Does ethnicity affect survival following colorectal cancer? A prospective, cohort study using Iranian cancer registry

Background: The present study compared the differences between survivals of patients with colorectal cancer according to their ethnicity adjusted for other predictors of survival. Methods: In this prospective cohort study patients were followed up from definite diagnosis of colorectal cancer to death. Totally, 2431 person-year follow-ups were undertaken for 1127 colorectal cancer patients once every six months. The data were analyzed by stata software using bivariate analysis, multivariate analysis, and Cox regression. Results: The age at diagnosis was significantly different between men and women (p < 0.03). 61.2 were male and the rest were female. Most patients were Fars (51.2), followed by Turciks (21.5), Kurds (8.2), and 7.5 Lurs. Of the patients, 75 had a survival of more than 2.72 years, 50 a survival of 5.83 years, and 25 longer than 13.1 years after diagnosis. Risk ratio was significantly different among ethnics (p < 0.05). The variables of ethnicity, being non married, tumor grade, family history of cancer, and smoking were considered as determinants of the patients' survival in Cox regression model. The median survival time in Fars, Kurds, Lurs, Turks and other ethnics was 5.83, 2.44, 5.49, and 8.52 years, respectively. Conclusion: Ethnicity and access to healthcare are predictors of survival of patients with colorectal cancer which may define priorities in controlling cancer and implementing interventional and prevention plans

Prevalence of hypertension and type 2 diabetes mellitus in patients with colorectal cancer and their median survival time: A cohort study

Background: Type 2 diabetes mellitus (DM) and hypertension are worldwide epidemic. Association between DM and colon cancer was obtained in previous studies. Prevalence of DM and hypertension in the patients with colorectal cancer (CRC) has not been reported in Iran. The present study was aimed to investigate the prevalence of hypertension and type 2 DM and their effect on median survival time in patients with CRC. Materials and Methods: Overall, 2570 individual-year follow-ups were conducted for 1127 patients with CRC. For the diagnosis of type 2 DM, fasting blood sugar test and glycosylated hemoglobin test were used and for hypertension, blood pressure was measured in two turns. The descriptive indices were calculated, and the mean and median survival from CRC diagnosis time was calculated using survival analysis and a comparison among survival times was done through log-rank test. Stata software 12 (Stata Corp. 2011. Stata Statistical Software: Release 12. College Station, TX: Stata Corp LP) was used for data analysis. Results: The prevalence of hypertension and type 2 DM in the patients with CRC was respectively 13.38% (95% confidence interval CI]: 11.1-15.8) and 8.69% (95% CI: 7-10.7). Median survival time in patients with hypertension and DM were 8.52 and 4.9 years. According to log-rank test, no significant difference was observed between the survival time of CRC patients suffering from hypertension and diabetes type 2. Conclusion: The obtained findings in this study indicate that survival time in patients with type 2 DM less than hypertension but two metabolic diseases have the same effect on survival rate of the patients with CRC. Understanding the risk factors for CRC may guide the development of strategies targeted toward its prevention

Regional differences in cancer incidence trend in tehran, Iran: A contextual study on the effect of socioeconomic status at regional level

Background: Cancer is a major public health concern all over the world. The aim of the current study is to demonstrate changing trends of cancer incidence from 2006 to 2009 in Tehran (capital city of Iran) and evaluate the effect of living in different regions according to their median socioeconomic status (SES) on cancer cumulative incidence. Methods: The incident cases were obtainedfromthe population based cancer register of ministry of healthandmedicine in Iran; we examined the annual percent changes (APCs) and overall trends of total cancer incidence across regions in Tehran. The age and sex standardized incidence rates were computed by the direct method. Poisson regression and negative binominal regression model were used to assess the existence of trends across 4 consecutive years, as well as the effect of living in each region, literacy rate, and employment rate across regions on this trend. All the analyses were done by Stata 12.0 software. Results: The findings of this study showed downward and nonlinear trend during 4 years. The age-standardized incidence rate (ASR) was higher in men compared to women in this period. ASRs for overall 4 years were 114 and 101 per 10,0000 men and women, respectively. Average annual percent change based on ASR and regression model for each sex was the same and around -5 and -6, respectively. Incidence rate also differed between districts so that north and center districts had higher incidence than southern parts in both sexes. The lowest rate ratio attributed to district 17 and 18 located in south of Tehran and the highest rate ratio attributed to district 6 for each sex compared to the baseline district 16. Results reported the sharp increase of 59 and 37 in district 6 compared to district 16 in men and women, respectively. Better regional social status increased the risk of cancer among women. Also, the results showed a partially significant interaction with higher decrease in annual trend of cancer rate in socially more deprived regions. Conclusions: The results showeddownwardand nonlinear decreasing trend during 4 years, especially in regions with lower socioeconomic status. Incidence rate also differed between districts so that northern regions had higher incidence than southern regions. Spatio-temporal Analysis of these cancer rates with adjustment for more regional socio-economic characteristicsmaybetter explain the disparities in rate of cancer in different districts across time. © 2018, Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences

Epidemiologic characteristics of orthopedic surgical site infections and under-reporting estimation of registries using capture-recapture analysis

Background: Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method. Methods: This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patients` characteristics. Results: Totally, 76.24 of SSIs were detected post-discharge. Staphylococcus aureus (11.38) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 and 65.17, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95 CI, 552�695) and under-reporting percentage was 63.32. Conclusion: To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended. © 2021, The Author(s)

Regional differences in cancer incidence trend in tehran, Iran: A contextual study on the effect of socioeconomic status at regional level

Background: Cancer is a major public health concern all over the world. The aim of the current study is to demonstrate changing trends of cancer incidence from 2006 to 2009 in Tehran (capital city of Iran) and evaluate the effect of living in different regions according to their median socioeconomic status (SES) on cancer cumulative incidence. Methods: The incident cases were obtainedfromthe population based cancer register of ministry of healthandmedicine in Iran; we examined the annual percent changes (APCs) and overall trends of total cancer incidence across regions in Tehran. The age and sex standardized incidence rates were computed by the direct method. Poisson regression and negative binominal regression model were used to assess the existence of trends across 4 consecutive years, as well as the effect of living in each region, literacy rate, and employment rate across regions on this trend. All the analyses were done by Stata 12.0 software. Results: The findings of this study showed downward and nonlinear trend during 4 years. The age-standardized incidence rate (ASR) was higher in men compared to women in this period. ASRs for overall 4 years were 114 and 101 per 10,0000 men and women, respectively. Average annual percent change based on ASR and regression model for each sex was the same and around -5 and -6, respectively. Incidence rate also differed between districts so that north and center districts had higher incidence than southern parts in both sexes. The lowest rate ratio attributed to district 17 and 18 located in south of Tehran and the highest rate ratio attributed to district 6 for each sex compared to the baseline district 16. Results reported the sharp increase of 59 and 37 in district 6 compared to district 16 in men and women, respectively. Better regional social status increased the risk of cancer among women. Also, the results showed a partially significant interaction with higher decrease in annual trend of cancer rate in socially more deprived regions. Conclusions: The results showeddownwardand nonlinear decreasing trend during 4 years, especially in regions with lower socioeconomic status. Incidence rate also differed between districts so that northern regions had higher incidence than southern regions. Spatio-temporal Analysis of these cancer rates with adjustment for more regional socio-economic characteristicsmaybetter explain the disparities in rate of cancer in different districts across time. © 2018, Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences

Seroprevalence of SARS-CoV-2 in Guilan Province, Iran, April 2020

We determined the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an affected area in northern Iran in April 2020. Antibodies to SARS-CoV-2 were detected in 528 persons by using rapid tests. Adjusted prevalence of SARS-CoV-2 seropositivity was 22.2 (95 CI 16.4-28.5). © 2021 Centers for Disease Control and Prevention (CDC). All rights reserved

Indirect estimation of child mortality using 2011 census data in the islamic republic of Iran Estimation indirecte de la mortalité juvénile à l�aide des données du recensement de 2011 en république islamique d�iran

Background Child mortality rates are considered to be one of the key indicators of child health. Aims The main objective of this research was to calculate child mortality rates (CMRs) indirectly, using census data, and to investigate using spatial pattern analysis the presence of any clustering patterns among provincial regions. Methods The Trussell version of the Brass method and Coale�Demeny West model were used to estimate CMRs and life expectancy (LE) at birth. The analyses were performed using the QFive program of MORTPAK 4 software. For cluster analysis, local and global Moran�s I indexes were measured. Results Infant mortality rate, under-5 mortality rate, 1�4 mortality rate and LE at birth were estimated as 21.9, 26, 4.1 (deaths per 1000 live births) and 72.1 years, respectively. Global Moran�s I index was calculated as 0.09, 0.09, 0.08 and 0.12, respectively. Conclusion Special attention must be paid in provinces with high clusters regarding the evaluation of public health programmes, and the cause of failure of these programmes in reduction of childhood mortality indices. © World Health Organization (WHO) 2020

Spatial analysis of mortality rate of pedestrian accidents in Iran during 2012�2013

Objectives: Considering the high mortality rate of pedestrians in traffic accidents in Iran, the present study aimed to determine the high-risk and low-risk areas of accidents resulting in pedestrian deaths and the spatial analysis of their mortality rates. Methods: This cross-sectional study included 4,371 deceased pedestrians reported by the Legal Medicine Organization in Iran from March 2012 to March 2013. For spatial analysis, the collected data were entered into ArcGIS software version 10.2 and a spatial map of the mortality rate was drawn according to the distribution of data in the provinces. Using this software, high-risk and low-risk areas were identified by calculating the spatial autocorrelation of the data. The Moran�s index of road accident patterns was surveyed and high-risk and low-risk points were identified using the local Getis index. Results: The age-standardized incidence rate was 6.8 per 100,000. After analyzing the data using ArcGIS software, the local Moran�s index showed a cluster pattern with a high mortality rate in 3 provinces of Mazandaran, Gilan, and Qazvin. In identifying high-risk and low-risk points, the local Getis index showed 3 hot spots with a confidence interval of 99 in Qom, Qazvin, and Mazandaran and 5 hot spots with a 95 confidence interval in Markazi, Tehran, Zanjan, Gilan, and Golestan provinces. Conclusions: According to the cluster pattern of accidents in the 3 provinces and the presence of hot spots in 9 provinces, it is necessary to identify factors that increase the risk of death in the study provinces in order to reduce the mortality rate among pedestrians due to traffic accidents. Therefore, to reduce the pedestrian mortality rate, especially in high-risk provinces, some studies need to be conducted to determine the risk factors in pedestrian mortality. © 2019, © 2019 Taylor & Francis Group, LLC

Comparison of nested case-control and cohort analysis methodologies using a district TB registry data

Background and objective: The nested case-control study has become popular as an efficient alternative to the full-cohort design. This study compares the results of a nested case-control analysis approach with the full cohort analysis. Methods: A cohort of 276 subjects (new cases from a TB registry) was used for this study. Cox Regression model was used for the full cohort analysis. In order to do the nested case-control analysis, for each death, three random controls were selected from those who did not suffer from the outcome at the time of the outcome took place. Case control data was analyzed by the conditional logistic regression model. Results: Results from both cohort and nested case-control analyses show that treatment group is the only variable that affects on the outcome. Gender, place of residence, and age has no effect on the outcome. For binary exposure variables with trivial effects (e.g. Gender and place of residence), the relative efficiency of nested case-control study design is approximately 75%. Conclusion: Results of this study show that nested case-control study is not only an easy and cost-effective method for data analysis but also is as robust as cohort analysis in rate ratio and its variance estimation

Estimating the life expectancy using multiple decrement life tables in Tehran - 2010 abstract

Background & Objectives: Measuring the impact of various diseases on Life Expectancy(LE) is an important step toward prioritization in health. The present study was conducted to measure the impact of heart diseases, neoplasm, and respiratory diseases on life expectancy (LE) in 2010. Methods: Data on death and population for all 22 districts of Tehran were obtained from the main cemetery of Tehran and statistical center of Iran, respectively. Age-specific mortality rates and consequently LE were calculated for all 22 districts and both genders. Finally, the death probability assuming complete elimination of the diseases was calculated and the resulting life tables were obtained. Results: The LE at birth was estimated 74.6 and 78.4 years for total males and females in Tehran, respectively. The maximum and minimum LE at birth was 80 years in females and 72.7 years in males, respectively. Assuming complete elimination of heart diseases, the LE increased to 82.39 and 85.51 years in males and females, respectively while complete elimination of neoplasm resulted in an increase in LE to 76.27 years in men and 80.49 years in women. Finally, elimination of respiratory diseases increased the LE of men to 75.98 years and the LE of women to 79.97 years. Conclusion: The results indicated the high impact of the diseases on LE, especially the heart diseases. As a main result, LE will upgrade to more focus on this category. © 2015, Iranian Epidemiological Association. All rights received