Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder

Introduction: Gender identity disorders (GID) are heterogeneous disorders that may be influenced by culture and social norms. Aim: The aim of this study was to determine masculine and feminine gender roles in a group of Iranian patients with GID and compare these roles with two control groups. Methods: Twelve male-to-female (MF) and 27 female-to-male (FM) individuals with GID referred to Tehran Psychiatric Institute in Tehran, I. R. Iran were evaluated by self-report inventories and were compared with two groups of healthy controls (81 men and 89 women). Diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. Data analysis was done using analysis of variance and chi-squared test. Main Outcome Measures: Masculine and feminine gender roles were assessed by two questionnaires: (i) Gender-Masculine (GM) and Gender-Feminine (GF) scales derived from the Minnesota Multiphasic Inventory-2 (MMPI-2); (ii) Bem Sex Role Inventory (BSRI). Results: In the scales of masculinity, MF-GID individuals scored as male controls, but lower than female controls. FM-GID individuals scored similar to female controls and higher than male controls. In femininity scales, MF-GID individuals and control women seemed similar, and both scored higher than the other groups. FM-GID persons were considered less feminine than both controls in the GF scale of MMPI-2, but not in the BSRI. In both scales, FM-GID persons had higher scores than control women and MF-GID individuals. Conclusion: Iranian FM-GID individuals were less feminine than normal men. However, MF-GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261-268. © 2015 International Society of Sexual Medicine

Estimation of Water Requirement of Different Phenological Stages of Green Cumin Plant in Different Regions of Isfahan Province

IntroductionCumin (Cuminum cyminum L.) is an annual and herbaceous plant, with a vertical, round, narrow and branched stem, with a height of approximately 30-60 cm. This plant belongs to the Apiaceae family. This family is known for having plants with aromatic taste. Iran and some countries along the Mediterranean Sea are known as the primary origin for the cumin plant. In addition to Iran, cumin is cultivated in many countries such as Uzbekistan, Tajikistan, Turkey, Morocco, India, Syria, Mexico and Chile. About 300,000 tons of cumin seeds are produced in the world annually, of which China and Asian countries produce 70% and consume 90%. Short growing season (100 to 120 days), low water requirement and the possibility of rained cultivation, non-interference between cultivation and harvesting with other crops and no price fluctuation and proper economic justification are among the factors that interest farmers in cultivating this plant. In different regions, yields of 350 to more than 1000 kg of seeds are obtained from this plant, and 3350 cubic meters of pure water are needed for production. Materials and MethodsThis research was conducted in 2015 to 2017. The first year of the study included the collection and analysis of long-term climatic data of the region, and the second year included the implementation phase of the research. Analyzing meteorological data on the scale of decades and the cases of temperature, precipitation, wind speed, sunshine hours, relative humidity and evaporation from the pan were considered as criteria and by preparing the gradient equations, the rate of reference evaporation and transpiration was calculated. The required statistical information was obtained from 28 synoptic meteorological and climatology stations in Isfahan and some neighboring provinces. In the studies related to soil, apparent specific gravity and volumetric moisture content (field capacity and wilting point), soil salinity, soil texture and agricultural ability class of land in cultivation areas were considered. Soil-related information was used to calculate the soil evaporation coefficient (Ke), which describes the evaporation component in the trait (ETc). In fact, Ke is the basis for calculating the coefficient of reduction of evaporation from the surface layer (Kr) and the fraction of soil wet and exposed to air (few), and for its calculation, the presence of information related to soil characteristics is necessary. To calculate the soil characteristics, in addition to sampling from the fields in the research, the database of 1600 soil profiles in the soil and water research department of Isfahan province was also used. Results and DiscussionThe results showed that 18 cities in Isfahan province had cumin cultivation potential, which had a significant difference in terms of pure water requirement per hectare (5% level) and water consumption at different phenological stages (1% statistical level). In terms of water requirement per hectare, the cities of Isfahan province can be divided into three groups. Average water requirement per hectare in the first group (the cities of Golpayegan, Lenjan, Tiran and Karvan, Shahin and Shahr and Mime), the second group (the cities of Isfahan, Khomeini Shahr, Falavarjan, Shahreza, Kashan, Najaf Abad, Natanz), Mobarake, Dehaghan and Borkhar), and the third group (Aran and Bidgol, Ardestan, Khoor and Biabanak and Nain) were equal to 3000, 3240 and 3770 m-3 ha-1, respectively. The water requirement of the growth development stage in the cities of the third group was equal to 2029 m-3 ha-1, which was significantly different from the cities of the first and second groups (p < 1% level). According to the results, cumin might be a suitable plant for crop rotations in Isfahan province due to its low water requirement and tolerance to moisture stress. ConclusionThe water requirement for cultivating cumin in various regions of the province is notably lower compared to many common crops, such as wheat, barley, and safflower. In 10 out of the 18 cities included in the study, significant water savings of up to 3,240 cubic meters per hectare can be achieved by optimizing water transfer efficiency. For cumin cultivation, this water conservation can even reach 3,000 cubic meters in cities with cooler climates. Surprisingly, in the hot areas of Isfahan province, including Ardestan, Nain, Khoor, Biabanak, Aran, and Bidgol, it is feasible to grow cumin with a water consumption of just 3,770 cubic meters per hectare

Predictors of physical restraint in a psychiatric emergency setting

Background: Considering the negative consequences of using physical restraints, we conducted this study to identify patients who are more frequently restrained in a psychiatric emergency ward as an initial step to limit the use of restraint to the minimum possible. Methods: This was a retrospective case control study conducted in Iran Psychiatric Hospital in Tehran, Iran. We reviewed the files of 607 patients who were admitted during a one year period using convenience sampling; of them, 186 were in the restrained group and 421 in the unrestrained group. Results: Surprisingly, no significant difference was found between the restrained and unrestrained groups in demographic characteristics. The patients who were referred because of violence were diagnosed as having methamphetamine induced psychotic disorder or bipolar I disorder in manic 1episode and had a higher odds of being restrained (OR=2.51, OR=1.61, and OR=1.57 respectively). Being restrained was also associated with a longer duration of hospitalization and duration of staying in the emergency ward. Moreover, patients in their first admission were more frequently restrained. Conclusion: Medical and nursing staff should consider special measures for the patients who are at a higher risk for being restrained. More frequent visits and education for both patients and staff may be effective in reducing the number of physical restraints for these groups of patients

Fluoroscopic versus conventional computed tomography-guided biopsy

Background/Objective: To determine the success rate of computed tomographic (CT) fluoroscopic CT (CFT) and conventional CT (CCT) for needle navigation in biopsies from mediastinum. bone, and abdomen, liver and pelvis. Patients and Methods: Data from 122 consecutive percutaneous interventional biopsies performed with use of ECT guidance (mean age of 50.5: rage: 1-79 years) and 84 consecutive biopsis with CCT guidance (mean age: 50.7; range, 12-83 years) were gathered from the interventional radiologist and general practitioner. Results: The success rate of procedure was increased in the FCT group as compared with that of CCT group in some organs such as bone, abdomen, liver and pelvis. A statistically significant difference was noted when we compared FCT group with CCT in liver biopsies (P=0.019). The mean procedure time was lower in FCT group. The overall mean (±SD) FCT time was 200±90 (range: 20-400) sec; in CCT group, it was 420±260 (range: 605-800) second Conclusion: FCT facilities CT-guided biopsy procedure and reduces the procedure time by allowing visualization of the needle tip from skin entrance to the target point

Comparing ovarian radiation doses in flat-panel and conventional angiography during uterine artery embolization: A randomized clinical trial

Background: Uterine artery embolization (UAE) is a minimally invasive procedure performed under fluoroscopy for the treatment of uterine fibroids and accompanied by radiation exposure. Objectives: To compare ovarian radiation doses during uterine artery embolization (UAE) in patients using conventional digital subtraction angiography (DSA) with those using digital flat-panel technology. Patients and Methods: Thirty women who were candidates for UAE were randomly enrolled for one of the two angiographic systems. Ovarian doses were calculated according to in-vitro phantom study results using entrance and exit doses and were compared between the two groups. Results: The mean right entrance dose was 1586±1221 mGy in the conventional and 522.3±400.1 mGy in the flat panel group (P=0.005). These figures were 1470±1170 mGy and 456±396 mGy, respectively for the left side (P=0.006). The mean right exit dose was 18.8±12.3 for the conventional and 9.4±6.4 mGy for the flat panel group (P=0.013). These figures were 16.7±11.3 and 10.2±7.2 mGy, respectively for the left side (P=0.06). The mean right ovarian dose was 139.9±92 in the conventional and 23.6±16.2 mGy in the flat panel group (P<0.0001). These figures were 101.7±77.6 and 24.6±16.9 mGy, respectively for the left side (P=0.002). Conclusion: Flat panel system can significantly reduce the ovarian radiation dose during UAE compared with conventional DSA. © 2013, Tehran University of Medical Sciences and Iranian Society of Radiology; Licensee KowsarKowsar Ltd

Efficacy of transarterial chemoembolization on lesion reduction in colorectal liver metastases

Following failure of systemic chemotherapy, transarterial chemoembolization (TACE) is an available method to control unresectable liver metastases from colorectal carcinoma (CRC). The aim of present study was to evaluate the efficacy of chemoembolization for inoperable metastatic liver lesions from CRC. Forty-five CRC patients with liver metastases resistant to systemic chemotherapy were enrolled in our study. For each patient, three session of TACE were conducted with 45 days interval. A combination of mitomycin, doxorubicin, and lipiodol were used for TACE. A tri-phasic computed tomography scan and biochemical laboratory tests were performed for all patients at baseline and 30 days after each TACE. Image analysis included measurement of lesion diameters as well as contrast enhancement. Eleven patients deceased before completing three session and the final analyses were performed on the remaining 34 patients. Evaluation of a total 93 lesions in all patients after chemoembolization sessions revealed a 25.88 reduction in anteroposterior (AP) diameter, 33.92 transverse (T) diameter, and 42.22 in product of APxT diameter of lesions (P<0.001 for all instances). CT scan showed a total disappearance of 33 of lesions and evident reduction in contrast enhancement in 16 of them. There were no changes in contrast enhancement in 51 of lesions. Evaluation of single largest lesion in each patient revealed 57.32 reduction in AP diameter, 59.66 in T diameter, and 62.17 in product of APxT diameters (P<0.001 for all diameters). TACE offers a viable option for CRC patients with unresectable liver metastases by significantly reducing lesion size and contrast enhancement. © 2012 Tehran University of Medical Sciences. All rights reserved

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe