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IntroductionApproximately 0.5 million fatalities per year are attributed to substance use disorder (SUD). SUD is refractory to therapy and has a high relapse rate. Cognitive deficits are also common in patients with SUD. Cognitive–behavioural therapy (CBT) is a promising treatment that may build resilience and reduce relapse among people with SUD. Our planned systematic review aims to clarify the effect of CBT on resilience and the relapse rate in adult patients with SUD compared with treatment as usual or no intervention.Methods and analysisWe will search the Scopus, Web of Science, PubMed, Medline, Cochrane, EBSCO CINAHL, EMBASE and PsycINFO databases from inception to July 2023 for all relevant randomised controlled or quasiexperimental trials published in English. The follow-up period of included studies must be at least 8 weeks. The PICO (Population, intervention, control, and outcome) format was used to develop the search strategy. Search terms will be combined using boolean operators and have been customised for different databases. The Cochrane tool for randomised controlled trials will be used to assess the risk of bias in included studies. Extracted data will include bibliographic data, sample size, intervention method, summary of the findings, follow-up duration and effect sizes with standard errors. A random effects model will be used to combine effect measures. Subgroup analyses will be performed by CBT type, sex and SUD subtype, as applicable. I2statistics will be used to evaluate heterogeneity, and funnel plots will be used to address publication bias. If we detect significant heterogeneity, the findings will be reported as a systematic review without a meta-analysis.Ethics and disseminationEthical approval is not required for this study. The findings will be submitted for publication in a peer-reviewed journal.PROSPERO registration numberCRD42022344596.

Resumo Fundamento: O índice de massa corporal (IMC) é o índice mais usado para categorizar uma pessoa como obesa ou não-obesa, e está sujeito a limitações importantes. Objetivo: Avaliar o efeito direto do IMC nos desfechos cardiovasculares em participantes sem obesidade central. Métodos: Esta análise incluiu 14.983 homens e mulheres com idades entre 45-75 anos do Estudo de Risco de Aterosclerose em Comunidades (ARIC). O IMC foi medido como obesidade geral e a circunferência da cintura (CC), a relação cintura-quadril (RCQ) e circunferência do quadril como obesidade central. A estimativa de máxima verossimilhança direcionada (TMLE, no acrônimo em inglês) foi usada para estimar os efeitos totais (TEs) e os efeitos diretos controlados (CDEs). A proporção de ET que seria eliminada se todos os participantes fossem não obesos em relação à obesidade central foi calculada usando o índice de proporção eliminada (PE). P

IntroductionBreast cancer (BC) is the most common cancer among women worldwide. This study aimed to determine the disease-free interval (DFI) and the effect of risk factors and characteristics of first primary breast cancer survivors on the progression of contralateral breast cancer (CBC).MethodIn this retrospective cohort study, we identified 5003 women (containing 145 CBC and 4858 BC survivors) diagnosed with BC between 2000 and 2020 in the cancer research center. CBC was diagnosed at least 6 months after detection of primary BC. Kaplan–Meier method was used to indicate DFI and survival curves. To determine the risk factors of CBC, the Cox proportional hazard regression model was employed.ResultsThe median time interval among primary BC and CBC was 7.10 years (average: 7.57, range: 0.49-19.95). The 5-year DFI was 97%. The median age of CBC and primary BC patients was 47 (range 17-78) and 48 (range 17-90), respectively. ER+, PR+, and HER2+ were reported in 72.13%, 66.67%, and 30% of CBC patients. Also, 69.57% of patients had IDC pathology type and 81.90% and 83.64% of the patients were treated with adjuvant chemotherapy and external radiotherapy. More than half of the participants had no family history of BC (69.57%). The hazard ratio indicates that women 60-70 years old, a higher number of involved lymph nodes, and recurrence had significant relationships with CBC.ConclusionThis is the first study to investigate the risk factors of CBC and disease-free interval among BC survivors. Women with higher lymph node metastasis have a lower chance to develop CBC and patients with recurrence are at higher risk for CBC.

Summary Background Self-report is one of the most widely used techniques for the assessment of illicit drugs. Nonetheless, the data obtained from illicit drugs user through self-reports is associated with bias and random error. Therefore, validation of these kinds of studies should be determined. Objectives The aim of this study was to determine the agreement between family report of amphetamine/methamphetamine abuse by deceased individual and laboratory findings from autopsy. Methods In this cross-sectional study, demographic, epidemiological and laboratory data of people, whose cause of death was illicit drug use in Iran, between March 2015 and March 2018, were extracted by two checklists. Individuals with both laboratory results and family report regarding the amphetamine/methamphetamine use were extracted and agreement between their results was assessed using the Kappa index, sensitivity, specificity, positive predictive value, negative predictive value, and ROC curve. Results The total number of people who died due to illicit drugs use were 7762. There were 3716 (47.8%) cases with both questionnaire responses and lab results; 88.8% were male and the rest were female. Family reports demonstrated moderately low validity with a low Kappa agreement rate 0.33 (95% CI: 0.30, 0.36), sensitivity 60.3% (95% CI: 56.9–63.7) and moderately high specificity 77.9% (95% CI: 76.4–79.4). Conclusion Results of this study imply that self-report of family cannot be used as a valid response for amphetamine usage in deceases related to illicit drugs use.

Background and aims To elucidate the effect modification of general and central obesity by sex and age on the risk of cardiovascular events. Methods The analysis included 14,983 males and females aged 45–75 years from the Atherosclerosis Risk in Communities study. Obesity was defined with body mass index (BMI), waist-to-hip ratio (WHR) and body shape index (BSI) which categorized the participants as obese and non-obese. Targeted maximum likelihood estimation was used to estimate the risk ratio (RR) with the tmle package in R software. Results After adjustment, the strongest effect of BMI on CHD was in females (RR (95%CI): 1.26 (1.11, 1.42)) and in age>54 (RR (95%CI): 1.16 (1.06, 1.27)) and for HF it was in age>54 (RR (95%CI): 1.18 (1.10, 1.26)) and in females (RR (95%CI): 1.17 (1.08, 1.28)). Regarding central obesity, WHR (RR (95%CI): 1.19 (1.05, 1.34)) had the strongest effects on CHD for males and BSI (RR (95%CI): 1.140 (1.02, 1.26)) for age ≤ 54, and for HF the WHR (RR (95%CI): 1.22 (1.10, 1.36)) and BSI (RR (95%CI): 1.18 (1.07, 1.30)) had the strongest effects for age≤54, respectively. Conclusion Among males and age≤54, WHR index was associated with a higher risk of CHD and HF while BMI was so for females and age>54.

Background Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of “hospital-ward-month”), and then, the last observation carried forward method was used to replace the missing data. Results The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran’s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

Background Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method. Methods This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patients` characteristics. Results Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552–695) and under-reporting percentage was 63.32%. Conclusion To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.

Objectives: This study aims to investigate the risk factors associated with severity and death from COVID-19 through a systematic review and meta-analysis of the published documents in Iran. Methods: A systematic search was performed based on all articles indexed in Scopus, Embase, Web of Science (WOS), PubMed, and Google Scholar in English and Scientific Information Database (SID) and Iranian Research Institute for Information Science and Technology (IRA)NDOC indexes in Persian. To assess quality, we used the Newcastle Ottawa Scale. Publication bias was assessed using Egger's tests. Forest plots were used for a graphical description of the results. We used HRs, and ORs reported for the association between risk factors and COVID-19 severity and death. Results: Sixty-nine studies were included in the meta-analysis, of which 62 and 13 had assessed risk factors for death and severity, respectively. The results showed a significant association between death from COVID-19 and age, male gender, diabetes, hypertension, cardiovascular disease (CVD), cerebrovascular disease, chronic kidney disease (CKD), Headache, and Dyspnea. We observed a significant association between increased white blood cell (WBC), decreased Lymphocyte, increased blood urea nitrogen (BUN), increased creatinine, vitamin D deficiency, and death from COVID-19. There was only a significant relationship between CVD and disease severity. Conclusion: It is recommended that the predictive risk factors of COVID-19 severity and death mentioned in this study to be used for therapeutic and health interventions, to update clinical guidelines and determine patients’ prognoses.

Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016. Citations meeting inclusion criteria were full screened, and trial available data were abstracted independently and the Cochrane risk of bias tool was used for quality assessment. Results: Sixteen RCTs involving 2568 patients were subjected to this meta-analysis. The use of a Dex sedative regimen was associated with a reduce delirium prevalence [odd ratio (OR):0.33, 95% confidence intervals (CI): 0.24–0.45, I2= 5%, P

Introduction Population-based cancer registry (PBCR) plays a significant role in burden of cancer estimation. Estimating the completeness of cancer registry is one of the criteria to assess the quality of data (results). Also, Capture-recapture is one of the methods used to assess completeness of cancer registry. Objective This study was aimed to estimate the completeness of lung and bronchial cancer registry using three-source capture-recapture method in Khuzestan province. Materials and methods This study was carried out using three-source capture-recapture method and data were obtained from three sources including medical records, death certificates and pathology labs (reports) in Khuzestan. In this study, total new cases of lung and bronchial cancer registered by the three sources in 2011, were enrolled. Among the sources, the common cases were identified and the completeness rate of lung and bronchial cancer registry was calculated by log-linear method using R software, finally. Results Totally, 426 new cases for lung cancer had reported from the three sources in 2011. The completeness index of lung cancer registry was totally estimated 72%, as well as it was independently 40%, 25% and 37.6% for the medical records, pathology reports and death certificates sources, respectively. Conclusion According to the results, after collection and remove repetition of the cases related to lung cancer, it should be added their number registered by the pathology (labs), medical records and death certificates sources by 28%–40%, to estimate actual incidence of lung cancer. Also, the actual incidence of lung cancer cases related to each of medical records, pathology and death certificates was calculated by adding the reported values by 60%, 75% and 63%, respectively.

Background and aims: Cutaneous leishmaniasis (CL) is one of the most important parasitic diseases in the world. Sabzevar city is endemic area for CL in the north east of Iran. The aim of this study was to evaluate the time distribution of cutaneous leishmaniasis (CL) in Sabzevar County using the segmented regression model. Methods: This ecological study used the existing data related to the rural districts of Sabzevar County that were obtained from the Health Deputy of this county during 2011-2017. In addition, the segmented regression model was applied to evaluate the time trend of CLs. Finally, Joinpoint software was used for time series analysis. Results: A total of 1912 CL cases occurred in Sabzevar County from 2011 to 2017, with an incidence rate of 93.61 per 100000. The highest and lowest observed incidence rates were in 2011 (25 per 10000 persons) and 2015 (3.24 per 10000 persons), respectively. Based on the results, the annual incidence of CL in the intended region decreased and the annual percent change was equal to -22.40. Further, the time series analysis using segmented regression by rural districts showed a change point in the trend of the incidence of leishmaniasis in three rural districts (Pain Joveyn and Joghatai in 2014 and Qasabeh-ye Sharqi in 2013). In other words, the trend was different before and after the change point in the mentioned districts. Conclusion: In general, the results indicated that interventional, preventive, and therapeutic measures for breaking the chain of CL transmission in Sabzevar have been desirable in recent years. Eventually, it is suggested that further time-series studies be conducted at the level of the month or a longer interval in order to better evaluate the period effect and secular trend.

Child mortality rates are considered to be one of the key indicators of child health.The main objective of this research was to calculate child mortality rates (CMRs) indirectly, using census data, and to investigate using spatial pattern analysis the presence of any clustering patterns among provincial regions.The Trussell version of the Brass method and Coale-Demeny West model were used to estimate CMRs and life expectancy (LE) at birth. The analyses were performed using the QFive program of MORTPAK 4 software. For cluster analysis, local and global Moran's I indexes were measured.Infant mortality rate, under-5 mortality rate, 1-4 mortality rate and LE at birth were estimated as 21.9, 26, 4.1 (deaths per 1000 live births) and 72.1 years, respectively. Global Moran's I index was calculated as 0.09, 0.09, 0.08 and 0.12, respectively.Special attention must be paid in provinces with high clusters regarding the evaluation of public health programmes, and the cause of failure of these programmes in reduction of childhood mortality indices.التقدير غير المباشر لوفيات الأطفال باستخدام بيانات تعداد السكان لعام 2011 في جمهورية إيران الإسلامية.ياسر مخيري، سيد رياحي، إلهه رفيعى، زهرا اسدكل، سيد هاشمي نظرى.يُعتبر معدل وفيات الأطفال أحد المؤشرات الرئيسية لصحة الأطفال.كان الهدف الأساسي من هذا البحث هو حساب معدلات وفيات الأطفال بطريقة غير مباشرة، باستخدام بيانات تعداد السكان، والاستقصاء بشأن وجود أنماط التكتل على مستوى المناطق الإقليمية باستخدام تحليل النمط المكاني.استُخدمت نسخة تروسل الخاصة بطريقة براس ونموذج كول – ديمنى وست لتقدير معدلات وفيات الأطفال ومأمول العمر عند الميلاد. ولقد أُجريت التحليلات باستخدام برنامج QFive لبرمجيات MORTPAK4. ولتحليل التكتلات، قِيسَت مؤشرات موران I المحلية والعالمية.قُدِّر معدل وفيات الرضَّع، ووفيات الأطفال أقل من 5 سنوات، ومعدل وفيات الأطفال من عمر سنة إلى 4 سنوات ومأمول العمر عند الميلاد بما مقداره 21.9، و26، و4.1 (الوفيات لكل 1000 مولود حيٍّ) و72.1 عاماً على التوالي. وجاءت نتائج حساب مؤشر موران I العالمي 0.09، و0.0.9، و0.08 و0.12 على التوالي.يجب إيلاء عناية خاصة في الأقاليم ذات التكتلات المرتفعة في ما يتعلق بتقييم برامج الصحة العامة، وسبب إخفاق هذه البرامج في خفض مؤشرات وفيات الأطفال.Estimation indirecte de la mortalité juvénile à l’aide des données du recensement de 2011 en République islamique d’Iran.Les taux de mortalité juvénile sont considérés comme l’un des indicateurs clés de la santé de l’enfant.La présente recherche visait principalement à calculer les taux de mortalité juvénile de façon indirecte, à partir des données du recensement. Elle avait aussi pour objectif de rechercher la présence de tendances de regroupement dans les régions provinciales au moyen d’une analyse de la structure spatiale.La version de Trussell du modèle de Brass et le modèle Ouest des tables de Coale et Demeny ont été utilisés pour estimer les taux de mortalité juvénile et l’espérance de vie à la naissance. Les analyses ont été réalisées à l’aide du programme QFive du logiciel MORTPAK 4. Pour l’analyse en grappes, les indices de Moran local et global ont été mesurés.Le taux de mortalité infantile, le taux de mortalité des moins de 5 ans, le taux de mortalité des enfants de 1 à 4 ans et l’espérance de vie à la naissance ont été estimés à 21,9, 26, 4,1 (décès pour 1 000 naissances vivantes) et 72,1 ans, respectivement. L’indice global de Moran I a été calculé à 0,09, 0,09, 0,08 et 0,12, respectivement.Une attention particulière doit être portée aux provinces présentant des grappes importantes en ce qui concerne l’évaluation des programmes de santé publique et la cause de l’échec de ces derniers en termes de réduction des taux de mortalité juvénile.

Introduction: Air pollution is one of the main causes for the significant increase of respiratory infections in Tehran. In the present study, we investigated the associations between short-term exposure to ambient air pollutants with the hospital admissions and deaths. Materials and methods: Health data from 39915 hospital admissions and 2459 registered deaths associated with these hospital admissions for respiratory infections were obtained from the Ministry of Health and Medical Education during 2014-2017. We used the distributed lag non-linear model (DLNM) for the analyses. Results: There was a statistically positive association between PM2.5 and AURI in the age group of 16 years and younger at lags 6 (RR 1.31; 1.05-1.64) and 7 (RR 1.50; 1.09-2.06). AURI admissions was associated with O3 in the age group of 16 and 65 years at lag 7 with RR 1.13 (1.00-1.27). ALRI admissions was associated with CO in the age group of 65 years and older at lag 0 with RR 1.12 (1.02-1.23). PM10 was associated with ALRI daily hospital admissions at lag 0 for males. ALRI admissions were associated with NO2 for females at lag 0. There was a positive association between ALRI deaths and SO2 in the age group of 65 years and older at lags 4 and 5 with RR 1.04 (1.00-1.09) and 1.03 (1.00-1.07), respectively. Conclusion: Exposure to outdoor air pollutants including PM10, PM2.5, SO2, NO2, O3, and CO was associated with hospital admissions for AURI and ALRI at different lags. Moreover, exposure to SO2 was associated with deaths for ALRI.

Background: The unknowingness of COVID-19 compared to other respiratory diseases and gaining an overview of its diagnostic criteria led to this study, which was designed to summarize the signs and symptoms along with the clinical tests that described these patients. Methods: PubMed\MEDLINE, Web of Science, Core Collection, Scopus, and Google Scholar were systematically searched on September 27, 2020. After screening, we selected 56 articles based on clinical characteristics and laboratory and imaging findings in confirmed COVID-19 patients as eligibility criteria. To evaluate risk of bias, the Newcastle Ottawa scale, for publication bias, Egger’s test, and for heterogeneity, I2 and tau test were used;and finally, random-effects models were used for pooled estimation. Results: Pooled estimates for frequently clinical symptoms were as follows: fever (78% [95% CI, 74-82]), cough (60% [95% CI, 57-63]), and fatigue (31% [95% CI, 26-36]);and they were as follows for laboratory findings in lymphocyte (1.02 [95% CI, 0.92-1.12]), CRP (19.64 [95% CI, 13.96-25.32]), and platelet count (175.2 [95% CI, 165.2-185.2]);they were as follows for imaging findings in bilateral pneumonia (64% [95% CI, 56-72]), and ground glass opacity (60% [95% CI, 48-7]). Also, in the subgroup analysis, bilateral pneumonia with 18% and fatigue with 15%, had the highest difference in values between the groups. Conclusion: According to Forest plots, the CI and dispersion among studies were smaller in laboratory findings than in symptom and imaging findings, which might indicate a high alignment in the laboratory findings among studies. © Iran University of Medical Sciences

We determined the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an affected area in northern Iran in April 2020. Antibodies to SARS-CoV-2 were detected in 528 persons by using rapid tests. Adjusted prevalence of SARS-CoV-2 seropositivity was 22.2% (95% CI 16.4%–28.5%).

Background: Traffic accidents are one of the most common causes of mortality and physical disabilities, endangering the lives of many people all over the world annually and are among the top public health problems worldwide. In the present study, we aimed to investigate the trend of mortality rate due to traffic accidents in the provinces of Iran.Methods: In this cross-sectional study, all the deaths caused by traffic accidents in Iran during 2006-2018 were investigated. Using the population of the country by age, sex, and provinces of the country, the mortality rate was calculated and the trend of 13-year changes was studied. The negative binomial regression was used to analyze the linear or nonlinear trend of reduction in mortality rate during the study years. Microsoft Excel 2016 and Stata version 14 software were used to analyze the data.Results: During the study period, 259995 traffic accidents deaths occurred in Iran, of which 78.6% were men and 21.4% were women. The mean age of the deceased was 37.6 ± 20.7 years (37.4 ± 20 years in men and 38.6 ± 23 years in women). The number of the deaths in these years has decreased from 27,567 in 2006 to 17,183 in 2018 and the mortality rate has dropped from 39 per 100,000 in 2006 to 21 per 100,000 in 2018.Conclusion: Despite the decreasing trend in the mortality rate of traffic accidents in Iran during the study years, this trend was different across the provinces. Therefore, it seems necessary to design epidemiological studies to be conducted in different area and provinces of a country, to better and more accurately determine the factors affecting the occurrence of these deaths.

BACKGROUND Many factors contribute to the spreading of hospital-acquired infections (HAIs). OBJECTIVE This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method. METHODS In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs. RESULTS The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected. CONCLUSIONS The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.

Recent studies reported that some recovered COVID‐19 patients have tested positive for virus nucleic acid again. A systematic search was performed in Web of Science, PubMed, Scopus, and Google Scholar up to March 6, 2021. The pooled estimation of reinfection, recurrence, and hospital readmission among recovered COVID‐19 patients was 3, 133, and 75 per 1000 patients, respectively. The overall estimation of reinfection among males compared to females was greater. The prevalence of recurrence in females compared to males was more common. Also, hospital readmission between sex groups was the same. There is uncertainty about long‐term immunity after SARS‐Cov‐2 infection. Thus, the possibility of reinfection and recurrence after recovery is not unexpected. In addition, there is a probability of hospital readmission due to adverse events of COVID‐19 after discharge. However, with mass vaccination of people and using the principles of prevention and appropriate management of the disease, frequent occurrence of the disease can be controlled., Highlights The pooled estimation of re‐infection rate among recovered COVID‐19 patients was 3 per 1000 patients.The pooled estimation of recurrence rate among recovered COVID‐19 patients was 133 per 1000 patients.Hospital readmission among recovered COVID‐19 patients was 75 per 1000 patients.The possibility of re‐infection, recurrence and hospital readmission after recovery is not unexpected. Thus, adherence to principles of prevention besides vaccination is essential.

Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m

Objectives: We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016.Methods: In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used.Results: The relative risk of suicide mortality was greater than 1 in 43.0% of Iran’s provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran’s provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years.Conclusions: The highest risk of suicide mortality was observed in Iran’s northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

Background Hospital-acquired infections (HAIs) are a well-known cause of morbidity and mortality in hospitalized patients. This study aimed at investigating the survival rate in patients with ICU-acquired infections (ICU-AIs) and its related factors in Iran’s hospitals. Methods Data were obtained from the Iranian Nosocomial Infections Surveillance (INIS), which registers all necessary information on the main types of infection from different units of each included hospital. One thousand one hundred thirty-four duplicate cases were removed from the analysis using the variables of name, father’s name, age, hospital code, infection code, and bedridden date. From 2016 to 2019, 32,998 patients diagnosed with ICU-AI from about 547 hospitals. All patients were followed up to February 29, 2020. Results The median age of patients with ICU-AIs was 61 (IQR = 46) years. 45.5, 20.69, 17.63, 12.08, and 4.09% of infections were observed in general, surgical, internal, neonatal and pediatric ICUs, respectively. Acinetobacter (16.52%), E.coli (12.01%), and Klebsiella (9.93%) were the major types of microorganisms. From total, 40.76% of infected patients (13,449 patients) died. The 1, 3, 6-months and overall survival rate was 70, 25.72, 8.21 1.48% in ICU-AI patients, respectively. The overall survival rate was 5.12, 1.34, 0.0, 51.65, and 31.08% for surgical, general, internal, neonatal and pediatric ICU, respectively. Hazard ratio shows a significant relationship between age, hospitalization-infection length, infection type, and microorganism and risk of death in patients with ICU-AI. Conclusions Based on the results, it seems that the nosocomial infections surveillance system should be more intelligent. This intelligence should act differently based on related factors such as the age of patients, hospitalization-infection length, infection type, microorganism and type of ward. In other words, this system should be able to dynamically provide the necessary and timely warnings based on the factors affecting the survival rate of infection due to the identification, intervention and measures to prevent the spread of HAIs based on a risk severity system.

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p

Background and Purpose— Standard analytic approaches (eg, logistic regression) fail to adequately control for time-dependent confounding and, therefore, may yield biased estimates of the total effect of the exposure on the outcome. In the present study, we estimate the effect of body mass index, intentional physical activity, HDL (high-density lipoprotein) cholesterol, LDL (low-density lipoprotein) cholesterol, hypertension, and cigarette smoking on the 11-year risk of ischemic stroke by sex using the parametric g-formula to control time-dependent confounders. Methods— Using data from the MESA (Multi-Ethnic Study of Atherosclerosis), we followed 6809 men and women aged 45 to 84 years. We estimated the risk of stroke under 6 hypothetical interventions: maintaining body mass index 2 , maintaining normotension (systolic blood pressure 1.55 mmol/L, maintaining LDL Results— In men, the 11-year risk of ischemic stroke would be reduced by 85% (95% CI, 66–96) for all 6 hypothetical interventions. In women, this same effect was estimated as 55% (95% CI, 6–82). Conclusions— The hypothetical interventions explored in our study resulted in risk reduction in both men and women.

Objective To assess whether drowsy driving can increase road traffic accident related deaths and injuries. Design Systematic review and meta-analysis. Data sources Cochrane Injuries Group Specialized Register, Cochrane Central Register of Controlled Trials, EMBASE, Medline, National Technical Information service, Psychlit, International Road Research Documentation, Transport Research Information Service, and web sites related to the road safety organization were searched; experts were contacted, conference proceedings were hand searched, and relevant reference lists were checked. Inclusion criteria We sought to identify all epidemiological studies, published in English language, which assessed the association between fatigued or sleepy driving and the occurrence of car crashes lead to death or injury. Methods We conducted a systematic literature review with meta-analysis using PubMed, Google scholar and other valid databases to search for articles published from January 1980 through September 2016 to identify precise effect of drowsy driving on road traffic accidents. For each study odds ratio was calculated, the ratio of event odds in the drivers with drowsy driving divided by the drivers without drowsy driving, which were pooled to obtain an overall estimate using a fixed and random effects models. Findings Fourteen articles satisfying inclusion criteria were identified that all of them were included in quantitative synthesis. Pooled odds ratio obtained by fixed and random effect models was 1.29 (95% CI 1.24 to 1.34) and 1.34 (95% CI 1.25 to 1.43), respectively. Conclusion Our findings that obtained from meta-analysis (with high level of evidence) suggest a significant association between crash involvement and drowsy driving. It seems that establishment of strategies to reduce any risk factors of road traffic accident such as drowsy driving can be effective in decreasing traffic crashes.

Objectives: Considering the high mortality rate of pedestrians in traffic accidents in Iran, the present study aimed to determine the high-risk and low-risk areas of accidents resulting in pedestrian deaths and the spatial analysis of their mortality rates. Methods: This cross-sectional study included 4,371 deceased pedestrians reported by the Legal Medicine Organization in Iran from March 2012 to March 2013. For spatial analysis, the collected data were entered into ArcGIS software version 10.2 and a spatial map of the mortality rate was drawn according to the distribution of data in the provinces. Using this software, high-risk and low-risk areas were identified by calculating the spatial autocorrelation of the data. The Moran's index of road accident patterns was surveyed and high-risk and low-risk points were identified using the local Getis index. Results: The age-standardized incidence rate was 6.8 per 100,000. After analyzing the data using ArcGIS software, the local Moran's index showed a cluster pattern with a high mortality rate in 3 provinces of Mazandaran, Gilan, and Qazvin. In identifying high-risk and low-risk points, the local Getis index showed 3 hot spots with a confidence interval of 99% in Qom, Qazvin, and Mazandaran and 5 hot spots with a 95% confidence interval in Markazi, Tehran, Zanjan, Gilan, and Golestan provinces. Conclusions: According to the cluster pattern of accidents in the 3 provinces and the presence of hot spots in 9 provinces, it is necessary to identify factors that increase the risk of death in the study provinces in order to reduce the mortality rate among pedestrians due to traffic accidents. Therefore, to reduce the pedestrian mortality rate, especially in high-risk provinces, some studies need to be conducted to determine the risk factors in pedestrian mortality.

Aims To search for pharmaceutical additives in illicit alcoholic beverages referred to the laboratory of Legal Medicine Organization in Iran in 2017. Methods Hundred beverages were sampled. Ethanol content was determined by gas chromatography with flame ionization detection (GC–FID) and then a liquid-liquid extraction combined with reversed-phase high performance liquid chromatography equipped with a photodiode array detector (PAD) was employed for the qualitative analysis. The analysis was confirmed using gas chromatography coupled with mass spectroscopy (GC/MS). Results In 15% either one or more of the following were detected: tramadol, methadone, diazepam, oxazepam, flurazepam and alprazolam. Tramadol was found with highest frequency. Conclusions The wide availability of addictive pharmaceutical is leading to fortification of alcoholic beverages on some countries. The addition of such depressant additives should be better known because of the potentially fatal consequences of the combination with ethanol, as well as the potential for adverse effects on behavior.

BackgroundRecent studies have shown that antibiotic exposure during infancy is associated with increased body mass in healthy children. This study was performed to investigate the association between early-life antibiotic exposure and risk of childhood obesity.MethodsA systematic review and meta-analysis was performed to comprehensively and quantitatively determine the association between early antibiotic exposure and risk of childhood obesity. Various databases such as PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane and Google Scholar were searched. A random-effects meta-analysis was performed to pool the statistical estimates. Additionally, a subgroup analysis was performed based on the time of follow-up.ResultsNineteen studies involving at least 671,681 participants were finally included. Antibiotic exposure in early life was significantly associated with risk of childhood weight gain and obesity (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.04–1.06).ConclusionsAntibiotic exposure in early life significantly increases the risk of childhood weight gain and obesity.

This study was conducted to investigate the effect of the prepregnancy BMI on the risk of gestational diabetes mellitus (GDM). Five electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were searched for literature published until 1 January 2018. The two-stage, random effect meta-analysis was performed to compare the dose-response relationship between BMI and GDM. As well as studies with categorized BMI, studies that treat BMI as a continuous variable were analysed. A total of 33 observational studies with an overall sample size of 962 966 women and 42 211 patients with GDM were included in analysis. The pooled estimate of GDM risk in the underweight, overweight, and obese pregnant women was 0.68, 2.01, and 3.98 using the adjusted OR and 0.34, 1.52, and 2.24 using the adjusted RR. The GDM risk increased 4% per unit of increase in BMI with both the crude and adjusted OR/RR models. Also, the risk of GDM increased 19% with the crude model and 14% with the adjusted model. The existence of dose-response relationship between the pre-pregnancy BMI and GDM can strengthen the scientific background for vigorous public health interventions for the control of pre-pregnancy BMI as well as the weight gain during pregnancy.

The authors aim to investigate the GDM and the dose-response association of BMI with it in pregnant women in Kermanshah, Iran. During the 2015-2016 year, the 1010 pregnant women were studied. The restricted cubic spline method was used to evaluate the relationship between BMI and GDM. The risk of GDM was 10.1%. The incidence rate ratio for GDM indicates a non-significant protective effect and, then a significant risk for GDM occurrence along with BMI. BMI can be used as a predictive factor. A healthy diet and recommended levels of physical activity are suggested to prevent overweight and obesity and subsequent GDM.

Background The Metabolic syndrome (MetS), refers to one of the most challenging public health issues across the world. The aim of this study was to explore the clusters of participants on the basis of MetS components and determine its effect on coronary heart disease (CHD). Methods This study used the information from Multi-Ethnic Study of Atherosclerosis (MESA). MESA was performed at 6 US sites and was a population-based cohort study of 6776 adults (3576 females; 3200 males), aged 45 to 84 years. The participants were free of clinical cardiovascular disease at baseline. Latent class analysis (LCA) was conducted to achieve the study's objectives. The outcome variable was CHD during the study period (2000−2012). Results The prevalence of all Mets components (except triglyceride (TG) and fasting blood glucose (FBS)) is more common in females than in males. Three latent classes were recognized: (1) Non-MetS, (2) low risk, and (3) MetS. Notably, MetS latent class included 29.88% and 35.38% in females and males, respectively. After adjustment for covariates (e.g. demographic, biomarker etc.), MetS latent class showed a positive association with CHD events in both genders. Conclusions Results showed that clustering pattern of the MetS components, as well as the association between latent classes and risk of incident CHD events, are different in females and males. Notable percentages of individuals are in the MetS class, which emphasizes the necessity of implementing preventive interventions for this sub-group of the population.

In the present study, numerical method is established to analyze the effect of fin geometry and the inlet mass flow rate of the shell, on the Exergy loss in the newly design cylindrical shell and the helically coiled finned tube heat exchangers with an internal core inside the shell. The inlet fluid of coil side is the hot water with the temperature of 70 °C and the velocity equal to 1 m/s. While, the inlet fluid of the shell side is the dry cold air with the temperature of 10 °C and the velocity equal to 1–4 m/s. For validation of the model, the coil and shell side Nusselt number and the friction factor of the coil side is compared with the previous experimental correlations and an acceptable agreement is observed. Results indicate that, with the increase of the inlet mass flow rate of the shell side, fins height and number, NTU, heat transfer and the fan work the Exergy loss increases. Furthermore, it was found, the Exergy loss is always equal to 23.4% of the heat transfer rate. At the end of this work, two correlations are proposed to obtain the optimal values of the operational and geometrical characteristics of the heat exchanger.

Background: Coronary artery disease is among the first causes of death in Iran. Secondary prevention with drug therapy is recommended following acute myocardial infarction (MI) to reduce the risk of new cardiovascular events and death. Methods: This is a retrospective cohort study on data collected from 21181 cases of MI recorded by the MI Registry of Iran from 2013 to 2014. Ten therapies that were prescribed to patients at the time of discharge were divided into 6 groups. Survival rates were estimated using the Kaplan-Meier method and Cox regression analysis. Results: The most common MI location was in the anterior wall (31.87%). Anticoagulants, aspirin, clopidogrel were the most common prescribed medications (94.73%). Overall, 28-day (short-term) and 3-year survival rates were 0.95 (95% CI: 0.95–0.96) and 0.82 (95% CI: 0.81–0.82). In non-ST-elevation myocardial infarction (NSTEMI) patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants/ aspirin and clopidogrel, beta-blockers and statins medication were simultaneously taken and the highest short- and long-term survival rates were observed in patients who took anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers and statins medication. In STEMI patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were simultaneously taken. The highest short- and long-term survival rates were observed in patients who received anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers, statins, ACEIs and ARBs. Conclusion: Prescription of the best combination of drugs, in addition to adherence to a healthy lifestyle and medication, can improve the survival rates after MI.

Additional file 1: Appendix 1. ICU-acquired infections rate per 1000 patients and 1000 patient-days by hospital affiliation in Iran hospitals-2018. Appendix 2. ICU-acquired infections rate per 1000 patient-days by hospital performance indicators in Iran hospitals-2018. Appendix 3. ICU-acquired infections rate per 1000 patients and 1000 patient-days by the province in Iran hospitals-2018.

Additional file 1: Appendix 1. Univariable Cox regression analysis of survival of ICU-acquired infection patients by ward.

This study investigated the presence of SARS-CoV-2 in air of public places such as shopping centers, a post office, banks, governmental offices, and public transportation facilities including an airport, subways, and buses in Tehran, Iran. A total of 28 air samples were collected from the eight groups of public and transportation locations. The airborne particle samples were collected on PTFE or glass fiber filters using two types of samplers with flow rates of 40 and 3.5 L/min, respectively. The viral samples were leached and concentrated, and RNA was extracted from each. The presence of viral RNA was evaluated using novel coronavirus nucleic acid diagnostic real time PCR kits. In 64% of the samples, SARS-CoV-2 RNA (62% and 67% from the public places and transportation, respectively) was detected. Positive samples were detected in banks (33%), shopping centers (100%), governmental offices (50%), the airport (80%), subway stations (50%), subway trains (100%), and buses (50%). Logistic regression showed that number of people present during the sampling and the sampled air volume were positively associated with presence of SARS-CoV-2; while the percentage of people with masks, air temperature, and sampling site's volume were negatively related to SARS-CoV-2's presence. However, none of these associations were statistically significant. This study showed that most public places and transportation vehicles were contaminated with SARS-CoV-2. Thus, strategies to control the spread of COVID-19 should include reducing the number of people in indoor spaces, more intense disinfection of transport vehicles, and requiring people to wear masks., Graphical abstract Image 1, Highlights • In total, SARS-CoV-2 was detected in 64% of the air samples. • 62% and 67% from the public places and transportation were positive. • Number of people and the sampled air volume positively associated with SARS-CoV-2. • The percentage of people with masks and temperature were related to SARS-CoV-2.

Hospital-acquired infections (HAIs) lead to increased length of hospital stay, inappropriate use of broad-spectrum antibiotics and multiple antibiotic resistance. This study aimed to investigate the rate of HAIs in Iran. In this multi-centre study, the rate of HAIs was calculated based on the data collected through Iranian nosocomial infections surveillance for patients with HAIs, as well as through hospital statistics and information systems on hospital-related variables. Data were analysed using Stata software; in addition, ArcGIS was used for plotting the geographical distribution of HAIs by different provinces. The mean age of the 107 669 patients affected by HAIs was 52 ± 26.71 years. Just over half (51.55%) of the patients were male. The overall rate of HAIs was 26.57 per 1000 patients and 7.41 per 1000 patient-days. The most common HAIs were urinary tract infections (26.83%; 1.99 per 1000 patient-days), ventilator-associated events (20.28%; 1.5 per 1000 patient-days), surgical-site infections (19.73%; 1.45 per 1000 patient-days) and bloodstream infections (13.51%; 1 per 1000 patient-days), respectively. The highest rate of HAIs was observed in intensive care units. Device, catheter and ventilator-associated infections accounted for 38.72%, 18.79% and 16% of all HAIs, respectively. Based on the results, HAIs are common in intensive care units, and urinary tract infections and device-related infections are more prevalent in Iran. To reduce HAIs it is recommended to implement appropriate policies and interventions, train staff about the use of devices, and prepare and update protocols and guidelines for improving the quality of care., Highlights • The overall rate of HAIs was 26.57 per 1000 patients and 7.41 per 1000 patient-days. • Hospital-acquired infections are common in ICU wards, while UTIs and device-related infections are more prevalent in Iran. • Device, catheter and ventilator-associated infections accounted for 38.72, 18.79%, and 16% of all HAIs, respectively.

Background: Patients admitted to intensive care units (ICUs) are particularly susceptible to hospital-acquired infections (HAIs) and the HAIs are higher in the ICUs than other wards of the hospital. This study aimed at investigating factors associated with ICU-acquired infections incidence in Iran. Methods: In this multi-center study, Iranian nosocomial infections surveillance (INIS) and hospital statistics and information system (AVAB) were used to collect data on patients with HAIs in 2018. The data was expanded based on 12 months of the year (13,632 records in terms of "hospital-ward-month") and then, the last observation carried forward method was used to replace the missing data. The generalized negative binomial regression with “patient-days” as an offset variable was used to identify the factors affecting ICU-acquired infections incidence.Results: The median age of patients was 57.5 (IQR=55.09) years. Of the 22.92%, 5.76%, 13.62%, 43.41%, and 14.29% of patients were in NICU, PICU, internal ICU, general ICU, and surgical ICU, respectively. Only 13.73% of hospitals were in efficient zone (zone III). Based on multivariable regression, the number of death (IRR=1.02), the number of infections due to the device (catheters and ventilators) (IRR=1.1), ward type (PICU (IRR=1.58), internal ICU (IRR=1.63), general ICU (IRR=1.53) and surgical ICU (IRR=1.47)), hospital's expertise, hospital's accreditation, bed occupancy rate indicator (IRR=1.17 for moderate conditions) were associated with an increase of ICU-acquired infections incidence. Infection due to ventilator, infection due to catheter, and the number of surgery in hospitals reduced 5%, 7%, and 1% incidence of infections, respectively. Conclusions: Based on the results, the most common ICU-acquired infections were VAE and UTI. Therefore due to the high sensitivity of intensive care units, full hygiene should be taught to the medical staff, especially the ICU wards. Ventilators and catheters should be used in special circumstances and minimum duration.

Population exposure to environmental contaminants can be precisely observed through human biomonitoring studies. The present study aimed to systematically review all the biomonitoring studies conducted in Iran on some selected carcinogen environmental pollutants. In this systematic review study, 11 carcinogen agents were selected including arsenic, cadmium, chromium, nickel, lindane, benzene, trichloroethylene (TCE), pentachlorophenol (PCP), radon-222, radium-224, − 226, − 228, and tobacco smoke. The Web of Science, PubMed, and Scopus databases were searched for peer-reviewed articles published in English. After several screening steps, data were extracted from the studies. Meta-analyses (a random-effect model using the DerSimonian-Laired method) were performed only for the biomarkers with more than three eligible articles, including cadmium in blood and breast milk, and arsenic in breast milk. Methodological quality of the studies was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for cross-sectional studies. Of the 610 articles found in the database search, 30 studies were eligible for qualitative review, and 13 were included in the meta-analysis (cadmium in blood (n = 3), cadmium in breast milk (n = 6), and arsenic in breast milk (n = 4)). The overall pooled average concentrations (95% CI) of cadmium in blood, cadmium in breast milk, and arsenic in breast milk were 0.11 (95% CI: 0.08, 0.14), 5.38 (95% CI: 3.60, 6.96), and 1.42 (95% CI: 1.02, 1.81) µg/L, respectively. These values were compared with the biomarker concentrations in other countries and health-based guideline values. This study showed that there is a need for comprehensive action plans to reduce the exposure of general population to these environmental contaminants.

Background: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is a major public health problem in Iran. It imposes heavy costs on governments and affected people. Determining the survival duration of patients and recognizing the related factors can help the disease surveillance system. Objectives: The current study aimed at determining the survival rate and the related factors concerning patients with HIV/AIDS identified in Tehran, Iran. Methods: The study population of the current retrospective cohort consisted of patients with HIV/AIDS covered by the Health Center of Southern Tehran. The data were obtained by referring to the HIV/AIDS care centers and reviewing the patients’ records. Survival rates of the study subjects during 10 years follow-up were calculated. The Cox proportional-hazards model was used to determine the relationship between independent variables and survival of patients with HIV/AIDS. Results: A total of 487 patients were investigated in the current study. Four-hundred thirty-three subjects (88.9%) were male, and 54 (11.1%) female. The mean ± standard deviation of the participants’ age was 44.08 ± 9.00 years. According to univariate analyses, the variables of gender, marital status, education level, occupational status, transmission way, infection with hepatitis C or tuberculosis, and history of antiretroviral treatment were significantly associated with the survival time of patients with AIDS. In the final model, a significant relationship was found between the variables of treatment, coinfection with tuberculosis, occupational status, education level, marital status, and mortality. Conclusions: The current study was one of the few research that examined the survival rate of HIV-infected patients in Iran. Considering the expansion of AIDS epidemic in Iran, it is necessary to take appropriate measures to prevent the spread of the epidemic and decrease the mortality rate of infected patients through early detection and timely treatment of HIV-positive people coinfected with tuberculosis, creation of employment opportunities for patients and addicted individuals, controlling substance abuse, and paying more attention to harm reduction programs in individuals that have unsafe sex as one of the most important high-risk groups to increase their survival time.