The Histopathological Findings in Appendectomy Specimens in an Iranian Population.

BACKGROUND: Appendicitis is one of the most common causes of acute abdominal surgeries. The importance of parasitic etiologies in the pathogenesis of appendicitis is not well known in appendectomy specimens on a large scale in southwestern Iran. The current study aimed to retrospectively assess the demographic data and histopathological records of appendicitis in a 28-year period in Fars province, southwestern Iran. MATERIALS AND METHODS: Histopathological records of 13,013 patients who had undergone surgeries for appendicitis at Dr. Ali Shariati Hospital, affiliated with the Fasa University of Medical Sciences from December 1993 to January 2021 were reviewed and data concerning the patients' demographic data and histopathological records were retrieved from each record. More than 6800 archived microscopic glass slides were also reviewed. RESULTS: From a total of 13,013 histopathological records of surgical excisions of appendicitis that were reviewed over a 28-year period, 8,189 (62.9%) were male and 4,842 (37.1%) were female. Patients' age ranged from 2 to 98 years, with a mean age of 24.68±19.87 years. The most common inflammatory changes were 5,687 (43.7%), 1,228 (9.4%), 670 (5.1%), 522 (4%), and 363 (2.8%) cases of acute appendicitis, suppurative appendicitis, early acute appendicitis, gangrenous appendicitis, and perforated appendicitis respectively. Microscopically, no viral inclusions, fungal elements, and histopathologic findings of bacterial causes were found. Parasitic infections such as helminthiasis were detected in 74 (0.6%) cases aged from 6 to 63. Enterobiasis (Syn. oxyuriasis, pinworm infection) accounted for 73 (98.6%) of the 74 helminthiases, while ascariasis accounted for 1 (1.4%). Out of 74 cases, 29 (39.2%) showed evidence of appendicitis. CONCLUSION: The results suggest that although parasitic agents are minor causes of appendicitis, these agents should be kept in mind during differential diagnosis. However, whether every parasitic infection leads to appendicitis is controversial.

Multiple sclerosis incidence rate in southern Iran: a Bayesian epidemiological study.

BACKGROUND: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the associations s of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions. METHOD: Data from 5468 patients diagnosed with MS were collected, according to the McDonald's criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province. RESULTS: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS. CONCLUSION: Bayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.

Investigating the Effect of Hearing Aid Use on the Balance Status of Children with Severe to Profound Congenital Hearing Loss Using the Pediatric Clinical Test of Sensory Interaction for Balance.

BACKGROUND: Since the hearing and vestibular organs are close to each other, the correlation between hearing and balance is one of the principal issues, especially in people with hearing loss. PURPOSE: In this study, the effect of the auditory system on human balance performance was investigated by comparing the balance status of hearing-impaired children in the aided and unaided situations. RESEARCH DESIGN: In this cross-sectional study a group of children were assigned the task to compare the balance sways in two aided and unaided situations. STUDY SAMPLING: A total of 90 children aged 7 to 10 years with severe to profound congenital hearing loss and the healthy vestibular system of both genders served as the research population. DATA COLLECTION AND ANALYSIS: After a complete evaluation of the hearing and vestibular system and validation of the hearing aid performance, body sway was recorded using the pediatric clinical test of sensory interaction for balance in aided and unaided situations in the presence of background noise from the speaker. RESULTS: According to this study, there was no difference in body sway in aided and unaided situations for conditions 1, 2, and 3. In comparison, in conditions 4, 5, and 6 of the test, there was a statistically significant difference in body sway between aided and unaided situations. However, there was no difference in the sway of the body in aided and unaided situations between girls and boys. CONCLUSION: According to this study, hearing aids can improve balance in challenging listening environments.

The protection motivation theory for predict intention of COVID-19 vaccination in Iran: a structural equation modeling approach.

BACKGROUND: Many efforts are being made around the world to discover the vaccine against COVID-19. After discovering the vaccine, its acceptance by individuals is a fundamental issue for disease control. This study aimed to examine COVID-19 vaccination intention determinants based on the protection motivation theory (PMT). METHODS: We conducted a cross-sectional study in the Iranian adult population and surveyed 256 study participants from the first to the 30th of June 2020 with a web-based self-administered questionnaire. We used Structural Equation Modeling (SEM) to investigate the interrelationship between COVID-19 vaccination intention and perceived susceptibility, perceived severity, perceived self-efficacy, and perceived response efficacy. RESULTS: SEM showed that perceived severity to COVID-19 (ß = .17, p < .001), perceived self-efficacy about receiving the COVID-19 vaccine (ß = .26, p < .001), and the perceived response efficacy of the COVID-19 vaccine (ß = .70, p < .001) were significant predictors of vaccination intention. PMT accounted for 61.5% of the variance in intention to COVID-19 vaccination, and perceived response efficacy was the strongest predictor of COVID-19 vaccination intention. CONCLUSIONS: This study found the PMT constructs are useful in predicting COVID-19 vaccination intention. Programs designed to increase the vaccination rate after discovering the COVID-19 vaccine can include interventions on the severity of the COVID-19, the self-efficacy of individuals receiving the vaccine, and the effectiveness of the vaccine in preventing infection.

Measurement Invariance and Psychometric Analysis of Oxford Happiness Inventory Scale across Gender and Marital Status.

BACKGROUND: The Oxford Happiness Inventory (OHI) is a self-report tool to measure happiness. A brief review of previous studies on OHI showed the lack of evaluation of OHI fairness/equivalence in measuring happiness among identified groups. METHODS: To examine the psychometric properties and measurement invariance of the OHI, responses of 500 university students were analyzed using item response theory and ordinal logistic regression (OLR). Relevant measures of effect size were utilized to interpret the results. Differential test functioning was also evaluated to determine whether there is an overall bias at the test level. RESULTS: OLR analysis detected four items across gender and two items across marital status to function differentially. An assessment of effect sizes implied negligible differences for practical considerations. CONCLUSIONS: This study was a significant step towards providing theoretical and practical information regarding the assessment of happiness by presenting adequate evidence regarding the psychometric properties of OHI.

Bayesian Spatial Joint Model for Disease Mapping of Zero-Inflated Data with R-INLA: A Simulation Study and an Application to Male Breast Cancer in Iran.

Hierarchical Bayesian log-linear models for Poisson-distributed response data, especially Besag, York and Mollié (BYM) model, are widely used for disease mapping. In some cases, due to the high proportion of zero, Bayesian zero-inflated Poisson models are applied for disease mapping. This study proposes a Bayesian spatial joint model of Bernoulli distribution and Poisson distribution to map disease count data with excessive zeros. Here, the spatial random effect is simultaneously considered into both logistic and log-linear models in a Bayesian hierarchical framework. In addition, we focus on the BYM2 model, a re-parameterization of the common BYM model, with penalized complexity priors for the latent level modeling in the joint model and zero-inflated Poisson models with different type of zeros. To avoid model fitting and convergence issues, Bayesian inferences are implemented using the integrated nested Laplace approximation (INLA) method. The models are compared according to the deviance information criterion and the logarithmic scoring. A simulation study with different proportions of zero exhibits INLA ability in running the models and also shows slight differences between the popular BYM and BYM2 models in terms of model choice criteria. In an application, we apply the fitting models on male breast cancer data in Iran at county level in 2014.

Assessment of Differential Item Functioning in Health-Related Outcomes: A Simulation and Empirical Analysis with Hierarchical Polytomous Data.

BACKGROUND: The purpose of this study was to evaluate the effectiveness of two methods of detecting differential item functioning (DIF) in the presence of multilevel data and polytomously scored items. The assessment of DIF with multilevel data (e.g., patients nested within hospitals, hospitals nested within districts) from large-scale assessment programs has received considerable attention but very few studies evaluated the effect of hierarchical structure of data on DIF detection for polytomously scored items. METHODS: The ordinal logistic regression (OLR) and hierarchical ordinal logistic regression (HOLR) were utilized to assess DIF in simulated and real multilevel polytomous data. Six factors (DIF magnitude, grouping variable, intraclass correlation coefficient, number of clusters, number of participants per cluster, and item discrimination parameter) with a fully crossed design were considered in the simulation study. Furthermore, data of Pediatric Quality of Life Inventory™ (PedsQL™) 4.0 collected from 576 healthy school children were analyzed. RESULTS: Overall, results indicate that both methods performed equivalently in terms of controlling Type I error and detection power rates. CONCLUSIONS: The current study showed negligible difference between OLR and HOLR in detecting DIF with polytomously scored items in a hierarchical structure. Implications and considerations while analyzing real data were also discussed.

Human intestinal sarcocystosis in Iran: there but not seen.

Human sarcocystosis is a rare infection caused by the genus Sarcocystis who human serve as definitive (intestinal form of infection) host or intermediate (extraintestinal form) host for some various Sarcocystis species. The detection of Sarcocystis oocysts/sporocysts in the feces usually incidentally and is achieved by microscopic examination of the fresh or preserved specimens. To rule out any parasitological etiology among 23,875 (aged 2 months to 95 years) apparently immunocompetent Iranian individuals (from October of 2010 to June of 2016) with abdominal discomforts referred to several teaching hospitals and local clinical laboratories in Fars Province, Iran, their fecal samples were examined using light microscopy. Most pathogenic parasite-positive and doubtful samples were sent to the Intestinal Protozoology Laboratories of Fasa and Shiraz Universities of Medical Sciences to further examination to detect probable co-infection with other underdiagnose parasitoses. In addition to the common protozoal and helminthic infections, during the course of examining stool specimens using direct smear mixed with saline or iodine mounts and by formalin-ethyl acetate techniques, four cases of intestinal Sarcocystis infection as only or concurrently infected with other parasites were found. The present paper presents cases of human intestinal Sarcocystis infection in Iran. Since Sarcocystis are small in size and usually rare in stool, they often go unnoticed. It should be noted that stool smears must be examined with great care to avoid misinterpretation of Sarcocystis infections in microscopic examinations. To the best of our knowledge, co-infection of intestinal sarcocystosis and other principal parasitoses in stool investigations has not been reported earlier.

Knowledge and Attitude about Andropause Among General Physicians in Shiraz, Iran 2014.

BACKGROUND: Andropause in men refers to the clinical and biochemical syndrome associated with advanced age and characterized by a deficiency in serum testosterone levels. With the increase in aging male population and life span in Iran and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. The results of some research have shown that there is still low level of knowledge and attitude toward andropause among health professionals. This study aimed at assessing the level of knowledge and attitude of general physicians regarding andropause in 2014. METHODS: This cross-sectional study was carried out on 402 general physicians in Shiraz. A researcher-made questionnaire was developed for assessing the level of knowledge and attitude of general physicians about andropause. SPSS 18 was used to analyze the data, and descriptive statistics, ANOVA and Pearson correlation were applied for data analysis. RESULTS: The mean score of knowledge and attitude about andropause was 29.4 out of 76 and 35.1 out of 45, respectively. The findings showed a poor level of knowledge and positive attitude toward andropause among general physicians. There was a significant relationship between occupational status and knowledge about andropause (P<0.001). There was a statistically significant relationship between attitude and demographic characteristics (P<0.05). The correlation between knowledge and attitude toward andropause was not statistically significant (P=0.548). CONCLUSION: The findings of the present study indicate the need for designing educational interventions to improve the knowledge and attitude of andropause among general physicians.

Growth Velocity of Infants From Birth to 5 Years Born in Maku, Iran.

BACKGROUND: Growth velocity standards are essential for proper evaluation of child growth. The goal of this study was to construct weight, height and head circumference growth velocity charts for infants. METHODS: This study includes 256 infants (124 boys and 132 girls) born in Maku, Northwest of Iran, and monitored from birth until they were 5 years. The weights and heights of the subjects were recorded at birth, one, two, four, six months and 1, 1.5, 2, 3, 4 and 5 years of age, while the head circumferences were measured until they were 1.5 years old. In this study, the LMS method using LMS chart maker software, was utilized to obtain growth velocity centiles. RESULTS: Growth velocity charts for weight, height and head circumference (5th, 50th, 95th percentiles) were obtained. The velocity growth charts decreased rapidly from birth to 2 years and then remained relatively constant up to 5 years for both sexes. The growth velocity of boys was higher than girls through the first year of age but became equal at 12 months of age and no significant difference was seen up to 5 years. CONCLUSION: Growth velocity studies are really sparse in Iran. In this study, longitudinal data were used to obtain growth velocity centiles. Furthermore, the weight and height velocities of infants from Shiraz, southern Iran, and U.K were compared.

Child Weight Growth Chart and Its Associated Factors in Birth Cohort of Maku Using a Growth Curve Model and LMS Method.

BACKGROUND: Infant growth is defined as a positive change in body size over a period of time, and is a sensitive predictor of social health. The most effective way to determine child growth is by measuring birth weight and constructing a weight growth trajectory. Many studies were conducted on the effects of different factors on birth weight, but investigations of these effects on growth trajectory are really sparse. This study analyzes longitudinal data to determine factors affecting growth trajectory and used LMS chart for comparing children. MATERIALS AND METHODS: In a cohort study, 256 neonates born in 2004 in Maku, Iran, were recruited and were followed until 2009.The weight of the neonates were measured at 12 occasions from birth, until the age of 5 years. A growth curve model was used to determine the affecting factors. The parametric LMS method was used to construct the reference centiles curve of the weight (5th, 50th, 95th percentiles). FINDINGS: The findings show that while controlling the other factors, birth region, breast feeding duration, mother's education and infants' gender significantly influenced the longitudinal weight rate. However, other variables did not reveal any significant association with growth. The growth charts increased rapidly from birth to 5 years of age for both sexes. It was observed that male children grew faster than females, through the first year of age up to 5 years. CONCLUSION: Although every child has a growth potential, this capacity could be influenced by various factors and can be compared with other infants through a growth chart. We used longitudinal data to obtain the risk factor of growth trajectory. LMS method was also used for description of growth. Thereafter, the weight chart of Shiraz, southern Iran's corresponding infants, was compared.

Measurement equivalence of the KINDL questionnaire across child self-reports and parent proxy-reports: a comparison between item response theory and ordinal logistic regression.

Measurement equivalence is a necessary assumption for meaningful comparison of pediatric quality of life rated by children and parents. In this study, differential item functioning (DIF) analysis is used to examine whether children and their parents respond consistently to the items in the KINDer Lebensqualitätsfragebogen (KINDL; in German, Children Quality of Life Questionnaire). Two DIF detection methods, graded response model (GRM) and ordinal logistic regression (OLR), were applied for comparability. The KINDL was completed by 1,086 school children and 1,061 of their parents. While the GRM revealed that 12 out of the 24 items were flagged with DIF, the OLR identified 14 out of the 24 items with DIF. Seven items with DIF and five items without DIF were common across the two methods, yielding a total agreement rate of 50 %. This study revealed that parent proxy-reports cannot be used as a substitute for a child's ratings in the KINDL.

An ortho-rhom-bic polymorph of 2-(1,3-benzothia-zol-2-yl)-6-eth-oxy-phenol.

In the title mol-ecule, C(15)H(13)NO(2)S, an intra-molecular O-H⋯N hydrogen bond forms an S(6) ring motif. The benzothia-zole ring system and the benzene ring form a dihedral angle of 8.9 (3) Å. In the crystal, mol-ecules are linked by weak C-H⋯O hydrogen bonds, forming chains along the b axis. In addition, π-π inter-actions [centroid-centroid distances = 3.772 (4) and 3.879 (4) Å] are observed.

(E)-3-[(3-Eth-oxy-2-hy-droxy-benzyl-idene)amino]-benzoic acid.

In the title compound, C(16)H(15)NO(4), a potential bidentate N,O-donor Schiff base ligand, the benzene rings are inclined to one another by 4.24 (12)°. The mol-ecule has an E conformation about the C=N bond. An intra-molecular O-H⋯N hydrogen bond makes an S(6) ring motif. In the crystal, pairs of O-H⋯O hydrogen bonds link the mol-ecules, forming inversion dimers with R(2) (2)(8) ring motifs. These dimers are further connected by C-H⋯O inter-actions, forming a sheet in (104). There is also a C-H⋯π inter-action present involving neighbouring mol-ecules.

(E)-4-[(4-Diethyl-amino-2-hy-droxy-benzyl-idene)amino]-benzoic acid.

In the title compound, C(18)H(20)N(2)O(3), a potential bidentate N,O-donor Schiff base ligand, the benzene rings are inclined at an angle of 12.25 (19)°. The mol-ecule has an E conformation about the C=N bond. One of the ethyl groups is disordered over two positions, with a refined site-occupancy ratio of 0.55 (1):0.45 (1). An intra-molecular O-H⋯N hydrogen bond makes an S(6) ring motif. In the crystal, pairs of O-H⋯O hydrogen bonds link mol-ecules, forming inversion dimers with R(2) (2)(8) ring motifs.

(E)-3-[(2-Hy-droxy-3-meth-oxy-benzyl-idene)amino]-benzoic acid.

In the title compound, C(15)H(13)NO(4), the dihedral angle between the substituted benzene rings is 9.9 (8)°. Part of the mol-ecule (the salicylaldimine segment) is disordered over two sets of sites, with a refined site-occupancy ratio of 0.550 (14):0.450 (14). Intra-molecular O-H⋯N hydrogen bonds form S(6) ring motifs. In the crystal, pairs of O-H⋯O hydrogen bonds link mol-ecules into centrosymmetric dimers with R(2) (2)(8) ring motifs. The crystal packing also features C-H⋯π inter-actions.

{4,4'-Dimethyl-2,2'-[(2,2-dimethyl-propane-1,3-di-yl)bis-(nitrilo-methanylyl-idene)]diphenolato}nickel(II) monohydrate.

In the title compound, [Ni(C(21)H(24)N(2)O(2))]·H(2)O, both the complex mol-ecule and the water mol-ecule lie on a twofold rotation axis. The Ni(II) ion is coordinated in a distorted square-planar geometry by the tetra-dentate ligand. The dihedral angle between the two symmetry-related benzene rings is 47.12 (8)°. In the crystal, pairs of symmetry-related O-H⋯O hydrogen bonds form R(2) (2)(6) ring motifs. In addition, there are weak inter-molecular C-H⋯O hydrogen bonds, and π-π stacking inter-actions with a centroid-centroid distance of 3.4760 (8) Å.

Aqua-chloridobis(2-eth-oxy-6-formyl-phenolato-κO,O)chromium(III) acetonitrile hemisolvate.

In the mononuclear complex mol-ecule of the title compound, [Cr(C(9)H(9)O(3))(2)Cl(H(2)O)]·0.5CH(3)CN, the Cr(III) atom displays an elongated octa-hedral coordination geometry. The dihedral angle between the benzene rings is 12.27 (11)°. Adjacent complex mol-ecules are linked into dimers by O-H⋯O hydrogen bonds, generating rings of R(1) (2)(6) and R(1) (2)(5) graph-set motifs, and by aromatic π-π stacking inter-actions, with a centroid-centroid distance of 3.812 (2) Å. The crystal packing is further stabilized by inter-molecular C-H⋯N hydrogen bonds. The C and N atoms of the acetonitrile solvent mol-ecule are located on a crystallographic twofold axis.