Aberration detection in influenza trends in Iran by using cumulative sum chart and period regression

Objectives: This study aims to determine the alarm thresholds in influenza outbreaks and aberration detection in the influenza trend in Iran by using cumulative sum control chart (CUSUM) and period regression. Methods: We used the weekly reported influenza-positive (types A and B) cases from Iran between January 2015 and November 2019. The period regression model and CUSUM chart were used as detection algorithms to figure out the alarm thresholds. Results: The mean ± SD and the median (95 CI) of the determined threshold per week were 34.85 ± 15.29 and 28.30 (17.67�64.62). According to the period regression, there were nine epidemic periods of influenza from 2015 to 2019. By using the CUSUM and considering a different h (h is an appropriate value that leads to the desired estimation for upper control limit) for the calculation of the upper control limit, 88, 84, 73 and 67 weeks were determined as the epidemic period. Conclusion: According to the current study, the incidence of influenza showed a cyclic pattern and the epidemic recurred each year. Understanding this cyclical pattern can help health policymakers launch prevention programs such as vaccination during certain months of the year. © 2020 The Author

The prevalence of depression among Iranian infertile couples: an update systematic review and meta-analysis

Background: Depression is a common mental disorder. Infertility can lead to depression. The current systematic review and meta-analysis were conducted to estimate the pooled prevalence of depression among Iranian infertile couples. Seven electronic databases (Google Scholar, MagIran, SID, Science Direct, PubMed, Scopus, Web of Science) were searched, up to August 2019, for relevant published studies. The pooled prevalence of depression also pooled mean of depression score was determined using a random-effects model with a 95 confidence interval (95 CI). All analyses performed using Stata ver11 (Stata Corporation, College Station, TX, USA). The 0.05 was considered a significant level. The main body: Totally, 230 studies were retrieved and 31 studies included in the meta-analysis. The pooled prevalence of depression among infertile couples was about 35.3 (95 CI 24.1�46.5), and the prevalence of depression among females and males was 48.7 (95 CI 24.0�73.3) and 9 (95 CI 0 to 23.7), respectively. Conclusions: Our findings suggest a high prevalence of depression in infertile couples. The results can highlight an important and growing mental disorder among infertile couples that may be overlooked. © 2020, The Author(s)

Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study

Background: An outbreak of COVID-19 in Iran has spread throughout the country. Identifying the epidemiological characteristics of this disease will help to make appropriate decisions and thus control the epidemic. The aim of this study was characterization of the epidemiological features of COVID-19 in Iran. Methods: In this retrospective study, data related to the epidemiological characteristics of COVID-19 patients admitted to Baqiyatallah Hospital in Tehran, Iran, from 19 February 2020 to 15 April 2020 have been analyzed and reported. Patient characteristics including age, gender and underlying diseases were investigated. Data were collected through patient records. Sex ratio, Case Fatality Rate (CFR) and daily trend of cases were also determined. A multiple logistic regression analysis was also performed to assess affecting factors on mortality. Results: From February 19, 2020 to April 15, 2020, 12870 patients referred to the hospital emergency department, of which 2968 were hospitalized with COVID-19 diagnosis. The majority of cases were in the age group of 50 to 60 years of old. The male-to-female ratio was 1.93:1. A total of 239 deaths occurred among all cases for an overall CFR of 1.85 based on the total number of patients (both outpatient and inpatient) and 8.06 among hospitalized patients. Out of all patients 10.89 had comorbidity. Diabetes, chronic respiratory diseases, hypertension, cardiovascular diseases, chronic Kidney diseases and cancer were the most common comorbidities with 3.81, 2.02, 1.99, 1.25, 0.60 and 0.57 , respectively. Male gender (OR=1.45, 95 CI: 1.08-1.96), older age (OR=1.05, 95 CI: 1.04-1.06) and having underlying diseases (OR=1.53, 95 CI: 1.04-2.24) were significantly associated with mortality. Conclusions: The results of this study showed that Male gender, older age and having comorbidities were significantly associated with the risk of death among COVID-19 patients. It is important to pay special attention to male elderly patients with underlying diseases. © 2020 Elsevier B.V

Investigating the Relationship between Mode of Delivery and Dysmenorrheal in 15-49 Year Old Women in Ahvaz

Introduction: Approximately 50% of all women experience dysmenorrhea. It seems that childbirth can decrease menstrual pain; though, significant effect of delivery mode on dysmenorrhea has not been clearly explained. This study was carried out to determine the association between mode of delivery and dysmenorrhea frequency and severity. Methods: This is a cross-sectional and analytical study in which 384 eligible women were selected randomly from 9 health centers in Ahvaz. A questionnaire was used for data collection including two sections of demographic characteristics as well as obstetric and menstrual history. Severity of dysmenorrheal was investigated through verbal Multidimensional scoring system (VMSS) and rated on a four-point scale: 0= no dysmenorrhea, 1=minimal, 2=moderate, 3=severe dysmenorrheal. The research data was analyzed through chi-square and McNamara. Results: Frequency of caesarean was 41.4% and frequency of dysmenorrhea was 51.6%, while before the first delivery, it was 79.4%. Before and after delivery most frequent scale in severity of dysmenorrheal involved 1 and 0 respectively. Using McNamara, there was a significant relationship between delivery and frequency of dysmenorrhea (P<0.001); though, type of delivery did not reveal any relationship to the frequency and severity of dysmenorrhea. There was a positive association among frequency of dysmenorrhea with education, ethnicity and occupation. Conclusion: According to the results, overall delivery declines dysmenorrheal, however; there is no difference between vaginal and caesarean delivery. Hence, further researches are required to explore this issue

Determine the most common clinical symptoms in COVID-19 patients: A systematic review and meta-analysis

Introduction. COVID-19 is an emerging infectious disease. The study about features of this infection could be very helpful in better knowledge about this infectious disease. The current systematic review and meta-analysis were aimed to estimate the prevalence of clinical symptoms of COVID-19 in a systematic review and meta-analysis. Methods. A systematic review using Medline/PubMed, Scopus, and Google scholar has been conducted. In the current systematic review and meta-analysis, the articles published in the period January 1, 2020, to April 2, 2020, written in English and reporting clinical symptoms of COVID-19 was reviewed. To assess, the presence of heterogeneity, the Cochran�s Q statistic, the I2 index, and the tau-squared test were used. Because of significant heterogeneity between the studies the random-effects model with 95 CI was used to calculate the pooled estimation of each symptom prevalence. Results. The most common symptoms in COVID-19 patients include: Fever 81.2 (95 CI: 77.9-84.4); Cough: 58.5 (95 CI: 54.2-62.8); Fatigue 38.5 (95 CI: 30.6-45.3); Dyspnea: 26.1 (95 CI: 20.4-31.8); and the Sputum: 25.8 (95 CI: 21.1-30.4). Based on the meta-regression results, the sample size used in different studies did not have a significant effect on the final estimate value (P &gt; 0.05). Conclusions. Considering the main symptoms of COVID-19 such as Fever, Cough, Fatigue, and Dyspnea can have a key role in early detection of this disease and prevent the transmission of the disease to other people. © Copyright by Pacini Editore Srl, Pisa, Italy

Epidemiological survey of the most prevalent cancers and its association with other non-communicable diseases among the Iranian Military Community between 2001�2017: A cross-sectional study

Background and Aim: The burden of non-communicable disease (NCD) such as cancers and diabetic is increasing. The purpose of the current study was to perform an epidemiological survey for pattern recognition of the most prevalent cancers, type 1 diabetes, type 2 diabetes, and multiple sclerosis among the Iranian military community from 2001 to 2017. Methods: In this cross-sectional study all registered cancers, type 1 diabetes, type 2 diabetes and multiple sclerosis in the Iranian military community between 2001�2017 were collected. Simple proportions and the Spearman correlation coefficient were used for data analysis. Results: The total number of registered cancers during 2001�2017 was about 31675 cases in the Iranian military community. A total of 15413 (48.66) were females and 16262 (51.34) were males. The most prevalent cancers in this group were: breast, prostate, colon and gastric cancers respectively. The incidence of colon and gastric cancers among males was more than females. The trend of cancers among the Iranian military community was increasing. There was a positive and significant association between the incidence of cancers with type 1 diabetes, type 2 diabetes and multiple sclerosis in the Iranian military community. Conclusion: Considering the increasing trend of cancers and the presence of the positive association between cancers and other NCDs such as different types of diabetes and multiple sclerosis, the diagnosis and control of common risk factors can be an important approach for disease prevention and reduction. © 2019 Baqiyatallah University of Medical Sciences. All rights reserved

Dietary compliance in Iranian children and adolescents with celiac disease

Maryam Taghdir,1 Naser Honar,2 Seyed Mohammad Mazloomi,3 Mojtaba Sepandi,4 Mahkameh Ashourpour,1 Musa Salehi5 1Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Pediatric Gastroenterology and Hepatology, Shiraz University of Medical Sciences, Shiraz, Iran; 3Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 4Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Sciences, Tehran, Iran; 5Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Introduction: Celiac disease (CD) is caused due to intake of gluten, a protein component in wheat, barley, and rye. The only treatment currently available for CD is strict lifetime adherence to a gluten-free diet (GFD) which is a diet that excludes wheat, barley, and rye. There is limited information on barriers to following a GFD. The present study aimed to investigate the compliance with a GFD, barriers to compliance, and the impact of compliance on the quality of life (QOL) in Iranian children and adolescents suffering from CD.Methods: In this cross-sectional study, a total of 65 known cases of CD (both males and females), diagnosed in Namazi Hospital, a large referral center in south of Iran, selected by census were studied in 2014. Dietary compliance was assessed using a questionnaire. A disease-specific QOL questionnaire for children with CD (the celiac disease DUX [CDDUX]) was used. Comparisons between categorical variables were performed using chi-square test.Results: Sixty-five patients, 38 females (58.5%) and 27 (41.5%) males, were surveyed. Mean (&plusmn; standard deviation [SD]) age of the respondents was 11.3 (&plusmn;3.8) years. Dietary compliance was reported by 35 (53.8%) patients. The mean (&plusmn; SD) CDDUX score was higher in dietary-compliant patients (33.5 [&plusmn;19.4] vs 26.7 [&plusmn;13.6], respectively, P=0.23). The score of CDDUX in parents of patients in dietary-compliant group was more than the noncompliant patients (28.1 [&plusmn;13.5] vs 22.1 [&plusmn;14], respectively, P=0.1). Barriers to noncompliance were poor or unavailability (100%), high cost (96.9%), insufficient labeling (84.6%), poor palatability (76.9%), and no information (69.23%).Conclusion: Approximately half of the patients with CD reported dietary compliance. Poor or unavailability was found to be the most important barrier contributing to noncompliance. The QOL was better in compliant patients. Proposed strategies to improve compliance are greater availability of gluten-free products, better food labeling, and better education about the diet and condition. Keywords: child, gluten enteropathy, adherence, gluten-free diet, quality of lif

Spatio-temporal analysis of colorectal cancer using a geographic information system in the Iranian military community during the period 2007-2016

Introduction: Colorectal cancer (CRC) is one of the most prevalent cancers among Iranian people. The study of spatio-temporal distribution of disease has an important role in the design of disease prevention programmes. The purpose of the current study was to describe the spatio-temporal distribution of CRC in the Iranian military community as a sample of the Iranian population. Methods: In the current ecological study, all registered cancer cases in the Iranian military community during the period 2007-2016 were considered. To identify hotspots, Getis-Ord Gi statistics were used. All analyses were performed using ArcGIS 10.5 and Excel 2010. Results: The highest incidences of CRC in 2007-2008, 2009-2010 and 2011-2012 were recorded in Kermanshah province. The highest incidences of CRC in 2013-2014 were seen in Kermanshah, Ghilan, Tehran and North Khorasan. In 2007-2008 and 2009-2010, hotspots were detected in West Azarbayjan. In 2011-2012, hotspots were detected in Zanjan and Qazvin. In 2013-2014, a hotspot was detected in Qazvin. Finally, West Azerbaijan was the hotspot for CRC in 2015-2016. Conclusions: The incidence of CRC in men was higher than in women. Also it appeared that North and North West Iran were risk areas for this disease, and so these areas should be considered in the design of disease prevention programme for this cancer type. Additionally, the determination of individual risk factors in the aforementioned geographical areas can play an important role in the prevention of this type of cancer. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ