The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic / 한국역학회지

METHODS@#This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants’ parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors. @*RESULTS@#The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively). @*CONCLUSIONS@#The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.

Determining the Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza Strip / 가정의학회지

Background@#This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip. @*Methods@#A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach. @*Results@#The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities. @*Conclusion@#The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions.

Determining the Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza Strip / 가정의학회지

Background@#This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip. @*Methods@#A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach. @*Results@#The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities. @*Conclusion@#The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions.

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study / 한국역학회지

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Transition in tobacco use stages and its related factors in a longitudinal study

OBJECTIVES@#Considering the increase in the non-communicable diseases associated with tobacco use in recent decades in Iran, it is necessary to have a general view of the current condition. This study aimed to identify factors associated with tobacco use and to estimate the probability of a 5-year transition in the stages of tobacco use in an adult population.@*METHODS@#In this study, 5190 people in the 40-64-year-old population of Shahroud (North East of Iran) were interviewed in 2009 and 2014 on tobacco smoking. The association of independent variables with tobacco smoking was evaluated using the population-averaged logit model. We calculated smoking transition probabilities from non-smoking to current smoking and past-smoking stages during a 5-year span.@*RESULTS@#The prevalence of current tobacco smoking in 40-69-years age group was 11.1% (95% CI 10.3-12.0), 1% among women (95% CI 0.8-1.3) and 25.6% among men (95% CI 23.7-27.6). During this 5-year period, the probability of transition of a non-smoker to an overall current tobacco smoker was 2.3%. Meanwhile, 18.5% of the overall current tobacco smokers had changed into past smokers. Unemployed (OR = 2), male gender (OR = 53.9), widow/widowers (OR = 5.4), divorces (OR = 3.3), and high economic status (OR = 1.2) are associated to tobacco smoking.@*CONCLUSIONS@#Compared with the other studies, the prevalence of tobacco use in this population is low but transition rate of non-smokers into current smokers or past smokers is high. Conducting interventions on determinants of starting and quitting smoking and education and awareness raising on the risk and harms of smoking seems necessary.

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study / 한국역학회지

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study / 한국역학회지

OBJECTIVES@#The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.@*METHODS@#In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.@*RESULTS@#The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.@*CONCLUSIONS@#Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Predictors of incidence of fall in elderly women; a six-month cohort study

Objective: To determine the incidence and predictive factors of the falls in elderly women in Northern Iran

Methods: A total of 717 elderly women aged 60 years and above in Amirkola, Northern of Iran participated in this study. Age, history of falls during the 12 months leading to the study, accompanying diseases, status of balance, cognitive status, orthostatic hypotension, state of depressive symptoms, strength of quadriceps muscles and serum vitamin D level were assessed as independent variables during baseline measurement. Incidence of fall [dependent variable] was recorded during a six-month follow-up period

Results: Of the participants, 7.8% had experience of fall, out of which 50.0% experienced it once, 25.0% twice, and the rest three times or more. With aging, the incidence of orthostatic hypotension also increased and symptomatic depression became aggravated. In the final model, the variables of the number of accompanying diseases [RR=1.78, 95% CI: 1.00-3.18], severe cognitive impairment [RR=12.70, 95% CI: 3.05-52.86], and depressive symptoms [RR=3.19, 95% CI: 1.48-6.86] remained as strong associated variables for incidence of fall

Conclusion: With increasing severity of depressive symptoms and cognitive impairment along with the comorbidities, incidence of fall also increases in the elderly. Thus, psychological aspects of the elderly and comorbidities in this group should be taken care of seriously

association of the transitions in smoking stages with prevalence of cigarette smoking in the classes and schools: a longitudinal study

Adolescent tobacco use remains a major public health priority to reduce the prevalence of tobacco use in community. The aim of this study was determining the association of the transitions in smoking stages with prevalence of cigarette smoking in the classes and schools in adolescents of Tabriz City [northwest of Iran]. Fifty-six high schools were randomly selected, and 4903 students completed a self-administered questionnaire on cigarette smoking twice with a 12-months interval in 2010 and 2011. Transition from experimenter to regular smoker stage was associated with the prevalence of cigarette smoking in the school. The results have shown the association of student's smoking uptake with the prevalence of cigarette smoking in the school. This highlights the importance of enforcing smoke free policies in schools

Corneal topography patterns in the Tehran eye study: warning about the high prevalence of patterns with a skewed radial axis

The purpose of this study is to determine the distribution of corneal topography patterns in Tehran. In this population-based study, a total of 442 individuals were randomly selected by cluster sampling for complete ophthalmologic examination. A total of 404 [788 eyes] met the inclusion criteria and were enrolled in this study. Orbscan II [Bausch and Lomb Surgical, Salt Lake City, USA] was used to determine the anterior segment indices and axial power maps for each eye. On the basis of the axial power maps, the symmetric bowtie [SB] [29.0%] and asymmetric bowtie with inferior steepening [16.7%] patterns were the most prevalent and the irregular [3.3%] and superior steepening [1.5%] patterns the least prevalent. Asymmetric bowtie pattern with a skewed radial axis [AB-SRAX] was seen in 7.6% of eyes. These cases had both thinner and steeper corneas compared with round and SB ones [P < 0.014 and P< 0.006]. Maximum anterior elevation in 5 mm zone, of AB-SRAX corneas were higher; than other patterns [P< 0.01] except for superior steepened and inferior steepened ones. The distribution of corneal topographic patterns in Iranians seems like other Asian population on the whole. The 7.6% prevalence of AB-SRAX patterns may be a warning on keratoconus prevalence in our population. This is in line with recent regional reports

Effect of anterior chamber depth on the choice of intraocular lens calculation formula in patients with normal axial length

To compare the accuracy of Sanders-Retzlaff-Kraff II [SRK II] and 3[rd] and 4[th] generation intraocular lens [IOL] formulas and to compare the effect of different anterior chamber depths among the IOL formulas in cataract patients with normal axial length [AL; 22.0-24.5 millimeters, mm]. A retrospective chart review was performed of patients with normal AL who underwent cataract surgery. The SRK II and 3[rd] generation IOL formulas [Hoffer Q, SRK T, Holladay l] were compared to the 4[th] generation Haigis formula. For analysis, preoperative anterior chamber depth [ACD] was divided into three subgroups- =/<3, 3-3.5, and >/= 3.5 mm. The mean error [ME] and mean absolute error [MAE] of each formula was compared for each subgroup against the total. The difference between the ME and MAE of the formulas were compared for each ACD subgroup. P< 0.05 was considered statistically significant. The study sample was comprised of 309 eyes. The MAE were 0.56 D, 0.52 D, 0.51 D, 0.50 D, and 0.50 D with Haigis, Hoffer Q, SRK T, Holladay 1, and SRK II formulas, respectively The Haigis formula was a significantly weaker predictor than the SRK T [P < 0.00l] and Holladay 1[P= 0.035]formulas. The ME with Haigis formula was -0.23 D which changed to -0.06 D with ACD >/= 3.5 mm [P = 0.002]. The ME was -0.24 D with SRK II and changed to -0.09D with ACD 0.05, all comparisons]. The SRK II formula can predict refraction in patients with normal AL and ACD less than 3 mm with less error and is preferred over other formulas. The Haigis formula is the preferred choice in patients with a normal AL and ACD longer than 3.5 mm. The prediction accuracy of Hoffer Q, SRK T, and Holladay 1 is comparable in normal AL

algorithm of smoking stages assessment in adolescents: a validation study using the latent class analysis model

Not withstanding the importance of smoking stages evaluation in adolescents, there is not an appropriate instrument for its measurement. This study aims to introduce an appropriate instrument for measurement of smoking stages in adolescents and to examine its validity using latent class analysis [LCA] model. We designed an algorithm to measure the smoking stages. The relevancy and clarity of the algorithm was examined by experts and lay experts. We assessed the reliability of our algorithm using test retest method. Moreover, using the LCA, we studied the validity of the stages measured by the designed algorithm in 4903 students [ages 14-19], who were randomly selected from grade 10 high school students in Tabriz [North West of Iran]. The algorithm content validity indicates high relevancy and clarity percentages. Intra-class correlation of 0.929 was found in the assessment of the reliability of smoking stages [9 stages] in 154 students within a two week interval. The LCA model revealed nine interpretable classes [G[2] = 0.051, df = 1, P = 0.821] for the measurement of smoking stages. Examination of the smoking cessation stages in a sample of 218 students in the cessation stage demonstrated that the results for five classes could be interpreted [G[2] = 0.001, df = 1, P = 0.975]. The results suggested that this algorithm is clear, valid, and reliable.

Factors affecting survival of patients with oesophageal cancer: a study using inverse Gaussian frailty models

<p><b>INTRODUCTION</b>Oesophageal cancer is one of the most common causes of cancer mortality in developing countries, including Iran. This study aimed to assess factors affecting survival of patients with oesophageal cancer using parametric analysis with frailty models.</p><p><b>METHODS</b>Data on 359 patients with oesophageal cancer was collected from the Babol Cancer Registry for the period 1990-1991. By 2006, the patients had been followed up for a period of 15 years. Hazard ratio was used to interpret the risk of death. To explore factors affecting the survival of patients, log-normal and log-logistic models with frailty were examined. The Akaike Information Criterion (AIC) was used for selecting the best model(s). Cox regression was not suitable for this patient group, as the proportionality assumption of the Cox model was not satisfied by our data (p = 0.007).</p><p><b>RESULTS</b>Multivariate analysis according to parametric models showed that family history of cancer might increase the risk of death from cancer significantly. Based on AIC scores, the log-logistic model with inverse Gaussian frailty seemed more appropriate for our data set, and we propose that the model might prove to be a useful statistical model for the survival analysis of patients with oesophageal cancer. The results suggested that gender and family history of cancer were significant predictors of death from cancer.</p><p><b>CONCLUSION</b>Early preventative care for patients with a family history of cancer may be important to decrease the risk of death in patients with oesophageal cancer. Male gender may be associated with a lower risk of death.</p>

Analysis of familial aggregation in total, against-the-rule, with-the-rule, and oblique astigmatism by conditional and marginal models in the Tehran eye study

The purpose was to determine the familial aggregation of the total, against-the-rule [ATR], with-the-rule [WTR], and oblique astigmatism by conditional and marginal models in the Tehran Eye Study. Total, ATR, WTR, and oblique astigmatism were studied in 3806 participants older than 5 years from August 2002 to December 2002 in the Tehran Eye Study. Astigmatism was defined as a cylinder worse than or equal to -0.5 D. WTR astigmatism was defined as 0 +/- 19[degree sign], ATR astigmatism was defined as 90 +/- 19[degree sign], and oblique when the axes were 20-70[degree sign] and 110-160[degree sign]. The familial aggregation was investigated with a conditional model [quadratic exponential] and marginal model [alternating logistic regression] after controlling for confounders. Using the conditional model, the conditional familial aggregation odds ratios [OR] [95% confidence interval] for the total, WTR, ATRs, and oblique astigmatism were 1.49 [1.43-1.72], 1.91 [1.65-2.20], 2.00 [1.70-2.30], and 1.86 [1.37-2.54], respectively. In the marginal model, the marginal OR of the parent-offspring and sib-sib in the total astigmatism were 1.35 [1.13-1.63] and 1.54 [1.13-2.11], respectively; WTR 1.53 [1.06-2.20] and 1.94 [1.21-3.13] and; ATR 2.13 [1.01-4.50] and 2.23 [1.52-3.30]. The model was statistically significant in sib-sib relationship only for oblique astigmatism with OR of 3.00 [1.25-7.20]. The results indicate familial aggregation of astigmatism in the population in Tehran adjusted for age, gender, cataract, duration of education, and body mass index, so that the addition of a new family member affected with astigmatism, as well as having a sibling or parents with astigmatism, significantly increases the odds of exposure to the disease for all four phenotypes. This aggregation can be due to genetic and/or environmental factors. Dividing astigmatism into three phenotypes increased the odds ratios

Smoking stages in an Iranian adolescent population

The aim of this study is determining the prevalence of smoking stages in adolescents of Tabriz city [northwest of Iran] and identifying the personal, environmental, and psychological factors relating to cigarette smoking. Fifty-seven high schools were randomly selected, and 4903 students were completed a self-administered questionnaire about cigarette smoking and the related risk factors. The association of independent variables with cigarette smoking was evaluated using the ordinal logistic regression model. In total, 17.3% of the participants were experimenters [95% CI: 15.8-18.9] and 5.0% were regular smokers [95% CI: 3.7-6.2]. The results showed that the male gender [OR=2.92; CI: 1.94-4.77], age [OR=1.27; CI: 1.02-1.64], having general risk taking behavior [OR=1.50; CI: 1.02-2.21], presence of a cigarette smoker in the family [OR=1.78; CI: 1.23-2.54], friendship with close cigarette smoker friends [OR=2.52; CI: 1.65- 3.86], substance abuse experience [OR=8.27; CI: 2.61-25.61], attitude toward cigarette smoking [OR=1.22; CI: 1.10-1.27] and positive thinking about cigarette smoking [OR=1.05; CI: 1.01-1.14] are associated to cigarette smoking in adolescents. The cigarette smoking prevalence is minimal in Tabriz city adolescents, especially in girls; but the experimenter prevalence is considerable. Findings of this study justifies adopting more serious measures in the pre-adolescence and adolescence period

Intention to start smoking and its related factors in never smoked adolescents in Tabriz, 2010

Intention to smoking is a strong predictor of future smoking behavior. The aim of this study is identifying the personal, environmental, and psychological factors relating to intention to smoking in adolescents of Tabriz city [Northwest of Iran]. Four thousand nine hundred and three [4903] students were randomly selected and completed a self-administered questionnaire about cigarette smoking, intention to smoking, and the related risk factors through multi-stage sampling. The association of independent variables with intention to smoking was evaluated using the multi-variable logistic regression model. The mean age of student was 15.7 +/- 0.73 years, and 42.9% of the samples were male. The results showed that 95.0% of students were in committer stage [students who had never smoked and were sure never start smoking]. Having general risk-taking behavior [OR 2.90; 95% confidence interval [CI]: 1.21-6.97], smoker in the family [OR 2.60; 95% CI: 1.20-5.61], and positive attitude towards cigarette smoking [OR 1.30; 95% CI: 1.18-1.43] had statistically significant association with intention to start smoking in future. Majority of non-smokers have firm decision to not start smoking in the future. Having general risk-taking behavior, smoker in the family, and positive attitude towards smoking are associated with intention to smoking in adolescents

prevalence and determinants of pterygium and pinguecula in an urban population in Shahroud, Iran

While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study [response rate: 82.2%]. The prevalence of pterygium in at least one eye was 9.4% [95% CI, 8.6-10.3], while 2.9% [95%CI, 2.4-3.3] had bilateral pterygium. The prevalence was significantly higher in men [11.4% vs. 8.0%], and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% [95%CI, 59.1-62.9] in at least one eye, and 49.0% [95%CI, 47.1-50.9] in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women [70.6% vs. 53.8%]. The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education

Six year trend in cataract surgical techniques in Iran

To determine the cataract surgery techniques performed in Iran from 2000 to 2005. Materials and Methods- This study was part of the Iranian Cataract Surgery Survey [ICSS] which was a retrospective cross-sectional study. All major ocular surgery units and 10% of randomly selected minor units throughout Iran were included. Excluding the 2 week Iranian New Year holiday, 1 week per season between 2000 and 2005 [a total of 24 weeks] was selected for each center, and data on all cataract surgeries performed during these weeks were collected by reviewing patient records. The ANOVA repeated measure test was performed to determine longitudinal changes with a P<0.05 denoting statistical significance. Phacoemulsification with intraocular lens [IOL] implantation has become the surgical method of choice in Iran, increasing from less than 7% in 2000 to 57% in 2005 [P<0.000l]. Extracapsular cataract extraction showed a reverse trend compared to phacoemulsification, decreasing from greater than 91% in 2000 to 41% in 2005 [P<0.000l]. Intracapsular cataract extraction and lensectomy were rarely performed without significant changes over time [P>0.05] Phacoemulsification with IOL implantation has become the preferred cataract surgery method in Iran during recent years

association between refractive errors and cataract: the Tehran eye study

To determine the association between refractive errors and different types of cataract in Tehran, Iran. In a cross-sectional survey with a stratified cluster sampling approach, refractive errors were tested under cycloplegia. Myopia and hyperopia were defined as a spherical equivalent refractive error <-0.5 diopters [D] and more than +0.5 D, respectively. Cataract was graded according to the Lens Opacities Classification System III classification and the association between refractive errors and cataract was assessed. Of 1434 participants over the age of 40 years who participated in the study, data from 1313 right eyes were analyzed. The mean age of the participants was 52.7 +/- 10.0 years, and 58.3% [n = 767] were female. Overall, myopia was more prevalent among those with cataract [odds ratio [OR]: 2.00, 95% confidence interval [CI]: 1.38-2.89]. Based on the type of cataract and refractive errors, the odds of myopia was significantly higher with nuclear cataracts [OR: 1.81, 95% CI: 1.14-2.87]. The odds of myopia was higher for cases of nuclear cataract with some degrees of posterior subcapsular cataract [PSC] [OR: 3.33, 95% CL 1.42-7.80]. Of nine participants with cortical cataract, seven participants had hyperopia [OR: 3.77, 95% CI: 0.78-18.31]. Individuals with nuclear and PSC showed a significantly higher prevalence of myopia while the prevalence of hyperopia was lower in those with cataract. High myopia was seen in higher grades of nuclear cataract. The high percentage of hyperopia was also significant in patients with cortical cataract. More studies are necessary to clarify the correlation between cortical cataract and hyperopia