The role of history of blood pressure and diabetes in the prevalence of stroke in Azar cohort

Introduction: The prevalence of diabetes and hypertension has been growing steadily in the last decade. These are important risk factors for stroke and the contribution of each risk factor may change due to geographical location. We conducted the present study with the aim of determining the relationship between blood pressure and diabetes history and stroke in the population covered by the Azar Cohort. Methods: In this case control study which was a subset of Azerbaijan province study (Azar Cohort), 357 patients were divided into patients with and without a history of stroke. The two variables of hypertension and diabetes history, in these two groups were compared. Data were collected and compared with inferential statistical tests. Results: The results showed that blood pressure could increase the risk of stroke by 3.68 times (95% CI: 2.32-5.86). The history of diabetes mellitus in people with and without stroke was not statistically significant (OR=1.54; 95% CI: 0.87-2.72). Conclusion: The results of this study showed that high blood pressure is a predictor of stroke but diabetes cannot be effective in stroke in the cohort population of Azerbaijan

Incidence of Leukemia in the Northwest of Iran

Background: Leukemia is cancer of the blood or bone marrow, characterized by an unusualincrease in white blood cells. It is the sixth most common malignancy in the country in bothmales and females. The aim of this study was to document some epidemiological features ofleukemia in the Northwest of Iran.Methods: The study subjects (n=669, including 377 males and 292 females) comprised allleukemia cases registered/notified to the clinical and pathology centers of Tabriz and Ardebilcities, from 2003 to 2006. All patients were classified using the ICD-10 based coding system(C91-C95, C77 and C42). Ninety-five percent confidence intervals were calculated to assessthe statistical significance of the data.Results: Annual incidence of leukemia was 3.7 [95% CI: 3.3–4.0] and 4.9 [95% CI: 4.2–5.6]per 100 000 population in Tabriz and Ardebil, respectively, with an overall case fatality rateof 13.5 percent [95% CI: 10.8–16.0]. The sex ratio (male/female) was 1.23. Myeloid leukemia(C92) and Hematopoetic and Reticuloendothelial system (C42) accounted proportionally formore than 47 percent of cases in the region. Over the study period, the annual occurrence ofleukemia in the region increased from 3.9 [95% CI: 3.4–4.5] to 4.1 [95% CI: 3.5–4.6] per 100000 population (P>0.1).Conclusions- The data from this cross-sectional study of leukemia in the North-West of Iranmay be used as the baseline information to establish a population-based registry of hematologicdisorders in the area for health care and research purposes. However, more investigationsare needed to develop effective strategies to control the relevant disorders in high-riskgroups

Staple Food Fortification with Folic Acid and Iron and Gastrointestinal Cancers:Critical Appraisal of Long-Term National Fortification

The co-occurrence of wheat flour fortification with folic acid and iron and gastrointestinal cancer incidences were critically assessed in the East Azerbaijan province in Northwest of Iran. In an ecological design, overall gastrointestinal cancer rate ratios and their 95% confidence intervals (95% CI) were calculated as primary outcome before (2004-2006) and after (2007-2015) the introduction of fortification. No consistent changes were observed in esophageal and gastric cancer, but the rate ratios of colorectal cancer increased significantly after fortification in the 35-54 years age group (women: 2.07, 95% CI: 1.79-2.49; men: 1.59, 95% CI: 1.33-1.89) and the 55-74 years age group (women 1.50, 95% CI: 1.27-1.76; men: 2.51, 95% CI: 2.13-2.95). The increased incidence of colorectal cancer was contemporary with long-term fortification; further investigation is required to establish the associations

Arsenic Exposure, Dermatological Lesions, Hypertension, and Chromosomal Abnormalities among People in a Rural Community of Northwest Iran

Chronic exposure to arsenic compounds is one of the major public-health problems in many developing and some developed countries. The aim of this study was to investigate the effects of chronic exposure to arsenic on dermatological lesions, hypertension, and chromosomal abnormalities among people in a community in the northwest of Iran. The occurrence of dermatological lesions, hypertension, and chromosomal abnormalities was investigated in two groups: Ghopuz village, including 101 subjects with chronic exposure to arsenic in drinking-water and Mayan village, including 107 subjects with no exposure. Daily/yearly absorbed amounts of arsenic were calculated for all subjects. Cumulative arsenic index for each individual was then estimated on the basis of age, water consumption, and location of residence. Arsenic concentration in drinking-water sources in Ghopuz and Mayan villages was 1031±1103 μg/L and non-detectable respectively. The mean systolic blood pressure in the exposure group [n=137, 95% confidence interval (CI 132–142)] was significantly higher than that in the control group (n=107, 95% CI 99.9–114). A similar significant difference was observed for diastolic blood pressure (exposed: n=82, 95% CI 79–85 vs non-exposed: n=71, 95% CI 66–75). The incidence of hyperkeratosis was 34 times higher among the exposure group compared to the control subjects [odds ratio (OR)=34, p<0.001)]. A significant difference was also observed in the occurrence of skin-pigmentation between the two groups (OR=2.4, p<0.007). Location and severity of the pigmentations were statistically different between the two groups. Twenty-five percent of the subjects in the exposure group showed chromosomal abnormalities (p=0.05). Arsenic exposure was a serious health problem in the region. More studies are needed to investigate the long-term effects and dose-response relationship of arsenic in the region and similar areas. Wide-ranging monitoring programmes for drinking-water sources should be implemented by public-health authorities

Folic Acid Supplement Intake and Risk of Colorectal Cancer in Women; A Case Control Study

Background: An ongoing controversy exists on the role of folic acid supplementation in colorectal cancer risk among epidemiological studies. Objective: To assess the association between maternal folic acid supplementation and colorectal cancer risk. Methods: A paired matched case control study of 405 subjects was performed, including women residing in 135 villages of East Azerbaijan, Iran. Per area, subjects were followed regularly in local healthcare centers, where health- and social-related information have been collected prospectively in face to face interviews by well-trained health workers. We extracted folic acid supplement intake, baseline characteristics, and confounders from healthcare records. The data for study participants were linked to national cancer registry repositories, from which we retrieved the data of 135 women diagnosed with colorectal cancer between 2005 to 2015. Two hundred seventy controls were individually matched with cases in terms of residing village, age, and gender. We applied multivariate conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Findings: There was no significant association between folic acid supplementation and colorectal cancer risk in those with history of folic acid intake compared to those with no history of intake (OR 0.95; 95% CI 0.59 to 1.53), in those with less than five years of folic acid (0.79; 0.45 to 1.39) or in those with ≥5 years intake (1.09; 0.52 to 2.26). This risk did not change after adjustment for covariates or further stratification. Conclusions: Maternal folic acid supplementation did not affect colorectal cancer risk in a population where supplemental folic acid is prescribed with regular intervals for women of child-bearing age

Reliability and validity of the Farsi version of the standardized assessment of personality-abbreviated scale

Introduction: A short screening tool for high-risk individuals with personality disorder (PD) is useful both for clinicians and researchers. The aim of this study was to assess the validity and reliability of the Farsi version of the Standardized Assessment of Personality-Abbreviated Scale (SAPAS). Methods: The original English version of the SAPAS questionnaire was translated into Farsi, and then, translated back into English by two professionals. A survey was then conducted using the questionnaire on 150 clients of primary health care centers in Tabriz, Iran. A total of 235 medical students were also studied for the reliability assessment of the questionnaire. The SAPAS was compared to the short form of Minnesota Multiphasic Personality Inventory (MMPI). The data analysis was performed using receiver operating characteristic (ROC) curve technique, operating characteristic for diagnostic efficacy, Cronbach's alpha, and test-retest for reliability evaluation. Results: We found an area under the curve (AUC) of 0.566 [95% confidence intervals (CI): 0.455-0.677]; sensitivity of 0.89 and specificity of 0.26 at the cut-off score of 2 and higher. The total Cronbach's alpha coefficient was 0.38 and Cohen's kappa ranged between 0.5 and 0.8. Conclusion: The current study showed that the Farsi version of the SAPAS was relatively less efficient, in term of validity and reliability, in the screening of PD in the population

Acceptability and compliance with a breast cancer prevention campaign in the Northwest Region, Iran

Aim: Breast cancer screening intended to improve survival and treatment outcomes. This study aimed to document the acceptability and compliance of the breast cancer prevention campaigns.Materials &amp; methods: Healthy women aged 35-65 years were recruited from various regions of the Northwest of Iran. All women were invited to participate in self-examination training for the breast and then re-Assessed by clinical examination and mammography.Results: A total of 321 healthy women were recruited, and volunteered to undergo at least one breast self-examination. The first and second clinical examinations were conducted on all women. Ultimately, 272 women (84.7%) underwent mammography. The most common barriers to screening were found to be fear of positive results, fear of cancer, lack of knowledge, fear of the mammography procedure and pain, travel distance and costs.Conclusion: The most critical challenge for implementing a breast cancer prevention program was the lack of knowledge and attitude. </p

Assessment of neuropsychiatric indicators in children and adolescents with primary brain tumors and other brain space occupying lesions before and after surgery

&nbsp; Objective Cognitive abilities may be impaired due to brain lesions in children and adolescents. This study aimed to investigate neuropsychiatric indicators in children and adolescents with primary brain tumor and other brain space occupying lesions (SOL) before and after surgical procedure. Methods &amp; materials the current study is a pre and post study which was conducted on 81 patients with brain space occupying lesions aged less than 18. Patients with metastatic brain tumors were excluded. The study was performed between 20 December 2016 to 20 December 2017 on patients hospitalized in neurosurgery ward of Imam Reza university hospital, Tabriz, Iran. Before and after surgical procedure, Digit span forward and backward Task (to assess working memory), Stroop task and Trail Making Task A &amp; B (to assess attention) and Rey Osterrieth Complex Figure Test (to assess Visual Spatial Memory) were done. Then, scores of tests were compared with normal values as well as the post-surgery scores. Results the most prevalent type of space occupying brain lesion was medulloblastoma and the most common region of involvement was posterior fossa tumor. Scores of all tests after surgery comparing to before surgery were significantly improved (P&lt;0.05). In assessment of Digit span forward and backward Task with standard scores, there was no significant difference among scores of patients before surgery with the standard value (P&gt;0.05). Regarding scores of various stages of Rey Osterrieth Complex Figure Test, the&nbsp; scores of immediate recall stage was significantly low (P&lt;0.05). Among Trail Making Task A &amp; B and stroop task, before surgery, just the Trail Making Task A &amp; B was significantly increased (P&lt;0.05). Scores of Trail Making Task A was significantly higher in patients with medulloblastoma and anatomically in left temporal tumors which indicate greater damage of attention field (P&lt;0.05). In addition, in cerebellar tumor, scores of immediate recall stage of Rey Osterrieth Complex Figure Test was significantly lower (P&lt;0.05). Conclusions Visuo-Spatial Memory and attention in pre-surgery assessments was significantly impaired comparing to general population (P&lt;0.05). Working memory, Visuo-Spatial Memory and attention showed improvement comparing to pre-surgery. Deficits in attention domain was greater in medulloblastoma

Prevalence of Spinal Deformities among School Age Children in Iran: A Systematic Review and Meta-Analysis

Background: Postural disorders and spinal deformities are one of the common conditions in children and adolescents. The aim of this systematic review and meta-analysis was to study the prevalence of spinal deformities among school age children in Iran.Methods: The search strategy was developed using keywords relating to kyphosis, lordosis, scoliosis, child and Iran in the databases of Medline, Scopus, CINAHL, Psycinfo as well as Persian local databases up to January 2020. Articles were appraised by two reviewers using the checklist of Joanna Briggs Institute (JBI) and data was extracted in the designed tables and analyzed using R software with a random effects model. The heterogeneity and dispersion of data was presented in Forest plots.Results: Eighteen studies were included in the meta-analysis. The total population included 84195 students consisting of 39202 boys and 45947 girls. The mean age of the participants was 12.71±1.18 years. The total prevalence of kyphosis was 13.06% [95% CI 0.07; 0.22], the total prevalence of scoliosis was 2.61% [95% CI 0.014; 0.045] and the total prevalence of lordosis was 32.59% [95% CI 0.23; 0.43]. The prevalence of deformities was higher in girls. Kyphosis and scoliosis was more frequent in elementary school children but lordosis was more frequent in middle school students. Confirmation of diagnosis with radiology as well as clinical examination yielded a lower prevalence compared to diagnosis only made by clinical examination.Conclusion: The prevalence of spinal deformities in school age children in Iran is on the average level compared to the other countries and lordosis is more common in girls. Designing further studies to evaluate etiology and risk factors of this condition is recommende

Impact of RAS/RAF mutations on clinical and prognostic outcomes in metastatic colorectal cancer

Introduction: Early-activated RAS/RAF mutation status is a key molecular finding in colorectal cancer (CRC), while these mutations have been proposed as predictive and prognostic biomarkers. The present study has been designed as a longitudinal study to evaluate and summarize the different genotypes of metastatic CRC (mCRC), and assessing any association with the disease prognosis and clinicopathological characteristics. This study was performed in two main referral hospitals of Tabriz University of Medical Sciences, over three years (2016-2018). Methods: Mutations were detected by Idylla tests of KRAS/NRAS/BRAF among a total of 173 mCRCs, using surgically-resected specimens or biopsied samples. To evaluate the factors associated with overall survival (OS) and prognosis, the Cox proportional hazards model was used in two steps to estimate the outcome measures (hazard ratio, or HR) with a 95% confidence interval (CI). Results: The nominal 1 to 5-year OS rates were 78%, 65%, 55%, 46%, and 42%, respectively. KRAS mutations in codon 12 was an independent significant prognostic factor, as the patients with codon 12 mutations had a significantly lower OS (P Log-rank=0.049) and a higher hazard of mortality (HR=2.30; 95% CI: 0.95-5.58; P=0.066). Also, the mCRC patients with liver metastasis (HR=2.49; 95% CI: 1.49-12.52; P=0.002) and tumors of the distal colon (HR=3.36; 95% CI: 1.07-10.49; P=0.037) had a significantly worse prognosis. Conclusion: KRAS mutation in codon 12 was an independent significant poor prognostic factor, and patients with liver metastasis had a significantly worse prognosis. Routinely performing specific oncogenic tests may help improve the patients’ prognosis and life expectancy