Systematic review of priority setting studies in health research in the Islamic Republic of Iran

Background: Several research priority-setting studies have been conducted in different countries, including the Islamic Republic of Iran.

Aims: We conducted a systematic review and evaluated the quality of the priority-setting reports about health research in the Islamic Republic of Iran.

Methods: English and Farsi databases were searched from January to July 2016 to extract reports [up to December 2015] about priority setting in health research in the Islamic Republic of Iran. We constructed a checklist to extract data from the identified studies. Articles were studied in detail and content analysis was carried out. Relevant items were scored and analysed using Microsoft Excel.

Results: We identified 36 articles. Eight articles involved all the main stakeholders. About half the articles used valid criteria for ranking. Transparency was fulfilled in 13 articles. Upstream rules and regulations were ignored in 26 articles. An implementation plan was considered in 9 articles and context analysis was demonstrated in only 3.

Conclusions: Developing standard packages for priority setting, training of researchers and improving the capacity of organizations may improve the quality of priority-setting studies in the future.

Is there any evidence for a viral cause in achalasia?

Background:Achalasia, as an incurable disease is defined by the lack of normal esophageal peristalsis and loss of lower esophageal sphincter relaxation due to impaired myenteric neural plexus. The exact cause of myenteric neural cells degeneration in achalasia is still unknown. One hypothesis is that certain neurotropic viruses and autoimmune factors cause the inflammatory response in myenteric network, which consequently destroy neural cells. This study was designed to find the evidence of viral causes of achalasia

Methods: In this case-control study, 52 patients with achalasia and 50 controls referred to Shariati Hospital, were evaluated for the genome of neurotropic viruses, HPV, and adenovirus by polymerase chain reaction [PCR] and reverse transcription [RT] PCR techniques

Results:Genome assessment of neurotropic DNA viruses turned out negative in the patients, however, the genome of HSV-1 [Herpes simplex virus] was found in tissues of six controls. No neurotropic RNA viruses were observed in the tissue samples and whole blood of both the patients and controls.Among non-neurotropic viruses, adenovirus genome was positive in tissues of two out of 52 patients and three out of 50 controls. In addition, one out of 52 patients and two out of 50 controls were positive for HPV infection in tissues

Conclusion: We could not detect any significant relationship between achalasia and HPV, adenovirus, and neurotropic viruses in the cases. Nevertheless, it does not exclude the hypothesis of either an alternate viral species or resolved viral infection as the etiology of achalasia

Esophageal cancer in golestan province, Iran: a review of genetic susceptibility and environmental risk factors

Esophageal squamousi cell carcinoma [ESCC] is an aggressive tumor that is typically diagnosed only when the tumor has gained remarkable size, extended to peripheral tissues, and led to dysphagia. Five-year survival of advanced cancer is still very poor [19%], even with improved surgical techniques and adjuvant chemoradiation therapy

Therefore, early detection and prevention are the most important strategies to reduce the burden of ESCC

Our review will focus on the studies conducted in Golestan province, an area with a high prevalence of ESCC in northern Iran. We review three aspects of the research literature on ESCC: epidemiological features, environmental factors [including substance abuse, environmental contaminants, dietary factors, and human papilloma virus [HPV], and molecular factors [including oncogenes, tumor suppressor genes, cell cycle regulatory proteins, and other relevant biomarkers]

Epidemiological and experimental data suggest that some chemicals and lifestyle factors, including polycyclic aromatic hydrocarbons [PAHs], cigarette smoking, opium use, and hot tea drinking are associated with the development of ESCC in Golestan

HPV infects the esophageal epithelium, but so far, no firm evidence of its involvement in esophageal carcinogenesis has been provided. Some of these factors, notably hot tea drinking, may render the esophageal mucosa more susceptible to injury by other carcinogens

There are few studies at molecular level on ESCC in Golestan

Increasing awareness about the known risk factors of ESCC could potentially reduce the burden of ESCC in the region. Further studies on risk factors, identifying high risk populations, and early detection are needed