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Objectives@#Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. @*Methods@#This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. @*Results@#Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). @*Conclusions@#Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.
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Objectives@#Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. @*Methods@#This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. @*Results@#Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). @*Conclusions@#Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.
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Chest tube removal pain is one of the most important complications after open heart surgery. The removal of a chest tube is a painful and frightening experience and should be managed with as little pain and distress as possible. The aim of this study is to assess the effect of beloved person's voice on chest tube removal pain in patients undergoing open heart surgery. 128 patients were randomly assigned to two groups: one group listened to beloved person's voice during the procedure, and the other did not. Since pain was measured by linguistic terms, a fuzzy logistic regression was applied for modeling. After controlling for the potential confounders, based on fuzzy logistic regression, the beloved person's voice reduced the risk of pain. Therefore, using beloved person's voice could be effective, inexpensive and safe for distraction and reduction of pain
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Background: Imbalanced diet, as it may cause micronutrient malnutrition has been known as a causal factor for several chronic diseases. Several studies in Iran have shown that some micro-nutrient deficiencies are prevalent and of high concern. Minerals such as calcium and iron can supply physical and mental health as well as survival, and growth development. In this study, Nutrient density analysis was used to display Iranian households' diet quality
Methods: In this descriptive-analytical study, the diet quality of seven provinces, namely Eastern Azarbaijan, Isfahan, Tehran, Khorasan, Khouzestan, Sistan Balochestan and Fars was assessed in terms of calcium and iron. To do so, the data were obtained through national household food consumption survey conducted by National Nutrition and Food Technology Research Institute, 2000-02, in Iran
Results: Generally, 80% of households' calcium density was less than the standard value and this rate was 40-70% for iron. Index of nutrition quality [INQ] for calcium and iron were respectively almost 1/2 and 1/3 of requirements in all provinces
Conclusions: There were significant differences in calcium intake density between the rural and urban households however; there were no differences between the selective provinces and all over the country
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Aim: To estimate the change in years of life lost [YLL] due to gastric cancer mortality after correcting formisclassification in registering causes of death using the Bayesian method
Background: For evaluating the health status of a country and determining priority of risk factors, some epidemiologicindicators are needed. Due to premature death, YLL is one of the most widely used indicators. To have an exact estimate ofYLL, an accurate death registry data is needed, but the Iranian death registry is subject to misclassification error
Material and methods: Gastric cancer mortality data from 2006 to 2010 for Iran were extracted from national deathstatistics. The rate of misclassification in registered causes of deaths was estimated, using Bayesian method for eachyear. Then YLL of gastric cancer is estimated for different age-sex categories before and after implementing Bayesianmethod
Results: Using Bayesian method, the estimated misclassification rate for gastric cancer in cancer without label group were 5%,3%, 3%, 7% and 7% respectively from 2006 to 2010. Estimated Years of life lost due to gastric cancer before correctingmisclassification were respectively 111684.93, 114957.31, 112391.93, 112250.53 and 113300.92 person-years for years 2006to 2010. After correcting misclassification, the total YLL of gastric cancer increased to 1535.19, 921.11, 908.39, 2566.39 and2507.00 person-years, respectively from 2006 to 2010
Conclusion: If health policy makers ignore the existence of misclassification in registered causes of death, they mayunderestimate the burden of some causes of death and overestimate some others
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Background and Objectives: according to the available evidence, consumption of milk and other dairy products among Iranians is far less than recommendations. The share of different milks [i.e., traditionally vs. industrially processed] and its associated variables are, however, neither consistent nor fully known in different Provinces
Materials and Methods: this cross-sectional study was conducted to determine household milk consumption and its association with selected socio-demographic factors in West Azerbaijan Province, North-west Iran. A total of 650 households were selected from urban and rural areas in three major Azeri and Kurdish districts [i.e. Urmia, Khoy and Mahabad] using a multi-stage cluster sampling method. Data were collected using socioeconomic and milk frequency questionnaires
Results: the findings indicated that traditionally-processed milk [bulk] was the most common milk consumed at household level [62.5%]. Mean of bulk milk consumption in urban and rural areas was 479+/-23 and 730+/-64 ml/wk per capita, respectively. It was also shown that establishment of the new food subsidization policy has decreased the mean of household milk consumption by approximately 3 l/wk in urban areas. Factor analysis detected a significant decrease in the higher tertiles of family size/ethnicity score consumption of both bulk and pasteurized milk, which resulted in decreased consumption of total milk
Conclusions: designing and implementation of alternative approaches, such as targeted milk subsidies for poor households or vulnerable age-groups should be considered
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Background and Objectives: Two clinical forms of leishmaniasis exist in Iran: cutaneous and visceral. According to the sporadic reports of new cases of Visceral Leishmaniasis [VL] in Lorestan province, real status of VL is not clear, so this study aimed to describe the seroprevalence of VL in Delphan city
Materials and Methods: In this descriptive analytic study, blood samples were collected from children /= 1/3200 accompanied with clinical symptoms was considered as VL diseas
Results: 800 collected serum samples, 21[2.62%] showed anti-Leishmania antibodies at titers of 1/800 and 1/1600, whereas 5[0.62%] showed anti-Leishmania antibodies at titers of ?1/3200. But just one of them showed clinical symptoms [anemia and large abdominal] which is under treatment with miltefosine
Conclusion: A new focus of VL with low endemicity is going to be formed in our region, which showed that further studies on vector and reservoirs is necessary in the region and other parts of Lorestan province
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Leis mania is one of the most important diseases in Iran, with high prevalence in some part of country including, Tehran province this study was aimed to investigate the cutaneous lesions of patients studies was also referred to different 1aporatory of Health center of Vermin [a city In Tehran province], sand flies species m selected area. In this cross sectional study demographic data was collected by special questionnaire. Smears of suspected patients to stained and examined by microscope Sand flies were collected by sticky traps CDC light haps and aspirators, female specimens mere mounted and identified by diagnostic keys at species level Leis mania parasites were observed m 56 820 of cases. Disease was more common among male [64%] the majority of patients [3094] aged between 25-39 year old. Most lesions [50%] observed in hands and legs of patients, 76% of affected people had lust one lesion Half of them had a history of travel to endemic areas. More than 2500 sand flies captured during this study; among them 1100 female specimens were mounted and identified The prevalent spicies was Sergentomyia spp [65/9%], the second was papatasi [33/20%]. It should be mentioned that Ph sergenti, Ph alexandri and Ph caucasicus group also were identified in lower percentage According to current results and the status of the studied region including it seems that [Agricultural Activities animal husbandry and migration] cutaneous leishmaniasis could be a health threatening problem
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Conduct disorder is characterized with aggressive behaviors, deceitfulness or theft, destruction of property and serious violations of rules, prior to age 18 years. Attachment to God is a relationship with God that reveals aspects of individual thought. Secure attachment is associated with an increased ability to forgive. Various studies indicated the association between insecure attachment and delinquency and criminal behavior. The aim of this study was to evaluate the attachment to God and forgiveness in adolescents with conduct disorder at Tehran reformatory. This study is a cross-sectional study. The attachment to God and Transgression-Related Interpersonal Motivations Scale--12-Item Form [TRIM-12], were completed by 60 adolescents between 14 -18 years old with conduct disorder, with or without substance abuse disorders, and ADHD, at Tehran reformatory. Descriptive statistics and linear regression methods was used to analyze the data in SPSS-16. The results showed that anxiety and avoidant attachments to God and avoidance and revenge motivations in adolescents with conduct disorder are high. A history of addiction, criminality, and mental disorders among family members predicted increasing avoidant attachment to God among this group of adolescents in the univariate model. Also, parental divorce and attention deficit-hyperactivity variables predicted increased revenge motivation in the univariate model, and unemployed father predicted avoidance motivation, in the multivariate model. There is a defect in the ability to forgive in adolescents with insecure attachment and conduct disorder, there are basic requirements for the design of interventions and spiritual treatment programs specifically for this group of adolescents
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Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS[19]. The mean age of the patients was 48.30 [SD=11.41]. According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer [p value<0.001]. Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant [p value> 0.001]. In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant [p value> 0.007]. Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant [p value=0.05 and p value=0.02, respectively]. The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women
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Humans , Female , Risk Factors , Social Class , Family , Cross-Sectional StudiesABSTRACT
Background: We need a defined population for determining prevalence and incidence of diseases, as well as conducting interventional, cohort and longitudinal studies, calculating correct and timely public health indicators, assessing actual health needs of community, performing educational programs and interventions to promote healthy lifestyle, and enhancing quality of primary health services. The objective of this project was to determine a defined population which is representative of Tehran, the Capital of Iran. This article reports the methodology and establishment of the research network of Tehran defined population
Methods: This project started by selecting two urban health centers from each of the five district health centers affiliated to Shahid Beheshti University of Medical Sciences in 2012. Inside each selected urban health center, one defined population research station was established. Two new centers have been added during 2013 and 2014. For the time being, the number of the covered population of the network has reached 40000 individuals. The most important criterion for the defined population has been to be representative of the population of Tehran. For this, we selected two urban health centers from 12 of 22 municipality districts and from each of the five different socioeconomic of Greater Tehran. Merely 80000 individuals in neighborhoods of each defined population research station were considered as control group of the project
Findings: Totally we selected 12 defined population research stations and their under-covered population developed a defined population which is representative of Tehran population
Conclusion: a population lab is ready now in metropolitan of Tehran
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Stage is one of the most important prognostic factors for the cancer diagnosis, including the breast cancer. Studies have found that the rate of breast cancer late-stage diagnosis, among the women with lower socioeconomic status, is more than the others. The aim of this study was investigation the relationship between family levels of socioeconomic status and stage at diagnosis of breast cancer. This cross-sectional, descriptive study has conducted on 526 patients who have suffered from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti university of Medical science, from March 2008 till December 2013. A reliable and valid questionnaire about family status of socioeconomic status, have filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. The results have indicated that the mean age of the patients was 48.30 [SD=11.41]. There was a significant relationship between stage at diagnosis of breast cancer and family levels of socioeconomic status at the time of diagnosis [p=0.024]. Also, the relationship between stage at diagnosis and living place [in or out of Tehran] was significant [p=0.044]. In the Multiple logistic regressions, these associations were significant. There wasn't any significant relationship between stage of diagnosis of breast cancer and age, marital status and family history. Regarding the results of this study, deep paying attention to the family socioeconomic status as an important variable in stage at diagnosis of breast cancer, among Iranian women, was too important, and then providing the prevention plans related to this topic has seemed necessary
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Background: Obesity and metabolic syndrome are serious public health problems. It is suggested that high calcium diet can improve lipid profile, blood pressure and insulin resistance
Methods: In this clinical trial, 75 healthy overweight or obese premenopausal women were randomly allocated to one of the following dietary regimens for 8 weeks: 1] a control diet 2] a calcium-supplemented diet containing 800mg/d calcium carbonate 3] a high milk diet containing three servings of low fat milk [all of them providing a 500kcal/day deficit]. At baseline and after 8 weeks, waist circumference [WC], blood pressure, serum triglyceride [TG], fasting blood sugar [FBS], and high density lipoprotein cholesterol [HDL-C] were measured
Results: After 8 weeks, WC, FBS and HDL-C decreased in all groups [P<0.001], but there were no significant reduction in TG and blood pressure. Reduction of WC in the milk group was significantly higher than the controls [P=0.028]. Also, reduction of HDL-C in the calcium and milk groups was less than the controls [P=0.023 and P=0.019, respectively]. Changes in FBS, TG and blood pressure were not significantly different among the 3 groups
Conclusion: We found that increasing milk consumption led to more WC reduction. Milk or calcium intake caused less adverse effect on HDL-C, but has no effect on the blood pressure, FBS and TG. So increase in milk or calcium intake can reduce WC among the metabolic syndrome complications
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The aim of this study is to evaluate the association between different treatments and survival time of breast cancer patients using either standard Cox model or stratified Cox model. The study was conducted on 15830 women diagnosed with breast cancer in British Columbia, Canada. They were divided into eight groups according to patients' ages and stage of disease Either Cox's PH model or stratified Cox model was fitted to each group according to the PH assumption and tested using Schoenfeld residuals. The data show that in the group of patients under age 50 years old and over age 50 with stage ? cancer, the highest hazard was related to radiotherapy [HR= 3.15, CI: 1.85-5.35] and chemotherapy [HR= 3, CI: 2.29- 3.93] respectively. For both groups of patients with stage ?? cancer, the highest risk was related to radiotherapy [HR=3.02, CI: 2.26-4.03] [HR=2.16, CI: 1.85-2.52]. For both groups of patients with stage III cancer, the highest risk was for surgery [HR=0.49, CI: 0.33-0.73], [HR=0.45, CI: 0.36-0.57]. For patients of age 50 years or less with stage IV cancer, none of the treatments were statistically significant. In group of patients over age 50 years old with stage ?V cancer, the highest hazard was related to surgery [HR=0.64, CI: 0.53-0.78]. The results of this study show that for patients with stage I and II breast cancer, radiotherapy and chemotherapy had the highest hazard; for patients with stage III and IV breast cancer, the highest hazard was associated with treatment surgery
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The lack of a proper sewage collection and disposal system, the water and sewerage project, in the city of Rasht, became a priority by Guilan province Urban Water and Sewerage Company with the government partnership and World Bank financial support. The objective of this research was to complete the first phase of a two-phase study, to determine the impact of using an urban sewerage system on acute diarrhea in children under five years old, in Rasht city in the Guilan province. The study is a concurrent control before and after field trial which is carried out in two phases: before [phase I] and after [phase II]. Sampling for phase I was performed in the middle month of each season, November and February 2009 and May and August 2010. The incidence of acute Diarrhea was measured with the participation of 1560 mothers of children under 5 years old. This was done in two groups: the intervention group [inside the sewerage system project perimeters] and the control group [outside the project perimeters]. Data was collected by local female general practitioners and medical students by doorto- door interviews with mothers. Data was analyzed using the SPSS 11.5 software package. The Pearson Chi-Square was used to compare qualitative variables between groups, whilst the t-test and One-Way ANOVA was used to compare quantitative variables. The average annual incidence of acute diarrhea in children under five years old was 10.4% [9.4% in the intervention group and 11.4% in the control group]. The seasonal pattern of acute diarrhea incidence was 10.5% [9.3% in the intervention group and 11.7% in the control group] in May, 12.5% [11.5% in the intervention group and 13.4% in the control group] in August, 9.3% [8.1% in the intervention group and 10.5% in the control group] in November, and 9.1% [8.5% in the intervention group and 9.8% in the control group] in February respectively. The study showed the incidence of acute diarrhea in children under five years old in Rasht city is moderate and it follows a seasonal pattern. The highest rate was seen in summer and the lowest rate in winter. It is expected to decrease with the initiation of the sewerage system program
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The purpose of this study was to investigate the possible association between pregnancy weight gain and child weight at the 12th and 24th months of age in Damavand city, North-East Tehran, Iran. Materials and Methods: In a cross-sectional study, using existing data collected by the urban health centers, records of 266 women who attended urban health centers for prenatal care and delivered between March 2004 and March 2008 with singleton term pregnancy were analyzed. Data on pre-pregnancy weight and height, total pregnancy weight gain, mother's age, parity, neonatal birth weight, birth order, mother's education, working status, breastfeeding practice and child weight at the 12th and 24th months of age were extracted. Pregnant Women were categorized based on their pre-pregnancy body mass index [BMI] as underweight, normal, and overweight and obese. Chi-square and ANOVA tests were employed to analyze data using SPSS software. Mean [+/-SD] of gestational weight gain was 11.4+/-3.9 kg. On average, 34% of mothers had inadequate weight gain, while 44 and 22% gained appropriate and excessive weight, respectively, based on the US Institute of Medicine [IoM-1990] guidelines. About 11, 56, 20 and 13% of mothers were defined as underweight, normal, overweight, and obese based on their BMI values. Initial BMI and educational level was associated with pregnancy weight gain. There was a significant difference between mean child weight at the 12th and 24th months of ages in all three categories of pregnancy weight gain, i.e. inadequate [<6.8 Kg], normal [6.8-11.3 Kg], and excessive [>11.3 Kg] [p< 0.01]. Gestational weight gain seemed associated with child weight. Educating and assisting pregnant women to meet the weight gain within recommendations range might therefore be an important strategy to prevent child malnutrition, both under- and overweight, in early life
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Trichomonas vaginalis causes trichomoniasis and metronidazole is its chosen drug for treatment. Ferredoxin has role in electron transport and carbohydrate metabolism and the conversion of an inactive form of metronidazole [CO] to its active form [CPR]. Ferredoxin gene mutations reduce gene expression and increase its resistance to metronidazole. In this study, the frequency of ferredoxin gene mutations in clinical isolates of T.vaginalis in Tehran has been studied. Forty six clinical T. vaginalis isolates of vaginal secretions and urine sediment were collected from Tehran Province since 2011 till 2012. DNA was extracted and ferredoxin gene was amplified by PCR technique. The ferredoxin gene PCR products were sequenced to determine gene mutations. In four isolates [8.69%] point mutation at nucleotide position -239 [the translation start codon] of the ferredoxin gene were detected in which adenosine were converted to thymine. Mutation at nucleotide -239 ferredoxin gene reduces translational regulatory protein's binding affinity which concludes reduction of ferredoxin expression. For this reduction, decrease in activity and decrease in metronidazole drug delivery into the cells occur. Mutations in these four isolates may lead to resistance of them to metronidazole
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Colon cancer is the third cause of cancer deaths. Although colon cancer survival time has increased in recent years, the mortality rate is still high. The Cox model is the most common regression model often used in medical research in survival analysis, but most of the time the effect of at least one of the independent factors changes over time, so the model cannot be used. In the current study, the survival function for colon cancer patients in Tehran is estimated using non-parametric Bayesian model. In this survival study, 580 patients with colon cancer who were recorded in the Cancer Research Center of Shahid Beheshti University of Medical Sciences since April 2005 to November 2006 were studied and followed up for a period of 5 years. Survival function was plotted with non-parametric Bayesian model and was compared with the Kaplan-Meier curve. Of the total of 580 patients, 69.9% of patients were alive. 45.9% of patients were male and the mean age of cancer diagnosis was 65.12 [SD= 12.26] and 87.7 of the patients underwent surgery. There was a significant relationship between age at diagnosis and sex and the survival time while there was a non-significant relationship between the type of treatment and the survival time. The survival functions corresponding to the two treatment groups cross, in comparison with the patients who had no surgery in the first 30 months, showed a higher level of risk in the patients who underwent a surgery. After that, the survival probability for the patients undergoing a surgery has increased. The study showed that survival rate has been higher in women and in the patients who were below 60 years at the time of diagnosis
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Humans , Male , Female , Survival , Statistics, Nonparametric , Bayes Theorem , Survival RateABSTRACT
Cancer is the third most common cause of death in Iran, the leukemia cancer is one of the most important causes of cancer mortality. Regarding cancer mortality, data would be important to monitor the program screening effects, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was mortality rates evaluating, then leukemia cancer trends among the Iranian population within almost a period of a decade, i.e. from 1995 to 2004. National death Statistic Reported by Ministry of Health and Medical Education [MOH and ME] from 1995 to 2004, stratified by age group, sex, and cause of death, have included in this study. Leukemia cancer has expressed as the annual mortality rates/100,000, in general, and/or per gender, and age group. The general mortality rate of leukemia cancer has slightly increased within the mentioned study period, from 0.44 to 2.54, then leukemia cancer mortality has often seen in men more than women. The mortality rate of leukemia has significantly increased throughout Iran. Associated risk factors with leukemia have headmost identified for their prevention and control. So, future studies to reveal leukemia risk factors among the Iranian population would be crucial in order to control its burden