Country Pharmaceutical Situation Based on World Health Organization Indicators: Evidence from an Upper-Middle Income Country

Evaluating the performance of national authorities has a pivotal role in the development of evidence-based policymaking. Regarding the complexity of the pharmaceutical sector and its severe impacts on public health, Food and Drug Administrations' (FDA) performance should be evaluated at regular intervals. This study aims to depict a comprehensive picture of the Iranian pharmaceutical situation and its structural gaps. In this cross-sectional descriptive study, inspired by indicators proposed by the world health organization (WHO), a checklist was developed with six component topics and 239 indicators. These topics considered the existence and performance of six critical structures, including national drug policy (NDP), regulatory system, medicine supply system, medicine financing, production and trade, and rational use of drugs (RUD). Afterward, the translation validity and then face and content validity of the research tool was confirmed by relevant experts. The data were collected by referring to official documents, reports, and critical informants in the Iranian Food and Drug Administration (IRFDA). According to the WHO indicators, the scores for structures of IRFDA are 80% in NDP, 61.5% in the regulatory system, 64.7% in the medicines supply system, 84.8% in medicines financing, and 60% in production, and trade, and 71.7% in RUD. Considering the status of structures and processes, IRFDA should attempt to provide an action plan commensurate with the NDP. Besides, it should modify the regulations regarding its responsibilities and authorities, develop transparency and accountability in its offices, publish a national essential medicines list, and revise motivational and punitive policies to create RUD

Common Aeroallergens in Patients with Asthma and Allergic Rhinitis Living in Southwestern Part of Iran: Based on Skin Prick Test Reactivity

Aeroallergens continue to have a key role in the pathogenesis of asthma and allergic diseases and have recently received increased attention in medical research throughout the world. The prevalence of aeroallergens vary in different regions, depending on the type of climate. The aim of the present study was to determine prevalence of the sensitivity to aeroallergens among patients with asthma and allergic rhinitis (AR), based on skin prick test (SPT) reactivity in the province of Bushehr, Iran. In this cross-sectional study, 743 patients were enrolled. The participants had asthma and AR and reacted to at least one allergen with SPT. Skin prick test with standard extracts including house dust mites (HDMs), animal dander, molds and pollens were performed on patients according to the herbal geography of the area. The male to female ratio and mean age of the patients were 1.03 and 27.6± 15.4 year, respectively. Out of 567 patients with AR, the common aeroallergens were HDMs (88.5%), molds (82.9%), animal dander (79.5%), weeds (77.6%), trees (75.5%) and grass pollen (71.5%). Moreover, among 176 patients with asthma, the prevalence of aeroallergens were HDMs (90.5 %), molds (80.7%), animal dander (77.5%), weeds (73.3%), trees (73.3%) and grass pollen (67.9%). The sensitivity to animal dander, Chenopodium album and Russian thistle pollens were significantly associated with the severity of AR. Moreover, sensitivity to animal dander such as cat and feather of birds, cockroach, Bermuda grass and Chenopodium album pollens were significantly associated with the severity of asthma. The results of this study revealed that HDM was the most common sensitizing aeroallergen in patients with asthma and AR. Molds and animal dander as indoor allergens were also common aeroallergens. We suggest that the hot weather and ambient humidity in the region may be the main cause of the change in the pattern of SPT reactivity

Prevalence and Risk Factors of Asthma and Allergic Diseases in Primary Schoolchildren Living in Bushehr, Iran: Phase I, III ISAAC Protocol

Asthma and allergic diseases present a major health burden. Information on the prevalence of these diseases indicates that these diseases are increasing in various parts of the world. It was hoped that this study would be helpful to health system policy-makers in planning allergy prevention programs in the region. The prevalence of asthma and allergic diseases and relation between the various risk factors involved were assessed among schoolchildren in the city of Bushehr, Iran. The ISAAC Phase I and III questionnaires were completed by parents of 1280 children aged 6-7 years and self-completed by 1115 students aged 13-14 years. The prevalence of atopic eczema, allergic rhinitis and asthma among 6-7 year-old students were 12.1%, 11.8% and 6.7%, respectively. While, the prevalence of these diseases among 13-14 year-old students were found to be 19%, 30% and 7.6%, respectively. There was an association between asthma and allergic rhinitis as well as eczema (p<0.05). Consumption of fast food as a risk factor was significantly associated with asthma (p=0.03). The prevalence of asthma and allergic diseases was high among schoolchildren in the city of Bushehr, Iran. Also an association was observed between the fast food consumption and asthma. Keywords: Allergic rhinitis; Asthma, Atopic eczema; Children; ISAAC; Prevalenc

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Burden of tracheal, bronchus, and lung cancer in North Africa and Middle East countries, 1990 to 2019: Results from the GBD study 2019

ObjectiveTo provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region.Methods and materialsThe Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs).ResultsIn the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use.ConclusionThe incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved

Prevalence of Seafood Allergy in Student Living in Bushehr and Borazjan

Background: Seafood allergy is potentially severe, but the prevalence of this group of food allergies in Iran, has not been determined. The objective of this study was to estimate the prevalence of seafood allergy in student living in Bushehr and Borazjan. Materials and Methods: We performed a cross-sectional, random school survey by using a questionnaire in 2012-13. A total of 608 (36% male, and 64%) female) were asked questions about personal and family history of allergies, food and seafood allergy. Results: The overall prevalence of food allergy was 12% (Total 73 subjects, 69.8% male and 30.2% female), and seafood allergy was 4.4% (Total 27 subjects, 36.6% male, 43.4% female). Fish allergy (1.4%) and shrimp and shellfish allergy (3.5%) were reported. The most frequently reported symptoms were skin (49.3%), gastrointestinal (28.7%), and respiratory reactions (2.7%). Seafood allergy was not associated with subjects reporting atopic diseases, significantly (P> 0.05), while the other food allergy was positively associated (P=0.00). Conclusion: Our study is the first report on prevalence estimates for seafood allergy in Bushehr province. Findings indicated high prevalence of seafood allergy in student, therefore further studies and significant health concern is needed

Human exposure to aerosol from indoor gas stove cooking and the resulting nervous system responses

Our knowledge of the effects of exposure to indoor ultrafine particles (sub-100 nm, #/cm3) on human brain activity is very limited. The effects of cooking ultrafine particles (UFP) on healthy adults were assessed using an electroencephalograph (EEGs) for brain response. Peak ultrafine particle concentrations were approximately 3 × 105 particle/cm3, and the average level was 1.64 × 105 particle/cm3. The average particle number emission rate (S) and the average number decay rate (a+k) for chicken frying in brain experiments were calculated to be 2.82 × 1012 (SD = 1.83 × 1012, R2 = 0.91, p = 0.0013) particles/min, 0.47 (SD = 0.30, R2 = 0.90, p < 0.0001) min−1, respectively. EEGs were recorded before and during cooking (14 min) and 30 min after the cooking sessions. The brain fast-wave band (beta) decreased during exposure, similar to people with neurodegenerative diseases. It subsequently increased to its pre-exposure condition for 70% of the study participants after 30 min. The brain slow-wave band to fast-wave band ratio (theta/beta ratio) increased during and after exposure, similar to observed behavior in early-stage Alzheimer's disease (AD) patients. The brain then tended to return to its normal condition within 30 min following the exposure. This study suggests that chronically exposed people to high concentrations of cooking aerosol might progress toward AD

Human exposure to aerosol from indoor gas stove cooking and the resulting nervous system responses.

Our knowledge of the effects of exposure to indoor ultrafine particles (sub-100 nm, #/cm3 ) on human brain activity is very limited. The effects of cooking ultrafine particles (UFP) on healthy adults were assessed using an electroencephalograph (EEGs) for brain response. Peak ultrafine particle concentrations were approximately 3 × 105 particle/cm3, and the average level was 1.64 × 105 particle/cm3 . The average particle number emission rate (S) and the average number decay rate (a+k) for chicken frying in brain experiments were calculated to be 2.82 × 1012 (SD = 1.83 × 1012 , R2  = 0.91, p = 0.0013) particles/min, 0.47 (SD = 0.30, R2  = 0.90, p < 0.0001) min-1 , respectively. EEGs were recorded before and during cooking (14 min) and 30 min after the cooking sessions. The brain fast-wave band (beta) decreased during exposure, similar to people with neurodegenerative diseases. It subsequently increased to its pre-exposure condition for 70% of the study participants after 30 min. The brain slow-wave band to fast-wave band ratio (theta/beta ratio) increased during and after exposure, similar to observed behavior in early-stage Alzheimer's disease (AD) patients. The brain then tended to return to its normal condition within 30 min following the exposure. This study suggests that chronically exposed people to high concentrations of cooking aerosol might progress toward AD

Artificial Intelligence in Cancer Care: From Diagnosis to Prevention and Beyond

&lt;p&gt;Artificial Intelligence (AI) has made significant strides in revolutionizing cancer care, encompassing various aspects from diagnosis to prevention and beyond. With its ability to analyze vast amounts of data, recognize patterns, and make accurate predictions, AI has emerged as a powerful tool in the fight against cancer. This article explores the applications of AI in cancer care, highlighting its role in diagnosis, treatment decision-making, prevention, and ongoing management. In the realm of cancer diagnosis, AI has demonstrated remarkable potential. By processing patient data, including medical imaging, pathology reports, and genetic profiles, AI algorithms can assist in early detection and accurate diagnosis. Image recognition algorithms can analyze radiological images, such as mammograms or CT scans, to detect subtle abnormalities and assist radiologists in identifying potential tumors. AI can also aid pathologists in analyzing tissue samples, leading to more precise and efficient cancer diagnoses. AI's impact extends beyond diagnosis into treatment decision-making. The integration of AI algorithms with clinical data allows for personalized treatment approaches. By analyzing patient characteristics, disease stage, genetic markers, and treatment outcomes, AI can provide valuable insights to oncologists, aiding in treatment planning and predicting response to specific therapies. This can lead to more targeted and effective treatment strategies, improving patient outcomes and reducing unnecessary treatments and side effects. Furthermore, AI plays a crucial role in cancer prevention. By analyzing genetic and environmental risk factors, AI algorithms can identify individuals at higher risk of developing certain cancers. This enables targeted screening programs and early interventions, allowing for timely detection and prevention of cancer. Additionally, AI can analyze population-level data to identify trends and patterns, contributing to the development of public health strategies for cancer prevention and control. AI's involvement in cancer care goes beyond diagnosis and treatment, encompassing ongoing management and survivorship. AI-powered systems can monitor treatment response, track disease progression, and detect recurrence at an early stage. By continuously analyzing patient data, including imaging, laboratory results, and clinical assessments, AI algorithms can provide real-time insights, facilitating timely interventions and adjustments to treatment plans. This proactive approach to disease management improves patient outcomes and enhances quality of life.&lt;/p&gt