The presence of anti thyroid and anti ovarian auto-antibodies in familial premature ovarian failure

Background: Premature ovarian failure (POF) is a disorder of multi causal etiology. Autoimmunity has been proposed as a mechanism for some cases of ovarian follicle dysfunction which is evident in POF. The aim of this study was to identify the level of auto-antibodies in POF and familial POF patients. Materials and Methods: In this study, auto-antibodies including anti-ovarian antibody (AOA), anti thyroid peroxidase (TPO) and anti thyroglobulin (TG) antibodies were assessed in the sera of 43 cases with spontaneous POF including 12 cases affected by familial POF. The control samples were obtained from sera of 39 women with normal ovulatory or post menopause women. Results: AOA were detected in 46.5 of the POF group, 41.7 of the familial POF group and 41 of the control group without significant statistical difference between the three groups. Thyroid peroxidase (TPO) antibody was found in 32.6 of the POF group, 41.6 of the familial POF group and 10.3 of the control group. Anti TPO was detected significantly high in both POF and familial POF groups (p<0.02 and p<0.01, respectively). Thyroglobulin (TG) antibody was found in 48.8 of the POF group, 75 of the familial POF group and 23.1 of the control group with meaningful difference (p<0.02 and p<0.001, respectively). TG antibody was significantly higher in familial POF group in comparison to POF group (p<0.03). Conclusion: Although measurement of AOA is not a reliable method for diagnosis of auto-immune POF, but existence of anti thyroid antibodies in familial POF (mainly anti TG) can potentially represent an autoimmune mechanism. It is possible to propose a genetic component for developing autoimmune POF supported by presence of anti thyroid antibodies in familial POF

Bullying and being bullied; how much can it increase the risk of depression and anxiety in students? A multilevel fixed-effect model analysis

Background: School violence as a health issue is a global concern. One of the problems that affect the health and well-being of children at school is bullying. Objectives: In this study, we aimed to examine the association of depression and anxiety with bullying among 6 - 19-year-old students in Iran. Methods: This study was conducted in Tehran, Iran, in 2020. A multistage cluster sampling method was used, and 54,550 students aged six to 19 years of both sexes, from urban and rural areas, were selected. Standard questionnaires, according to the WHO recommendations, were used for data collection. Involvement in bullying in the past 12 months and anxiety and depression status in both bully and bullied students were investigated by standard questionnaires. To compare the psychiatric problems and violent behavior, the Wald chi-square test was applied. The multilevel fixed-effect model and logistic multivariate regression were used to adjust the multilevel effects and estimate the odds of anxiety and depression in both bully and bullied students. All statistical analyses were performed at a 95 significance level. Results: Of the total students, 50.9 were males, 29.45 were in the 6 - 10 age group, and 70.55 in the 11 - 19 age group. There was a significant difference in depression and anxiety between boys and girls in both age groups (P < 0.001). Amongst males, 11.7 of the students aged 6 - 10 and 11 of the students aged 11 - 19 and in females, 7.7 aged 6 - 10 and 10.4 aged 11 - 19 had at least four experiences of bullying to others in the last year. The odds ratios for depression in male bullies were 1.3 and 1.5 in 6 - 10 and 11 - 19 age groups, respectively. The odds ratios for depression in bullied males and females were 4.2 and 3.9 in 6 - 10 and 2.9 and 4.3 in 11 - 19 age groups, respectively. Bulling others increased the odds of anxiety to 1.7 and 1.9 in males and 2.1 and 1.9 in females in 6 - 10 and 11 - 19 age groups, respectively. In bullied students, the odds of anxiety were estimated at 2.9 and 2.2 in males and 3.4 and 2.2 in female students respectively, in 6 - 10 and 11 - 19 age groups. Conclusions: There was a significant positive association between psychological disorders (anxiety and depression) and bullying among 6 - 19-year-old students. Victims of bullying were more at risk of depression and anxiety. This health-threatening phenomenon should not be ignored. Copyright © 2021, Author(s)

Control of antimicrobial resistance in Iran: The role of international factors

Background: Antimicrobial resistance (AMR) is currently causing various challenges for all countries around the world. Accordingly, the WHO is placing a great emphasis on the global partnership and allinaces to drive countries towards developing policy guidances and a strategic framework for AMR contatiment. This study thus seeks to elaborate on the international factors underlying AMR management in Iran. Methods: Semi-structured interviews were conducted with managers from the Ministry of health (n = 14), Iran veterinary organization (n = 4), the national professional associations (n = 3) and researchers (n = 3), between November 2018 and July 2019. Participants were selected using purposeful and snowball sampling. Interviews were recorded and transcribed verbatim and were subsequently coded and analyzed thematically using MAXQDA software (V.18) and reported. Results: International enabling and predisposing factors were identified in relation to the AMR control in the country. Enabling factors included knowledge transfer, facilitation in policy agenda setting, formulation and implementaion process, and AMR monitoring. Predisposing factors, alternatively, encompassed the migration of infectious patients, trafficking of medicine and livestock from neighboring countries, and the imposed sanctions. Conclusion: Nowadays, AMR is taken cognizance of as a global challenge, thus to be addressed effectively, needs an international consensus more than ever. This harmony would not certainly underrate national efforts, but instead, is needed to reinforce such efforts through e.g. technical and financial assistance. It is suggested for policymakers to use all available political and legal means such as health diplomacy to establish humanitarian channels in order to enhance global convention and remove possible barriers as the sanctions and reduce their adverse consequences for AMR control. © 2020 The Author(s)

Why we can no longer ignore consecutive disasters

In recent decades, a striking number of countries have suffered from consecutive disasters: events whose impacts overlap both spatially and temporally, while recovery is still under way. The risk of consecutive disasters will increase due to growing exposure, the interconnectedness of human society, and the increased frequency and intensity of nontectonic hazard. This paper provides an overview of the different types of consecutive disasters, their causes, and impacts. The impacts can be distinctly different from disasters occurring in isolation (both spatially and temporally) from other disasters, noting that full isolation never occurs. We use existing empirical disaster databases to show the global probabilistic occurrence for selected hazard types. Current state‐of‐the art risk assessment models and their outputs do not allow for a thorough representation and analysis of consecutive disasters. This is mainly due to the many challenges that are introduced by addressing and combining hazards of different nature, and accounting for their interactions and dynamics. Disaster risk management needs to be more holistic and codesigned between researchers, policy makers, first responders, and companies

The epidemiology of tuberculosis in the Iranians' population in 2016

Background: Tuberculosis (TB) is the 10thmost common infectious disease in the world, and it is one of the major health problems in Iran despite the implementation of the National Tuberculosis Control Program. Methods: Tuberculosis data in Iran were used in 2016 by the Ministry of Health and Treatment. The data on mortality and incidence of disease were determined by age groups, sex, and the provinces of country. Data were analyzed using Excel (2010) and SPSS software. Findings: The overall incidence rate of tuberculosis in the country was 9.7 per 100000 population (10.7 in men and 8.7 in women). The highest incidence rate of TB and mortality in both sexes were over 80 years. The death rate was 1 person per 100,000 populations, 57.7 of whom were men. Most of the deaths were from pulmonary tuberculosis. The highest incidence and mortality rates were reported in Golestan and Sistan and Baluchestan provinces. Conclusion: The incidence and mortality rate of TB has decreased in recent decades in Iran. Nevertheless, considering the raising trend of human immunodeficiency virus (HIV) among the patients with TB, and the neighborhood with endemic countries, TB should be noticed as one of the most important health priorities in the health system of the country. © 2020 Isfahan University of Medical Sciences(IUMS). All rights reserved

Prevalence, risk factors, and epidemiology of food-borne botulism in Iran

Background: Botulism is a severe neuroparalytic disease caused by toxins produced by several Clostridium species. This work presents the surveillance results of botulism in Iran, with the distribution of the cases by regions and by vehicle of transmission. Methods: We describe the findings of the Centers for Disease Control and Prevention (CDC) surveillance on 2037 suspected cases of food-borne botulism during 2007�2017. Results: A total of 252 (12.3) cases were confirmed to food-borne botulism. The mean annual incidence per 100,000 Iranian Natives was 7.1 cases for male individuals and 3.3 cases for female individuals. All botulism events were confirmed to be foodborne. The most commonly implicated food was home-prepared traditional processed fish product, followed by the consumption of commercially canned products and non-pasteurized dairy products. Forty-eight (19) fatal botulism were reported which, the case-fatality rate declined from 4.5 to 0.7 during the study period. Conclusion: Laboratory-based diagnosis of botulism is an imperative procedure to elucidate cases, particularly food-borne botulism, to identify toxins in food and confirm clinical diagnosis, helping sanitary control measures. In addition, educational materials related to botulism prevention should be disseminated to different communities. © 2020 Atlantis Press

Outcome assessment of a triangular clinic as a harm reduction intervention in Rajaee-Shahr Prison, Iran

Background: Transmission of the human immunodeficiency virus (HIV) among incarcerated injection drug users (IDU) is a health epidemic in the Islamic Republic of Iran. Triangular clinics (TCs) were established in prisons as a harm reduction measure to decrease the risk of HIV transmission and other blood-borne infections. The objective of this study was to assess the immediate outcomes of one TC among male IDUs in Iran's Rajaee-Shahr prison.Methods: This study was conducted in two stages between 2003 and 2005. In the preparatory stage, focus group data was collected to update the prison's TC education and medical interventions and construct the self-report questionnaire. In stage two, 150 male IDUs were recruited in a closed cohort study design to assess the immediate outcome of the TC. Participants were measured at baseline and followed up to six months to measure their drug use, attitude toward and knowledge of high risk behaviours, serological conversion for HIV, HBV and HCV, and engagement in risky behaviors. The TC outcomes were determined through random urine analysis testing, a self-administered questionnaire and behaviour report cards, and viral infection testing.Results: The findings of the urine analyses indicated a minimal yet consistent decrease in drug use over the six months. The pre and post- self-administered questionnaire data relayed a modest change in IDU risky behaviours associated with sexual practices; this was greater in comparison to the knowledge and attitude measures. It was determined that age may have a detrimental effect as may viral infections (HIV and HBV) on knowledge, attitude and behavior change. Both education and employment may have a protective effect. Data collected from the self-report behaviour cards similarly showed a modest reduction in high risk practices. At the six month follow-up, only one case became HIV positive, 9 HCV and 17 HBV.Conclusions: Considering that HIV is concentrated among Iranian prisoners who inject drugs at a high level, the results of this study indicate that TCs are a possible effective intervention. However, many prisoners continued with risky behaviors even if they were participating in harm reduction measures, such as methadone maintenance therapy. © 2013 Asl et al.; licensee BioMed Central Ltd

The Prevalence of Amblyopia in 7-year-old Schoolchildren in Iran

Purpose: To determine the prevalence of amblyopia in schoolchildren aged 7 years in Iran, its relation with refractive errors, and its determinants. Methods: In this cross-sectional study, cluster sampling was done from elementary school students in 7 cities in Iran. In all schools, an optometrist conducted all tests, including measurement of uncorrected and corrected visual acuity, cycloplegic refraction, and cover test. In this study, amblyopia was defined as best corrected visual acuity 20/30 or less or a 2-line interocular optotype acuity difference with no pathology. Results: Of the 4157 students selected for the study, 3675 participated and final analyses were done with data from 3547 children. The prevalence of amblyopia was 1.88 (95 CI: 1.24-2.52) (n=63). The prevalence was 1.91 (95 CI: 0.85-2.97) in boys and 1.85 (95 CI: 1.12-2.58) in girls (p=0.92). Among these cases, 60.30 (n=38) were unilateral. Also, 61.9 were strabismic, 27.0 were anisometropic, 9.5 were isometropic, and one case (1.6) was due to congenital cataracts. Amblyopic individuals were more hypermetropic and the mean cylinder error was significantly higher. Conclusion: Necessary attention should be paid to amblyopia, although its prevalence in Iran is mid-range when compared with other countries. Amblyopia is more common in hyperopic and astigmatic individuals and therefore it is important to pay more attention to this refractive error during childhood. Since strabismus is the most common cause of amblyopia in Iran, children need to be checked for strabismus before the age of 5 years. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Prevalence and Correlates of Hepatitis C Infection among Male Injection Drug Users in Detention, Tehran, Iran

For the benefit of planning for the future care and treatment of people infected with hepatitis C virus (HCV) and to help guide prevention and control programs, data are needed on HCV seroprevalence and associated risk factors. We conducted a cross-sectional sero-behavioral survey of injection drug users (IDU) detained for mandatory rehabilitation during a police sweep of Tehran, Iran, in early 2006. During the study period, a consecutive sample comprising 454 of 499 (91.0%) men arrested and determined to be IDU by urine test and physical examination consented to a face-to-face interview and blood collection for HCV antibody testing. Overall, HCV prevalence was 80.0% (95% confidence interval (CI) 76.2–83.6). Factors independently associated with HCV infection included history of incarceration (adjusted OR 4.35, 95% CI 1.88–10.08), age of first injection ≤25 years (OR 2.72, 95% CI 1.09–6.82), and history of tattooing (OR 2.33, 95% CI 1.05–5.17). HCV prevalence in this population of IDU upon intake to jail was extremely high and possibly approaching saturation. Findings support that incarceration is contributing to the increased spread of HCV infection in Iran and calls for urgent increased availability of HCV treatment, long-term preparation for the care of complications of chronic infection, and rapid scale-up of programs for the primary prevention of parenterally transmitted infections among drug users