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Using scanning electron microscopy (SEM), six Salsola species from Iran were examined for their epidermis, seed, and fruit micromorphology. Among them were S. brachiata from section Heterotricha, S dendroides, S. incanescens, and S. orientalis from section Caroxylon, S. kali from section Kali, and S. turcomanica from section Physurus. Epidermal cells are divided into three types. There were diamond, irregular, and polygonal cells, as well as straight and undulated walls. Studied species of Salsola have smooth or sculptured fruit surfaces, and there are three main types of fruit surface ornamentation. There is a significant difference between these species based on the type of hair and density of the fruit. Seed shape and color have little systematic significance. The seed epidermis is composed of polygonal, elongated polygonal, irregular, and diamond cells. Although polygonal and irregular testa cells are most common, their size and shape can provide additional information and useful diagnostic characteristics at both specific and infraspecific levels. For taxonomic separation, the current study provides novel insights at micromorphological levels. RESEARCH HIGHLIGHTS: This article reports halophyte are shown as models for adaptation to extreme habitats. These plants are placed among the ecological communities of xerophytes. Here, for the first time, the microstructural analysis of Salsola has been investigated. Additionally, it provides new insights into plant species' response to extreme conditions, as well as possible adaptation strategies at the micromorphological level., (© 2024 Wiley Periodicals LLC.)

Background: This study aimed to evaluate the implementation of the prevention of mother-to-child transmission (PMTCT) of the HIV-PMTCT program in Kermanshah, west of Iran, from 2014 to 2021., Methods: The data of all HIV-infected mothers and their infants who were monitored by the Kermanshah behavioral diseases counseling center was extracted and recorded in a checklist., Results: Out of 95 included infant, 45 (47.4%) were girls and 50 (52.6%) were boys. The mothers were mostly infected with HIV via their infected spouse. The pregnancies of 77 cases (82.1%) were in accordance with the national guideline. The average length of treatment for this group was 185 days. Of the 18 mothers who did not receive treatment, nine were diagnosed during childbirth and nine had no available information. All infants born from infected mothers underwent after-birth-antiretroviral prophylaxis, and all remained healthy. There was no statistically significant relationship between the birth weight and height of neonates with maternal age, maternal last viral load, disease stage, education, and maternal CD4 levels. Only a statistically significant relationship was observed between the duration of treatment and the infants' weight., Conclusion: The results suggest the feasibility and effectiveness of the PMTCT program for HIV-positive mothers in Kermanshah. It seems that if pregnant HIV-positive women are diagnosed early and covered by a good prevention program on time, the risk of HIV to their babies will be reduced, significantly., (© 2023. The Author(s).)

Background: One of the most common symptoms in COVID-19 patients is olfactory and taste dysfunction., Aims/objectives: This study aimed to evaluate the olfactory threshold, and identification using objective tests in the Iranian population., Material and Methods: The present study was a prospective cohort study conducted in 2020-2021 on clinically recovering COVID-19 patients. Olfactory function was evaluated at the baseline, 4-6 weeks, and 12 weeks later. Olfactory threshold assessment was performed using the Saba Sabalan kit. The Iranian version of the Pennsylvania Smell Identification Test (IR-SIT) was used for olfactory identification. The olfactory threshold was categorized as poor (<8) and good olfaction (≥8)., Results: In the present study, 111 patients were examined, including 55 men and 56 women (mean age 41.4 and 53.4 years, respectively). The mean olfactory threshold was better for men (7.2) than for women (6.6). Analysis showed age to have a negative relationship with good olfaction at baseline (OR = 0.93, p  = .05). Using IR-SIT, only 29.7% had normal olfactory function. Using linear regression, smoking was found to be significantly related to baseline IR-SIT score (adjusted Beta <0.001, p  = .03)., Conclusions and Significance: Objective tests are appropriate methods for assessing olfactory dysfunction in COVID-19 patients. Further studies are recommended.

Background and Aim: Hemodialysis treatment saves the life of people with end-stage renal disease (ERDS), but does not prevent the suffering of the disease, anxiety, hopelessness, and so on. Many studies have been performed on self-care behaviors as well as body image in different patients, but so far, no research has been done to investigate the relationship between self-care behavior and body image concerns in hemodialysis patients. Therefore, the aims of this study are to determine the relationship between self-care behavior and body image concern in patients undergoing hemodialysis., Materials and Methods: A cross-sectional design was used to evaluate Self-care Behavior and Concerns about Body Image in a convenience sample of 280 patients with ERDS. Measures included demographic factors, health characteristics, and validated instruments of the study constructs Body Image Concern Questionnaire (BICI) and Assessment of self-care behaviors with arteriovenous fistula (ASBHD-AVF)., Results: This study showed that self-care behaviors have the ability to predict body image concerns. There was a negative and significant relationship between self-care behavior and body image concern ( B = -0.162, β = -0.140, p = 0.020). These variables explain 7.5% of predictors., Conclusion: Although the findings of the present study showed that increasing age and improving the level of self-care behaviors in patients undergoing hemodialysis reduces body image anxiety, but women were the strongest predictor of body image anxiety., 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 © 2022 Sharif Nia, Kohestani, Froelicher, Ibrahim, Ibrahim, Bayat Shahparast and Goudarzian.)

Severe forms of the coronavirus disease 2019 (COVID-19) can progress to sepsis-like complications accompanied by "cytokine storm" for which the most effective treatment has not yet been established. Our study describes the results of CytoSorb hemoadsorption in COVID-19 patients treated on the intensive care unit (ICU). In this retrospective study, 26 patients with COVID-19 and acute respiratory distress syndrome (ARDS) were treated with hemoadsorption therapy. Pre-, and post-treatment values (clinical and laboratory) were compared. Data are expressed as mean (confidence intervals, CI), or median [interquartile ranges, IQR], as appropriate. Patients received 2 hemoadsorption treatments. This resulted in a significant decrease in norepinephrine requirements, and inflammatory marker plasma concentrations (procalcitonin, C-reactive protein, ferritin) when comparing pre versus post treatment levels. The PaO 2 /FiO 2 and overall organ function (ie, Sequential Organ Failure Assessment-SOFA score) also improved significantly. Patients stayed on the ICU for 9 days and 21 of them survived. To the best of our knowledge, this is one of the largest case series to date reporting early experiences on extracorporeal hemoadsorption therapy in SARS-CoV-2 positive patients with hyperinflammation and moderate ARDS. Treatment proved to be effective, technically feasible and well-tolerated., (© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)

Objectives: matrix metalloproteinases including matrix metalloproteinase-2 play a key role in endometrial extra cellular matrix breakdown in endometriosis. Aberrant expression of matrix metalloproteinase-2 has been reported in eutopic and ectopic endometrial tissue of endometriosis patients so altered expression of matrix metalloproteinase-2 due to polymorphisms may lead to establishment and progression of endometriosis. In this study the association between -735 C/T (rs2285053) and -1575 G/A (rs243866) variants of matrix metalloproteinase-2 gene with presence of endometriosis in an Iranian population were investigated for the first time., Study Design: A case-control association study was conducted to investigate the role of MMP-2-735 C/T and &#95;1575 G/A variants in development of endometriosis. Polymerase chain reaction-restriction fragment length polymorphism method was used to determine genotype frequencies of these variants in 100 endometriosis patients and 200 normal samples. Total genomic DNA was extracted from blood samples and single-nucleotide polymorphism flanking regions were amplified using designed specific primers. Enzymatic digestion was performed using Pag I and Hinf I restriction enzymes for rs2285053 and rs243866 variants, respectively. Statistical analysis was ascertained using statistical package for social science version 16 and "SHEsis" software., Results: There were no significant differences in genotype frequencies of rs2285035 (-735C/T) variant between case and control groups (CC + CT vs. TT p = 0.40; OR = 0.50, 95 % CI 0.100-2.551). There were also no significant differences for C allele frequencies in both case and control groups (p = 0.9). For variant rs243866 (-1575 G/A) the differences in genotype frequencies between case and controls group were determined to be significant (GG + GA vs. AA p = 0.041; OR = 6.46, 95 % CI 0.82-50.43). The frequency of G allele was significantly different in case and control groups (p = 0.037)., Conclusion: In conclusion, existence of rs243866 variant in promoter region of matrix metalloproteinase-2 gene can increase the risk of endometriosis in Iranian women., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2020. Published by Elsevier B.V.)

Background: Despite 2.5 million infections and 169,000 deaths worldwide (as of April 20, 2020), no maternal deaths and only a few pregnant women afflicted with severe respiratory morbidity have been reported to be related to COVID-19 disease. Given the disproportionate burden of severe and fatal respiratory disease previously documented among pregnant women following other coronavirus-related outbreaks (SARS-CoV in 2003 and MERS-CoV in 2012) and influenza pandemics over the last century, the absence of reported maternal morbidity and mortality with COVID-19 disease is unexpected., Objective: To describe maternal and perinatal outcomes and death in a case series of pregnant women with COVID-19 disease., Study Design: We describe here a multiinstitution adjudicated case series from Iran that includes 9 pregnant women diagnosed with severe COVID-19 disease in their second or third trimester. All 9 pregnant women received a diagnosis of SARS-CoV-2 infection by reverse transcription polymerase chain reaction nucleic acid testing. Outcomes of these women were compared with their familial/household members with contact to the affected patient on or after their symptom onset. All data were reported at death or after a minimum of 14 days from date of admission with COVID-19 disease., Results: Among 9 pregnant women with severe COVID-19 disease, at the time of reporting, 7 of 9 died, 1 of 9 remains critically ill and ventilator dependent, and 1 of 9 recovered after prolonged hospitalization. We obtained self-verified familial/household cohort data in all 9 cases, and in each and every instance, maternal outcomes were more severe compared with outcomes of other high- and low-risk familial/household members (n=33 members for comparison)., Conclusion: We report herein maternal deaths owing to COVID-19 disease. Until rigorously collected surveillance data emerge, it is prudent to be aware of the potential for maternal death among pregnant women diagnosed as having COVID-19 disease in their second or third trimester., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: To investigate predictors of fear of falling (FOF) among older people with or without hip fracture., Methods: The FOF was assessed by the Visual Analogue Scale (VAS-FOF), anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). The modified Berg Balance Scale (mBBS) to evaluate functional balance was used. All people were asked to complete the dizziness Handicap Inventory (DHI) and the 36-item Short Form Health Survey (SF-36) for evaluating quality of life., Results: Eighty-eight older adults (44 cases; 44 controls) took part in this study. The case group had received surgical intervention for femoral neck or trochanteric fracture resulting from a fall. The results showed significantly more intensity of FOF in hip fracture patients than controls ( p < .001). The FOF was significantly correlated with anxiety, DHI, mBBS, and SF-36. The results of the multiple linear regression showed that four predictors explained about 44% of the variance of the FOF. It was found that mBBS and DHI significantly predicted FOF ( p < .001 and < .001, respectively)., Conclusions: The hip fracture patients had a high degree of the fear of falling, low quality of life and low functional capacity. The mBBS and DHI were significant predictors of the FOF in older adults., Clinical Implications: It may be useful to employ an inter-disciplinary approach to addressing fear of falling to best understand physiological and psychological contributions.

Background: Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics., Methods: The current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12-70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire., Results: A significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value<0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001)., Conclusion: Topical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics., Competing Interests: Declaration of Competing Interest The author’s confirm that there is no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: This study is aimed at investigating the olfactory function among different subtypes of Parkinson disease (PD) and the impact of sex on smell identification test., Methods: In this cross-sectional study, we used Iran-smell identification test (Iran-SIT). PD severity was determined using a Hoehn and Yahr (H&Y) scale. We used analysis of covariance (ANCOVA) to compare the olfactory function among different PD subtypes. All analyses were performed using SPSS software version 16.0., Results: In total, 66 males and 38 females participated in this study. The most common PD subtype was postural instability and gait difficulty (38.5%). Severe hyposmia and anosmia were found in 44.6 and 19.6% of participants, respectively. Women had a higher score in olfactory function than men (p = 0.44). The score of subjects with stage 1 in the H&Y scale was about 3 points higher than the score with stage 4. The ANCOVA showed a statistically significant effect of subtypes PD on Iran-SIT score after controlling for the effects of covariates (p = 0.03). There is a significant difference between tremor-dominant Parkinson disease (TDPD) and other subtypes of PD (p < 0.05). However, Iran-SIT scores failed to show a significant difference between men and women (p = 0.13)., Discussion/conclusion: Our results confirmed that PD is heterogeneous and there is significant variability in odor identification ability in these patients. We observed more olfactory impairment in TDPD, and subjects with higher H&Y stage. We recommended future studies with repeated measurements of different aspects of smell function to characterize the temporal relationship of olfactory dysfunction with PD., (© 2019 S. Karger AG, Basel.)

Cathelicidins are a family of antimicrobial peptides which exhibit broad antimicrobial activities against antibiotic-resistant bacteria. Considering the progressive antibiotic resistance, cathelicidin is a candidate for use as an alternative approach to treat and overcome the challenge of antimicrobial resistance. Cathelicidin-BF (Cath-BF) is a short antimicrobial peptide, which was originally extracted from the venom of Bungarus fasciatus. Recent studies have reported that Cath-BF and some related derivatives exert strong antimicrobial and weak hemolytic properties. This study investigates the bactericidal and cytotoxic effects of Cath-BF and its analogs (Cath-A and Cath-B). Cath-A and Cath-B were designed to increase their net positive charge, to have more activity against methicillin resistant S. aureus (MRSA). The results of this study show that Cath-A, with a +17-net charge, has the most noteworthy antimicrobial activity against MRSA strains, with minimum inhibitory concentration (MIC) ranging between 32-128 μg/ml. The bacterial kinetic analysis by 1 × MIC concentration of each peptide shows that Cath-A neutralizes the clinical MRSA isolate for 60 min. The present data support the notion that increasing the positive net charge of antimicrobial peptides can increase their potential antimicrobial activity. Cath-A also displayed the weakest cytotoxicity effect against human umbilical vein endothelial and H9c2 rat cardiomyoblast cell lines. Analysis of the hemolytic activity reveals that all three peptides exhibit minor hemolytic activity against human erythrocytes at concentrations up to 250 μg/ml. Altogether, these results suggest that Cath-A and Cath-B are competent candidates as novel antimicrobial compounds against MRSA and possibly other multidrug resistant bacteria.

Background and Purpose: Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. EBV is one of the most important viruses related to different types of malignancies. This study investigated the relationship between EBV and papillary thyroid carcinoma., Material and Methods: In this study the presence of Epstein-Barr Nuclear Antigen 1 (EBNA1) gene in papillary thyroid carcinoma tissues were examined by nested-PCR method. Paraffin-embedded tissues (N=41) blocks of thyroid cancer were used. DNA was extracted from all samples and then samples were evaluated for the presence of EBV gene., Results: In 41 samples, EBNA1 was detected in 65.8% of patients with papillary thyroid carcinoma which was significantly higher in younger ages., Conclusion: The significant presence of EBV genome in papillary thyroid carcinoma suggests that this virus may play a role in this cancer especially in younger ages. As a result, monitoring of patients with EBV latent infection for PTC can be very important., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Objective: To explore views of parents and childrens on safety and danger of outdoor environment, and implications for outdoor activities after school., Methods: The cross-sectional study was carried out in 2009-2010 and comprised 952 students between 7 and 9 years of age and 942 parents in Tehran. Two separate pre-designed questionnaires were used for children and parent. Data was analysed using SPSS 16., Results: The response rate of parents' and children's questionnaires regarding to socioeconomic deprivation were 830 (88.1%) from 942 and 932 (97.9%) from 952 respectively. Overall, 224 (27.0%) parents believed that the outdoor places children usually play after school are 'not dangerous" while 612 (65.7%) children believed that the streets they usually play on are safe. Besides, 238 (28.7%) parents believed that the volume of traffic in their neighbourhood makes crossing roads difficult. There was no significant difference between the responses of less and more economically deprived parents relating to the presence of dangerous places near their home within less than 5-minute walk (66.8% vs. 62.5%), on general safety describing their areas as being 'not dangerous' (25.6% vs. 18.8%) and who did not regard the volume of traffic in local environment as making crossing the road difficult (55.3% vs. 53.4%)., Conclusion: Many parents judged their outdoor places where their children played to be safe. If we assume that the physical environment of the more deprived areas is a more hazardous place than the less deprived areas, it suggests that the risk perception among the more deprived parents is poorer. If so, there is a need to be better informed about hazards in outdoor environment.

Aim: MicroRNAs (MiRs) are small noncoding RNAs that are involved in protein translation, osteoclastogenesis, and immunoregulation. Peri-implantitis and chronic periodontitis are multifactorial diseases. They are the consequence of complex interactions among host response, genetics, and environment. In the present study, we aimed to investigate the possible association between MiR146a/MiR499 gene polymorphisms and periodontitis/peri-implantitis as a first report in oral implantology., Methods: From 197 individuals referred to Periodontology Department of Shahid Beheshti Dental School, three groups were enrolled in the assessment: 75 patients in the chronic periodontitis (CP) group, 38 patients in the peri-implantitis (PI) group, and 84 healthy subjects. DNA was extracted from fresh blood samples from the arm veins of participants and transferred to KBiosience Institute (Hoddesdon, United Kingdom) for genotyping. Chi-squared and Kruskal-Wallis tests were performed using SPSS software v.19 for statistical analyses. P-value < 0.05 was considered significant., Results: The genotype frequencies in MiR 146a and MiR 499 were significantly different among the three groups., Conclusions: MiR146a (rs2910146) and MiR499 (rs3746444) gene polymorphisms may be genetic determinants for increased risk of chronic periodontitis and peri-implantitis in Iranians. More studies with larger sample sizes in different populations are necessary for determining the effect of these SNPs.

The approach to treatment in patients with both coronary artery disease and major carotid disease is controversial. We analyzed our results of concomitant coronary artery bypass and carotid endarterectomy. Twenty-three patients aged 58 years or older underwent elective concomitant coronary artery bypass and carotid endarterectomy with mild hypothermia (32°C). Demographic characteristics and preoperative risk factors were recorded prospectively. Data were collected during a mean follow-up of 22 ± 9 months. The mean age of the patients was 71 ± 7 years. Twenty-one patients were in New York Heart Association class I to II, and 2 were in class III. Early mortality was 8.6%. There was no early postoperative stroke. Mean intensive care unit stay was 64.5 ± 30.5 h. One (4.3%) patient had a stroke one year later. One- and 2-year survival rates were estimated to be 86.9% and 73.9%, respectively. Although concomitant coronary and carotid artery surgery remains controversial, cooling to 32°C provided good results in this challenging group of patients managed by one team.

Introduction: Approval of smoking by friends and teachers is likely to increase the probability of smoking by the students. This study aims to determine whether adolescent smoking is associated with teachers or other students smoking, after controlling for confounders., Materials & Methods: In a cross sectional study, a representative sample of 4599 students in the third grade were selected from high schools in Tehran. A 21 item questionnaire was administered consisting of demographic and tobacco smoking habit questions. Pattern of adolescent tobacco smoking was compared between two sexes. Association between smoking behavior and perceived exposure to teachers smoking were assessed using bivariate and multivariate analyses, adjusting for parental, best friends and sibling smoking and sex. A multivariate logistic regression model was constructed and adjusted Odds Ratios were estimated., Results: In total, 4591 students, aged 17 to 19 years, consisting of 2092 (45.6%) boys and 2499 (54.4%) girls, with the overall mean age of 17.53 +/- 0.59 years, were recruited. Of the students studied, 250 (12.1%) of boys and 131 (5.3%) of girls reported being current smokers (p = 0.001). The proportion of smoker and non-smoker students reporting to have been exposed to teachers smoking inside the school building was 209 (55.7%) and 1191 (29.3%), respectively (p = 0.001). Of those reporting being exposed to teachers smoking outdoors on school premises, 220 (58.7%) were smokers and 1205 (29.2%) were non-smokers (p = 0.001). After adjusting for sex, smoking habit of father, mother, brothers, sisters and best friends, adolescent perceived exposure to teachers smoking on school premises, but not inside school, was significantly associated with current smoking (OR = 2.1, 95 % CI:1. 7-2. 7). Adolescent exposure to best friend smoking was strongly associated with current smoking after adjusting for above variables (OR=6. 7, 95 % CI:5-9)., Conclusion: Teachers smoking during school hours and best friend smoking are the two important determinants to be considered in any project aiming to establish tobacco-free schools.

Background: Neuromyelitis Optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system with distinguishing features from multiple sclerosis (MS). NMO has an unknown etiology with poor prognosis in which anti-aquaporin-4 receptor IgG seems to play a major role. The purpose of this study is to represent a clinical and demographic data of NMO in Iranian population., Methods: Of 1800 patients attending our MS clinic, 44 patients with NMO were recruited from 2006 to 2009., Results: Female to male ratio was 3:1 and the disease affected women in younger ages than men (P = 0.04). The median expanded disability status scale score was 3 and the mean duration of symptoms was 4.53 +/- 3.41 (median = 4) years with annual relapse rate of 1.13 year/patient. The most frequent symptoms at presentation were optic neuritis 22 (50%) and transverse myelitis 14 (31.8%). Out of 12 patients whose titer of NMO-IgG was measured, four (30.7%) patients were seropositive. Twenty-eight patients (63%) received azathioprine for a mean duration of 16.84 +/- 27.91 months with significantly lower annual relapse rate (0.4 year/patient)., Conclusions: Iranian patients as a Caucasian population living in Asia seem to have the same clinical features in comparison with the reported studies from Western countries. Although the duration of follow-up was not too long, but they may possibly have a more benign course.

Objective: To evaluate the safety of the Plastibell neonatal circumcision technique and the incidence of complications in Iranian neonates., Materials & Methods: In this study, 7510 term neonates born between 2001 and 2006 in Rafsanjan medical centers, with age range of 3-36h, were randomized into two groups. In group A (3760 cases), an incision was made in the dorsal surface of the prepuce and then 3min frenular manual compression was performed with a sponge. In group B (3750 cases), frenular hemostasis was achieved using ophthalmologic thermal cautery. The two groups were compared in terms of complications of hemorrhage, wound infection, urine retention and delayed wound healing., Results: In group A, bleeding occurred in 15 cases (0.4%), and in group B in two cases (0.05%). The bleeding rate in group A was significantly higher (P=0.002). In group A, urinary retention was seen in 12 cases (0.03%), in comparison to 35 cases (0.9%) in group B. This complication rate was significantly higher in group B (P=0.001). Local or systemic infection was not seen in either group., Conclusion: Although using thermal cautery we have less bleeding, the total complication rate is increased significantly., (Copyright (c) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

The National Immunization Technical Advisory Group (NITAG) was established in Iran in 1982 and has made many important technical recommendations (e.g., regarding polio eradication, introduction of new vaccines, organizing special studies) that have contributed to a dramatic decline in vaccine preventable disease burden. The NITAG consists of experts from the Ministry of Health and Medical Education (MOHME), vaccine manufacturers, and medical universities with national Expanded Program of Immunization (EPI) staff serving as the secretariat. It is not completely independent from MOHME or EPI. It meets on a quarterly basis, and publishes national guidelines and immunization schedules that are updated regularly. Although primarily an advisory body, representation from MOHME members, including the EPI manager, ensures almost universal implementation of NITAG recommendations., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Iran was formerly considered to be located in a low prevalence zone for multiple sclerosis (MS). During the last decade the number of patients has increased. This study was conducted to estimate the prevalence of MS in the capital city of the country., Methods: We re-evaluated the files of all patients who had registered at the Iranian Multiple Sclerosis Society during a 10-year period., Results: 8,146 patients (72.3% female, 27.7% male) with a female-to-male ratio of 2.60 had registered. Mean age of disease onset was 27.24 (SD: 8.32). A relapsing-remitting pattern was recognized in 84.9% of the patients. The number of new registrations tripled from 2002 to 2008 and the female-to-male ratio increased from 2 to 3.12. The prevalence of MS in Tehran is estimated to be at least 51.9 per 100,000. Visual impairment was the main presenting symptom., Conclusions: It seems that the prevalence of MS has increased to a medium-to-high risk level in Iran. The mean age of onset was similar to other studies but the calculated prevalence of early onset MS was increased. The cumulative data indicates that the female-to-male ratio is increasing annually., (Copyright 2010 S. Karger AG, Basel.)

We here report the incidence of different types of genitourinary cancers among the Iranian population according to the records of the Iran Ministry of Health and Medical Education. In a population-based cancer-registry study in 2005, all recorded data in pathology laboratories, freestanding cancer clinics and treatment centers, physician offices, and other state central registries were obtained with the assistance of Iran Universities of Medical Sciences and sent to the Diseases Management Center in the Health Ministry. The prevalences of urological cancers were as follows: bladder cancer 48.3%; prostate cancer 33.4%; renal cell carcinoma 10.3%; renal pelvis and ureter cancer 0.75%; testicular cancer 6.15%; penile cancer 0.15%; urethral cancer 0.45%; and other unspecified urinary cancers 0.43%. The male to female ratios for the various common urological cancers varied between 1.69 (renal cell carcinoma) and 7.75 (unspecified urinary cancers). The incidence of prostate cancer among our population was dramatically higher than in other countries of Asia. However, bladder cancer was found to be the commonest of the genitourinary cancers, especially in elderly patients, among our population.

Kala-azar (visceral leishmaniasis) is endemic in southern Iran. We retrospectively evaluated 367 infants and children with visceral leishmaniasis at hospitals affiliated to Shiraz University of Medical Sciences in Fars Province (located in the southwestern part of Iran). Seasonal variation was observed with more cases presenting in late winter, spring and a few in summer. The predominant clinical features in these patients were chronic fever, pallor, weight loss, abdominal distention, and hepatosplenomegaly. Lymphadenopathy was less common. Common laboratory abnormalities included anemia, leukopenia, thrombocytopenia, hypoalbuminemia and hypergammaglobulinemia. Liver function tests were deranged in two-thirds of patients. Immuno-fluorescence antibody (IFA) test was positive in all patients and all had positive bone marrow smears or cultures for Leishmania donovani. Patients responded well to Glucantim therapy with a cure rate of 96.7%. Relapse was observed in 8.2%(30) of patients. Mortality in this series was 7.3%. Twenty-three patients died during therapy. Jaundice and grossly deranged liver function tests were bad prognostic signs.

Background: The evaluation of toxoplasma chorioretinitis is of utmost importance in the early diagnosis, treatment, and prevention of visual problems that can otherwise lead to permanent blindness. The aim of this study was to determine the prevalence of toxoplasma chorioretinitis among primary school students in Tehran., Material/methods: This cross-sectional study involved 1529 healthy primary school students from the 19 school districts in Tehran (2003-2004). The mean age was 9.7+/-1.55 years. Serum anti-toxoplasma level (IgG) was measured by quantitative chemiluminescent immunoassay (CLIA) and students with positive result were referred to an ophthalmologist for further evaluation., Results: Of the 1529 students, 1377 (90%) had negative and 152 (10%) had positive serum titers. Seroprevalence was higher in boys (12%) and increased with age. Sixty-five students (43%) were referred to an ophthalmologist and acute chorioretinitis was diagnosed in a nine-year-old boy who was given antitoxoplasma medication and was free of any active lesion one year later., Conclusions: Seroprevalence was lower than in some other studies performed in Iran, which can be attributed to climate conditions and urban life. Considering the low rate of visits to an ophthalmologist, this indicates the need for increased awareness regarding the disease and its complications.

Cytogenetic analysis performed at diagnosis is considered to be the most valuable prognostic factor in acute non-lymphocytic leukemia (ANLL), a very heterogeneous disease. Little data exist in Iran regarding the cytogenetic characteristics of ANLL . Therefore, cytogenetic investigations were performed for 58 patients with various subtypes of ANLL with unstimulated short term culture and high resolution cell synchronization techniques. Among the 58 evaluated patients, 45 (77.5%) showed clonal karyotypic abnormalities and the percentages of the abnormal cells were recorded within the range of 30%-100%. Some 14 were classified as M1, 20 as M2, 19 as M3 , 3 as M4, 1 as M5 and 1 as M6. The most common chromosome rearrangements were t(15;17), t( 8;21) and t(9;22). Trisomy of chromosome 8 (+8) was the most frequent numerical alteration in 3 patients with M1, M2 and M6. The incidence of other chromosomal defects, including -10, DMCs , -19 , 5q- , dicentric(dic), chromatid breaks, and marker chromosomes was relatively high. Similarities and dissimilarities of our study with others may be due to the role of genetic sensitivities as well as uneven geographic distribution in the pathogenesis of ANLL. Further prospective studies are warranted to precisely elucidate ethnic differences in the pathogenesis of this disease in different populations.

In observational and experimental studies in the health sciences involving human populations, it is sometimes considered desirable to recruit subjects according to designs that specify a predetermined number of subjects in each of several mutually exclusive classes (generally but not necessarily demographic in nature). This type of adaptive sampling design, now generally referred to as multiple inverse sampling (MIS), has received recent attention, and estimation methods are now available for several sequential MIS sampling designs. In this class of designs, subjects are sampled randomly and sequentially, usually one at a time, until all classes have the pre-specified number of subjects. In this paper, we extend MIS for finite population sampling to estimation of the parameters in multiple logistic regression under MIS. Using estimated logistic regression parameters and cost components obtained from the Isfahan Healthy Heart Program (IHHP), we report findings from a simulation experiment in which it appears that, at fixed cost, MIS at the last stage of sampling compares favourably to simple random sampling. The IHHP is a large community intervention study for prevention of cardiovascular disease being conducted in Isfahan, Iran and two other cities in Iran. The IHHP identified subjects through a multistage sample survey in which MIS was used at the final stage of sampling. MIS is one of several methods of adaptive sampling that are generating considerable interest and show promise of being useful in a wide variety of applications., (Copyright 2005 John Wiley & Sons, Ltd.)