Economic burden of HIV/AIDS Infection in Iran : a modelling approach

Background: The Human Immunodeficiency Viruses/Acquired Immunodeficiency syndrome HIV/AIDS is a leading cause of mortality and morbidity in Low-and-Middle-Income-Countries (LMICs). It might potentially lead to an economic burden on the health system. There is no certainty about the prevalence of HIV/AIDS in Iran. To the best of our knowledge, there is a lack of economic evidence in the country. Therefore, this study aims to estimate the cost of illness of HIV/AIDS infection in Iran. Methods: We applied a societal perspective to capture the direct and indirect costs attributed to HIV/AIDS in Iran. We used data for age-standardized prevalence produced by the country HIV/AIDS Surveillance System for 2018. The study estimates both direct and indirect costs for a hypothetical cohort of the Iranian adult population (here equates to all registered cases with Surveillance System). For mitigating the uncertainty around the estimations, we have used an optimistic and pessimistic analysis. Results: The base case scenario showed that total direct costs and indirect costs attributed to the HIV/AIDS infection were US$7,946,530 and US$ 1,288,586 at the end of 2018. Also, the total cost is 8,785,116 US$. Conclusions: Direct costs have formed approximately 85% of total costs. The policymakers and planners should consider that these costs are only related to diagnosed or registered infected populations. These costs will be raised dramatically with increasing the diagnosed patients

Pain characteristics of older residents in Iranian nursing homes Caractéristiques des douleurs ressenties par les résidents âgés dans les maisons de retraite iraniennes

Background: Pain is a common complaint among the aging population, particularly among the older residents of nursing homes. Aims: The main aim of the study was to examine the pain characteristics among older residents of nursing homes in Tehran, Islamic Republic of Iran. Methods: This was a cross-sectional study. The sample consisted of 394 older adults admitted to Tehran nursing homes. To gather the required data, Brief Pain Inventory and Abbreviated Mental Test score were used. Results: 51 of the female and 26 of the male participants suffered from pain. Lower extremity and lower part of back were the most frequently affected. Pain interfered with general activity (P < 0.001), mood (P = 0.016), walking (P < 0.001), normal work (P < 0.001), relations with others (P = 0.043), sleeping (P = 0.002) and enjoyment of life (P = 0.019) of the older residents and these effects were more prominent in female sex. Factors such as age, gender and schooling were of significant relationships with pain (P < 0.001) and its intensity (P <0.001). Conclusions: Chronic pain is common among older residents of nursing homes and deteriorates their quality of life. This study reconfirms the previously mentioned importance of using effective pain evaluation and pain management strategies in nursing homes. © World Health Organization (WHO) 2019. Some rights reserved

Development and psychometric properties of the physical rehabilitation services acceptability questionnaire

Background: Access to rehabilitation services is considered to be a right for all people. One of the most important indicators for access to rehabilitation services is an individual's general acceptance of rehabilitation. This tool was designed based on relevant studies and experiences of rehabilitation specialists to design a questionnaire to specifically measure patient acceptability of physical rehabilitation services. Methods: In this study, an exploratory sequential mixed methods design was used. The first phase included a review of the literature and analysis of relevant studies, focus group discussions, and qualitative content analysis. In the second phase, construct validity was assessed by exploratory and confirmatory factor analysis. Also, convergent and divergent validity were measured. Reliability was evaluated by internal consistency (Cronbach's alpha and McDonald's Omega) and construct reliability. Statistical procedures were calculated by SPSS-AMOS24 and JASP0.9.2 software. Results: A total of 200 questionnaires were completed by members of Iranian Disability Campaign. Three factors and 25 items were identified according to results of the first phase of this study. In the second phase, face validity was confirmed. To assess the content validity ratio, 9 items, with the mean of content validity ratio (CVR) < 0.49, were deleted, while the content validity index (CVI) < 0.79 was revised. The kappa coefficient < 0.6 was fair and scale content validity index (SCVI) under 0.9 was considered appropriate. Results of exploratory factor analysis showed that 48 of the variance of the acceptability of physical rehabilitation services was based on patients' satisfaction, ethical behavior, and patient centered services. Confirmatory factor analysis confirmed the suitability of the final model. Convergent and divergent validity and reliability of the measure, the Physical Rehabilitation Services Acceptability questionnaire was fulfilled. Conclusion: Findings indicated that the proposed constructs that promoted the Acceptability of Physical Rehabilitation Services Questionnaire had good validity and reliability in participants with physical disabilities. © Iran University of Medical Sciences

Predicting postoperative complications for gastric cancer patients using data mining

Gastric cancer refers to the development of malign cells that can grow in any part of the stomach. With the vast amount of data being collected daily in healthcare environments, it is possible to develop new algorithms which can support the decision-making processes in gastric cancer patients treatment. This paper aims to predict, using the CRISP-DM methodology, the outcome from the hospitalization of gastric cancer patients who have undergone surgery, as well as the occurrence of postoperative complications during surgery. The study showed that, on one hand, the RF and NB algorithms are the best in the detection of an outcome of hospitalization, taking into account patients’ clinical data. On the other hand, the algorithms J48, RF, and NB offer better results in predicting postoperative complications.FCT - Fundação para a Ciência e a Tecnologia (UID/CEC/00319/2013

Molecular genetics study on population of Salmo trutta caspius spring and autumn forms in Southern Caspian Sea using microsatellite marker method basin and establish an alive gene bank

Caspian brown trout (Salmo trutta caspius) is an important from the point of economy. In this study genetic diversity of (Salmo trutta caspius) was investigated using microsatellite markers from two regions of the Iranian coastline of Southern Caspian Sea (Cheshmeh Kileh River in Mazandaran Province and Karganrud River in Gilan Province). The purpose of this research was the study of Salmo trutta caspius possible populations related to genetic diversity and population structure in the Caspian Sea and introducing the useful genetic markers. For this purpose the number 225 fishes from two Rivers were collected. DNA was extracted and amplified with 16 pairs of microsatellite primers using Polymerase Chain Reaction (PCR). The amplified products were loaded on polyacrylamide gels and bands were analyzed using Gene Alex and Pop Gene soft wares. Observed and expected heterozygosity averages were 0.46 ± 0.09 and 0.60 ± 0.10, respectively. According to the results from this study, Genetic polymorphism has been seen in this population

Application of Artificial Neural Network in Predicting the Survival Rate of Gastric Cancer Patients

&quot;nBackground: The aim of this study was to predict the survival rate of Iranian gastric cancer patients using the Cox proportional hazard and artificial neural network models as well as comparing the ability of these approaches in predicting the survival of these patients.&quot;nMethods: In this historical cohort study, the data gathered from 436 registered gastric cancer patients who have had surgery between 2002 and 2007 at the Taleghani Hospital (a referral center for gastrointestinal cancers), Tehran, Iran, to predict the survival time using Cox proportional hazard and artificial neural network techniques. &quot;nResults: The estimated one-year, two-year, three-year, four-year and five-year survival rates of the patients were 77.9%, 53.1%, 40.8%, 32.0%, and 17.4%, respectively. The Cox regression analysis revealed that the age at diag-nosis, high-risk behaviors, extent of wall penetration, distant metastasis and tumor stage were significantly associated with the survival rate of the patients. The true prediction of neural network was 83.1%, and for Cox regression model, 75.0%.&quot;nConclusion: The present study shows that neural network model is a more powerful statistical tool in predicting the survival rate of the gastric cancer patients compared to Cox proportional hazard regression model. Therefore, this model recommended for the predicting the survival rate of these patients

Human myiasis survey in Ilam Province, Southwest of Iran

Myiasis is the infestation of live human and vertebrate animals with dipterous larvae, which at least for a period. Ilam Province of Iran is one of the most important animal husbandry areas, especially nomadic, in Iran. The objective of this study was to identify the prevalence of myiasis in shepherds in Ilam Province. A cross-sectional study was conducted among the shepherds in Ilam Province, western Iran. Out of the 11 counties in Ilam Province, 6 were randomly chosen from three different climates for this study. A questionnaire was used by a trained interviewer to obtain the information from subjects. The disease has been seen in spring, summer, and autumn seasons. About 94.1 of people have been infested at least once. Pharyngeal myiasis had the highest prevalence with 58.3. Itchy, painful throat, sneeze, cough, and headache were common symptoms. About 85.1 of people described the symptoms of the disease as severe and very severe. About 75.4 stated that the duration of the disease was more than 5 days. According to the results of the study, it was found that the prevalence of myiasis among shepherds in the Ilam Province is high and it is necessary to take appropriate measures to control the disease and increase health literacy

KNOWLEDGE AND ATTITUDES OF THE RURAL POPULATION AND VETERINARY AND HEALTH PERSONNEL CONCERNING CRIMEAN-CONGO HEMORRHAGIC FEVER IN WESTERN IRAN IN 2012

Crimean-Congo Hemorrhagic Fever (CCHF) is an emerging zoonotic disease in Iran. It became a public health problem in the country after an epidemic during 1999 in western Iran. Subsequent studies showed that the disease is now endemic in 23 out of 31 provinces of Iran. The more people become aware of CCHF, the more this disease will be prevented. Therefore, knowledge assessment studies are essential for planning a structured questionnaire to conduct a program of interviews and in training programs. The present study was conducted in an at risk area in western Iran. During Jun-Jul, 2012, a descriptive cross-sectional study was conducted involving 194 people in Darreh Shahr County, Ilam Province, western Iran. The first interrogation was conducted in 4 villages and the second was focused on the health and veterinary staffs of the County who may have been exposed to the disease or may have come in contact with patients suffering from the disease. An interview was conducted through a structured questionnaire concerning CCHF in all studied populations. Statistical analysis of the collected revealed that 61.7 of those interviewed had some information about the role of ticks in disease transmission, while only 14.8 had correct information about CCHF and its' vector. The education levels and jobs of the respondents correlated significantly with their knowledge about the role of ticks in disease transmission, awareness of CCHF and its' routes of transmission, as well as with the symptoms of the disease (P = 0.000). Most health and veterinary staff members had varying levels of knowledge about ticks and tick-borne diseases, while 64.6 recognized CCHF as a tick-borne disease. Their information about ticks was obtained mainly from academic courses (61.1). A relationship of direct employment in public health or veterinary medicine areas led to improved knowledge of 41.6 of respondents. Education of the interviewed personnel was correlated with their knowledge related to methods of tick control (P = 0.002); and the efficacy of various methods of control (P = 0.02). Public education related to CCHF and its transmission routes is recommended via TV/radio broadcasts; however health workers can also play an important role in educating and training villagers. Specialized programs are needed to improve the knowledge of relevant health and veterinary staffs

REGIONAL EVALUATION OF BACTERIAL CONTAMINATION IN HOSPITAL ENVIRONMENT COCKROACHES

Cockroaches play an important role in transmission of different diseases either mechanically and occasionally biologically. The aim of current study was on the identification of cockroaches and their contamination to different bacteria in two hospitals affiliated to the Kordestan University of Medical Sciences which was performed in 2003. Cockroaches were collected from different parts using sticky traps, direct collection, and by means of vacuum cleaner. Collected cockroaches were identified according to the reliable systematic keys. Some of the collected cockroaches were selected randomly for the presence of bacteria in their external parts as well as in the digestive tract using specific culture media. Totally 450 specimens were collected. From which 44.4% identified as American Cockroach, Periplaneta Americana   and remaining German cockroach, Blattella germanica   . Among collected cockroaches 58 specimens of German cockroaches and 40 American cockroaches were selected to search for the presence of bacteria. Results of culture media exhibited that 89.8% (88.98) of cockroaches were positive to the bacteria. The bacteria were found mainly on external parts (67%) and remaining from alimentary canal. The main common bacteria was found Escherichia coli   , however, only 5.1% was Escherichia sp., which was found on external parts. Among two hospitals it is found that Tohid hospital was more infected (97.5%). In the hospitals the infectivity of American cockroaches was more prevalent than other species. All the American cockroaches and 70% of German cockroaches were infected to at least one bacterium. Result showed that the presence of cockroaches in the hospitals can threaten the health of hospitalized patients. Both cosmopolitan species was found infected in the hospitals. Sanitation of different departments as well as different method of control is recommended in the context of Integrated Vector Management for cockroach control

Detection of Outliers methods in medical studies

&amp;nbsp; Background: An outlier is an observation that lies an abnormal distance from other values in a random sample from a population. Outliers sometimes deal with to abnormality in obtained results from collected data and information. known outlier data by researchers, physicians and other persons that work in medical fields and sciences is important and they must control data before getting result about outlier data, effect of them in information bias and how to remove &amp;amp; control to obtain minimum bias and exact data .in this paper we had trying by known technique and tests to control them and minimized the errors related to them.Methods: This paper has been done on 30 student&apos;s height in Tarbiat Modares University that measured by meter in smoothing area. We applied some methods such as; Z-test, Grub test and graphical methods to determine outliers. In this paper the advantage and disadvantage of methods were evaluated and finally compares with each other.Results: The above tests showed that the data values 153, 110 among collected data were outliers. All of the methods showed that the above data were outliers. Calculation quartiles and intermediate quartiles showed that the observations under 125 and upper 141 were mind outliers and if the observation under 119 and upper 147 is the sever outliers. According to upper situations the amounts of 110 and 153 is the sever outliers and resulted from all methods.Conclusion: The results showed that all methods were useful in determine outlier data and between them Quartiles were important to known severe and mild outliers. Also Grub test with p-Value is very useful to report outliers