Spatial analysis of breast cancer incidence in Iran

Breast cancer (BC) is the most common cancer in females (27 of the total) and the main cause of death (16) due to cancer in women in developed and developing countries. Variations in its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present spatial analysis of breast cancer incidence in Iran in 2009 was conducted using data from the national cancer registry system. The reported incidences of the disease were standardized according to the World Health Organization population and the direct method. Then data was inserted into the GIS software and finally, using the Hot Spot Analysis (Geties-Ord Gi), high-risk areas were drawn. Provinces with incidences 1.96 SD higher or lower than the national average were considered as hot spots or cold spots, at the significance level of 0.05. In 2009, a total of 7,582 cases of BC occurred in Iran. The annual incidence was 33.2 per hundred thousand people. Our study showed that the highest incidence of BC in women occurred in the central provinces of the country, Tehran, Isfahan, Yazd, Markazi and Fars. The results of hot spots analysis showed that the distribution of high-risk BC was focused in central parts of Iran, especially Isfahan province (p < 0.01). The other provinces were not significantly different from the national average. The higher incidence in central provinces may be due to greater exposure to carcinogens in urban areas, a Western lifestyle and high prevalence of other risk factors. Further epidemiological studies about the etiology and early detection of BC are essential. © 2016, Asian Pacific Journal of Cancer Prevention

A systematic review and meta-analysis on incidence of prostate cancer in Iran

Background: Prostate cancer is a global health concern. In Iran, its epidemiology is not precisely recognized. We aimed to evaluate incidence of prostate cancer among Iranian populations. Methods: In this systematic review, we searched the databases PubMed, Web of Sciences, Scopus and Google Scholar for English studies and the databases Magiran, Scientific Information Database, IranMedex and IranDoc for Persian studies, using related keywords. The cross-sectional articles published from inception to 31 December 2018 were included. Meta-analysis was conducted on the collected data with STATA software using random effects model. Results: Out of 763 articles initially obtained, 9 articles were finally included after applying the predefined exclusion criteria. Analysis of 9 studies on the incidence of prostate cancer showed a crude rate of 7.1 per 100 000 population (95 confidence interval CI: 5.6-8.6). Also, the pooled age-standardized incidence rate was 8.7 per 100 000 (95% CI: 6.7-10.4). Studies performed in the period 2004-2012 had significantly a higher pooled estimate of the crude incidence rate (9.2 per 100 000 95% CI: 7.9-10.4) compared with those conducted in the period 1996-2003 (4.5 per 100 000 95% CI: 2.8-6.2). This trend was also observed based on the age-standardized incidence rate (11 per 100 000 95% CI: 9.4-12.5 versus 6.3 per 100 000 95% CI: 4-8.5). Conclusion: Despite low rate of prostate cancer occurrence in Iran, it is recommended that preventive measures be taken against this disease by health policy makers. Also, more epidemiological studies are needed to better find out the pattern of prostate cancer among Iranian populations. © 2019 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution Licens

Spatial analysis of colorectal cancer in Iran

Colorectal cancer is one of the most common cancers. Due to demographic changes, it is predicted that the incidence of this cancer will increase. Variations of its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present assessment of spatial patterns of colorectal cancer incidence in Iran was performed. In this ecological study, the new cases of colon cancer were extracted from Cancer Registry Center report of the Health Deputy of Iran in 2009. The reported incidences of the disease were standardized on the basis of the World Health Organization population and the direct method. Then the data were inserted into the GIS software, and finally, using the analysis of hot spots (Getis-Ord Gi) high-risk areas were drawn. Provinces that are higher or lower than the national average (1.9 SD) were considered hot spots or cold spots, significant at the level of 0.05. A total of 6,210 cases of colorectal cancer were registered in Iran in 2009, of which 3,727 were in men and 2,783 in women (age-standardized rates of 11.3 and 10.9 per 100,000 population, respectively). The results showed that in central and northern Iran including Isfahan, Qom, Tehran, Qazvin and Mazandaran significant hot spots in men were present (p < 0.05). In women also we have high incidence in northern and central states: Mazandaran province (p < 0.01) and the province of Tehran (p < 0.05) had higher incidences than the national average and were apparent as significant hot spots. Analysis of the spatial distribution of colorectal cancer showed significant differences between different areas pointing to the necessity for further epidemiological studies into the etiology and early detection. © 2016, Asian Pacific Journal of Cancer Prevention

Home birth and barriers to referring women with obstetric complications to hospitals: a mixed-methods study in Zahedan, southeastern Iran

<p>Abstract</p> <p>Background</p> <p>One factor that contributes to high maternal mortality in developing countries is the delayed use of Emergency Obstetric-Care (EmOC) facilities. The objective of this study was to determine the factors that hinder midwives and parturient women from using hospitals when complications occur during home birth in Sistan and Baluchestan province, Iran, where 23% of all deliveries take place in non- hospital settings.</p> <p>Methods</p> <p>In the study and data management, a mixed-methods approach was used. In the quantitative phase, we compared the existing health-sector data with World Health Organization (WHO) standards for the availability and use of EmOC services. The qualitative phase included collection and analysis of interviews with midwives and traditional birth attendants and twenty-one in-depth interviews with mothers. The data collected in this phase were managed according to the principles of qualitative data analysis.</p> <p>Results</p> <p>The findings demonstrate that three distinct factors lead to indecisiveness and delay in the use of EmOC by the midwives and mothers studied. Socio-cultural and familial reasons compel some women to choose to give birth at home and to hesitate seeking professional emergency care for delivery complications. Apprehension about being insulted by physicians, the necessity of protecting their professional integrity in front of patients and an inability to persuade their patients lead to an over-insistence by midwives on completing deliveries at the mothers' homes and a reluctance to refer their patients to hospitals. The low quality and expense of EmOC and the mothers' lack of health insurance also contribute to delays in referral.</p> <p>Conclusions</p> <p>Women who choose to give birth at home accept the risk that complications may arise. Training midwives and persuading mothers and significant others who make decisions about the value of referring women to hospitals at the onset of life-threatening complications are central factors to increasing the use of available hospitals. The hospitals must be safe, comfortable and attractive environments for parturition and should give appropriate consideration to the ethical and cultural concerns of the women. Appropriate management of financial and insurance-related issues can help midwives and mothers make a rational decision when complications arise.</p

Using co-production to improve the appropriate use of sub-seasonal forecasts in Africa

Forecasts on sub-seasonal to seasonal (S2S) timescales have huge potential to aid preparedness and disaster risk reduction planning decisions in a variety of sectors. However, realising this potential depends on the provision of reliable information that can be appropriately applied in the decision-making context of users. This study describes the African SWIFT (Science for Weather Information and Forecasting Techniques) forecasting testbed which brings together researchers, forecast producers and users from a range of African and UK institutions. The forecasting testbed is piloting the provision of real-time, bespoke S2S forecast products to decision-makers in Africa. Drawing on data from the kick-off workshop and initial case study examples, this study critically reflects on the co-production process. Specifically, having direct access to real-time data has allowed user-guided iterations to the spatial scale, timing, visualisation and communication of forecast products to make them more actionable for users. Some key lessons for effective co-production are emerging. First, it is critical to ensure there is sufficient resource to support co-production, especially in the early co-exploration of needs. Second, all the groups in the co-production process require capacity building to effectively work in new knowledge systems. Third, evaluation should be ongoing and combine meteorological verification with decision-makers feedback. Ensuring the sustainability of project-initiated services within the testbed hinges on integrating the knowledge-exchanges between individuals in the co-production process into shaping sustainable pathways for improved operational S2S forecasting within African institutions

Biallelic variants in ZNF142 lead to a syndromic neurodevelopmental disorder.

Biallelic variants of the gene encoding for the zinc-finger protein 142 (ZNF142) have recently been associated with intellectual disability (ID), speech impairment, seizures, and movement disorders in nine individuals from five families. In this study, we obtained phenotype and genotype information of 26 further individuals from 16 families. Among the 27 different ZNF142 variants identified in the total of 35 individuals only four were missense. Missense variants may give a milder phenotype by changing the local structure of ZF motifs as suggested by protein modeling; but this correlation should be validated in larger cohorts and pathogenicity of the missense variants should be investigated with functional studies. Clinical features of the 35 individuals suggest that biallelic ZNF142 variants lead to a syndromic neurodevelopmental disorder with mild to moderate ID, varying degrees of delay in language and gross motor development, early onset seizures, hypotonia, behavioral features, movement disorders, and facial dysmorphism. The differences in symptom frequencies observed in the unpublished individuals compared to those of published, and recognition of previously underemphasized facial features are likely to be due to the small sizes of the previous cohorts, which underlines the importance of larger cohorts for the phenotype descriptions of rare genetic disorders

Relationship between Death Anxiety and Mental Health Status among Nurses in Hospitals Affiliated to Babol University of Medical Sciences

BACKGROUND AND OBJECTIVE: Nurses are frequently faced with death and dying patients due to the nature of their job. Death anxiety in these people may be associated with depression, generalized anxiety and suicidal thoughts, which may impair their performance. This study aims to assess the relationship between death anxiety and mental health status among nurses. METHODS: This analytical study was carried out through evaluation the intensive care unit, emergency and operating room nurses in hospitals affiliated to Babol University of Medical Sciences using Templer's Death Anxiety Scale (DAS) and General Health Questionnaire (GHQ-28). DAS score ranged from 0 to 15; higher score indicated greater death anxiety. GHQ evaluated physical health, anxiety, social activity and depression. Respondents who got higher scores had more psychological problems. FINDINGS: Of 142 nurses who participated in this study, 88 nurses (68.7%) had high death anxiety and 40 nurses (31.3%) had low death anxiety. There were no significant relationship between death anxiety and variables of age, gender, marital status, place of activity and education level. There was a significant inverse relationship between death anxiety and subscales of GHQ including anxiety (p=0.008) and lack of social activity (43 nurses [31.6%] with low death anxiety vs. 93 nurses [68.4%] with high death anxiety) (p=0.046). CONCLUSION: The results of this study demonstrated that death anxiety is highly prevalent among nurses. Therefore, educational intervention programs are necessary to reduce death anxiety and its complication

Relationship Between The Breast Cancer History And Prostate Cancer In Relatives With Prostate Cancer

BACKGROUND AND OBJECTIVE: The family history of breast and prostatism cancer is a risk factor for prostate cancer. Considering the common pathogens for prostate and breast cancers, the aim of this study was to determine the relationship between the patient's prostate cancer and their first and second-class relatives with the history of breast cancer. METHODS: This case-control study was conducted on 300 patients who underwent biopsy in Shahid Beheshti hospital due to prostate enlargement. Patients were divided into two groups based on biopsy: a) prostate cancer in case group and benign prostate enlargement in control group. Additional information of the first and second-class relatives of patients was collected in the checklist and evaluated. The patients (150 control, 150 experimental) were selected using simple sampling method. The experimental and control groups who underwent biopsy suffered from prostate cancer and benign prostate enlargement, respectively. Additional information was collected in the checklist and evaluated for patients in the first and second grade families. FINDINGS: The mean age of patients was 72.17±9.788 and 70.01±9.921 in case and control group, respectively. The frequency of breast cancer in the family of patients with prostate cancer and healthy persons was 16 (59.3%) and 11 (40.3%), respectively and the frequency of prostate cancer was 26(17.3%) and 2(1.3%), respectively (p <0.001). The frequency of breast cancer was greater in first than second grade familie in both groups. In both groups, the history of breast cancer was higher in patients older than 40 years. CONCLUSION: The results of the study indicated that the frequency of prostate cancer is probably higher if the first and second-class relatives affect with prostate cancer than breast cancer

Evaluation of the Anatomical Relationship between the Mandibular Canal and Roots of Third Molars Using Cone-beam Computed Tomography (CBCT)

BACKGROUND AND OBJECTIVE: Injury to the inferior alveolar nerve during extraction of mandibular third molars is one of the serious complications after surgery. Therefore, the precise localization of IAN in relation to the third molar is one of the critical issues before extraction of this tooth. The aim of this study was to evaluate the position of mandibular canal in the mandible and its relation to the roots of the third molar using cone-beam computed tomography (CBCT) in a selected Iranian population. METHODS: In this cross-sectional study, the CBCT images of 168 patients (214 mandibular third molars) were evaluated. The position of the mandibular canal in the mandible (lingual, central, buccal) and the position of the mandibular canal with respect to the root apex (lingually, centrally and buccally), were recorded. FINDINGS: Mandibular canals were located lingually in 68.5% of cases, centrally in 27.3% of cases, and buccally in 4.2% of cases(p<0.001). Also, of 355 third molar roots evaluated, 5.4% were located lingually, 26.5% centrally, and 68.2% buccally with respect to the mandibular canal (p<0.001). Furthermore, the position of the mandibular canal in relation to the mesial and distal roots of third molars with separate roots (141 teeth) was different in 25 cases. CONCLUSION: Considering the results of this study that in most cases the mandibular canal is not in line with the roots of third molars, the use of three-dimensional imaging techniques such as CBCT is essential to the investigation of the relationship between the mandibular canal and the roots of this tooth