Incidence rate of thyroid cancer in Iranian population, trend analysis from 2003 to 2009

Background and aims: Thyroid cancer is the most common endocrine malignant and papillary cancer and three times more prevalent in women than men. The aim of this study was to evaluate the incidence rate and trend of thyroid cancer in Iranian population. Methods: National incidence was rated by Iran National Cancer Registry data derived from Iran’s annual national cancer registration reported from 2003 to 2009. The crude rate and age standardized rate were used to express the incidence of thyroid cancer. Results: The results indicated that, the incidence of thyroid cancer increased from 2003 to 2009. The age standardized rate for women and men increased from 2.02 and 0.82 to 4.2 and 1.36 per 100,000, respectively. Conclusion: This study indicated remarkable increasing trends in thyroid cancer incidence. So, attention to high risk groups and public programs is necessary to reduce the incidence of this cancer in future

Magnesium Gargle versus Ketamine Gargle in Postoperative Sore Throat Pain; A Randomized Placebo-Controlled Clinical Trial

Background: A wide range of approaches have been tested for the prevention and treatment of postoperative sore throat pain (POST pain). This study attempted to compare the effects of gargling with Ketamine or Magnesium Sulfate on POST pain.  Materials and Methods: In a randomized clinical trial, 60 patients scheduled for prone position laminectomy were randomly assigned into three groups: Ketamine (n=20), Magnesium (n=20), and Control (n=20). The Magnesium group received magnesium sulfate gargle (30 mg/kg in a total of 30 ml 5% Dextrose water), the Ketamine group received Ketamine gargle (0.5 mg/kg in a total of 30 ml 5% Dextrose water) and the control group received 30 ml 5% Dextrose water gargle; all these solutions were administered 10 min before anesthesia induction. Visual Analog Scale (VAS) for throat pain was recorded in the recovery room; immediately after arrival and then, at 2, 4, and 24 hours postoperatively in the ward. Would there be any VAS equal to or more than 3 of 10, rescue analgesics were administered immediately and their cumulative doses were recorded.  Results: The incidence of complaint-free patients in the Ketamine group was significantly higher than in the other two groups. The incidence of sore throat with VAS≥3, mandating rescue analgesia, was significantly lower than the other two groups. patient satisfaction after surgery was significantly higher in the Ketamine group.  Conclusion: Patients experiencing POST pain treated with “Ketamine gargle” had better results compared with “Magnesium Sulfate” or “Placebo” gargle.&nbsp

Under-estimation and Over-estimation in Gastric Cancer Incidence Registry in Khorasan Provinces, Iran

Gastric cancer is a disease which the cells forming the inner lining of the stomach start to divide uncontrollably, forming a mass called a tumor. Patients with gastric cancer from low facility provinces like North and South Khorasans may diagnose and registered in full featured provinces like Razavi-Khorasan; this causes misclassification error. The presence of this error makes the registry systems inaccurate and unreliable for estimating the burden of cancer and policy making. Two approaches are recommended for reducing the effects of misclassification; the first is using a small validation sample and the second is a Bayesian analysis which provides subjective prior information for the subset of the parameters to correct the statistics. Data for this study extracted from Iranian annual of national cancer registration report in 2008. The age standardized rate due to gastric cancer [ICD-10; C16] were expressed as rate per/100,000 population for male and female of North, South and Razavi Khorasans. To correct the misclassification effect, a Bayesian approach was used with Poisson count regression and beta prior. The reported expected coverage of cancer incidence for Razavi-Khorasan was 155.5% and exceeds than what expected, whereas the North and South Khorasans have just observed respectively 34.8% and 41.4% of their expected coverage. The results of the Bayesian analysis indicated that there was about 34% misclassification in gastric cancer incidence registry from North and South Khorasans in Razavi-Khorasan. In planning for resource allocation, authorities should consider that, low incidence of gastric cancer in North and South Khorasans, may be the effect of misclassification and it is needed to allocate them more health facilities and improve their address registration accuracy using National ID, electric bill, etc.

Efficacy and safety of fractional CO2 laser and tranexamic acid versus microneedling and tranexamic acid in the treatment of infraorbital hyperpigmentation

Objective To compare the efficacy and safety of microneedling and fractional CO2 laser in combination with tranexamic acid (TA) in the treatment of infra-orbital hyperpigmentation. Patients and methods This split-face clinical trial performed on 30 volunteers. The patients were randomly assigned to treat with fractional CO2 laser and microneedling, both combined with TA topically. Three monthly treatment sessions were performed. Two blinded dermatologists evaluated the response after each treatment session and one and three months after the last session. We also asked patients to evaluate their overall satisfaction at the final follow up. Adverse effects have also been documented. Results Both methods showed significant improvement in all sessions comparing with the baseline state (p value <.05). There were no significant differences between two methods on the days 30, 90, and 150. But the laser showed significantly higher improvement on day 60. The patients’ satisfaction did not reveal any significant difference between the two sides. Adverse events were temporary with no significant difference between both sides except for erythema that lasts longer with microneedling. Conclusions Both fractional CO2 laser and microneedling in combination with topical TA seem to be effective modalities in the treatment of infraorbital hyperpigmentation with no significant side effects

Socioeconomic inequality in childhood obesity and its determinants: a Blinder–Oaxaca decomposition

Objective: Childhood obesity has become a priority health concern worldwide. Socioeconomic status (SES) is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. Methods: This multicenter cross‐sectional study was conducted in 2011–2012, as part of a national school‐based surveillance program performed in 40,000 students, aged 6–18‐years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the SES of participants was categorized to quintiles. SES inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the SES quintiles, the concentration index (CCI), and slope index of inequality (SII). The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Results: Overall, 36,529 students completed the study (response rate: 91.32%); 50.79% of whom were boys and 74.23% were urban inhabitants. The mean (SD) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51%, 8.35%, and 17.87%, respectively. The SII for overweight, obesity and abdominal obesity was −0.1, −0.1 and −0.15, respectively. CI for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low SES groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest SES groups. Conclusion: This study provides considerable information on the high prevalence of excess weight in families with higher SES at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels

Socioeconomic inequality in childhood obesity and its determinants: a Blinder-Oaxaca decomposition

Abstract Objective Childhood obesity has become a priority health concern worldwide. Socioeconomic status is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. Methods This multicenter cross-sectional study was conducted in 2011-2012, as part of a national school-based surveillance program performed in 40,000 students, aged 6-18-years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the socioeconomic status of participants was categorized to quintiles. Socioeconomic status inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the socioeconomic status quintiles, the concentration index, and slope index of inequality. The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Results Overall, 36,529 students completed the study (response rate: 91.32%); 50.79% of whom were boys and 74.23% were urban inhabitants. The mean (standard deviation) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51%, 8.35%, and 17.87%, respectively. The SII for overweight, obesity and abdominal obesity was -0.1, -0.1 and -0.15, respectively. Concentration index for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low socioeconomic status groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest socioeconomic status groups. Conclusion This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels