Cancer registry in Iran: A brief overview

Cancer registry is an important tool for any successful cancer control program. The first formal cancer related data from Iran were published in 1956. In 1969, observations documenting a high incidence of esophageal cancer in the Caspian Littoral, urged researchers to set up the first population-based cancer registry in this region. This cancer registry was established jointly by University of Tehran and the International Agency for Research on Cancer (IARC). In 1976, another cancer registry started its activities in Fars Province. In 1984, the Parliament passed a bill mandating the report of all tissues "diagnosed or suspected as cancer tissue" to the Ministry of Health. While only 18% of all estimated cancer cases were reported in first reports, this rate increased to 81% in 2005 In 1998, Tehran Population-Based Cancer Registry started to collect data from cases of cancer referred to the treatment and diagnostic facilities throughout the Tehran metropolis. Digestive Disease Research Center, Tehran University of Medical Sciences, established four new population-based cancer registries in Northern Iran and another in Kerman Province in the south. These five provinces have a total population of about 9.5 million, and constitute about 16% of the total population of Iran. While the pathology-based cancer registration is in place, we hope that the addition of the population-based cancer registries, and establishment of new registries in poorly-covered areas, will improve cancer reporting in the country

The relationship between nurses' clinical competency and job stress in Ahvaz university hospital, 2013

زمینه و هدف: صلاحیت بالینی پرستاری، شایستگی کاربرد همزمان دانش، مهارت، نگرش ها و ارزش ها در مراقبت از بیمار است که به دلیل اهمیت آن اخیراً مورد توجه بیشتری قرار گرفته است. با توجه به اهمیت روز افزون موضوع صلاحیت پرستاری، شناخت عوامل مرتبط با آن و از جمله استرس شغلی ضروری به نظر می رسد؛ لذا مطالعه حاضر با هدف تعیین رابطه صلاحیت بالینی و استرس شغلی پرستاران شاغل در بیمارستان های دانشگاهی شهر اهواز در سال1392 انجام شد. روش بررسی: در این پژوهش توصیفی- تحلیلی که به صورت مقطعی در طی سال 1392 انجام شد، 80 نفر پرستار شاغل در بیمارستان های آموزشی شهر اهواز از طریق نمونه گیری تصادفی انتخاب و وارد مظالعه شدند. ابزار گردآوری داده ها شامل پرسشنامه های استرس شغلی Osipow و پرسشنامه صلاحیت بالینی Benner بود که به صورت خود ایفاء تکمیل گردیدند. میزان صلاحیت بالینی پرستاران ارزیابی و ارتباط آن با استرس شغلی تعیین شد. یافته ها: بیشتر پرستاران (3/81 درصد) دارای استرس شغلی متوسط بودند. میانگین نمره کل صلاحیت بالینی پرستاران 48/18± 15/61 بود. آزمون همبستگی پیرسون نشان داد که بین استرس شغلی و صلاحیت بالینی پرستاران در تمام حیطه های آن همبستگی منفی و معنی داری وجود دارد (01/0>P). همچنین بین میزان استرس شغلی و بکارگیری صلاحیت بالینی کل ارتباط معنی داری وجود داشت (001/0>P). نتیجه گیری: بر اساس نتایج مطالعه حاضر، افزایش استرس شغلی پرستاران با کاهش صلاحیت های بالینی آنها رابطه دارد که بایستی مورد توجه مدیران پرستاری قرار گیرد

Endoscopic screening for precancerous lesions of the esophagus in a high risk area in northern Iran

Background: Esophageal squamous cell carcinoma (ESCC) is a major health problem in many developing countries, including Iran. ESCC has a very poor prognosis, largely due to late diagnosis. As a first step in developing an early detection and treatment program, we conducted a population-based endoscopic screening for ESCC and its precursor lesion, esophageal squamous dysplasia (ESD), in asymptomatic adults from Golestan Province, northern Iran (a high-risk area for ESCC) to evaluate the feasibility of such a program and to document the prevalence and risk factor correlates of ESD. Methods: This cross-sectional study was conducted among participants of the Golestan Cohort Study (GCS), a population-based cohort of 50,000 adults in eastern Golestan Province. Randomly selected GCS participants were invited by telephone. Those who accepted were referred to a central endoscopy clinic. Eligible subjects who consented were asked to complete a brief questionnaire. Detailed information about selected risk factors was obtained from the GCS main database. Endoscopic examination with was performed with Lugol's iodine staining; biopsies were taken from unstained lesions as well as the normally stained mucosa of the esophagus, and the biopsies were diagnosed by expert pathologists according to previously described criteria. Results: In total, 1906 GCS subjects were invited, of whom only 302 (15.8%) were successfully enrolled. Esophagitis (29.5%) and ESD (6.0%) were the most common pathological diagnoses. Turkmen ethnicity (adjusted OR = 8.61; 95%CI: 2.48-29.83), being older than the median age (OR = 7.7; 95% CI: 1.99-29.87), and using deep frying cooking methods (OR = 4.65; 95%CI: 1.19-18.22) were the strongest predictors for ESD. There were significant relationships between esophagitis and smoking (p-value<0.001), drinking hot tea (P value = 0.02) and lack of education (P value = 0.004). Conclusion: We observed a low rate of participation in endoscopic screening. The overall prevalence of ESD was 6.0%. Developing non-endoscopic primary screening methods and screening individuals with one or more risk factors may improve these rates

THE CRYSTAL AND MOLECULAR STRUCTURE OF N, N&apos;-3, 6-DIOXA-1, 8-OCTANEBIS (SALICYLALDIMINE), C 20 H 24 N 2 O 24

Abstract - The crystal structure of the compound C 20 H 24 N 2 O 24 was determined by direct methods. The crystals are monoclinic, space group P2 1 /n, and unit cell parameters are: a= 10.234

U-Pb zircon geochronology, geochemistry, and petrogenesis of the Hamech intrusions in the Kuh-e-Shah volcano-plutonic complex, Eastern Iran

The Hamech area is located in the west of Kuh-e-Shah volcano-plutonic complex, close to the boundary between the Lut Block and Sistan Suture Zone (SSZ), and is composed of monzonite to diorite porphyries and rare gabbro that intruded into older volcanic rocks. U-Pb zircon dating indicates an age of 36.9 ± 1 Ma for gabbro (Late Eocene, Priabonian) and 38.6 ± 0.5 Ma for dacite (Late Eocene, Bartonian). Geochemically, the studied intrusions are dominantly I-type, high-K calc-alkaline, and metaluminous features. Primitive mantle-normalized trace-element spider diagrams of these rocks present enrichment in ion lithophile elements such as Cs, Rb, Ba, K, and Sr and depletion in high field strength elements such as Nb, Ti, Zr, and heavy rare earth elements. Besides, chondrite-normalized rare earth elements plots of the rocks show enrichment in light rare earth elements (6.85 < LaN/YbN < 9.72) and a lack or weak negative Eu anomaly (Eu/Eu* = 0.81–1.02). The initial 87Sr/86Sr and 143Nd/144Nd ratios for the rocks from 0.704541 to 0.704880 and from 0.512633 to 0.512691, respectively, when recalculated to an age of 39 Ma. The εNd(i) values vary from +0.87 to +1.99, which fits into a suprasubduction mantle wedge source for the parental melts. All data suggest that the Hamech intrusions developed in a low maturity continental margin arc setting related to the convergence of the Afghan and Lut Blocks and subduction of Sistan oceanic crust during the Eocene.publishe

Mortality and cancer in relation to ABO blood group phenotypes in the Golestan Cohort Study

Background: A few studies have shown an association between blood group alleles and vascular disease, including atherosclerosis, which is thought to be due to the higher level of von Willebrand factor in these individuals and the association of blood group locus variants with plasma lipid levels. No large population-based study has explored this association with overall and cause-specific mortality. Methods: We aimed to study the association between ABO blood groups and overall and cause-specific mortality in the Golestan Cohort Study. In this cohort, 50,045 people 40- to 70-years old were recruited between 2004 and 2008, and followed annually to capture all incident cancers and deaths due to any cause. We used Cox regression models adjusted for age, sex, smoking, socioeconomic status, ethnicity, place of residence, education and opium use. Results: During a total of 346,708 person-years of follow-up (mean duration 6.9 years), 3,623 cohort participants died. Non-O blood groups were associated with significantly increased total mortality (hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01 to 1.17) and cardiovascular disease mortality (HR = 1.15; 95% CI: 1.03 to 1.27). Blood group was not significantly associated with overall cancer mortality, but people with group A, group B, and all non-O blood groups combined had increased risk of incident gastric cancer. In a subgroup of cohort participants, we also showed higher plasma total cholesterol and low-density lipoprotein (LDL) in those with blood group A. Conclusions: Non-O blood groups have an increased mortality, particularly due to cardiovascular diseases, which may be due to the effect of blood group alleles on blood biochemistry or their effect on von Willebrand factor and factor VIII levels. \ua9 Etemadi et al

Is correction for metallic artefacts mandatory in cardiac SPECT/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

Introduction: Metallic artifacts due to pacemaker/ implantable cardioverter defibrillator (ICD) leads in CT images can produce artifactual uptake in cardiac SPECT/CT images. The aim of this study was to determine the influence of the metallic artifacts due to pacemaker and ICD leads on myocardial SPECT/CT imaging. Methods: The study included 9 patients who underwent myocardial perfusion imaging (MPI). A cardiac phantom with an inserted solid defect was used. The SPECT images were corrected for attenuation using both artifactual CT and CT corrected using metal artifact reduction (MAR). VOI-based analysis was performed in artifactual regions. Results: In phantom studies, mean-of-relative-difference in white-region, between artifact-free attenuation-map without/with MAR were changed from 9.2 and 2.1 to 3.7 and 1.2 for ICD and pacemaker lead, respectively. However, these values for typical patient were 9.7±7.0 and 3.8±2.4 for ICD and pacemaker leads respectively, in white-region. MAR effectively reduces the artifacts in white-regions while this reduction is not significant in black-regions. Conclusion: Following application of MAR, visual and quantification analyses revealed that while quality of CT images were significantly improved, the improvements in the SPECT/CT images were not as pronounced or significant. Therefore cardiac SPECT images corrected for attenuation using CT in the presence of metallic-leads can be interpreted without correction for metal artefacts. © 2018 Tehran University of Medical Sciences. All rights reserved

Preozonation and Prechlorination Effects on TOC Removal by Nanofiltration in Water Treatment

ABSTRACT: In this study, NF membrane was used for surface water treatment. The rejection of organic material, measured as Total organic carbon (TOC), by Nanofiltration was examined. The effects of application of pre-ozonation and pre-chlorination on TOC removal are discussed and their performances are compared with the performances of Nanofiltraion system without pretreatment process. In NF, natural organic rejection is high and no pre-treatment are required. Coagulation targets large hydrophobic organics which foul NF membranes by precipitation and gel layer formation. The results showed that TOC removal in Preozonation-coagulation was higher than prechlorinationCoagulation. In addition pretreatment increases Nanofiltration efficiency

Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population

Background: There is considerable variation in hypertension prevalence and awareness, and their correlates, across different geographic locations and ethnic groups. We performed this cross-sectional analysis on data from the Golestan Cohort Study (GCS). Methods: Enrollment in this study occurred in 2004-2008, and included 50 045 healthy individuals from Golestan Province in northeastern Iran. Hypertension was defined as a SBP at least 140 mmHg, a DBP at least 90 mmHg, a prior diagnosis of hypertension, or the use of antihypertensive drugs. Potential correlates of hypertension and its awareness were analyzed by logistic regression adjusted for sex, age, BMI, place of residence, literacy, ethnicity, physical activity, smoking, black and green tea consumption and wealth score. Results: Of the total cohort participants, 21 350 (42.7) were hypertensive. Age-standardized prevalence of hypertension, using the 2001 WHO standard world population, was 41.8 (95 confidence interval: 38.3-45.2). Hypertension was directly associated with female sex, increased BMI, Turkmen ethnicity, and lack of physical activity, and inversely associated with drinking black tea and wealth score. Among hypertensive patients, 46.2 were aware of their disease, 17.6 were receiving antihypertensive medication, and 32.1 of the treated patients had controlled hypertension. Hypertension awareness was greater among women, the elderly, overweight and obese patients, and those with a higher wealth score. Conclusion: Hypertension is highly prevalent in rural Iran, many of the affected individuals are unaware of their disease, and the rate of control by antihypertensive medications is low. Increasing hypertension awareness and access to health services, especially among less privileged residents are recommended. © Lippincott Williams and Wilkins

Ergodicity, Decisions, and Partial Information

In the simplest sequential decision problem for an ergodic stochastic process X, at each time n a decision u_n is made as a function of past observations X_0,...,X_{n-1}, and a loss l(u_n,X_n) is incurred. In this setting, it is known that one may choose (under a mild integrability assumption) a decision strategy whose pathwise time-average loss is asymptotically smaller than that of any other strategy. The corresponding problem in the case of partial information proves to be much more delicate, however: if the process X is not observable, but decisions must be based on the observation of a different process Y, the existence of pathwise optimal strategies is not guaranteed. The aim of this paper is to exhibit connections between pathwise optimal strategies and notions from ergodic theory. The sequential decision problem is developed in the general setting of an ergodic dynamical system (\Omega,B,P,T) with partial information Y\subseteq B. The existence of pathwise optimal strategies grounded in two basic properties: the conditional ergodic theory of the dynamical system, and the complexity of the loss function. When the loss function is not too complex, a general sufficient condition for the existence of pathwise optimal strategies is that the dynamical system is a conditional K-automorphism relative to the past observations \bigvee_n T^n Y. If the conditional ergodicity assumption is strengthened, the complexity assumption can be weakened. Several examples demonstrate the interplay between complexity and ergodicity, which does not arise in the case of full information. Our results also yield a decision-theoretic characterization of weak mixing in ergodic theory, and establish pathwise optimality of ergodic nonlinear filters.Comment: 45 page