The survey of family history of diabetes in patients with type 2 diabetes in Chaharmahal va Bakhteyari province, Iran, 2008

چکیده: زمینه و هدف: دیابت از گروه بیماری های متابولیک و یک اختلال چند عاملی است که با افزایش مزمن قند خون مشخص می شود. از آنجایی که در زمینه اپیدمیولوژی ژنتیک دیابت نوع 2 در کشور ما، مطالعات اندکی انجام شده و هنوز بطور قطعی مشخص نیست که توارث دیابت نوع 2 بیشتر از طرف کدام یک از والدین (پدر یا مادر) به فرزندان منتقل می شود، این مطالعه با هدف بررسی زمینه ژنتیکی بیماران دیابتی نوع 2 استان چهارمحال و بختیاری طراحی و اجرا گردید. روش بررسی: این بررسی یک مطالعه اپیدمیولوژیک از نوع توصیفی-تحلیلی است که جامعه پژوهش آن افراد مبتلا به دیابت نوع 2 در استان چهارمحال و بختیاری در سال 1387 بود. تعداد 254 نفر به روش تصادفی دو مرحله ای انتخاب و مورد بررسی قرار گرفتند. داده ها بوسیله مصاحبه و با تکمیل فرمی، جمع آوری و با نرم افزار STATA9 و آزمون مجذور کا مورد تجزیه و تحلیل قرار گرفت. یافته ها: از254 نفر بررسی شده 150 نفر (59) مونث و 104 نفر(41) مذکر بودند. متوسط سن آنها 6/8±8/54 سال و متوسط مدت زمان ابتلا به دیابت در آنها 8/5±4/7 سال بود. 116 نفر (7/45) از آنها دارای سابقه خانوادگی مثبت دیابت بودند که از این میان، 4/61 مادر دیابتی، 8/19 پدر دیابتی، 9/62 خواهر دیابتی، 1/18 برادر دیابتی، 5/40 دختر دیابتی و 1/18 پسر دیابتی داشتند. سابقه خانوادگی دیابت در مادر بیشتر از پدر، در خواهر بیشتر از برادر و در دختران بیشتر از پسران بود (001/0>P). نتیجه گیری: نسبت شانس ابتلا به دیابت برای کسانی که سابقه خانوادگی مثبت دیابت در مادر دارند بیشتر و مهم تر از پدر بوده و می توان اظهار نمود که به احتمال قوی، توارث دیابت نوع 2 بیشتر از طریق مادر به فرزندان منتقل می شود.

Molecular population genetic of Persian sturgeon (Acipenser persicus) and stellate sturgeon (Acipenser stellatus) using microsatellite markers

The fishery stocks of most commercial aquatic stocks in the world have shown declining trends in the past two decades. Several factors have been responsible for the decline of stocks the most important of which over fishing and over-exploitation, pollution, loss of natural habitats and natural spawning grounds, construction of dams and bridges across the important rivers which restrict the migratory routes of spawners, decrease in natural reproduction and rehabilitation of stocks through artificial breeding programs. Over-exploitation of stocks and pollution directly affect decreasing stocks in an ecosystem. Not differentiating between different populations and stocks of a species found distributed in an aquatic ecosystem is considered one of the main factors which causes the depletion of stocks in most ecosystems in the world. In most cases this is because genetic variations in aquatic stocks in the wild are not taken into consideration. Six species of sturgeons are found living in the Caspian Sea and its drainage basin which produce more than 85-90% of the world caviar. The Persian sturgeon (Acipenser persicus) and the stellate sturgeon (Acipenser stellatus) are the main sturgeon species of the Caspian Sea. The Persian sturgeon is mainly found in the south Caspian Sea while the stellate sturgeon stocks are considered shared stocks by the five Caspian littoral states. Due to over fishing in the past two decades the legal catch figures for sturgeon stocks in the Caspian Sea dropped from 28500 tons in 1985 to less than 1500 tons in 2004. Similarly caviar production also dropped from 3000 tons to 110 tons in 2005. With regard to the severe reduction in sturgeon stocks it is necessary to take essential steps before these valuable species are totally wiped out. The fisheries management of the five Caspian littoral states should focus their efforts on identifying the different populations and stocks found in the Caspian Sea. Concerted measures should be taken to study the distribution and biomass of the different populations in order to develop a scientific solution for the sustainable use of these endangered species and to secure the long term conservation of sturgeon stocks. The aim of present study was to evaluate the genetic structure of the population of two species Acipenser persicus and Acipenser stellatus and to develop molecular markers to identify and differentiate different populations of these two species

Study on genetic structure of Caspian Sea sturgeons in the stock assessment of sturgeon in Iranian coastline of the south Caspian Sea

The population genetic structure of the Persian sturgeon (Acipenser persicus) in the 2, 3, 4 fisheries regions and Sefidrud River was investigated based on the DNA sequencing method during 2010–2013 sturgeon stock assessment in the south Caspian Sea . DNA samples were extracted using ammonium acetate, the quantity of DNA was measured at 260 and 280 nm using spectrophotometry by Nanodrop (ND 1000 model), and the quality was checked by 1% agarose gel electrophoresis. Two sets of mitochondrial gene (D-loop and cytochrom b) after synthesis were used for polymerase chain reaction (PCR). A Neighbor-Joining (NJ) tree was constructed for all haplotypes according to Kimura 2-parameter model using Mega Version 4.0.1, number of haplotypes, haplotype diversity (Hd) and nucleotide diversity and their corresponding variances, genetic divergence overall and between paired populations (Fst) by 10,000 permutations and exact test, the gamma distribution shape parameter for the rate heterogeneity among sites and nucleotide sequence, the historical demographic pattern of A.persicus using neutrality tests and mismatch distribution analysis (D test of Tajima and Fs test of Fu), also the concordance of the observed with the expected distribution under the sudden population model using the Harpending, s raggedness index (Hri) were analysed. All calculations were conducted using ARLEQUIN version 3.11 and DnaSP 4.0. The aligned mtDNA sequences of D-loop and cytochrom b genes were consisted of 500 and 700 base pairs (bp) respectively. 13 and 4 haplotypes were defined, the average haplotype diversity were 0.961 and 0.419, average nucleotide diversity were 0.038 and 0.002, The gamma distribution shape parameter were 0.19 and 0.20 indicating moderate mutation rate heterogeneity among sites in A.persicus. The lowest value of Fst for D-loop gene was calculated between Sefidrud and four fisheries region (-0.002) and the Fst values observed for cytochrom b gene was 0.04 with Nm=5.37 and not statistically significant. The exact test of population differentiation (non-differentiation exact P values) showed significant differences between Sefidrud and other areas (P ≤0.05) for D-loop gene and for cytochrom b gene was nonsignificant (P ≥0.05). The mismatch analysis produced a unimodal distribution of pairwise differences for both genes which was consistent with the sudden population expansion model. Tajima’s D and Fu’s Fs statistics were significantly negative (D= -0.84 and - 0.99, P>0.01; Fs=-0.220 and -0.079, >0.01). ARLEQUIN calculated the value of t as 13.65 and the time since population expansion was estimated to be approximately 1501 years before present based on the mutation rates for the control region and this value for cytochrom b gene t= 0.98 which population expansion time was 7.84 years before present. The results of this study based on D-loop gene showed that population of A.persicus in the Sefidrud River is differ from other studied areas. Therefore fisheries managements of this unique and valuable stock for restocking and conservation of gene pools is strongly recommended

Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access Article under the CC BY 4.0 license. Background: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings: Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Funding: Bill & Melinda Gates Foundation

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40.0% (95% uncertainty interval [UI] 39.4-40.7) to 50.3% (50.0-50.5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46.3% (95% UI 46.1-46.5) in 2017, compared with 28.7% (28.5-29.0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88.6% (95% UI 87.2-89.7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664-711) of the 1830 (1797-1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76.1% (95% UI 71.6-80.7) of countries from 2000 to 2017, and in 53.9% (50.6-59.6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe

Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2 center dot 5th and 97 center dot 5th percentiles of those 250 draws. Findings While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62 center dot 6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

A Case Report of Adenoid Cystic Carcinoma of the Bartholin Gland

Abstract: Primary adenoid cystic carcinoma of the Bartholin gland is a rare carcinoma in female genitalia tract. In review of literature less than 100 cases have been reported. The presented case is a 44 - year - old married woman with complain of a painful mass in the vulvar area. The nodule was excised and microscopic examination revealed adenoid cystic carcinoma of Bartholin gland origin. A few months later radical vulvectomy with bilateral inguinal lymphadenectomy was performed. In the pathology report, margins and all separated lymph nodes from inguinal area were free of tumor. Keywords: Adenoid cystic Carcinoma, Bartholin glands, Vulvar cancer