11-Year Trend of Mortality from Fatal Road Traffic Injuries in The Center of Iran; a Cross-sectional Study.

Introduction: Road traffic injuries (RTIs) are one of the major health problems in developed and developing countries. In Iran, RTIs are the first leading cause of years of life lost (YLL). So, the present study investigated the 11-year trend of RTI- related mortalities in Iran. Methods: This study was a population-based cross-sectional study. All-cause deaths as well as RTI-related mortalities' data were collected from the Civil Registration Organization (CRO) and Legal medical organization (LMO) of Isfahan during 2011-2021. The mid-year population, number of deaths due to RTIs, the crude and age-standardized mortality (per 100,000) of RTIs, and the percentage of proportional mortality by sex and year of accident during the study period were calculated and reported. Also, trend analysis was done using join point regression program. Results: During the study period, 11,248 deaths occurred due to RTIs in Isfahan province. 8,894 cases were male (79.03%), the highest number of deaths in both male and female cases was reported in those aged 15-39 years. Among the males, trend of standardized mortality in 2011-2015 was decreasing (annual percentage changes = -6.76(CI 95%: -2.53, -15.03)), while in 2015-2021 it was increasing (annual percentage changes = 3.00 (CI 95%: 0.63, 9.87)). However, no significant trend was observed among females. Conclusion: The findings of the present study showed that the number and standardized mortality rate of RTIs decreased during the 11-year period. It seems that applying stricter policies, improving the quality of the roads of the province, improving the quality of cars, and increasing the number of hospital and pre-hospital medical facilities can play an effective role in reducing RTIs.

Associations of Major Dietary Patterns and Dietary Diversity Score with Semen Parameters: A Cross-Sectional Study in Iranian Infertile Men.

BACKGROUND: This cross-sectional study pointed to assess the relationship between major dietary patterns and dietary diversity score with semen parameters, in infertile Iranian males. MATERIALS AND METHODS: In this cross-sectional study, 260 infertile men (18-55 years old) who met the inclusion criteria, entered the study. Four Semen parameters, namely sperm concentration (SC), total sperm movement (TSM), normal sperm morphology (NSM) and sperm volume were considered according to spermogram. A 168-item food frequency questionnaire (FFQ) was used to collect dietary intakes and calculate dietary diversity score. Factor analysis was used to extract dietary patterns. RESULTS: The following four factors were extracted: "traditional pattern", "prudent pattern", "vegetable-based pattern" and "mixed pattern". After adjusting potential confounders, those in the highest quartile of the traditional pattern had 83% less odds for abnormal concentration, compared with the first quartile (OR=0.17, 95% CI: 0.04-00.73); however, subjects in the highest quartile of this pattern had 2.69 fold higher odds for abnormal sperm volume as compared with those of the first quartile (95%Cl: 1.06-6.82). Men in the second quartile of prudent pattern had 4.36 higher odds of an abnormal sperm volume in comparison to the reference category (95%CI: 1.75-10.86), after considering potential confounders. With regard to mixed pattern, men in the second, third and fourth quartile of this pattern had respectively 85 (5%Cl: 0.03-0.76,), 86 (95%Cl: 0.02-0.75) and 83 % (95%Cl: 0.034-0.9) less odds of abnormal concentration, compared with the first quartile. Additionally, no significant association was found between dietary diversity score and sperm quality parameters. CONCLUSION: Higher intake of the traditional diet was linked to lower abnormal semen concentration and poorer sperm volume. Also, the mixed diet was associated with reduced prevalence of abnormal semen concentration.

Efficacy of herbal combination of sedge, saffron, and Astragalus honey on major neurocognitive disorder.

BACKGROUND: Major neurocognitive disorder (MCD) is an acquired progressive decline in cognitive abilities that causes a drop in specific acquired performance compared to former performances. We tried to investigate the efficacy of herbal combination of sedge, saffron, and Astragalus honey on cognitive and depression score of patients with MCD. MATERIALS AND METHODS: It was a randomized double-blind clinical trial conducted on sixty patients with MCD, who referred to the geriatric psychiatry clinic of Isfahan University of Medical Sciences in Iran. All the study participants had been using anti-MCD medications. Participants were randomized to receive a combination of sedge, saffron, and Astragalus honey in case group (n = 30) or placebo group for 8 weeks other than anti-MCD medications. Cognitive and depression scores were assessed using Addenbrook's Cognitive Scale and Geriatric Depression Scale, respectively, before intervention and at the 1st and 2nd months after intervention. The ANCOVA repeated-measure test was used to analyze the data using SPSS 20 software. RESULTS: The Addenbrook's Cognitive Test score was 32.2 ± 26.5 in intervention and 22.1 ± 15.1 in control group before intervention (P = 0.074) and 38.8 ± 27.7 in intervention group and 22.6 ± 14.1 in control group in control group 1 month after intervention (P = 0.007). In addition, Geriatric Depression Scale score was 14.6 ± 7.9 in intervention group and 14.5 ± 6.9 in control group before intervention (P = 0.945) and 12.9 ± 6.9 in intervention and 14.3 ± 7.1 in control group 1 month after intervention (P = 0.465) and 12.2 ± 6.5 in intervention group and 14.4 ± 7.1 in control group 2 month after intervention (P = 0.224). CONCLUSION: Our findings suggest that adding the herbal combination of sedge, saffron, and Astragalus honey to the current protocols of treatment of MCD patients could be useful in the improvement of cognitive and depression score of these patients.

Development and Validation of a Questionnaire for Preliminary Assessment of Heat Stress at Workplace.

BACKGROUND: Current heat stress indices are not completely suitable for heat strain screening in developing countries due to their inherent and applied limitations. The aim of this study was development of a questionnaire method entitled "Heat Strain Score Index" (HSSI) in order to perform a preliminary assessment of heat stress at work. METHODS: This research included six phases (i) Item generation (ii) Content validity (iii) Reliability analysis (iv)Structure validity (v) Concurrent validity and (vi) Classification of thermal risk level. In item generation phase, 40 items were identified to have impact on the heat strain. Content validity was evaluated by occupational health specialists. RESULTS: In consistency assessment, Cronbach's coefficient (α) of items was 0.91. Exploratory factor analysis on items HSSI draft identified four subscales which explained 71.6% of the variance. Correlation between the HSSI score with aural temperature was 0.73. Cut-off point; sensitivity and specificity for upper no thermal strain zone were 13.5, 91% and 50%, respectively. Whereas Cut-off point, sensitivity and specificity for lower thermal strain zone were 18, 86% and 73%. CONCLUSIONS: The results showed that 18 variables that were measurable through subjective judgment and observation in the HSSI scale covered heat stress key factors. This scale demonstrated reliability and initial validity in scale were suitable. Therefore HSSI scale for primary evaluation heat stress is appropriate.

Genetic association of rs1520333 G/A polymorphism in the IL7 gene with multiple sclerosis susceptibility in Isfahan population.

BACKGROUND: Multiple sclerosis (MS) is an inflammatory neurodegenerative disease in which the insulating membrane of central nervous system is damaged. The etiology of MS includes both genetic and environmental causes. A Genome - Wide Association Study (GWAS) recognized genetic single nucleotide polymorphisms (SNP) linked with MS predisposition among which immunologically related genes are considerably over signified. The purpose of the present study is to explore the association of rs1520333 C/T polymorphism in the IL7 gene variants with the risk of MS in a subset of Iranian population. MATERIALS AND METHODS: In this case - control study, 110 cases with MS and 110 controls were contributed. DNA was extracted from blood samples and to amplify the fragment of interest contain rs1520333 SNP, polymerase chain reaction - restriction fragment length polymorphism method was implemented for genotyping of the DNA samples with a specific restriction enzyme (MwoI). SPSS for Windows software (version 18.0; SPSS, Chicago, IL, USA) was used for statistical analysis. RESULT: We demonstrated the important association between G allele [odds ratio (OR) =1.6614, confidence interval (CI) =1.12-2.47, P = 0.0124] and GG genotype (OR = 7.45, 95% CI = 2.13-25.97, P 0.0016) of the rs1520333 SNP for susceptibility to MS after adjustment for age, and gender. OR adjusted for age, gender, and body mass index has displayed similar outcomes. CONCLUSION: These results indicate that the rs1520333 SNP is a significant susceptibility gene variant for development of MS in the Iranian population. Nevertheless, functional studies are required to completely elucidate how this SNP contributed to MS pathogenesis.

Child Weight Growth Trajectory and its Determinants in a Sample of Iranian Children from Birth until 2 Years of Age.

BACKGROUND: Growth is one of the most important indices in child health. The best and most effective way to investigate child health is measuring the physical growth indices such as weight, height and head circumference. Among these measures, weight growth is the simplest and the most effective way to determine child growth status. Weight trend at a given age is the result of cumulative growth experience, whereas growth velocity represents what is happening at the time. METHODS: This longitudinal study was conducted among 606 children repeatedly measured from birth until 2 years of age. We used linear mixed model to analyze repeated measures and to determine factors affecting the growth trajectory. LOWESS smooth curve was used to draw velocity curves. RESULTS: Gender, child rank, birth status and feeding mode had a significant effect on weight trajectory. Boys had higher weight during the study. Infants with exclusive breast feeding had higher weight than other infants. Boys had higher growth velocity up to age 6 month. Breast fed infants had higher growth velocity up to 6 month, but thereafter the velocity was higher in other infants. CONCLUSIONS: Many of the studies have investigated child growth, but most of them used cross-sectional design. In this study, we used longitudinal method to determine effective factors on weight trend in children from birth until 2-year-old. The effects of perinatal factors on further growth should be considered for prevention of growth disorders and their late complications.

Comparison of parent adolescent scores on Strengths and Difficulties Questionnaire.

BACKGROUND: Child and adolescent psychiatry has benefited from the application of self-report questionnaires because it is short, less costly and easy to apply. So we select the Strengths and Difficulties Questionnaire (SDQ) and evaluate the agreement between the self-report and parent report form. MATERIALS AND METHODS: Subjects were 1934 Adolescents, 11-18 years old. After obtaining the samples consent, SDQ parent rated form and self-rated form were filled. The collected data were analyzed using the STATA statistical package version 9. RESULTS: The adolescents obtained higher total difficulty scores than their parents, but it was not significant (P = 0.203). Boys had higher total difficulty scores than girls by parent informant (P = 0.001), but by self-report girls had higher total difficulty scores than boys (P = 0.42). 11-14 years had higher total difficulty scores by parent report than self-report (P = 0.42), but 15-18 years had higher total difficulty scores by self-report than parent report (P = 0.36). CONCLUSION: SDQ self-rating from adolescents may contribute better to the diagnostic process in the clinical setting.

MSI2 expression is decreased in grade II of gastric carcinoma.

Gastric cancer is the second most frequent cause of cancer death worldwide. In Iran, gastric cancer is the first cause of national cancer-related mortality in men and the second one in women. In mammals, the Musashi family of RNA binding proteins comprises the Musashi1 and Musashi2 proteins, encoded by the MSI1 and MSI2 genes. Mammalian Musashi contributes to the self-renewal of various types of stem cells. Furthermore, there is mounting evidence that stem cells exist in many tissues. Due to this, Msi appears to be associated with tumorigenesis. In the present study, 30 paired gastric tissue samples were examined for MSI2 gene expression by quantitative real-time RT-PCR. Our results demonstrated that the relative expression of the gene did not significantly alter between tumoral and non-tumoral tissues and different tumor types; but there was a statistical difference between the MSI2 gene expression in different tumor grades, of note between grade I and grade II.

Elevated serum levels of cell death circulating biomarkers, M30 and M65, in patients with ß-thalassemia major.

Deposition of iron in visceral organs, mainly in the liver, causes tissue damage in ß-thalassemia major (ß-TM) patients. Keratin 18 (K18) represents one of the major caspase substrates during apoptosis of hepatocytes. To better characterize the hepatic apoptosis and/or necrosis in ß-thal patients, the circulating levels of M65 (soluble intact K18) and M30 (the caspases-generated K18 fragment) were measured in 40 ß-TM patients and compared with 40 healthy controls. The ratio of M30/M65 (caspase-cleaved to total K18) was also determined in thalassemic and normal subjects. Results of the ELISA assays revealed that the serum levels of hepatocyte death markers, M65 and M30, were significantly increased in ß-thal patients compared to healthy controls (p <0.0001). M30 serum levels were also positively correlated with the serum levels of liver transaminases including aspartate aminotransferase (AST) (r = 0.337, p = 0.047) and alanine aminotransferase (ALT) (r =0.391, p = 0.02).

MSI1 overexpression in diffuse type of gastric cancer.

Being the third most frequent cause of cancer mortality in the world, gastric cancer is the major cause of cancer-related mortality in Iran. Musashi1 recognizes a motif in the 3'UTR of target mRNAs - involved in cell cycle regulation, proliferation and apoptosis - and represses the translation of the mRNAs. As tissue stem cells exist in many adult tissues other than the CNS, Musashi is considered to be associated with many malignancies. In the current study, we aimed to assess Musashi1 gene expression in human stomach cancer. In total, 30 paired gastric tumoral and adjacent non-tumoral tissue specimens were examined for gene expression by qReal-Time RT-PCR. Our results demonstrated that the expression of the gene did not significantly change between tumor/non-tumor tissues (p value: 16×10(-2)) and different grades (p value: 36×10(-2)). However, there was a statistical difference between the MSI1 gene expression in different tumor types, i.e., intestinal versus diffuse type (p value: 3×10(-2)). All together, further investigations should be done to elucidate the precise molecular mechanisms by which MSI1 contribute to the pathogenesis of gastric cancer.

Differential expression of ZFX gene in gastric cancer.

Gastric cancer accounts for 8% of the total cancer cases and 10% of total cancer deaths worldwide. In Iran, gastric cancer is the leading cause of national cancer-related mortality. Most human cancers show substantial heterogeneity. The cancer stem cell (CSC) hypothesis has been proposed to reconcile this heterogeneity. ZFX encodes a member of the krueppel C2H2-type zinc-finger protein family that is required as a transcriptional regulator for self-renewal of stem cells. A total of 30 paired tissue gastric samples were examined for ZFX gene expression by quantitative real-time RT-PCR. Although the relative expression of the gene was significantly high in 47% of the examined tumour tissues, its expression was low in the others (53%). There was a statistically significant association between the ZFX gene expression and different tumour types and grades. This is the first report that shows ZFX was differentially expressed in gastric cancer. Of note, it was overexpressed in diffused-type and grade III gastric tumoural tissues. Due to this, ZFX may have the potential to be used as a target for therapeutic interventions.

Perinatal depression in a cohort study on Iranian women.

BACKGROUND: Childbearing years in the women's life are associated with the highest risk of depression. In this study depression in third trimester of pregnancy and after delivery was studied. Depressive symptom score and the proportion of mothers above a threshold were compared to indicate probable depressive disorder at each stage. METHODS: This prospective cohort study was conducted in rural areas of Isfahan province of Iran from September 2007 to January 2008. Subjects were all in their third trimester and followed up from the beginning of the study to 6-8 weeks postpartum. At all, 2156 pregnant women completed the self report questionnaires but 258 were excluded because they were incomplete and final analysis was done with 1898 samples. At the final stage the sample size was decreased to 1291. RESULTS: The prevalence of depression based on BDI score greater than 20 in last trimester of pregnancy, was 22.8% and rate of depression based on EPD score greater than 12 between 6 to 8 weeks after delivery, was 26.3%. Incidence of Post Partum Depression (PPD) in 6 to 8 weeks after delivery in those who were not clinically depressed during pregnancy was 20.1%. Results showed that history of depression, unplanned pregnancy, being housewife and having 3 or more children had significant relation with ante partum depression. CONCLUSIONS: Two main risk factors for post partum depression are previous history of depression and depression during current pregnancy. It is important to assess these variables during pregnancy in order to facilitate timely identification of women at risk.

The efficacy of attendance and semi-attendance group cognitive-behavioral therapy (CBT) on the anxiety disorders of adolescent girls.

BACKGROUND: Anxiety disorders are one of the most psychiatric disorders in children and adolescents that can cause long life functional disability. The first line treatment for this disorder is cognitive behavioral therapy that has primary, secondary and tertiary preventive effect, but is expensive and long time. Today there is some effort to find short term, group, semi-attendance and low cost therapies. METHODS: Subjects were 42 girls (12- 17 y) with at least one anxiety disorder according to DSM-IV-TR with their parents who were divided into two groups randomly: group A which participated in 8 sessions and group B which participated in 4 sessions and the contents of sessions 3, 4, 6, and 7 were recorded on a CD for them. The tests used in this study were: SCARED, CATS, CAIS-C, CAIS-P, conducted before (T0), just after (T1) and three months after the treatment (T2). The collected data were analyzed by multivariate analysis of covariance test using SPSS software package, version 15.0. RESULTS: There was no significant difference between efficacy of semi-attendance group CBT and attendance group CBT in T0, T1 and T2 according to 4 tests (p = 0.311). The difference between the scores of these tests between T0 andT1 and T0 and T2 was significant in both groups (p < 0.001) but the difference between T1 and T2 was not significant. (p = 0.771). CONCLUSIONS: The efficacy of semi-attendance group CBT and attendance group CBT is similar and would sustain after 3 months.

Risk factors of postpartum depression in rural areas of Isfahan Province, Iran.

BACKGROUND: Postpartum depression is defined as a major depressive episode that occurs within four weeks after delivery. However, investigators describe a dramatic increase in the incidence of mood disorders after childbirth with the largest risk during 90 days after delivery. We aimed to study the risk factors of postpartum depression in women living in rural areas of Isfahan Province in Iran. METHODS: We assessed 6627 women, two to 12 months after delivery, for depression and putative risk factors. RESULTS: Unemployment, low education, mothers' young age, undesired gender of the child, unplanned pregnancy, and history of depression were the main risk factors of postpartum depression. History of depression, low education, primiparity, unplanned pregnancy, and undesired gender of the child had the highest risk score for postpartum depression in this group of Iranian women. CONCLUSION: Risk factors of postpartum depression in Isfahan Province were very similar to other studies, but the negative impact of low level of education, unplanned pregnancy, and undesired gender of the child on postnatal depression seems to be characteristic of this population.