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Introduction: Mothers of preterm infants need support to deal with the issues caused by the early birth of their infants. Objective: The authors examined the impact of a multifaceted supportive approach on the mothers' perceived support levels. Methods: The present quasi-experimental study was performed on 143 mother–preterm infant pairs, in two neonatal intensive care units (NICUs) of referral and educational hospitals in Tehran, Iran. The base of developed interventions was known to support system patterns of mothers with preterm infants. Different supportive interventions (appraisal, instrumental, emotional, and informational) of mothers were implemented during three months. The Nurse Parent Support Tool was applied for assessing perceptions of perceived support by mothers. Routine care was provided for the control group. The results were analyzed by STATA software 13. Categorical variables were analyzed by chi-square test, t -test, and inverse probability treatment weights. Results: Following adjustments of mean differences of outcomes between study groups (95% confidence interval), all support scores, such as instrumental support, −1.23 (95% CI −1.04 to −1.43), total support, −1.83 (95% CI −1.6 to −2.06), appraisal support, −2.01 (95% CI −1.73 to −2.29), emotional support, −1.87 (95% CI −2.15 to 1.6), and informational support, −2.12 (95% CI −1.82 to −2.43), were significantly higher in the interventional group than in the control group (p <.001). Conclusions: Support received by mothers of preterm infants determines maternal/neonatal health. Information sharing and effective ways to support are essential elements in the mother's ability to deal with the new, stressful situation. This multifaceted supportive approach considerably improved mothers' perceived support. [ABSTRACT FROM AUTHOR]

Introduction: Emerging infectious diseases such as SARS-CoV-2 can cause pandemics and create a critical risk for humans. In a previous pilot study, we reported that the immunological responses induced by cutaneous leishmaniasis (CL) could decrease the incidence and severity of COVID-19. In this large-scale case–control study, we assessed the possible relationship between mortality and morbidity of COVID-19 in healed CL persons suffering scars compared to cases without CL history. Methods: This controlled cross-sectional study was conducted between July 2020 and December 2022 in the endemic and high-burden areas of CL in southeastern Iran. In the study, 1400 previous CL cases with scars and 1,521,329 subjects who had no previous CL were analyzed. We used R 4.0.2 to analyze the data. Firth's bias reduction approach corresponding to the penalization of likelihood logistic regression by Jeffreys was also employed to influence the variables in the dataset. Also, a Bayesian ordinal logistic regression model was performed to explore the COVID-19 severity in both case and referent groups. Results: The occurrence and severity rate of COVID-19 in CL scar cases are significantly less than in the non-CL control group, while in the CL scar subjects, patients with critical conditions and mortality were not observed. The morbidity (OR = 0.11, CI 0.06–0.20 and P < 0.001) and severity of COVID-19 in previous cases with CL scars were significantly diminished than that in the control group (credible interval − 2.57, − 1.62). Conclusions: The results represented a durable negative relationship between cured CL and COVID-19 incidence and severity. Additional studies seem necessary and should be designed to further validate the true impact and underlying mechanistic action of CL on COVID-19. [ABSTRACT FROM AUTHOR]

Elder abuse is a major problem that has physical, sexual, psychological, financial, and negligence dimensions. This can lead to physical ailments such as fractures and mental disorders such as anxiety and depression. The aim of this study was to determine the prevalence and related factors of elder abuse in Shahroud county, northeast of Iran. This cross-sectional study was conducted on 360 Iranian older people referred to Shahroud health centers by using cluster sampling method with inclusion criteria of; age over 60 years and mental and cognitive health and exclusion criteria of severe physical disease and disrupting the process of completing the questionnaire. Elder abuse was measured using a Vulnerability to Abuse Screening Scale (VASS) with a score higher than 2 and the relationship between age, gender, education, housing status, number of children, employment status, marital status, insurance status, and living arrangement with elder abuse was examined in a logistic regression model. The prevalence of elder abuse was 38.6%. Living with spouse and children (OR = 0.20) and living with spouse (OR = 0.43) were associated with lower risk of elder abuse compared with living alone in the regression model. A significant number of Iranian older people are exposed to abuse and health care systems need to take steps to reduce this social problem. It is suggested that the older adults live at least in marriage status as much as possible and that a cultural context to deal with the phenomenon be adopted through education and planning. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is a zoonotic disease and Iran is one of the ten countries with has the highest estimated cases of leishmaniasis. This study aimed to determine the time trend of cutaneous leishmaniasis (CL) incidence using the ARIMA model in Shahroud County, Semnan, Iran. Methods: In this study, 725 patients with leishmaniasis were selected in the Health Centers of Shahroud during 2009–2020. Demographic characteristics including; history of traveling, history of leishmaniasis, co-morbidity of other family members, history of treatment, underlying disease, and diagnostic measures were collected using the patients' information listed in the Health Ministry portal. The Box-Jenkins approach was applied to fit the SARIMA model for CL incidence from 2009 to 2020. All statistical analyses were done by using Minitab software version 14. Results: The mean age of patients was 28.2 ± 21.3 years. The highest and lowest annual incidence of leishmaniasis were in 2018 and 2017, respectively. The average ten-year incidence was 132 per 100,000 population. The highest and lowest incidence of the disease were 592 and 195 for 100,000 population in the years 2011 and 2017, respectively. The best model was SARIMA (3,1,1) (0,1,2)4 (AIC: 324.3, BIC: 317.7 and RMSE: 0.167). Conclusions: This study suggested that time series models would be useful tools for predicting cutaneous leishmaniasis incidence trends; therefore, the SARIMA model could be used in planning public health programs. It will predict the course of the disease in the coming years and run the solutions to reduce the cases of the disease. [ABSTRACT FROM AUTHOR]

Background. Social isolation is a common and serious health issue in the older community-dwelling adults that leads to negative consequences such as suicidal thoughts, psychological distress, as well as a decline in welfare, health and quality of life. Objectives. This study aimed to determined the prevalence of social isolation and related factors in older Iranian adults. Material and methods. This cross-sectional study was performed on 290 older community-dwelling Iranian adults using a multistage sampling method in Shahroud, Iran. Social isolation was measured using the Lubben Social Network Scale-18 (LSNS-18) with a score higher than 36. Data was analysed using descriptive and inferential statistics (multivariate logistic regression). The significance level was set at 0.05. Results. The prevalence of social isolation was 57.9%. Marriage history (married or deceased spouse – divorced), higher education and living arrangements (living with a spouse or with a spouse and children) were factors associated with lower social isolation; however, social isolation was higher in older adults with two or more children (p = 0.03). Conclusions. A high percentage of older Iranian adults suffer from social isolation. It is suggested that older adults not live alone, get married and have academic education as much as possible, and it is necessary to take extensive measures to reduce this social issue. [ABSTRACT FROM AUTHOR]

Negligible data are available following major social activities and environmental changes on leishmaniasis. Therefore, how interactions between these events influence cutaneous leishmaniasis (CL) risk is not well-known. This longitudinal study was undertaken to explore the impact of interventions conducted between 1971 and 2020 in Bam county, which has had the highest disease burden in Iran. Only confirmed CL cases during this period were taken into account. Data were analyzed by SPSS 22 using the X2 test to assess the significance of the difference between proportions. Moreover, we used interrupted time series (ITS) to assess the impact of three environmental events during this period. Overall, 40,164 cases of CL occurred in the past five decades. Multiple complex factors were among the leading causes that synergistically induced the emergence/re-emergence of CL outbreaks in Bam. The main factors attributed negatively to CL control were cessation of malaria spraying activity, expansion of the city spaces, and a massive earthquake creating new breeding potentials for the vectors. The highest impact on CL incidence during these years was related to the earthquake [coefficient = 17.8 (95% CI: 11.3, 22.7); p-value < 0.001]. Many factors can contribute to CL outbreaks in endemic foci. They also can cause new foci in new areas. Since humans are the single reservoir for CL in this area, early detection and effective management significantly contribute to controlling CL to reduce the disease burden. However, essential evidence gaps remain, and new tools are crucial before the disease can ultimately be controlled. Nevertheless, sustained funding and more trained task forces are essential to strengthen surveillance and case management and monitor the interventions' impact. Author summary: We aimed to conduct this longitudinal observation to assess the impact of interventions applied between 1971 and 2020 in Bam county, Iran's highest anthroponotic cutaneous leishmaniasis burden. Only confirmed CL cases were taken into account. Overall, 40,164 cases of CL occurred in the past five decades. Multiple complex factors were among the leading causes that synergistically induced the emergence/re-emergence of CL outbreaks in Bam. The main factors attributed negatively to CL control were cessation of malaria spraying activity, expansion of the city spaces, and a massive earthquake creating new breeding potentials for the vectors. Since humans are the single reservoir host for CL in this area, early detection and effective management significantly contribute to controlling CL to reduce the disease burden. However, continuous funding and more trained forces are critical to strengthening surveillance and case management and monitoring the interventions' impact. [ABSTRACT FROM AUTHOR]

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery. Method: This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month. Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding selfefficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7). Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers. [ABSTRACT FROM AUTHOR]

Background: The first confirmed cases of COVID-19 in Iran were reported in Qom city. Subsequently, the neighboring provinces and gradually all 31 provinces of Iran were involved. This study aimed to investigate the case fatility rate, basic reproductive number in different period of epidemic, projection of daily and cumulative incidence cases and also spatiotemporal mapping of SARS-CoV-2 in Alborz province, Iran.Methods: A confirmed case of COVID-19 infection was defined as a case with a positive result of viral nucleic acid testing in respiratory specimens. Serial interval (SI) was fitted by gamma distribution and considered the likelihood-based R0 using a branching process with Poisson likelihood. Seven days average of cases, deaths, doubling times and CFRs used to draw smooth charts. kernel density tool in Arc GIS (Esri) software has been employed to compute hot spot area of the study site.Results: The maximum-likelihood value of R0 was 2.88 (95%, CI: 2.57-3.23) in the early 14 days of epidemic. The case fatility rate for Alborz province (Iran) on March 10, was 8.33% (95%, CI:6.3-11), and by April 20, it had an increasing trend and reached 12.9% (95%,CI:11.5-14.4). The doubling time has been increasing from about two days and then reached about 97 days on April 20, 2020, which shows the slowdown in the spread rate of the disease. Also, from March 26 to April 2, 2020 the whole Geographical area of Karj city was almost affected by SARS-CoV-2.Conclusions: The R0 of COVID-19 in Alborz province was substantially high at the beginning of the epidemic, but with preventive measures and public education and GIS based monitoring of the cases,it has been reduced to 1.19 within two months. This reduction highpoints the attainment of preventive measures in place, however we must be ready for any second epidemic waves during the next months. [ABSTRACT FROM AUTHOR]

Airborne pollen is considered one of the causative agents of hay fever, allergic rhinitis, conjunctivitis, and asthma. We aimed to investigate airborne pollens in the context of Shiraz located in the southwest of Iran and find their association with meteorological parameters.  The survey was conducted from October 2017 to September 2018, using seven days of volumetric Burkard spore trap, located in the center of the city. A total of 5810 pollen grains/m3 belonging to 15 taxa were identified and recorded. Among them, 73.8% was the tree, while the grass, shrub, and weed constituted 13.56%, 3.5%, and 9.2% of total reported pollens, respectively. The major pollen types were Platanaceae (28.39%), Oleaceae (21.17%), Pinaceae (15.11%), Amaranthaceae (9.29%), and Brassicaceae (8.02%). A higher number of pollen counts and types were recorded in March, followed by September, while it was lower in May. Meteorological parameters were correlated with the monthly pollen counts. Wind speed was found to have a positive correlation with Platanaceae concentration. The significant correlation between pollen concentration and the temperature was positive for Poaceae, Amaranthaceae, and Plantaginaceae and negative for Rosaceae, Oleaceae, and Ulmaceae.  Poaceae and Amaranthaceae were negatively correlated with humidity and positively with Rosaceae, Oleaceae, and Plantaginaceae. A negative correlation was found between rainfall and Poaceae and Amaranthaceae, while Plantaginaceae had a positive correlation with this parameter. The results of this study may be helpful for allergologists in the diagnosis and treatment of airborne allergic disorders due to pollen grains. [ABSTRACT FROM AUTHOR]

Background. Elderly abuse is a major problem in developing countries and causes complications such as reduced quality of life, increased incidence of mental diseases and even death. Objectives. To evaluate the validity of a Persian version of the Vulnerability Abuse Screening Scale (VASS) in the elderly. Material and methods. This methodological study was performed on 200 older adults (aged ≥ 60) in Iran. Measurements included the Elderly Vulnerability to Abuse Screening Scale (VASS), Mini-Mental State Examination (MMSE) and Abbreviated Mental Test Score (AMTS). Results. The mean and standard deviation of the studied population was 68 ± 5.8 years. After applying the necessary changes in the items at the face and content validity stage, the initial reliability was confirmed in a sample of 50 elderly with a Cronbach’s alpha coefficient of 0.74. The initial tool model (12-question version) was not validated in the factor analysis process, so the second tool model (9-question version) was prepared and found to have construct validity. Cronbach’s alpha coefficient in the 9-question version was 0.70, and the intra-class correlation coefficient was 0.99. Conclusions. According to the study results, it seems that the Persian 9-question version can be used as a valid and reliable tool in the study and assessment of vulnerability to abuse in the Iranian elderly population. [ABSTRACT FROM AUTHOR]

Background: Epidemics of cutaneous leishmaniasis (CL) are occurring more frequently and spreading faster and farther than before in many areas of the world. The present study aimed to assess a long-lasting emerging epidemic (2005–2019) of 5532 cases with anthroponotic CL (ACL) in peri-urban areas of Kerman city in southeastern Iran. Methods: This descriptive-analytical study was carried out for 15 years in Kerman province, southeastern Iran. The data were passively obtained through the health surveillance system and the Kerman Leishmaniasis Research Center. Every subject was diagnosed using direct smear microscopy. The representative causative agent was further examined by ITS1-PCR, PCR-RFLP, 7SL RNA gene sequencing and phylogenetic analyses. For each subject, a case report form designating demographic and clinical data was recorded. Results: A different pattern of ACL incidence was found in peri-urban areas compared to that in the city of Kerman. The incidence rate of ACL cases has significantly increased (P < 0.001) from 2005 to 2016 in new settlements with a gradual decline after that. The overall average risk of contracting the disease was 7.6 times higher in peri-urban areas compared to Kerman city, an old endemic focus. All isolates consisting of six variants were confirmed to be Leishmania tropica. The overall pattern of the ACL infection indicates that the etiological agent of ACL is propagated and transmitted by the bite of female Phlebotomus sergenti sandflies from person to person from dissimilar clones as reflected by the complexity of the migrants' backgrounds in the province. Conclusions: The movement of populations and establishment of new settlements in peri-urban areas close to endemic areas are major risk factors for and are directly linked to CL. The underlying factors of this emerging ACL epidemic caused by L. tropica were disasters and droughts, among others. A robust commitment to a multilateral approach is crucial to make improvements in this area. This will require decisive coordinated actions through all governmental factions and non-governmental organizations. Furthermore, active and passive case detection strategies, early diagnosis, and effective treatment could help control the disease. [ABSTRACT FROM AUTHOR]

This study was conducted to identify areas of endemism for Acantholimon species using parsimony analysis of endemicity (PAE) and to detect endemic species richness of the genus in the region. The results obtained from the two methods used in this study were used in determining the priorities for the conservation of Acantholimon species in Iran. The distribution database of 62 endemic species belonging to this genus was formed by 1250 georeferenced observations in Iran. The study area was divided into 1̊×1̊ grids of operative geographical units (OGUs) and the species × area matrix including presence/absence data was created. The endemic species richness was calculated using circular neighborhood with a radius of 50 km in 10 × 10 km2 raster cells using DIVA-GIS software. The results of PAE analysis have shown four areas of endemism (AOEs) in Iran. AOE1: including Alborz and Zagros mountains, the mountains of central Iran. AOE2 and AOE3 are located in Khorassan subregion and AOE4 contains parts of western Iran. The map of endemic species richness indicated that the highest number of endemic species occurs in central Alborz region as well as Kerman, Chahar-Mahal and Bakhtiari, and Isfahan provinces. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the relationship between assertion and aggression with addiction potential among students in Shahroud University of Medical Sciences. Methods: In this cross-sectional study conducted in 2019, 500 students of Shahroud University of Medical Sciences, were selected by multistage random sampling, for a study using the Addiction Potential Scale, and Assertion and Aggression Questionnaires. Data were analyzed using ANOVA, Chisquare, t test, Pearson's correlation coefficient, and the linear regression model. Results: The mean scores of addiction potential, aggression, and assertion were 32.7 ± 17.2, 41.5 ± 12.9 and 139.4 ± 22.3, respectively. In this study, 38.8% (N = 194) of students had high aggression and 76.8% (N = 384) had high assertion. In the regression model, aggression, history of drug and addictive substances abuse, history of tobacco use, and history of alcohol abuse were significantly related to addiction potential (p ≤ 0.05). There was a negative relationship between assertion and addiction potential so that with oneunit increase in the assertion score, the addiction potential score decreased by -0.11. Conclusion: Given the direct relationship between aggression and addiction potential, and since more than three-quarters of the students had moderate to high aggression, it is necessary to pay more attention to this issue. Interventions may play an important role in improving the current situation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Metabolic syndrome (MetS) is a group of risk factors that are associated with increased risk for atherosclerotic cardiovascular disease. OBJECTIVE: The objective of this study was to determine the prevalence of metabolic syndrome and its individual components among Iranian bakery workers. METHODS: A cross-sectional study enrolling 163 randomly selected bakery workers from Semnan province (Northeast Iran), was conducted in 2017. A standard questionnaire was used for data collection. Analyses were performed using t-test, one-way ANOVA and Latent Class Analysis (LCA) in R software. RESULTS: The prevalence of MetS was 19.8% among bakery workers. More bakery workers with MetS had no regular exercise (p = 0.001) and worked more than eight hours a day (p = 0.001). In this study, the International Diabetes Federation (IDF) diagnostic criteria had more agreement with the American Heart Association (AHA) (49.1%) than the World Health Organization (WHO) and Adult Treatment Panel (ATP) criteria. Also, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) had the highest sensitivity for diagnosing MetS. The sensitivity of the four diagnostic methods, WHO, IDF, ATP and AHA, were 45.2%, 61.7%, 67.9% and 64.8%; and their specificity were 98.2%, 100%, 100% and 100%, respectively. CONCLUSION: The prevalence of MetS is high among bakery workers in Iran. Increased physical activity and intake of fruit and vegetables are recommended for the prevention of MetS. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationship between self-efficacy, general health and burnout of the staff at Shahroud University of Medical Sciences. Methods: In 2015, 249 staff at Shahroud University of Medical Sciences (from a total reference population of 520 staff members) were selected through stratified random sampling. To collect the data, Sherer self-efficacy Scale, General Health Questionnaire and Maslach Burnout Inventory were used. The collected data were analyzed through ANOVA, Pearson correlation and Chi-square tests using SPSS 16. The relationship between self-efficacy, general health and burnout (latent factors) were studied using structural equation modeling with Stata 14. Results: The mean age of participants was 36.97 ± 7.60 years, and the mean number of years work experience was 12.29 ± 7.57. The mean scores of general health, self-efficacy and burnout were 28.24 ± 11.14, 62.30 ± 9.21 and 81.67 ± 22.18, respectively. The results of the study showed a statistically significant relationship between self-efficacy and general health which equals −0.32. A statistically significant relationship also existed between burnout scores and general health scores (beta = 0.78). Conclusion: The results showed that high self-efficacy improves the general health of employees at the Shahroud University of Medical Sciences and reduces burnout. Special attention should be paid to self-efficacy in the prevention of burnout. [ABSTRACT FROM AUTHOR]

Objectives: Unhealthy lifestyles among young people are seriously related to incapacity and health problems in adulthood. The aim of this study was to determine the importance of a health-promoting lifestyle and its association with self-efficacy and well-being. Methods: In this cross-sectional study, a sample of 500 students from Shahroud University of Medical Sciences (Shahroud, Iran) were randomly selected in 2017. The Persian versions of Health-Promoting Lifestyle Profile, Self-Efficacy Scale, and WHO-5 Well-Being Index were used. Results: Among the participants, 34% of students had an abnormal imaginable well-being, and 68% of students had high self-efficacy. The mean score of a health-promoting lifestyle was 127.47 ± 19.78, which is interpreted as moderate, and the mean score of physical activity was 14.10 ± 4.95, which is poor. There was a significant relationship between well-being, and self-efficacy with health-promoting lifestyle. Age, gender, educational level, place of residence, student employment, self-efficacy, and wellbeing were associated with students' lifestyles. Conclusion: A health-promoting lifestyle of students in this study was moderate and they did not have an acceptable level of physical activity. The direct effect of well-being, and self-efficacy on lifestyle, revising students' curriculums to improve their health behaviors, and general health indicators, can all lead to the enhancement of health-promoting lifestyles. [ABSTRACT FROM AUTHOR]

Background: The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment. Methodology/Principal findings: This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079–2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075–2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008–2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204–3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906–3.936, p≤0.001). Conclusions/Significance: The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L. tropica. [ABSTRACT FROM AUTHOR]

Background: Drug dependency is one of the most important issues in any society and it is among the most widespread health risk factors. Objectives: This study was conducted to determine quality of life in drug-dependent individuals, who were under methadone treatment, and non-drug dependent persons in Shahroud (northeast of Iran). Methods: In this comparative study, 266 drug dependent participants and 541 non-drug dependent participants were studied in 2014. The Persian version of SF-36 Quality of Life Questionnaire was used to collect data. The data were analyzed using chi square test, t test, and ANOVA. Results: The majority of the participants (77.1%) in both groups were male. The mean age of drug-dependent participants was 37.6± 10.7, the mean duration of drug dependency was 12.0±9.3 years, and the mean duration of treatment in methadone maintenance treatment centers (MMT) was 24.6 ± 22.6 months. No significant difference (P > 0.05) was observed between the 2 groups in any aspects of quality of life other than the vitality (P = 0.001). Conclusions: In this study, quality of life scores were not significantly different between drug dependent and non-dependent participants. It seems that treatment with the use of methadone and buprenorphine can play a good role in improving quality of life of addicts. [ABSTRACT FROM AUTHOR]

Background: The concept of family-centered care is increasingly being recognized at the international level. Objectives: Development of a support system for parents of premature infants (PPI), based on family-centered care and scientific evidences. Methods: The method is based on four key steps. 1) Explaining parents’ needs, including comprehensive review of quantitative studies, meta-synthesis of qualitative studies conducted in Iran by search of Iranian databases (IranMedex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) and comparative study. 2) A comprehensive review to identify effective interventions in supporting PPI and ranking interventions. 3) Designing a model to support PPI. 4) Evaluating designed system for supporting the PPI. Results: The results of this study identified five critical steps which the PPI experienced and 14 effective interventions to support them. Preconception: care before the next pregnancy; prenatal: preparing parents to see their baby for the first time, supporting parents in breastfeeding (BF), kangaroo care (KC) and infant massage; neonatal: spiritual self-care, individualized behavioral and developmental care programs, using scales to assess infant's behavior, supporting parents in BF, KC and infant massage, support forums for parents, relieving parents’ stress, sharing information and communication, family nurture interventions, supporting parents in transferring between neonatal units (NU), facilitating collaborative care in NU; discharge: discharge planning, support forums for parents, sharing information and communication and home: home support programs, individualized behavioral and developmental care programs, supporting parents in BF, KC and infant massage. Support forums for parents, sharing information and communication. Conclusions: Our proposed system provides a parent-centered system which can be implemented to provide high-quality care for PPI. [ABSTRACT FROM AUTHOR]

Aim: Traumatic childbirth is among the important factors that make childbirth an unpleasant experience and has psychological negative effects on women. This study aimed to determine the prevalence and risk factors associated with traumatic childbirth. Subject and methods: In this cross-sectional study, 400 women were interviewed in the first 48 h after childbirth in Torbate-heydariyeh (eastern Iran) in 2015. Traumatic childbirth was determined based on DSM-V-A criteria. Statistical analysis of the data was done through chi-square and logistic regression. Results: The prevalence of traumatic childbirth was 48.3% ( N = 193). Logistic regression showed variables such as place of residence, type of delivery, pregnancy complications, bleeding during pregnancy, rupture of grade 3 or 4 during delivery, and emergency cesarean section were significantly correlated with traumatic childbirth ( p <0.001). Conclusion: Considering the high prevalence of traumatic childbirth, it is recommended that its associated risk factors be identified so that negative psychological consequences for the mother can be prevented. [ABSTRACT FROM AUTHOR]

Hospitals play a critical role in the health promotion of the society. This study aimed to determine the impact of establishing standards of health promoting hospitals on hospital indicators in Shahroud. This applied study was a quasi-experimental one which was conducted in 2013. Standards of health promoting hospitals were established as an intervention procedure in the Fatemiyeh hospital. Parameters of health promoting hospitals were compared in intervention and control hospitals before and after of intervention (6 months). The data were analyzed using chi-square and t-test. With the establishment of standards for health promotion hospitals, standard scores in intervention and control hospitals were found to be 72.26 ± 4.1 and 16.26 ± 7.5, respectively. T-test showed a significant difference between the mean scores of the hospitals under study (P = 0.001).The chi-square test also showed a significant relationship between patient satisfaction before and after the intervention so that patients’ satisfaction was higher after the intervention (P = 0.001). Commenting on the short-term or long-term positive impacts of establishing standards of health promoting hospitals on all hospital indicators is a bit difficult but preliminary results show the positive impact of the implementation of standards in case hospitals which has led to the improvement of many indicators in the hospital. [ABSTRACT FROM AUTHOR]

The article presents a study which determined the sexual satisfaction and its influencing factors among fertile and infertile women in Shahroud, Iran. Topics discussed include analysis of data using ordinal logistic regression and Chi square tests, findings on the level of sexual satisfaction of the study participants , and the impact of women's education and husbands' jobs on sexual satisfaction ratings.

Background: In different studies, the prevalence of tobacco consumption has been growing in high schools boys. Objectives: This study was conducted to determine the prevalence of smoking and its related factors among Iranian high school students in 2011. Materials and Methods: In this cross-sectional study, 450 male students from 15 high schools of Shahroud (northeast of Iran) were selected for evaluation of the knowledge, attitude and practices (KAP) of students regarding tobacco consumption. Results: Overall, 51% (95% CI: 46.5 - 55.7) of the students had positive history of smoking for at least one time and 7.1% (95% CI: 5 - 10) of them were current smokers. The most prevalent source of information about smoking was TV and radio programs (48%) and friends were the second source (22%). Based on the students' opinions, entertainment and smoker friends were the most important reasons for smoking tendency. There was significant statistical association between students smoking and positive family history of smoking (P value < 0.05). Conclusions: The prevalence of smoking experince was very high among high school students. The most prevalent source of information about smoking was Iranian broadcasting companies. Positive family history of smoking and smoker friends were the important motivating factors toward smoking. [ABSTRACT FROM AUTHOR]

Objective: Although numerous studies have found higher rates of abortion and still births following consanguinity (familial marriages), the question of whether consanguinity significantly increases the risk of neonatal death has inadequately been addressed. This study aims to evaluate familial marriage effects on neonatal death in rural areas in Iran. Materials and methods: In this nested case-control study, 6900 new borns who were born in rural areas of Kohgiluyeh and Boyerahmad Province (South-West of Iran)were followed till the end of neonatal period, and neonatal death was the outcome of interest. Subsequently 97 cases and 97 controls were selected in study cohort by using risk set sampling model. Crude and adjusted odds ratios (OR) were estimated by using a conditional logistic regression model. Results: In the final model, prematurity (OR = 5.57), low birth weight (LBW) (OR = 7.68), consanguinity (first cousins) (OR = 5.23), C-section (OR = 7.27), birth rank more than 3 (OR = 6.95) and births interval less than 24 months (OR = 4.65) showed significant statistical association with neonatal mortality (p < 0.05). Conclusion: According to our findings, after adjusting the effects of other significant risk factors, familial marriage to first cousins is considered as an important risk factor for neonatal death. [ABSTRACT FROM AUTHOR]

Leishmaniasis has been identified as a significant disease in tropical and subtropical regions of the world, with Iran being one of the disease-endemic areas. Various treatments have been applied for this disease, and amphotericin B (Amp B) is the second line of treatment. Side effects of this drug have been reported in various organs. The present study investigated the effects of different types of Amp B on fetal organs using in silico and in vivo assays (chicken embryos). In vivo analysis was done by checking pathological changes, angiogenesis, and apoptosis alterations on eggs treated by Amp B and AmBisome. In silico approach was employed to predict the affinity of Amp B and AmBisome to the vascular endothelial growth factor A (VEGF-A), its receptor (KDR1), apoptotic-regulator proteins (Bcl-2-associated X protein (Bax), B-cell lymphoma (Bcl-2), and Caspase-8. The ADME-toxicity prediction reveals that AmBisome possesses a superior pharmacological effect to Amp B. The best result of all the dockings in the Molegro Virtual Docker (MVD) was obtained between Bax, Bcl-2, Caspase-8, KDR1, and VEGF-A targets. Due to the lower Egap (HOMO–LUMO) of AmBisome, the chemical reactivity of AmBisome was higher than that of Amp B. In vivo analysis showed that embryos that received Amp B exhibited less vascular density than AmBisome. Amp B alone significantly increased the expression of apoptosis and decreased angiogenesis genes compared to AmBisome. The histopathology analysis of the treated embryos showed a reduction in the blood vessel collapse and an increase in degenerative and apoptotic–necrotic changes in the embryonic tissues. Overall, the results suggest the potential benefits of AmBisome over Amp B, which might be a better treatment strategy to treat leishmaniasis during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of hypertension and pre-hypertension and its determinants in the 40-64 year old population of Shahroud in the north of Iran. Methods: The blood pressure of 5,190 of the 40-64 year old people participating in the first phase of Shahroud Eye Cohort Study was measured using the standard method. Sampling was done in 2009 using a random cluster approach. The prevalence of hypertension and pre-hypertension was determined by age and sex, and we used a multi-nominal logistic regression model to calculate the odds ratio (OR). Results: The prevalence of pre-hypertension was 37.2 % in men and 30.9 % in women, and the prevalence of hypertension was respectively 37.1 % and 39.0 %. In both sexes, there was an increase in the prevalence of hypertension and a decrease in the prevalence of pre-hypertension with age. Older age, male sex, higher body mass index, blood glucose higher than 140 mg/dl were found associated with hypertension and pre-hypertension. Also, diabetes increases the odds of hypertension (OR = 1.4) and a history of smoking was correlated with a decreased odds of having hypertension and pre-hypertension. Conclusion: According to the criteria of Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, the prevalence of hypertension and pre-hypertension was high in the studied population, and considering the epidemiologic transition of diseases in Iran, it can be concluded that a high percentage of the population are at risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: From ancient time human beings have used different plants, animals and minerals to prevent and treat various diseases. In this respect, plants have been of particular importance. Ethnobotany is the science of reviewing how indigenous people and local tribes have used their regional plants for particular purposes such as treating diseases in the past. The information gathered from such studies can help to improve national health systems and even lead to the discovery of new medicines. Keeping this in mind, in this study a survey of Sirjan area ethnobotany was conducted during 2011–2012. Materials and methods: At the beginning, thirteen local people were interviewed about their region?s medicinal plants and their consumptions. These plants were collected and identified using identification keys. The data collected was analyzed using quantitative value indices F IC, RFC and CI. Result: Many plants collected have medicinal properties and have been used by local people to treat various ailments. Of these plants, nineteen families, 37 genera and 43 species belonged to medicinal plants. Among them, Lamiaceae with 8 species and Malva L. with 3 species were the largest medicinal plant families and genera, respectively. These plants are often used as decoction (28%) and as powder (21%). Also, the fruit of these plants are used most often. Besides being used as medicinal plants, they have other uses such as food, fuel, etc. Malva sylvestris has the largest value of relative frequency of citation and cultural importance indices. The most ailment categories have the highest level of informant agreement (mean F IC=0.92). Conclusion: Despite the semi-desert climate and lack of rich vegetation, many medicinal and economic plants are found in Sirjan region. Uncontrolled harvesting of the medicinal plants such as Bunium persicum, Cuminum cyminum, Zataria multiflora and Satureja bachtiarica in this region by local people has increased the risk of their extinction and calls for a restrict control over their protection by the authorities. [Copyright &y& Elsevier]

Opium addiction and cutaneous leishmaniasis (CL) are endemic in different parts of Iran, particularly in Bam, where a massive earthquake occurred. This study was designed to compare the incidence rate and severity of CL cases among opium addicted and non-addicted individuals in south-eastern Iran. This study was carried out as a prospective cohort by active house-to-house visits of 1,481 habitants in Bam. CL cases were confirmed by smear and identification of Leishmania species was performed using nested-PCR. The data was analyzed by χ2 and t-tests, using SPSS software and also Kaplan-Meier survival curve and long-rank test in Stata 11.2 and P<0.05 was considered as significant. A total of 904 individuals consisting of 226 opium addicted and 678 non-addicted individuals were followed-up for a period of seven years. The two cohorts were similar in terms of age, sex and place of residency. A similar pattern of incidence was observed among the two cohort groups. In contrast, the severity of CL in terms of the number, duration and the size of the lesions in opium addicted individuals was significantly (P<0.001) higher than non-opium addicted individuals. In conclusion, the present findings indicate that there is no relationship between the incidence of CL and opium addiction. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the prevalence of low birth weight (LBW) and its related risk factors in an appropriate sample of neonates in Shahroud, northeast Iran. Methods: At this study, a random sample of 1000 neonates were selected of which 72 neonates were LBWs. We used univariate and multivariate logistic regression methods to evaluate the LBW risk factors in LBWs compared to normal weight infants. Findings: 7.2% of neonates were LBWs and 6.1% born before 37 weeks of gestation. Prematurity, high-risk pregnancy and maternal age have significant statistical association with LBW. Odds Ratio (OR) for prematurity was 42.82 (95%CI; 21.93-83.57), for high risk pregnancy 2.76 (95%CI; 1.47-5.19) and for maternal age group more than 35 years in comparison to 19-35 years age group 0.2 (95%CI; 0.05-0.71). Conclusion: Based on this study; prematurity and high risk pregnancy were the most important risk factors for LBW. There was also a reverse association between maternal age and LBW. [ABSTRACT FROM AUTHOR]

Four species of the genus Berberis L. have been reported from different regions, including Khorassan provinces. In this article, a revision of this genus in Khorassan provinces is presented. For better validation of the results, morphological, palynological, chromosomal and molecular studies were conducted on specimens collected from Khorassan provinces and preserved in FUMH and TARI herbaria. Morphological study resulted in recognition of three species of Berberis, from which two species are new records for Khorassan. Four unknown new taxa with new morphological characters were also identified, but left for further analysis because of the high percentage of polyploidy and hybridization in this genus. In order to analyze morphological data, 35 OTUs were provided and scored using the distance method and PCoA. The shape and size of pollen grains were nearly equal in the examined taxa, and there were no obvious differences between them. Chromosomal examination indicated tetraploidy (2 n = 4 x = 56) in all of the studied taxa. Molecular studies were accomplished by RAPD and sequencing of the ITS region to construct a framework of relationships between the taxa. Molecular studies emphasized the difference in the four unknown taxa from others. The total evidence indicates that Berberis L. shows a high percentage of polyploidy and hybridization. [ABSTRACT FROM AUTHOR]

Abstract: Phylogenetic analysis of 155 nuclear rDNA ITS sequences among them 19 Iranian endemic genera were used to elucidate phylogenetic relationships of Old World Brassicaceae from Iran in the context of the most recent tribal system suggested by Al-Shehbaz et al. [Al-Shehbaz, I.A., Beilstein, M.A, Kellogg, E.A., 2006. Systematics and phylogeny of the Brassicaceae (Cruciferae): an overview. Plant Syst. Evol. 259, 89–120]. Iranian endemic taxa are assigned to 16 clades, 15 of these correspond to recognized tribes. Our data support the recent tribal recognition of Calepina and relatives and further indicate that the Orychophragmus clade (with Conringia planisiliqua and Orychophragmus) may be recognized as a new tribe. Our data also support the inclusion of 13 genera not previously studied, or with unresolved positions in previous phylogenetic analyses in 10 tribes with the tribal assignment given in parentheses: Acanthocardamum (Aethionemeae), Alyssopsis (Camelineae), Anastatica (Malcolmieae), Asperuginoides (Cochlearieae), Camelinopsis (Thlaspideae), Didymophysa (Thlaspideae), Dielsiocharisi (Camelineae), Lachnoloma (Anchonieae), Micrantha (Anchonieae), Noccidium (Camelineae), Octoceras (Euclidieae), Pseudofortuynia (Sisymbrieae) and Streptoloma (Euclidieae). ITS data and morphological characters further indicate that the remaining five genera, i.e., Acanthocardamum, Olimarabidopsis, Brossardia, Noccidium and Zuvanda may be subsumed under Aethionema, Alyssopsis, Noccaea, Capsella and Conringia, respectively. Alyssum, Chorispora, Fibigia and Goldbachia are paraphyletic and Conringia, Malcolmia, Matthiola are polyphyletic taxa. [Copyright &y& Elsevier]

Background: Osteoporosis is an important public health problem in older adults. It is more common in postmenopausal women and not only gives rise to morbidity but also markedly diminishes the quality of life in this population. There is lack of information about the risk factor of osteoporosis in developing countries. In this study we aimed to assess the risk factors for osteoporosis in postmenopausal women from selected BMD centers of two developing Asian countries (Iran and India). Methods: This study is a multicenter interview-based study conducted in selected hospitals and health centers from urban areas in Iran and India. The case group included postmenopausal osteoporotic women who were identified as patients with bone density higher than 2.5 SD below average of young normal bone density (in L1-L4) spine region interest and/or total femoral region) by using DEXA method. The controls were chosen from postmenopausal women with normal bone density (in L1-L4 spine and total femoral regions using DEXA method) matching in age groups was strategy of choice. The sample sizes included from Iran a total of 363 subjects (178 osteoporotic and 185 normal) and from India a total of 354 subjects (203 osteoporotic and 151 normal). Results: The significant (p < 0.05) risk factors in present study population with their Odds Ratios (in parenthesis, respectively in Iran and India) were as follow: Lower education defined as less than class 12 or nil college (2.1) (2.7), duration of menopause greater than 5 years: (2.2) (1.4), Menarche age (after 14 years): (1.9) (1.6), Menopause age (before 45 years): (1.1) (2), Parity more than 3: (1.1) (1), Bone and joint problem (2.3) (2.2). Calcium supplementation (0.6) and HRT (0.4) were shown as protective factors and steroid therapy (3.3) was found as a risk factor in Iran. Calcium supplementation more than 1 year (0.3) was shown as a protective factor in India. Pure vegetarianism: (2.2) and Red meat consumption more than 4 times per week (1.4) was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3), almond (0.5), fish (0.5), fruits (0.4) and milk tea 4 cups per day and more (0.4) appeared to be significant protective factors in India. Regular consumption of cheese (0.5), milk (0.5), chicken (0.4), egg (0.6), fruit (0.4), tea 7 cups per day and more (0.3) were found to be significant protective factors in Iran. Exercises were shown as protective factor in Iran (0.4) and India (0.4). There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects. Conclusion: Osteoporosis in Iranian and Indian subjects also appears to be associated with several known risk factors that well described in the literature. There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects. It was shown a protective role of certain nutritional dietary components and also exercises in both populations and can be exploited in preventive educational strategies on osteoporosis in these populations. [ABSTRACT FROM AUTHOR]

High concentrations of fluoride (F) in powdered milk (formula milk) can have adverse health effects on the body. The F concentration in powdered milk was analysed in Iran in 2010. A total of twelve commercial brands of highly consumed powdered milk were selected to analyse the F content through the standard F ion-selective electrode method. From each brand, three samples with different production dates were selected. The means and standard deviation for F concentration in all the samples was 1·73 (sd 0·3) μg F/g. The minimum and maximum F content in powdered milk brands Humana2 and Humana3 was 1·32 (sd 0·1) and 2·36 (sd 0·3) μg F/g, respectively. The study revealed that there was no significant difference in F concentration in the samples that belonged to various dates. Humana3 had a high F concentration (with an average of 2·36 (sd 0·3) μg F/g), which can be a risk factor for increased dental fluorosis, especially when being prepared using water with a high content of F. [ABSTRACT FROM PUBLISHER]

Background: Metabolic syndrome (MetS) is a growing public health problem with a worldwide distribution, and its prevalence is rapidly increasing worldwide. Hence, this study aimed to compare the prevalence of MetS based on the International Diabetes Federation (IDF), the National Cholesterol Education Program Expert Panel Adult Treatment Panel III (NCEP ATP III), and the American Association of Clinical Endocrinologists (AACE) diagnostic criteria. Materials and Methods: In this cross-sectional study, a total of 4737 people aged 45–69 years were enrolled in the 2nd phase of Shahroud Eye Cohort Study. We evaluated the prevalence of MetS with 95% confidence intervals by age and sex groups and according to MetS components. The accuracy (sensitivity and specificity) of these three methods was compared using latent class analysis. Finally, kappa statistic was used to determine the agreement between the diagnostic methods. Results: The prevalence of MetS varied from a minimum of 47.2% (as defined by the AACE) to a maximum of 60.0% (as defined by the IDF). The sensitivity of the three diagnostic methods of IDF, NCEP ATP III, and AACE was 98.9%, 94.4%, and 91.1%, respectively, and the specificity of these three methods was 94.6%, 97.0%, and 98.4%, respectively. Moreover, the highest agreement was found between the definition of the IDF and the NCEP ATP III. Conclusion: The IDF diagnostic method has a higher sensitivity for the diagnosis of MetS in Iranian middle-aged people. It is recommended to use this method for identifying more people at risk of MetS. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which presents a case-control study on infant mortality risk factors in a northeastern area of Iran.

• This investigation was conducted as a case-control retrospective study • Patient history of cutaneous leishmaniasis reduced COVID-19 morbidity and mortality • Further longitudinal studies are needed to explore this protection We assessed the potential relationship between COVID-19 and laboratory-confirmed cutaneous leishmaniasis (CL)-registered cases with a history of scarring, compared with volunteer participants without history of CL. This case-control retrospective study was conducted in southeastern Iran with a high anthroponotic cutaneous leishmaniasis (ACL) burden. Overall, n=1010 CL cases (n=479 male, n=531 female) were evaluated for infection with SARS-CoV-2. In the CL case group, 2 men and 1 woman (0.3% in total) had a mild form of COVID-19 disease; none were hospitalized or died. In contrast, of n=2020 participants without history of CL, n=57 (2.9%) contracted laboratory-confirmed COVID-19, including mild (66.7%), hospitalized (26.3%), critical (3.5%) and fatal (3.5%). There was a strong negative association between CL infection and COVID-19. The burden of COVID-19 in CL-cured participants significantly reduced the morbidity (odds ratio: 0.12; CI: 0.03–0.30; P <0.001) and mortality (percentile: -4.10, -0.02). Participants with a history of CL scar had significantly reduced incidence of COVID-19 morbidity and mortality. The cross-protection mediated by CL may retard COVID-19 in endemic countries. However, further longitudinal studies are needed to explore the potential profile and duration of this protection offered by CL against COVID-19. [ABSTRACT FROM AUTHOR]

Persian poppy (Papaver bracteatum Lindl) is a precious medicinal plant found in limited regions of Iran. This plant possesses a significant amount of thebaine alkaloid, which can be easily converted into codeine. It can also be converted into Bentley compounds and several narcotic antagonists. This research aimed to investigate the morphological differences among nine Iranian populations of P. bracteatum in their natural habitats and compare them based on biochemical characteristics, such as thebaine content, amino acids, and fatty acids. The morphological variations were assessed using 30 quantitative traits. Analysis of variance revealed significant differences in 18 morphological characteristics among populations. The evaluation of thebaine content indicated that capsules consistently had higher thebaine content (3.7–9.3%) compared to roots (1.3–4.8%), stems (0.6–2.5%), and leaves (0.7–1%) in all populations, and the Rangeh-Rizhan population displayed the highest thebaine content (9.3 ± 0.12%) in capsules. Furthermore, 25 amino acids and four fatty acids were identified in leaves and were used as chemotaxonomic markers to distinguish between populations. Based on morphological and biochemical characteristics as well as combined datasets, five distinct clusters were created, each of which included two main groups and a few subgroups. However, populations inside the groups differed slightly in various clusters; Mahabad, Rangeh-Rizhan, and Janevareh populations were distinctly separated from others in clusters formed using morphological, fatty acids, and combined datasets. On the other hand, a clear-cut separation of the Polur population from the rest was evidenced in clusters created from thebaine and amino acids data. The principal coordinate analysis (PCoA) results were largely aligned with those of cluster analysis. This research revealed a high degree of morphological and phytochemical variations among P. bracteatum populations, which could provide new insights into the conservation and breeding of the Persian poppy populations. • Morphological diversity among Papaver bracteatum populations was investigated. • Amino and fatty acids may be effective tools for infra-species delimitation. • Capsules had higher thebaine content than roots, stems, and leaves. [ABSTRACT FROM AUTHOR]

[Display omitted] • Iranian mints showed a great diversity in essential oil yield and components. • First essential oil yield report in M. villosa , M. suaveolens , M. rutoundifolia. • Mentha suaveolens had the highest amount of essential oil yield 1.3 % (w/w). • Menthol (53.1 %) was the maximum constituent found in M. piperita. • For the first time carvone (27.12 %) was identified in M. rutoundifolia. Mentha is an important aromatic plant in the Lamiaceae family with a great industrial potential which has a very complex classification. Mint genotypes (Mentha × piperita 'Black', M. × piperita 'White', M. × aquatica , M. × villosa , M. longifolia , M. rutoundifolia , M. suaveolens) were gathered from different regions of Iran to investigate their essential oil (EO) yield and components. Mints were cultivated in the greenhouse and their essential oils were obtained by hydro distillation. EO yield varied from 0.51 to 1.3% (w / w). Gas chromatography analysis revealed that each species consisted of 46–64 constituents which make up about 98.2 %–99.85 % of their essential oils. A total 111 types of chemicals were identified, of which only ten were common between species, which together constitute 0.5 %–3.5 % of the total essential oils. The other 101 components showed a great diversity, of which 29 were major constituents of these genotypes. Principle component analysis (PCA) showed that the type and amount of the constituents are important to determine their groups. Diversity classification based on quantity and quality of EOs, put them into four groups. The highest detected components in the respective mints were: carvone (55.08 %), M. suaveolens ; menthol (53.1 %), M. ×piperita 'Black'; pulegone (44.55 %), M. longifolia ; menthofuran (38.67 %), M.×aquatica ; menthol (32.36 %), M. × piperita L. 'White'; carvone (27.12 %), M. rutoundifolia ; and neo-menthol (22.79 %), M.× villosa. For the first time new constituents were identified: α-terpinyl acetate (5.03 %) and geranyl tiglate (10.81 %) were found in M. longifolia ; carvone (27.12 %) was identified in M. rutoundifolia ; and neo-menthol (22.79 %) and pulegone (10.90 %) were detected in M. villosa. The phytochemicals demonstrate a great diversity among the studied Iranian mint species. These results merit further investigations at the gene expression and proteomics levels. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a Mediterranean dietary pattern on the incidence of macrovascular and microvascular complications of diabetes, namely cardiovascular disease (CVD), diabetic foot disorders, diabetic retinopathy, nephropathy, and neuropathy.Methods: This longitudinal study was conducted among 71392 adults with diabetes who attended academic tertiary-care outpatient clinics from February 2016 to March 2020 across Iran using the National Program for Prevention and Control of Diabetes database. Among them, 22187 patients with diabetes (type 1 and type 2) completed 2-11 follow-up visits after baseline registration. The association between adherence to a Mediterranean diet and diabetic complications was assessed using pooled logistic regression models. This association was adjusted for potential confounders. The effect of time was assessed using fractional polynomials.Results: A total of 22187 participants were included in the analysis (30.22% men and 69.78% women) with either type 1 (mean age 50.7 years) or type 2 (mean age 59.9 years) diabetes. After adjustment for confounding variables, there was a negative correlation between adherence to a Mediterranean diet and the incidence of CVD among patients with type 1 diabetes (T1D) and 2 diabetes (T2D) (OR= 0.53, 95% CI: 0.37 - 0.75, p-value <0.001 and OR= 0.61, 95% CI: 0.57 - 0.89, p-value <0.001, respectively). Also, the diet had a statistically significant protective effect against incident symptomatic neuropathy (OR= 0.32, 95% CI: 0.23 - 0.43, p-value <0.001, and OR= 0.68, 95% CI: 0.64 - 0.72, p-value <0.001, respectively), nephropathy (OR= 0.42, 95% CI: 0.30 - 0.58, p-value <0.001, and OR= 0.88, 95% CI: 0.80 - 0.96, p-value= 0.007, respectively), and retinopathy (OR= 0.32, 95% CI: 0.24 - 0.44, p-value <0.001, and OR= 0.68, 95% CI: 0.61 - 0.71, p-value <0.001, respectively) in T1D and T2D.Conclusion: The Mediterranean dietary pattern is associated with a lower incidence of CVD and microvascular complications (i.e. diabetic retinopathy, nephropathy, and neuropathy) among a cohort of patients with T1D and T2D in Iran. [ABSTRACT FROM AUTHOR]

Nickel bearing soils derived from serpentinized ultramafic rocks are widely exposed as two parallel zones in Bavanat region along the Sedimentary Zagros Orogenic (SZO) and Metamorphic Sanandaj-Sirjan (MSS) belts. These laterites in the Mazayejan area of the Northern zone are divided into two groups; the in situ soils found mainly in the east, and the transported soils which are common in the west of the study area. The maximum Ni concentration of the studied soils is 1787 μg g−1. The main vegetation types of the area include open shrub lands and semi-desert steppes. Many soil characteristics in the study area are quite variable, such as Mg/Ca ratio, exchangeable metal fraction, extraction efficiency (EF), pH, organic content (OM), texture, and cation exchange capacity (CEC) as well as seasonal variation of Ni availability and metal transfer to plants. This study indicated that low Mg/Ca ratio (0.1–2.3 μg g−1), high carbonate content (up to 42.8 wt%) and very low exchangeable Ni fraction (0.01–0.34 μg g−1) result in low uptake of nickel by plants. Low EF, but high pH and OM result in Ni fixation in the soils, and consequently low Ni transfer factor to plants. Clay textured soils with high CEC (10.5 wt%) are characterized by the lowest transfer coefficient of Ni from soil to plant, due to the stronger adsorption of Ni in the soils. Ni concentration in living tissues change with the season, the leaves of the same plants investigated in autumn contain more Ni than in spring. As a result, plant sampling in autumn should be preferred for nickel exploration when using biogeochemical and other methods such as Ni phytoextraction, by selected plants. Unlabelled Image • Laterites in Bavanat are divided into in situ and transported Ni-bearing soils. • Soil properties and sampling seasons affect Ni availability and transfer to plants. • Low Mg/Ca ratio, EF and exchangeable Ni fraction result in low uptake of nickel by plants. • High pH, CEC, OM values and clay texture lead to low transfer coefficient of Ni to plants. • Plant sampling in autumn is preferred in mineral exploration. [ABSTRACT FROM AUTHOR]

Abstract The objective of the present study was to compare the host's immune responses between unresponsive and responsive patients with anthroponotic cutaneous leishmaniasis (ACL) treated by meglumine antimoniate. A case-control study was carried out in an endemic focus in Iran. Blood samples were taken from patients and peripheral blood mononuclear cells (PBMCs) were isolated. Two wells were considered for each isolate of unresponsive and responsive patients; one was exposed to L. tropica (Lt -stimulated cells) and the other remained non-exposed (non-stimulated cells). After 24 h of incubation, whole RNA was extracted from each sample. Real-time quantitative PCR was carried out to confirm the differences in expression levels of IL-12 P40, IFN-γ, IL-1β, IL-4 and IL-10 among isolates. Data were analyzed and P < 0.05 was considered to be statistically significant. In our study, Lt -stimulated cells and non-stimulated cells in unresponsive groups demonstrated significantly lower expression levels of IL-1β, IL-12 P40 and IFN-γ genes and higher expression levels of IL-4 and IL-10 genes, compared to Lt -stimulated cells and non-stimulated cells in responsive groups. There was a negative correlation between IL-12 P40 with IL-10 and IL-1β with IL-10 in ACL Lt -stimulated cells in unresponsive group, while a positive correlation between IL-12 P40 with IL-1β and IL-12 P40 with IFN-γ in ACL Lt -stimulated cells in responsive group. Probably, different immune responses caused by various factors play a major role in the pathogenesis and development of unresponsiveness in ACL patients. The profile and timing of cytokine production correlated well with the treatment outcome of Leishmania infection. Graphical abstract Unlabelled Image Highlights • Blood samples were taken from two groups of patients with ACL and PBMCs were isolated. • Real-time qPCR was carried out to confirm the differences in expression levels of cytokines. • Significantly lower expression levels of IL-1β, IL-12 P40 and IFN-γ genes in unresponsive groups. • Significantly higher expression levels of IL-4 and IL-10 genes in unresponsive groups. [ABSTRACT FROM AUTHOR]

Context: Proper accountability to needs of premature infants' parents requires recognition of these needs and how they change in different conditions. Objective: This Meta-synthesis was conducted to understand the needs of Iranian parents with premature infants through their experiences in order to promote family-centered care. Data Sources: The search was conducted through the Iranian database (Iran Medex, Magiran, SID) and international resources (PubMed, Scopus, Google Scholar), without time limitation to April 12, 2015. Study Selection: The inclusion criteria for this study included the qualitative studies conducted in Iran on parents with premature infants. Consolidated criteria for reporting qualitative studies (COREQ) were used to assess the quality of articles. Data Extraction: This study is a meta-synthesis of 16 qualitative studies based on Noblit and Hare's (1988) methodology. Results: The meta-synthesis presented 5 correlated metaphors derived from 13 categories and 78 integrated codes. The metaphors indicated the most important needs of parents who have premature infants for emotional, instrumental, spiritual, appraisal, informational, and communicational support. In most cases, these needs overlapped with blur boundaries. The categories included: cultural challenges of parental role, parental development versus psychological stress, psychological stress stimuli, economic challenges of parental role, physical irritation, the need for family-centered care, the need for policy making regarding the constant presence of parents in the NICU, spiritual prosperity vs. spiritual alienation, spiritual self-care vs. spiritual self-harm, guided participation in caring for the infant, the efforts to meet parental role, informational challenges of parents, and informationalcommunicational supports. Conclusions: This Meta-synthesis provided a better understanding of the experiences of Iranian parents with premature infants and different areas of their needs. These findings could be used to design a comprehensive support system for such parents, which incorporate a holistic view of patient concerns, including religion and spirituality. [ABSTRACT FROM AUTHOR]

Background: Quality of life is an important indicator for the assessment of individual health, decision-making, and passing judgment on the overall health of the community. Objectives: This study aimed at comparing the quality of life among fertile and infertile women and the factors affecting it. Materials and Methods: In this cross-sectional study, the quality of life of 511 infertile women and 1017 fertile women was assessed using the Persian Version of SF36 quality of life questionnaire in 2013. To examine the relationship between demographic variables and quality of life, chi-square test and analysis of variance were used. The relationship between the factors affecting the quality of life was evaluated using multiple regressions. Results: Almost 10.1% of the participants reported low and very low quality of life, 38.6% reported average, and 51.3% reported good or very good quality of life. No significant difference was observed in the level of quality of life in fertile and infertile women (P = 0.8). The subscale mean scores of physical functioning and physical role limitation were significantly lower, and the mean scores of mental health and general health were higher in the fertile women than in the infertile. Conclusions: The results of the present study revealed that infertile women had significantly lower mean scores in the subscales of mental health and general health than the fertile women. [ABSTRACT FROM AUTHOR]

Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery. Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum. Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65±12.7 and 72.12±11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05). In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350]) and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023]) domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]). While multiparas, there was no relationship between QOL and type of delivery. Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery. [ABSTRACT FROM AUTHOR]

This quasi-experimental study aimed to evaluate the impact of spiritual reminiscence therapy (SRT) on depression and hope among older adults living in Shahroud, northeast of Iran. One hundred fifty-six older adults were selected through convenience sampling and assigned non-randomly to the intervention (n= 78) and control (n= 78) groups. The data collection tools included the Geriatric Depression Scale and Adult Hope Scale. For the intervention group, SRT was conducted in six weekly sessions, each lasting 60 to 90 min, over six weeks. The data were analyzed utilizing descriptive statistics and inferential tests (independent t-test, Chi-square test, and analysis of covariance). The two groups' post-intervention mean scores on depression (t= 11.63 and P< 0.001), and hope (t= 4.41 and P< 0.001) were statistically different, suggesting that SRT positively affected older adults by alleviating despair and boosting hope. The findings indicate that engaging in SRT can be beneficial in reducing depression and fostering hope among older adults., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Leishmaniasis is a complex disease. Any change in weather conditions affects the humans' social and agricultural expansion and, consequently, the parasite's life cycle in terms of ecology, biodiversity, social stigma, and exclusion. This population-based prospective longitudinal investigation was conducted between 1991 and 2021 in a well-defined CL (cutaneous leishmaniasis) focus in Bam County, southeastern Iran. A robust health clinic and health surveillance system were responsible for the ongoing systematic documentation, detection, identification, and management of CL cases. The exponential smoothing method via the state space model was used in the univariate time series. The TTR, smooth, and forecast packages were used in R software. Landsat satellite images from 1991, 2001, 2011, and 2021 were employed in the physical development. During this period, the temperature increased while the rainfall and humidity decreased. The findings showed a downward trend in the standardized drought index. Also, the results showed that climate warming and ecological changes profoundly affected the area's agricultural patterns and topographical features. Furthermore, the last three decades witnessed an elimination trend for zoonotic CL (ZCL) and the predominance of anthroponotic CL (ACL). The present findings showed that the critical factors in the predominance of ACL and elimination of ZCL were rising temperature, drought, migration, unplanned urbanization, earthquake, and agrarian reform. The wall-enclosed palm tree gardens excluded the primary ZCL reservoir host. They controlled the disease while providing suitable conditions for the emergence/re-emergence of ACL in the newly established settlements and the unplanned ecozone. Therefore, robust health infrastructures, sustained financial support, and evidence-based research studies are crucial to facilitating the necessary surveillance, monitoring, and evaluation to control and eliminate the disease., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: The Fear of Childbirth (FOC) is associated with several adverse health outcomes for children and women. This study aimed to evaluate the effectiveness of an interactive mobile health application named Tele-midwifery with an emphasis on continuous care and education, on FOC, self-efficacy, and childbirth mode in primiparous women., Methods: Seventy primiparous women attending the prenatal clinic of Baharlou Hospital in Tehran, Iran, were randomly assigned to two parallel intervention and control groups with 35 participants each. Women in the intervention group received Tele-midwifery for eight weeks, whereas women in the control group only received routine care. The Wijma delivery expectancy/experience questionnaire and the Childbirth Self-Efficacy Inventory were used to measure the FOC and self-efficacy at baseline and eight weeks after the intervention. The FOC and birth mode were also measured after birth., Results: There was a significant decrease in FOC among women in the intervention group compared to control groups after eight weeks of intervention (- 20.9 [95% Confidence Interval,-24.01 to-17.83], p < 0.001), and after birth (- 30.8, [95% CI-33.8 to-27.97], p < 0.001). After eight weeks, the mean self-efficacy score in the intervention group was significantly higher than the control group (p < 0.001). Compared to the control group, the intervention group had a lower C-Section (CS) rate (p = 0.03)., Conclusions: Tele-midwifery intervention reduced FOC, increased women's self-efficacy in childbirth, and decreased the number of CS in a group of first-time mothers. Healthcare providers can use the mHealth approach to support pregnant women with FOC., Trial Registration: Registration number: IRCT20200122046227N1, Registered on 27 January 2020., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Khademioore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Endotracheal intubation and mechanical ventilation are prevalent interventions in the operating room and intensive care unit. Recently, the complications of endotracheal tube cuff pressure have been a topic of interest. Therefore, this study compared the effect of pressure control and volume control ventilation modes on the endotracheal cuff pressure rate in patients undergoing general anesthesia and mechanical ventilation., Methods: In this triple-blinded randomized clinical trial, 50 patients undergoing open limb surgery and inguinal hernia were allocated to two groups of 25 based on inclusion criteria. After intubation, one group underwent ventilation on the pressure control ventilation mode, and the other underwent ventilation on the volume control ventilation mode. In both groups, using a manometer, the cuff's pressure was first adjusted in the range of 25-30 cm of water. Then, the cuff pressure was measured at 10, 20, and 30 min intervals. The data were statistically analyzed using independent t-test, and two-way repeated measures ANOVA., Results: The present study's findings showed that cuff pressure has significantly decreased over time in both study groups (F = 117.7, P < 0.001). However, a repeated measures ANOVA with a Greenhouse-Geisser correction showed no interaction between time and groups (F = 0.019, P = 0.98). The two groups had no significant difference in cuff pressure (F = 0.56, P = 0.458)., Conclusion: Since the cuff pressure has been significantly reduced in both groups over time, continuous monitoring of endotracheal tube cuff pressure in patients undergoing mechanical ventilation is essential. Therefore, it is suggested to keep the cuff pressure within the recommended range to prevent complications resulting from cuff pressure reduction, such as aspiration and ventilation decrease., Trial Registration: The study was registered in the Iranian Registry of Clinical Trial on 23/02/2019 (trial registration number: IRCT20181018041376N1)., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sharifi, Khosravi, Aflatoonian, Salarkia, Bamorovat, Karamoozian, Nekoei Moghadam, Sharifi, Aghaei Afshar, Agha Kuchak Afshari, Gharachorloo, Shirzadi, Amiri, Zainali, Doosti, Zamani and Gouya.)

Leishmaniasis is an overlooked, poverty-stricken, and complex disease with growing social and public health problems. In general, leishmaniasis is a curable disease; however, there is an expansion of unresponsive cases to treatment in cutaneous leishmaniasis (CL). One of the effective and ignored determinants in the treatment outcome of CL is poor treatment adherence (PTA). PTA is an overlooked and widespread phenomenon to proper Leishmania treatment. This study aimed to explore the effect of poor adherence in unresponsiveness to treatment in patients with anthroponotic CL (ACL) by comparing conventional statistical modalities and machine learning analyses in Iran. Overall, 190 cases consisting of 50 unresponsive patients (case group), and 140 responsive patients (control group) with ACL were randomly selected. The data collecting form that included 25 queries (Q) was recorded for each case and analyzed by R software and genetic algorithm (GA) approaches. Complex treatment regimens (Q11), cultural and lay views about the disease and therapy (Q8), life stress, hopelessness and negative feelings (Q22), adverse effects of treatment (Q13), and long duration of the lesion (Q12) were the most prevalent significant variables that inhibited effective treatment adherence by the two methods, in decreasing order of significance. In the inherent algorithm approach, similar to the statistical approach, the most significant feature was complex treatment regimens (Q11). Providing essential knowledge about ACL and treatment of patients with chronic diseases and patients with misconceptions about chemical drugs are important issues directly related to the disease's unresponsiveness. Furthermore, early detection of patients to prevent the long duration of the disease and the process of treatment, efforts to minimize side effects of treatment, induction of positive thinking, and giving hope to patients with stress and anxiety by medical staff, and family can help patients adhere to the treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)