Determinant factors of survival time in a cohort study on HIV patient using by time-varying cox model: Fars province, south of Iran

Background and aims: The pandemic of AIDS is a global emergency and one of the biggest challenges in social and individual life. This study aimed to evaluate the survival time of HIV patients and its effective factors. Methods: This historical cohort study was conducted on the individuals infected with HIV in Fars province, south of Iran, during 2006 to 2013. The study data were obtained from information documented in the patients’ records. For statistical analysis, at first, Kaplan-Meier survival analysis was used as univariate method and then, time varying Cox regression model was applied as multiple analyses. Results: The findings of the present study implied that some variables could play the role of risk factors in HIV patients, and shorten the patients’ life span e.g. older age, female gender, unemployment, delay in HIV diagnosis, drug injection, and higher Hemoglobin (HGB) levels. Conclusion: Many factors affect HIV patients’ survival time. Some of these factors, such as gender and genetic factors, are irreversible. However, some others, including drug injection, are preventable. This implies that in order to slow down the speed of HIV conversion to AIDS and delay the occurrence of death, special attention must be paid to these factors and changing the patients’ conditions accordingly

The Scientific Output of Kerman University of Medical Sciences, Iran, in Web of Science

Background & Objective: Publishing in journals indexed in well-known indexes is the best way to present an article internationally. It also illustrates the contribution of scholars to the advancement of knowledge in the world. This study aimed to investigate the scientific output of Kerman University of Medical Sciences, Iran, in Web of Science (WOS) during 2004 to 2013. Methods: This applied research uses scientometrics and citation methods to investigate the scientific publications of Kerman University of Medical Sciences during 2004-2013. The data were gathered from Web of Science. Results: During this time period, researchers at Kerman University of Medical Sciences had published 1053 documents in WOS. Most of the documents were in article format. The growth rate of scientific contribution was 70% and the university’s H-index was 30. The papers’ distribution followed the Lotka’s law. In total, the papers had received 4619 citations. Only 2.47% of papers were written by one author. The studied researchers had the most collaboration with Tehran University of Medical Sciences among Iranian universities and the University of Amsterdam among foreign universities. The fields pharmacy and pharmacology had produced the most papers. Conclusion: The results indicated a growing trend in publications and high rates of scientific collaboration by Kerman University of Medical Sciences. It is suggested that different departments follow the experience of departments with the most productivity in order to increase their output. In this way all departments will contribute to the university’s scientific output. Moroever, new policies should be considered to increase the citation rate. Key Words: Science production, Web of Science (WOS), Citation, Document, Scientometrics, Kerman University of Medical Sciences, H-inde

A comparative study on effectiveness of workshop education versus education via mobile learning (m-learning) in developing medical students’ knowledge and skill about cardiopulmonary resuscitation

INTRODUCTION: A variety of educational approaches are being used today to improve learning in the field of cardiopulmonary resuscitation. Therefore, the present study was conducted to compare workshop education with education via mobile learning (M-learning) in terms of their efficacy in developing medical students’ knowledge and skills about cardiopulmonary resuscitation. MATERIAL AND METHODS: The present study was quasi-experimental performed on 60 interns selected from a university of medical sciences in southwest Iran. Participants were assigned to either the workshop education group (n = 30) or the mobile learning group (n = 30). Before and after the intervention, the knowledge and skills of the participants in terms of basic and advanced cardiopulmonary resuscitation were measured by a questionnaire. The collected data were analyzed using descriptive statistics, Independent-Samples t-Test, Paired-Samples t-Test, and Chi-Square Test in SPSS software v. 22. RESULTS: Education via mobile learning caused a significant increase in the participants’ knowledge about cardiopulmonary resuscitation (p < 0.05). However, this method did not result in a significant difference in the participants’ skill scores, while the workshop education group showed a significant increase in their cardiopulmonary resuscitation skill scores (p < 0.05). CONCLUSIONS: Our results revealed that education via mobile learning was better in enhancing medical students’ knowledge about cardiopulmonary resuscitation. However, workshop education was more effective in developing practical skills in the field of cardiopulmonary resuscitation. Accordingly, educators are recommended to employ a combination of mobile learning and workshop education for achieving better results

Study of Toxic Effects of Oxothiazole Derivative as a New Antibacterial Agent

The spread of antibiotic-resistant bacteria in many humans and animals has driven researches to identify and design novel antibacterial agents. In vitro inhibitory activity of (2E)-2-(4,5-dihydro-4-oxothiazol-2-yl)-2-(thiazolidin-2-ylidene) acetonitrile against many bacterial pathogens has been proven in both veterinary and human medicine. In this study, its in vivo toxic effects was studied in mice. The median lethal dose (LD50) value of 239.88 mg/kg was estimated using intraperitoneal injection in 8 groups of mice after 48 h treatment. Then, intraperitoneal injections of LD50 of oxothiazole solution into 4 other mice were done to evaluate histopathological changes in their liver and kidney tissues. The histopathological studies were identified as fatty change, hepatitis, necrosis and regeneration in liver, and fibrosis, necrosis, nephritis, hyaline cast and hyperaemia in kidney. In conclusion, the synthesized oxothiazole derivative causes renal and hepatic toxicity in mice at medium concentrations. The change of thiazole substituents and complexation may reduce its toxicity

Rapamycin protects testes against germ cell apoptosis and oxidative stress induced by testicular ischemia-reperfusion

Objective(s):Rapamycin is an immunosuppressant compound with a broad spectrum of pharmaco-logical activities. In recent years, it has been used successfully to decrease ischemia-reperfusion injury in several organ systems. The purpose of the present study was to examine the effect of rapamycin on testicular ischemia-reperfusion injury. Materials and Methods: Seventy-two adult male Wistar rats were divided into six groups: control (group1), sham-operated (Group2), T/D + DMSO as vehicle group (group3), and groups 4–6; respectively received 0.5, 1, and 1.5 mgkg-1 of rapamycin , IP 30 min before detorsion. Ischemia was achieved by twisting the right testis 720o clockwise for 1 hr. The right testis of 6 animals from each group were excised 4 hr after detorsion for the measurement of lipid peroxidation, caspase-3, and antioxidant enzyme activities. Histopathological changes and germ cell apoptosis were determined by measuring mean of seminiferous tubules diameters (MSTD) and TUNEL test in right testis of 6 animals per group, 24 hr after detorsion. Results: Testicular T/D caused increases in the apoptosis, malondialdehyde (MDA), and caspase-3 levels and decreases in the superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities in ipsilateral testis (

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

A Monte Carlo study on dose distribution validation of GZP6 Co stepping source

AimStepping source in brachytherapy systems is used to treat a target lesion longer than the effective treatment length of the source. Cancerous lesions in the cervix, esophagus and rectum are examples of such a target lesion.BackgroundIn this study, the stepping source of a GZP6 afterloading intracavitary brachytherapy unit was simulated using Monte Carlo (MC) simulation and the results were used for the validation of the GZP6 treatment planning system (TPS).Materials and methodsThe stepping source was simulated using MCNPX Monte Carlo code. Dose distributions in the longitudinal plane were obtained by using a matrix shift method for esophageal tumor lengths of 8 and 10[[ce:hsp sp="0.25"/]]cm. A mesh tally has been employed for the absorbed dose calculation in a cylindrical water phantom. A total of 5[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]108 photon histories were scored and the MC statistical error obtained was at the range of 0.008–3.5%, an average of 0.2%.ResultsThe acquired MC and TPS isodose curves were compared and it was shown that the dose distributions in the longitudinal plane were relatively coincidental. In the transverse direction, a maximum dose difference of 7% and 5% was observed for tumor lengths of 8 and 10[[ce:hsp sp="0.25"/]]cm, respectively.ConclusionConsidering that the certified source activity is given with ±10% uncertainty, the obtained difference is reasonable. It can be concluded that the accuracy of the dose distributions produced by GZP6 TPS for the stepping source is acceptable for its clinical applications

Prevalence of Obesity and Overweight and Its Associated Factors in Urban Adults from West Azerbaijan, Iran: The National Food and Nutritional Surveillance Program (NFNSP)

Background and Objectives: Globally, the prevalence of overweight/obesity is increasing at an alarming rate. According to the World Health Organization (WHO), about 1.9 billion adults worldwide are overweight, and of these, over 600 million are obese. The purpose of this study was to determine the prevalence of overweight and obesity in West Azerbaijan, Iran, in 2014. Materials and Methods: Data were collected as part of the National Food and Nutritional Surveillance Program (NFNSP). A total of 249 men and women aged 20&ndash;60 from West Azerbaijan were included in the survey conducted in 2014. Body height and weight were measured with light clothing and no footwear after overnight fasting. Results: Mean age of the participants was 38.5 &plusmn;7.8 yrs. Mean BMI was 28.0&plusmn;4.9 kg/m2 (men: 26.8&plusmn;4.2 vs. women: 29.0&plusmn;5.3, p<0.001). The prevalence of overweight and obesity was 36.5% (men: 38.6 % vs. women: 34.8%, p: 0.439) and 33.3% (men: 25.4 vs. women: 40.0 %, p: 0.016), respectively. Women were more likely to be overweight or obese than males (P=0.038). Multiple logistic regression revealed that gender (women vs. men) (OR, 2.05; CI, 1.15-3.65; p,0.014) and age (OR, 1.06; CI, 1.01-1.1; p,0.004) increased the risk of becoming overweight or obese. Women who were housewives were five times more at risk of becoming overweight or obese (OR: 4.93; CI: 1.9-12.3; p<0.001) even after adjusting for age and educational level. Conclusions: The high prevalence of weight problems in West Azerbaijan is a serious health concern, especially in women. The lifestyle of housewives is a potential risk factor for weight gain in women. Keywords: Obesity, Prevalence, Azerbaijan, Adult