Completeness and Underestimation of Cancer Mortality Rate in Iran: A Report from Fars Province in Southern Iran

Background: The incidence and mortality rates of cancer are increasing worldwide, particularly in the developing countries. Valid data are needed for measuring the cancer burden and making appropriate decisions toward cancer control. We evaluated the completeness of GHDWK�UHJLVWU\�ZLWK�UHJDUG�WR�FDQFHU�GHDWK�LQ�)DUV�3URYLQFH��,��5��RI�,UDQ� Methods: We used data from three sources in Fars Province, including the national death registry (source 1), the follow-up data from the pathology-based cancer registry (source 2) and hospital based records (source 3) during 2004 – 2006. We used the capture-recapture PHWKRG�DQG�HVWLPDWHG�XQGHUHVWLPDWLRQ�DQG�WKH�WUXH�DJH�VWDQGDUGL]HG�PRUWDOLW\�UDWH��605��IRU�FDQFHU��:H�XVHG�ORJ�OLQHDU��//��PRGHOLQJ� for statistical analysis. Result: :H�REVHUYHG������������DQG�����FDQFHU�GHDWKV�LQ�VRXUFHV������DQG����UHVSHFWLYHO\��IWHU�GDWD�OLQNDJH��ZH�HVWLPDWHG�WKDW�PRUWDOLW\� UHJLVWU\�KDG�DERXW�����XQGHUHVWLPDWLRQ�IRU�FDQFHU�GHDWK��$IWHU�DGMXVWPHQW�IRU�WKLV�XQGHUHVWLPDWLRQ�UDWH��WKH�$605�RI�FDQFHU�LQ�WKH�)DUV� 3URYLQFH�IRU�DOO�FDQFHU�W\SHV�LQFUHDVHG�IURP������SHU��������������&,�������±�������WR������SHU��������������&,�������±��������DFFRXQWLQJ� IRU�����������&,�������±�������FDQFHU�GHDWKV�DQQXDOO\�� Conclusion: The mortality rate of cancer is considerably higher than the rates reported by the routine registry in Iran. Improvement in the validity and completeness of the mortality registry is needed to estimate the true mortality rate caused by cancer in Iran

Completeness and Underestimation of Cancer Mortality Rate in Iran: A Report from Fars Province in Southern Iran

Background: The incidence and mortality rates of cancer are increasing worldwide, particularly in the developing countries. Valid data are needed for measuring the cancer burden and making appropriate decisions toward cancer control. We evaluated the completeness o

Effects of gamma rays on rat testis tissue according to the morphological parameters and immunohistochemistry: radioprotective role of silymarin.

OBJECTIVE To determine the radioprotective effects of Silymarin in adult male Sprague-Dawley rats irradiated with γ-rays. METHODS The present experimental study was performed in Tehran University of Medical Sciences, Tehran, Iran from December 2009 to March 2010. The study was performed on 40 rats, which were randomly and equally divided into four groups: 1) control group: neither received Silymarin nor irradiated with γ-rays; 2) γ-irradiation group: testis region exposed to 2Gy of γ-rays; 3) Silymarin & γ-irradiation: rats received 100 mg/kg of Silymarin 24hrs before exposure to 2Gy of γ-rays; 4) Silymarin & γ-irradiation: rats received 200 mg/kg of Silymarin 24hrs before exposure to 2Gy of γ-rays. After animal experiments and preparing the tissue sections, different histological and histomorphological parameters of seminiferous tubules and the biological characteristics of Leydig cells were evaluated applying quantitative assessment, Johnson scoring, and Leydig cell apoptosis assay by TUNEL method. The data were analyzed applying ANOVA and Tukey's post hoc test, using SPSS software (V.19). RESULTS Irradiation of 2 Gy γ-rays to the testis of the rats significantly affected the frequency of spermatogonia, primary spermatocyte, round spermatid, spermatozoa, seminiferous tube and lumen diameters, thickness of the epithelium, Leydig cell nuclear diameter and volume, epithelium height, and apoptotic cells (p<0.05). However, administration of Silymarin improved the mentioned parameters specifically in 200 mg/kg of dosage. CONCLUSION Silymarin could act as a potent radioprotector and it can be used in modulation as well as improvement to radiation therapy to prevent male reproductive function, specifically seminiferous tubules in an animal model; however, its molecular mechanism is still not clear and needs more molecular researches

Human Papillomavirus and Risk of Head and Neck SquamousCell Carcinoma in Iran

Human papillomavirus (HPV) causes a subset of head and neck squamous cell carcinoma (HNSCC). Knowledge of determinants of α-, β-, and γ-HPVs types in the oral cavity is required for a better understanding of HNSCC development. Oral rinse samples of 498 HNSCC cases and 242 controls from the IROPICAN study—a large multicenter case-control study in Iran—were screened for 21 α-HPV, 46 β-HPVs, and 52 γ-HPVs using bead-based HPV genotyping assays. α-HPVs were detected only in 1.2% of the patients and 2.9% of the controls from which HPV16 was the most prevalent type among participants. β-HPVs were detected in 43.8% of the patients and 38.6% of the controls where the lip and oral cavity (45.5%) had the highest positivity. Values for γ-HPV prevalence in patients and controls were 26.1% and 24.7%, respectively. The highest percentage of γ-HPV positivity was found in the larynx (30.4%). Concerning the β genus, HPV23 and HPV38 were the most prevalent types among the patients and controls, respectively. For the γ genus, SD2 in cases and HPV134 in controls were the most prevalent types. Overall, detection of α-HPVs (aOR, 0.40; 95% CI = 0.1 to 1.2; P = 0.11), β-HPVs (aOR, 1.9; 95% CI = 0.9 to 1.6; P = 0.29), and γ-HPVs infections (aOR, 1.04; 95% CI = 0.7 to 1.5; P = 0.83) was not associated with the HNSCC development. Our data did not suggest an HPV-related etiology for HNSCC pathogenesis. Nonetheless, this study provides novel insights into the diversity of β-, and γ-HPVs in different HNSCC anatomical subsites

Sexual Dysfunction, Depression and Quality of Life in Patients With HIV Infection

Objective: In Iran, psychological aspect of HIV infection is poorly understood. The purposes of this study were to evaluate sexual dysfunction, depression rate and health-related quality of life and evaluate the association between sexual dysfunction, depression and quality of life in a group of HIV+ subjects in Shiraz, Iran. Methods: In this cross-sectional study, 278 male HIV-positive patients who had referred to voluntary counseling and testing and methadone maintenance therapy centers were recruited based on convenience sampling from May to October 2010. The purpose of the study was explained and interested individuals provided informed consent and completed validated questionnaires [Medical Outcomes Study Short Form-36 (SF-36), Brief Male Sexual Function Inventory (BMSFI), Beck Depression Inventory-short form(BDI)] to assess overall health related quality of life (HRQOL), sexual function, and depression. Results: Average age of the participants was 34.9 ± 10.7 years and 37.5% were severely depressed. Ordinal logistic regression indicated that sexual drive (-0.15; CI: -0.28 to -0.027), ejaculation (-1.91, CI: -2.71 to -1.12), and problem assessment (-0.098, CI: -0.17 to -0.02) had significant effect on depression type. Depression was significantly correlated with poorer quality of life in all domains. Pearson’s correlation coefficients between the BMSFI and the domains of SF-36 indicated that sexual drive (r= 0.215), ejaculation (r= 0.297) and problem assessment (r= 0.213) were significantly correlated with emotional wellbeing. Conclusion: Sexual function and depression showed association with quality of life. Effective treatment of depression and sexual function may improve the quality of life of HIV-infected person. Declaration of interest: None. Citation: Amini Lari M, Faramarzi H, Shams M, Marzban M, Joulaei H. Sexual dysfunction, depression and quality of life in patients with HIV infection. Iran J Psychiatry Behav Sci Behav Sci 2013

Is preoperative serum creatinine a reliable indicator of outcome in patients undergoing coronary artery bypass surgery?

ObjectiveEvaluating renal function by calculating creatinine clearance as an alternative measure to serum creatinine may give a better estimation of postoperative renal function in patients undergoing coronary artery bypass grafting.MethodsUsing our database, we conducted a retrospective review of the records of all 11,884 patients aged 21 years or older undergoing pure bypass grafting who required cardiopulmonary bypass. Preoperative renal function was categorized as normal renal function (serum creatinine ≤1.1 mg/dL and creatinine clearance > 60 mL/min), occult renal insufficiency (serum creatinine ≤ 1.1 mg/dL and creatinine clearance ≤ 60 mL/min), mild renal insufficiency (1.1 mg/dL < serum creatinine ≤ 1.5 mg/dL and creatinine clearance ≤ 60 mL/min) or moderate renal insufficiency (serum creatinine > 1.5 mg/dL and creatinine clearance ≤ 60 mL/min).ResultsOut of 11,884 patients in the sample, 7856 (66.1%) had normal renal function, and 706 (5.9%) had occult renal insufficiency. The rate of postoperative mortality, renal failure, atrial fibrillation, prolonged ventilation, intra-aortic balloon pump usage, and prolonged hospital stay (>7 days) was higher in patients with occult renal insufficiency than in the normal group in univariable analysis. Multivariable logistic regression analysis demonstrated that patients with occult renal insufficiency compared with the group with normal renal function were at higher risk for mortality (odds ratio = 2.59, 95% confidence interval 1.15–5.86; P = .022) and prolonged hospital stay (>7 d) (odds ratio = 1.30, 95% confidence interval 1.08–1.57; P = .005).ConclusionsTo identify higher-risk patients requiring special intensive care, and in whom new interventions can be performed to improve outcome, we recommend the preoperative calculation of creatinine clearance, especially in older women with a lower body mass index

Predicting the necessity of oxygen therapy in the early stage of COVID-19 using machine learning

Medical oxygen is a critical element in the treatment process of COVID-19 patients which its shortage impacts the treatment process adversely. This study aims to apply machine learning (ML) to predict the requirement for oxygen-based treatment for hospitalized COVID-19 patients. In the first phase, demographic information, symptoms, and patient’s background were extracted from the databases of two local hospitals in Iran, and preprocessing actions were applied. In the second step, the related features were selected. Lastly, five ML models including logistic regression (LR), random forest (RF), XGBoost, C5.0, and neural networks (NNs) were implemented and compared based on their accuracy and capability. Among the vari- ables related to the patient’s background, consuming opium due to the high rate of opium users in Iran was considered in the models. Of the 398 patients included in the study, 112 (28.14%) received oxygen-based treatment. Shortness of breath (71.42%), fever (62.5%), and cough (59.82%) had the highest frequency in patients with oxygen requirements. The most important variables for prediction were shortness of breath, cough, age, and fever. For opioid-addicted patients, in addition to the high mortality rate (23.07%), the rate of oxygen-based treatment was twice as high as non-addicted patients. XGBoost and LR obtained the highest area under the curve with values of 88.7% and 88.3%, respectively. For accuracy, LR and NNs achieved the best and same accuracy (86.42%). This approach provides a tool that accurately predicts the need for oxygen in the treatment process of COVID-19 patients and helps hospital resource management. Keywords COVID-19 · Opioid addiction · Oxygen treatment · Prediction · Machine learning · XGBoos

Loss of prostatic acid phosphatase and α-synuclein cause motor circuit degeneration without altering cerebellar patterning

Prostatic acid phosphatase (PAP), which is secreted by prostate, increases in some diseases such as prostate cancer. PAP is also present in the central nervous system. In this study we reveal that α-synuclein (Snca) gene is co-deleted/mutated in PAP null mouse. It is indicated that mice deficient in transmembrane PAP display neurological alterations. By using immunohistochemistry, cerebellar cortical neurons and zone and stripes pattern were studied in Pap-/- ;Snca-/- mouse cerebellum. We show that the Pap-/- ;Snca-/- cerebellar cortex development appears to be normal. Compartmentation genes expression such as zebrin II, HSP25, and P75NTR show the zone and stripe phenotype characteristic of the normal cerebellum. These data indicate that although aggregation of PAP and SNCA causes severe neurodegenerative diseases, PAP -/- with absence of the Snca does not appear to interrupt the cerebellar architecture development and zone and stripe pattern formation. These findings question the physiological and pathological role of SNCA and PAP during cerebellar development or suggest existence of the possible compensatory mechanisms in the absence of these genes.Peer reviewe

Opium use and risk of bladder cancer: a multi-centre case-referent study in Iran

Background Bladder cancer (BC) is the 10th most common type of cancer worldwide and the fourth most common type of cancer in Iran. Opium use is considered as one of the risk factors for BC. We aim to assess the association between various parameters of opium use, which in Iran is mainly ingested or smoked in various forms, and the risk of BC. Method In this multi-centre case-referent study in Iran, 717 BC cases and 3477 referents were recruited to the study from May 2017 until July 2020. Detailed histories of opium use (duration, amount, frequency) and potential confounders were collected by trained interviewers. Multivariable unconditional logistic regression models were used to measure adjusted odds ratio (OR) and 95% confidence intervals (CI). The ORs were adjusted for age, gender, place of residence and pack-years of cigarette smoking. Results Regular opium consumption was associated with an increased risk of BC (OR 3.5, 95% CI: 2.8, 4.3) compared with subjects who never used opium. Compared with continuous users, the risk decreased to one-third for those who stopped opium more than 10 years ago. The adjusted OR for those who used both crude opium (teriak) and opium juice was 7.4 (95% CI: 4.1, 13.3). There was a joint effect of opium and tobacco (OR for users of both opium and tobacco 7.7, 95% CI: 6.0, 9.7). Conclusions Regular opium use is associated with an approximately 4-fold risk for BC. The OR decreases along with the increasing time since stopping opium use