. This study aimed to evaluate the population-attributable risk of prevalent non-communicable diseases related to dairy product consumption. Methods: This cross-sectional analytical study involved 628 adults over 18 years old in Hamadan City in 2021. Clusters were selected based on comprehensive urban health centers. The standardized Iranian version of the food frequency questionnaire was used. Participants were categorized into 3 levels of dairy product consumption: >1 serving per day, 1-2 servings per day, and ≥3 servings per day. Results: The mean age of the 628 participants was 38.05 (SD: 12.5), with 42.36% being male. Cheese (54.5%), yogurt (39.7%), and milk (30.4%) were consumed most frequently. The prevalence of insufficient dairy product consumption was 48.6%, higher than that reported in previous studies. Insufficient dairy product consumption was associated with hypertension (9.3%), cardiovascular disease (5.6%), and osteoporosis (5.1%). Conclusion: Individuals with lower education levels, female gender, lowest quartile of socioeconomic status, and those diagnosed with cardiovascular disease were more likely to have insufficient dairy product consumption. Insufficient dairy product consumption was associated with hypertension, cardiovascular disease, and osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. Methods: Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. Results: In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR = 0.08; 95% CI: 0.04, 0.15; P-score = 0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). Conclusion: Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, [ABSTRACT FROM AUTHOR]

Background and Aims: Hypothyroidism is the most common disease of the thyroid gland. Thyroid hormone plays a crucial role in regulating tissue growth and metabolism. Additionally, patients with thyroid dysfunction have a higher incidence of caries and periodontal problems. The presence of calcium and phosphate ions seems to be effective in remineralizing teeth and reducing caries. The aim of this study was to evaluate the salivary level of calcium in patients with hypothyroidism. Results: The results of this study showed that saliva calcium concentration in patients with hypothyroidism is significantly lower than healthy subjects. Also, no significant association was found between salivary calcium levels and TSH and T4 hormones level of blood. Conclusion: The increased prevalence of dental caries in patients with hypothyroidism may be related to a decrease in their calcium levels. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is one of the most critical disorders, which affects approximately 20% of women of childbearing age and melatonin supplementation in these women can be effective. However, human studies in this area are particularly limited to IVF candidates. The aim of this clinical trial study was to evaluate the effect of melatonin on the in vitro fertilization (IVF) in PCOS involved women. In this clinical trial study, a total of 320 women with PCOS were randomly assigned to the intervention and control groups. Patients in the intervention group (n=160) received a combination of melatonin and metformin (3 mg and 500 mg, respectively) three times a day. The control group (n=160) received metformin 500 mg from the luteal phase of the cycle before the start of gonadotropin. Oocyte and embryo quality, number of oocytes, and pregnancy outcomes were compared in both groups. Our study revealed that the frequency of Metaphase II oocytes (69.9% vs. 57.9%, p＜0.001) and the number of embryos of the top-quality (grade A) were higher in the group treated with melatonin (40.3% vs. 29.9%, p=0.001). The rate of clinical pregnancy and implantation were also higher in the intervention group. The odds of clinical pregnancy in the intervention group was 1.8 times (p=0.039). Moreover, oral melatonin supplementation was effective in patients with PCOS, who were candidates for IVF because of the increased quality of mature oocytes, top-quality embryos, and increased odds of clinical pregnancy. [ABSTRACT FROM AUTHOR]

Giving consideration to the importance and on-going challenge of vocabulary learning, there is an increasing demand for seeking out new approaches that correspond well with the needs of digital natives. With the rapid advance of technology, deploying innovative approaches such as gamified and flipped mobile-assisted language learning is gaining worldwide popularity. The current study was an attempt to scrutinize the effectiveness of integrating gamification with flipped approach on EFL learners' receptive vocabulary learning. With the aim of carrying out this research, 68 EFL high school students were randomly allocated into an experimental and control group. The required data were gathered by means of pre- and post-tests. Moreover, the obtained data were analyzed through descriptive and inferential statistics including two paired, and one independent samples t-tests. Quantitative findings revealed that the experimental group participants outperformed their non-gamified coequals. Additionally, as post-test scores showed tremendous improvement, it was found that both aforesaid approaches were devastatingly effective in enhancing EFL learners' vocabulary development. The results of this study can be useful for EFL instructors and teachers for giving them insights on how to employ flipped approach for teaching receptive vocabulary. [ABSTRACT FROM AUTHOR]

Many studies have assessed the prevalence of alcohol consumption in Iran. In this study, we investigated the prevalence of alcohol consumption in different groups. We searched international and databases including PubMed, Web of Science, Scopus and we searched two main Farsi-language index databases including Scientific Information Database (SID) and the Irandoc. Grey literature search was also performed in Google Scholar, PsycINFO, ProQuest Dissertation and Theses without time limit until June 2020. All studies that reported the prevalence of alcohol consumption among Iranians were included in current study. From 9,038 screened studies, 109 studies with 925,480 participants were included. The pooled prevalence of alcohol consumption was estimated 24% (95% CI: 18.0–31.0), 12% (95%CI: 10.0–14.0), 14% (95%CI: 13.0–15.0), 19% (95%CI: 13.0–26.0), 15% (95%CI: 3.0–28.0) among prisoners, general population, students, drivers, and street children, respectively. This systematic review indicated higher prevalence of alcohol consumption in prisoners, drivers, and street children than the general population and other subgroups. The distribution of the alcohol prevalence studies in different groups and provinces were heterogeneous. The lack of studies among some groups and in regions warrants further, attention. [ABSTRACT FROM AUTHOR]

Background: Since the risk factors for miscarriage vary in different societies, the present study was conducted to investigate the effect of the related factors on miscarriage in the west of Iran (Zanjan city). We aimed to determine the modifiable and non-modifiable predictors of miscarriage. Methods: In this case-control study, 219 cases and 420 controls were selected among those living in the Zanjan (a city located in western Iran) in 2019. Data were collected by a 25-item checklist of medical records available in the comprehensive urban health service center. For assessing the effects of explanatory variables on miscarriage, the multiple logistic regression model was used at a 95% confidence interval. All analysis was conducted by Stata 14 software. Results: Short birth interval (less than 36 months) (OR=2.4, p<0.001) and ectopic pregnancy (OR=3.5, p<0.011) increase the odds of miscarriage. In other words, high education reduced the odds of miscarriage (OR:0.07,p<0.001). Conclusion: In the present study, increasing age, low education level, history of previous coagulation, previous spontaneous abortion, history of previous ectopic pregnancy and short birth intervals (less than 36 month) were associated directly with miscarriage. [ABSTRACT FROM AUTHOR]

Objectives: One of the simplest methods to increase keratinized gingiva is the modified apically repositioned flap (MARF) technique. In this method, the periosteum remains exposed, which may lead to postoperative pain and discomfort. In the presence of bone dehiscence, bone resorption and gingival recession may occur. Hence, this study aims to use platelet-rich fibrin (PRF) to promote wound healing in the MARF technique and overcome its disadvantages. Material and Methods: In this randomized controlled trial study, 10 patients (six males and four females with a mean age of 33.9±11.13) with less than 2mm of attached gingiva bilaterally were treated by the MARF + PRF membrane (test group), on the one hand, whereas, on the other hand, it was treated only by MARF (control group). Clinical parameters of keratinized gingiva include thickness, width, and vestibule depth before and 8 weeks after the intervention were measured. Results: The attached gingival width increased significantly in both groups (1.7mm in the MARF and 2.3mm in the PRF) and this was greater in the PRF group (p < .05). Gingival thickness in the PRF method was significantly higher than in the control group (p < .05). Probe depth, vestibular depth, and postoperative pain were not different in both groups. Wound shrinkage in the MARF group (51%) was significantly higher than in the PRF group (30%) (p < .05). Conclusion: Using PRF with the MARF method significantly increased the width and thickness of the gingiva and reduced shrinkage compared to MARF only. Postoperative pain and vestibular depth changes were similar in both groups. [ABSTRACT FROM AUTHOR]

Purpose: Despite the availability of a number of studies on the morphology of the roots and canals of maxillary molars, studies on this topic and their relation with anatomical landmark using cone-beam computed tomography (CBCT) are limited. Considering the variability in the anatomy and morphology of the roots in different populations and races, and the need for comprehensive information in this respect, this study assessed the root canal morphology of maxillary first and second molars and their relation with anatomical landmarks using CBCT. Methods: This descriptive cross-sectional study evaluated 193 CBCT scans taken as part of preoperative assessment. Number of roots and canals, canal shape according to the Vertucci's classification and Sert and Bayirli's additional canal types, and distance from the root to the maxillary sinus were assessed. Data were analyzed using paired t-test. Results: The most common root canal morphology of the mesiobuccal canal was Vertucci's type IV for the first molars and type I for the second molars. The roots of the majority of maxillary first and second molars were out of the sinus. In second molars, fusion of mesiobuccal to palatal roots had the highest frequency. Conclusion: CBCT can efficiently reveal the anatomical variations of the root canals and increase the success of treatment in complicated cases. Clinical Significant: For diagnosis of number of canal and facility of root canal treatment. [ABSTRACT FROM AUTHOR]

Background: Uncontrolled hypertension is a major public health problem among patients in developed and developing countries. The present study was conducted to investigate the prevalence and causes of uncontrolled hypertension to facilitate the design of more effective methods of hypertension control. Methods: This cross-sectional study was conducted on 303 adults with hypertension. The Standard Health Literacy Questionnaire was used to collect data. Uncontrolled hypertension was ascertained based on the WHO definition. A multiple logistic regression model was used at a 95% confidence level. Variables considered were confounders including age, sex, marital status, family size, income (monthly mean), smoking (past or current), education level, and physical activity (times in a week). Results: The mean (SD) age of the participants (n=303) was 59.3(12.7) years, and 57.4% were men. The prevalence of uncontrolled hypertension was 50.5%. The mean score of health literacy among patients with controlled hypertension was higher than that among patients with uncontrolled hypertension (64.83±23.72 vs 46.28±22.19; P<0.001). The odds of uncontrolled hypertension decreased by 3% in the patients (OR: 0.97; P=0.06). Adherence to treatment (OR: 0.13; P<0.001), salt consumption per package purchased per month (OR: 4.40; P=0.001), increased physical activity per hour per week (OR: 0.56; P<0.001), current or passive cigarette smoking (OR: 4.59; P=0.010), a positive history of chronic diseases (OR: 2.62; P=0.027), and increased family size (per 1 child) (OR: 0.57; P<0.001) were associated with uncontrolled hypertension. Conclusion: The results showed a borderline association between increased health literacy and hypertension control. Additionally, increased salt consumption, reduced physical activity, small family size, and underlying diseases (eg, diabetes, chronic heart disease, and renal disease) could increase the odds of uncontrolled hypertension in Iranian society. [ABSTRACT FROM AUTHOR]

The current study aimed to investigate the Iranian high school EFL learners' multicultural personality traits (MPTs) based on their differences in age. To this end, a convenient sample of 138 junior and senior high school learners aged between 14 and 18 years old were selected. Data were collected through a Multicultural Personality Questionnaire. It measures MPTs (open-mindedness, cultural empathy, emotional stability, social initiative, and flexibility) on a five-point Likert scale. An independent samples t-test was used to check the differences between MPTs of junior (14–16) and senior (16–18) high school students. MANOVA was utilized to see the differences between components of MPTs of participants in these two groups. Findings indicated that there is a significant difference between MPTs of junior and senior high school learners in terms of open-mindedness and cultural empathy. That is to say the younger group exhibited more open-mindedness and cultural empathy. Moreover, the results revealed that they were not different in terms of other components of MPTs as social initiative, emotional stability, and flexibility. Besides considering differences between target and native language cultural values and society norms, teachers should attempt to improve students' cultural empathy and open-mindedness in order to gain the students' knowledge of language and attain educational purposes. [ABSTRACT FROM AUTHOR]

Objectives: Considering the side effects of chlorhexidine (CHX), which is currently the gold-standard antimicrobial mouthwash, this study aimed to compare the effects of Green Kemphor and CHX mouthwashes on tooth staining and gingivitis. Materials and Methods: This randomized controlled crossover clinical trial evaluated 38 patients requiring CHX mouthwash following oral surgery and periodontal therapy. The patients were randomly assigned to CHX and Kemphor groups (n=19). In CHX group, patients used CHX mouthwash in the first 2 weeks, and after a 4-day washout period, they used Kemphor mouthwash for 2 weeks. This order was reverse in the Kemphor group. Gingivitis was evaluated using the Silness and Loe gingival index (GI), and tooth staining was evaluated by the Lobene index at 0 (baseline), 2 and 4 weeks. Data were analyzed by paired t-test. Results: CHX mouthwash significantly decreased the GI and increased tooth staining (gingival stains, body stains, and stain extent) at 2 weeks (P<0.05). Kemphor mouthwash significantly decreased the GI and increased tooth staining after 2 weeks (P<0.05). The GI in Kemphor group was significantly lower than that in CHX group at 4 weeks (P<0.05). Also, the tooth staining parameters in the Kemphor group were significantly lower than the corresponding values in the CHX group at 2 and 4 weeks (P<0.05). Conclusion: Kemphor had higher efficacy for reduction of GI and caused less tooth staining than CHX; thus, it may be recommended for use as an alternative to CHX. [ABSTRACT FROM AUTHOR]

Background: Physical, psychological, and social changes in the aging lead to new needs in the care of the elderly. The Camberwell Assessment of Need for the Elderly (CANE) evaluates older adults' care needs. This study aimed to assess the types of needs of the elderly using the CANE questionnaire. Study design: A systematic review. Methods: This systematic review included all cross-sectional studies. International databases, including Web of Sciences, Medline, Scopus, and ProQuest were searched up to June 2021. Such keywords as aged OR ageing OR "older adults" OR "older people" OR "older person" OR elderly, AND need OR "needs assessment" OR "met needs" OR "unmet needs" were used to design the search strategy. A 95% CI was calculated using the exact method, and the meta-analysis of proportion (metaprob) module was used for data analysis. Results: In total, 769 studies were retrieved in this review. At the following stages, 760 articles were excluded upon checking the duplicates; moreover, the titles and abstracts did not meet the eligibility criteria. Finally, nine studies remained. The mean±SD age of 2200 participants was obtained at 78.4±5.9 years. The highest and lowest met needs were related to the physical (45%) and social (21%) dimensions, respectively. Furthermore, the highest unmet needs were observed in the physical and social dimensions (0.07%), and the lowest unmet needs were related to the psychological and environmental dimensions (0.04%). Conclusions: The CANE is sensitive enough to identify unmet needs in different samples and settings. Therefore, a new care model and appropriate interventions for the elderly can be designed based on the CANE results. [ABSTRACT FROM AUTHOR]

Background: This report provided the effect of 15 preventable factors on the risk of breast cancer incidence. Study design: A systematic review and meta-analysis. Methods: A detailed research was conducted on PubMed, Web of Science, and Scopus databases in January 2020. Reference lists were also screened. Prospective cohort studies addressing the associations between breast cancer and 15 factors were analyzed. Between-study heterogeneity was investigated using the χ², T², and I² statistics. The probability of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs) using a random-effects model. Results: Based on the results, out of 147,083 identified studies, 197 were eligible, including 19,413,702 participants. The RRs (95% CI) of factors associated with breast cancer were as follows: cigarette smoking 1.07 (1.05, 1.09); alcohol drinking 1.10 (1.07, 1.12); sufficient physical activity 0.90 (0.86, 0.95); overweight/obesity in premenopausal 0.92 (0.82, 1.03) and postmenopausal 1.18 (1.13, 1.24); nulliparity 1.16 (1.03, 1.31); late pregnancy 1.37 (1.25, 1.50); breastfeeding 0.87 (0.81, 0.93); ever using oral contraceptive 1.00 (0.96, 1.05); ever using estrogen 1.13 (1.04, 1.23); ever using progesterone 1.02 (0.84, 1.24); ever using estrogen/progesterone 1.60 (1.42, 1.80); ever taking hormone replacement therapy 1.26 (1.20, 1.32); red meat consumption 1.05 (1.00, 1.11); fruit/vegetable consumption 0.87 (0.83, 0.90); and history of radiation therapy, based on single study 1.31 (0.87, 1.98). Conclusions: This meta-analysis provided a clear picture of several factors associated with the development of breast cancer. Moreover, the useful information in this study may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs. [ABSTRACT FROM AUTHOR]

Objective: Brucellosis is a zoonosis almost chronic disease. Brucellosis bacteria can remain in the environment for a long time. Thus, climate irregularities could pave the way for the survival of the bacterium brucellosis. Brucellosis is more common in men 25 to 29 years of age, in the western provinces, and in the spring months. The aim of this study is to investigate the effect of climatic factors as well as predicting the incidence of brucellosis in Qazvin province using the Markov switching model (MSM). This study is a secondary study of data collected from 2010 to 2019 in Qazvin province. The data include brucellosis cases and climatic parameters. Two state MSM with time lags of 0, 1 and 2 was fitted to the data. The Bayesian information criterion (BIC) was used to evaluate the models. Results: According to the BIC, the two-state MSM with a 1-month lag is a suitable model. The month, the average-wind-speed, the minimum-temperature have a positive effect on the number of brucellosis, the age and rainfall have a negative effect. The results show that the probability of an outbreak for the third month of 2019 is 0.30%. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders. [ABSTRACT FROM AUTHOR]

Background: The identification of statistical models for the accurate forecast and timely determination of the outbreak of infectious diseases is very important for the healthcare system. Thus, this study was conducted to assess and compare the performance of four machine-learning methods in modeling and forecasting brucellosis time series data based on climatic parameters. Methods: In this cohort study, human brucellosis cases and climatic parameters were analyzed on a monthly basis for the Qazvin province–located in northwestern Iran- over a period of 9 years (2010–2018). The data were classified into two subsets of education (80%) and testing (20%). Artificial neural network methods (radial basis function and multilayer perceptron), support vector machine and random forest were fitted to each set. Performance analysis of the models were done using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Root Error (MARE), and R2 criteria. Results: The incidence rate of the brucellosis in Qazvin province was 27.43 per 100,000 during 2010–2019. Based on our results, the values of the RMSE (0.22), MAE (0.175), MARE (0.007) criteria were smaller for the multilayer perceptron neural network than their values in the other three models. Moreover, the R2 (0.99) value was bigger in this model. Therefore, the multilayer perceptron neural network exhibited better performance in forecasting the studied data. The average wind speed and mean temperature were the most effective climatic parameters in the incidence of this disease. Conclusions: The multilayer perceptron neural network can be used as an effective method in detecting the behavioral trend of brucellosis over time. Nevertheless, further studies focusing on the application and comparison of these methods are needed to detect the most appropriate forecast method for this disease. [ABSTRACT FROM AUTHOR]

Background: Every year, a large number of people lose their lives or become injured seriously as a result of fires. Fires in buildings pose a great threat to resident safety. The aim of this systematic review is to identify preventive measures for fire-related injuries in residential buildings, taking into account associated risk factors. Methods: In this study, a systematic review was performed of all studies conducted in the field of residential building fires, influencing factors and available safety procedures. From the earliest record up to 7 July 2017, databases of PubMed, Web of Science/Knowledge, and Scopus were searched and selected articles included in the study. Results: A total of 5,613 published articles were examined, of which 30 were finally found to meet the inclusion criteria. The findings of the study were included in two main groups of preventive measures and risk factors for residential building fires and related injuries. Regarding preventive measures, the factors to reduce the risk of fire-related injuries raised in the studies under review included rule amendments, changes and modification of the environment, behavior change such as emergency evacuation during fire occurrence, improvements to emergency medical services, and awareness-raising. Also, many of the studies showed that areas with a large number of young children, older people, people with physical and mental disabilities, alcohol and drug addicts, smokers, single-family households and low-income families were particularly at risk of fire-related injuries and deaths. Conclusions: There are features in residential buildings and attributes among residents that can be related to fire hazard and fire-related injuries and deaths. The most important point of this study is to focus on preventive strategies including environmental modification, promotion of safety rules and changes in risk behavior among residents. Policy makers should pay more attention to these important issues in order to promote safety and injury prevention in relation to building fires. [ABSTRACT FROM AUTHOR]

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The world population is getting old rapidly; the aging population is the new phenomenon in Iran too. The aim of this meta-analysis was to estimate the overall and subscales mean score of quality of life (QOL) based on the Leiden-Padua (LEIPAD) questionnaire among the elderly population of Iran. The major international and national databases including; Medlin, Scopus, Science Direct, SID, MagIran, IranMedex, and Irandoc was searched. All cross-sectional studies, which measured the QOL among the elderly population in Iran using the LEIPAD questionnaire, were included. Furthermore, we used the following key words, "Quality of life," "aging," "aged," "elderly," and "Iran." Of 2155 records, four articles reminded for the meta-analysis, which involved 628 participants with a mean age of 71.73 ± 4.28 years. The mean scores of QOL in each scale were as follows: 10.80 (9.30-12.31) for physical health, 13.51 (6.81-20.21) for self-care scale, 8.60 (5.07-12.14) for depression and anxiety, 12.48 (10.39-14.58) for cognitive functioning scale, 2.19 (0.67-3.72) for sexual functioning scale, 10.98 (5.87-16.09) for life satisfaction scale, and 5.90 (3.64-8.16) for social desirability scale. This study revealed that the total QOL for the elderly population is relatively low in Iranian society. It is appeared to provide social support, and upgrade their QOL seems to be essential for the elderly population. [ABSTRACT FROM AUTHOR]

Background: Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in urine without having signs and symptoms. The aim of this meta-analysis was to estimate the overall prevalence of asymptomatic bacteriuria among Iranian pregnant women. Methods: Major national and international databases were searched up to November 2015, including Scientific Information Database, MagIran, Web of Science, Medline, Scopus, Science Direct and Ovid. The checklist of the STROBE statement was used for evaluating the quality of reporting. The extracted data were analyzed and the results were reported using a random-effects model with 95% confidence interval (CI). Results: From 3709 obtained studies, 20 included in the meta-analysis, which involved 15108 pregnant women. The overall prevalence of ASB was 0.13 (95% CI: 0.09, 0.17). The prevalence of ASB in the northern and southern regions of Iran was 0.13 (95% CI: 0.09, 0.18) and 0.11 (95% CI: 0.05, 0.16), respectively. Conclusion: Prevalence of ASB among Iranian pregnant women is considerable. Due to the complications of ASB for pregnant women and their children, preventative planning and control of ASB among pregnant women in Iran is necessary. [ABSTRACT FROM AUTHOR]

Background: Several studies have been conducted to investigate the prevalence of preeclampsia and eclampsia in Iran. These studies have yielded different results. This meta-analysis was aimed to estimate the prevalence of preeclampsia and eclampsia in Iran. Methods: International and national electronic databases were searched up to August 2014 including PubMed, Science Direct, Scopus, Science Information Database, Maglran, and IranMedex as well as conference databases. All studies, in which the prevalence or cumulative incidence of preeclampsia in Iran was reported, were included in this meta-analysis. Thirty-six separate studies were assessed involving overall 132,737 participants, of which 4360 had preeclampsia and 49 had eclampsia. Results: Overall prevalence of preeclampsia and eclampsia was 0.05 (95% Cl: 0.05, 0.06) and 0.23% (95% Cl: 0.12%, 0.33%) respectively. The prevalence of preeclampsia, increased from 0.04 (95% Cl: 0.03, 0.05) during 1996 to 2005 to 0.07 (95% Cl: 0.04, 0.09) during 2010 to 2013, while the prevalence of eclampsia decreased from 0.30% (95% Cl: 0.15%, 0.45%) to 0.01 % (95% Cl: 0.01 %, 0.01 %), during the same period. Conclusions: The preeclampsia prevalence had an increasing growth and the eclampsia prevalence had declining growth in recent years. In addition, despite many studies aimed the prevalence of preeclampsia and eclampsia in Iran, there is a significant variation between the results. So, it is difficult to give an exact estimation of the preeclampsia and eclampsia prevalence in Iran. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the alpha and beta-thalassemia mutations and assess the association of hematologic indices with mutations. Patients and Methods: In this cross sectional study, we assessed 275 suspected thalassemia carriers. Amplification refractory mutation system-polymerase chain reaction and Gap PCRwere used for detection of mutations. Results: CD 36 - 37 (-T) and -α3.7/αα were most common mutations. Mean of corpuscular hemoglobin and corpuscular volume was less among beta-thalassemia carriers in comparison to alpha-thalassemia carriers (P = 0.001). Conclusions: Detected mutations were different from other regions in Iran. After iron therapy, mean of corpuscular volume (MCV) was < 69 fL and mean of corpuscular hemoglobin was < 23 pg, maybe classified as beta-thalassemia carriers. [ABSTRACT FROM AUTHOR]

Objective. This Study was conducted after a diarrhea outbreak that occurred in Yazd Province, Iran. The aim of the study was to compare knowledge, attitude, practice, and other risk factors of the affected communities regarding diarrhea outbreak (the cities of Zarch, Meybod, and Ardakan) to nonaffected communities (the cities of Yazd and Taft). Methods. A knowledge, attitude, and practice (KAP) survey study was conducted from August to September 2013 enrolling 505 subjects who were referred to health centers anonymously during the epidemic. The questionnaire included the following four parts: (a) general characteristics such as gender, education level, source of health information obtaining; (b) 12 questions on knowledge (Min = 0, Max = 36); (c) 10 questions on attitude (Min = 0, Max = 50); and (d) nine questions on practice (Min = 0, Max = 27). Results. The overall mean score of knowledge, attitude, and practice was 28.17 (SD = 4.58), 37.07 (SD = 4.39), and 21.31 (SD = 3.81), respectively. Practice on food- and waterborne outbreaks was significantly higher in females (P = 0.001) and in nonaffected communities (P = 0.031). Conclusions. Nonaffected communities had a considerably better practice score. With the increase in the score of knowledge about food- and waterborne outbreaks, the score of practice increased slightly. [ABSTRACT FROM AUTHOR]

Background: Several studies have investigated the prevalence of osteoporosis among general population in several parts of Iran. However, the results have been inconsistent. This meta-analysis was conducted to estimate the overall prevalence of osteoporosis. Materials and Methods: International and national electronic databases were searched until April 2012, including Web of Knowledge, Medline, Scopus, Ovid, ScienceDirect, Science Information Database, IranMedex, MagIran, as well the relevant conference databases. The reference lists of included studies were screened as well. The cross-sectional studies addressing the prevalence of osteoporosis among Iranian general population were retrieved irrespective of age and sex. Bone mineral density (BMD) based on T-score was classified as follows: (a) normal (T-score ≥−1); (b) osteopenia (–2.5SD < T-score <−1SD); (c) osteoporosis (T-score ≤–2.5). Study quality was assessed using the recommended checklist of STROBE. Results: Of 2598 retrieved studies, 31 studies comprising 34,814 people was used for meta-analysis. The overall prevalence of osteoporosis in lumbar spine was 0.17 (95% CI: 0.13, 0.20) and that of osteopenia was 0.35 (95% CI: 0.30, 0.39). The prevalence was higher in older age groups, in women, and in the northern regions of the country, with an increasing trend in recent years. Conclusion: This meta-analysis indicated that osteoporosis and osteopenia are common problems among Iranian population older than 30 years. Furthermore, increasing trend of the diseases in recent years is promising a critical public health problem in Iran in the near future. However, due to the heterogeneity between the studies’ results, further evidence based on a national survey is needed to estimate the exact prevalence of the diseases in the country. [ABSTRACT FROM AUTHOR]

Objective: There is no universal consensus on the relationship between body mass index (BMI) and breast cancer. This meta-analysis was conducted to estimate the overall effect of overweight and obesity on breast cancer risk during pre- and post-menopausal period. Data Sources: All major electronic databases were searched until April 2012 including Web of Knowledge, Medline, Scopus, and ScienceDirect. Furthermore, the reference lists and related scientific conference databases were searched. Review Methods: All prospective cohort and case-control studies investigating the association between BMI and breast cancer were retrieved irrespective of publication date and language. Women were assessed irrespective of age, race and marital status. The exposure of interest was BMI. The primary outcome of interest was all kinds of breast cancers confirmed pathologically. Study quality was assessed using the checklist of STROBE. Study selection and data extraction were performed by two authors separately. The effect measure of choice was risk ratio (RRi) and rate ratio (RRa) for cohort studies and odds ratio (OR) in case-control studies. Results: Of 9163 retrieved studies, 50 studies were included in meta-analysis including 15 cohort studies involving 2,104,203 subjects and 3,414,806 person-years and 35 case-control studies involving 71,216 subjects. There was an inverse but non-significant correlation between BMI and breast cancer risk during premenopausal period: OR = 0.93 (95% CI 0.86, 1.02); RRi = 0.97 (95% CI 0.82, 1.16); and RRa = 0.99 (95% CI 0.94, 1.05), but a direct and significant correlation during postmenopausal period: OR = 1.15 (95% CI 1.07, 1.24); RRi = 1.16 (95% CI 1.08, 1.25); and RRa = 0.98 (95% CI 0.88, 1.09). Conclusion: The results of this meta-analysis showed that body mass index has no significant effect on the incidence of breast cancer during premenopausal period. On the other hand, overweight and obesity may have a minimal effect on breast cancer, although significant, but really small and not clinically so important. [ABSTRACT FROM AUTHOR]

The quality of reporting of cohort studies published in the most prestigious scientific medical journals was investigated to indicate to what extent the items in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist are addressed. Six top scientific medical journals with high impact factor were selected including New England Journal of Medicine, Journal of the American Medical Association, Lancet, British Medical Journal, Archive of Internal Medicine, and Canadian Medical Association Journal. Ten cohort studies published in 2010 were selected randomly from each journal. The percentage of items in the STROBE checklist that were addressed in each study was investigated. The total percentage of items addressed by these studies was 69.3 (95% confidence interval: 59.6 to 79.0). We concluded that reporting of cohort studies published in the most prestigious scientific medical journals is not clear enough yet. The reporting of other types of observational studies such as case-control and cross-sectional studies particularly those being published in less prestigious journals expected to be much more imprecise. [ABSTRACT FROM AUTHOR]

Background: The novel influenza A (H1N1) virus was first detected in March 2009 in Mexico and then disseminated to many other countries worldwide. In this study, we assessed the potential risk factors of swine flu as well as the most important clinical manifestations of this infectious disease among confirmed cases during early phase of pandemic H1N1. Methods: Subjects (cases and controls) were selected from those patients with signs and symptoms of respiratory tract infection who referred to health centers of eight cities throughout Hamedan Province, western Iran form July to December 2009. Characteristics of the participants were obtained by interviewers using pre-determined questionnaire. Cases were distinguished by pharyngeal soap specimens positive for influenza A virus using polymerase chain reaction (PCR). Logistic regression model was conducted at 0.05 significance level using Stata 9.1 statistical software to assess the effects of various risk factors on H1N1 influenza infection. Results: Totally, 245 confirmed cases of H1N1 influenza were compared with 388 controls. Case fatality rate of influenza infection was about 2.86%. In comparison with age group of 1-19 yr old, adjusted odds ratio estimates was 1.91 [95% CI: 1.06, 3.46] for age group of 20-39 yr old, 0.94 [0.37, 2.38] for age group of 40-59 yr old, and 0.34 [0.09, 1.37] for age group of 60 -79 yr old. Adjusted odds ratio estimates of influenza A infection was 8.12 [95% CI: 3.11, 21.6] for pregnant women compared to nonpregnant women; 1.84 [95% CI: 1.32, 2.86] for high educated individuals in comparison with low educated individuals; 2.11 [95% CI: 1.25, 3.57] for whose who had close contact with suspected influenza patients; and 2.15 [95% CI: 1.16, 3.98] for individuals with normal body mass index (BMI= 25-30) compared with underweight individuals (BMI< 20). There were no significant differences in clinical manifestations between cases and controls. Conclusion: The risk of influenza A infection is highest among children and adolescents, pregnant women, high educated individuals, and those who had close contact with suspected influenza patients during pandemic phase. In addition, there is no pathogonomonic sign or symptom to distinguish influenza infection clinically from other kinds of respiratory track infections. [ABSTRACT FROM AUTHOR]

Objectives: This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.Methods: PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.Results: Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.Conclusions: This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs. [ABSTRACT FROM AUTHOR]

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors. [ABSTRACT FROM AUTHOR]

Background: Cancer is one of the most common non-communicable diseases in both sexes and a major cause of disability and death around the world, as well as in Iran. The aim of the present manuscript is to report the results of the Global Burden of Disease study 2010 (the GBD 2010) to compare them with other similar findings. The paper also discusses the current deficiencies in the GBD study. Our aim was to describe and criticize the attributed burden of cancers according to the GBD results by sex and age. Methods: The GBD 2010 has profited from 100 collaborators worldwide and provides a vast network of data on health outcomes, vital registries, and population surveys. The GBD has used various scientific-approved methods to estimate important health statuses like death rates, life expectancy, and healthy adjusted life expectancy, disability-adjusted life years, years of living lost due to premature death and years of life with disabilities. In the present study, we extracted and graphed the GBD results for Iran in order to present a better scheme for readers. Results: The mortality rate of cancers in Iranians has increased by about 8.5%, while the disability-adjusted life year rates have declined by about 9%, and years lost due to premature death have also decreased by about 10% from 1990 to 2010 compared to an 85% increase in years of life with disabilities in the same time period. Conclusion: The burden of all non-communicable diseases (NCDs) including cancers shows a decrease during the past two decades. However, these diseases still remain a global health challenge. Prevention should be considered as an important priority and responsibility. The health authorities also need to determine the burden of cancers at national and sub-national levels for implementation of effective preventive strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cancer registry can be a very important component of health information system in developing countries. Routine collection of data and ongoing monitoring of their quality can have a crucial role in priority setting and evidence-based policy making for controlling cancers and trends follow-up in low and middle-income countries. Evaluation of cancer registered data consists of four important components including: comparability, completeness, validity, and timeliness. Similar frameworks are utilized in different countries all over the world. METHODS AND MATERIALS: We will use the national annual cancer registry reports in Iran alone or perhaps along with other Iranian published reports about childhood cancer incidence to determine the stability and trend of incidence rates over time and compare above mentioned reports with childhood cancer incidence data reported by other countries through a systematic review as well as in some cases meta-analysis in order to assess data quality. Data will also be collected from other sources such as death certificates to estimate mortality rates and other different methods will also be additionally applied, by use of which death certificates would be utilized to assess the quality of data, too. CONCLUSION: As the first step for proper measuring incidence rate of all types of cancers all over the country, we will assess and evaluate reported national cancer registry data in Iran in order to estimate the national burden of cancers in 1990 - 2013. [ABSTRACT FROM AUTHOR]