Late-onset neuromyelitis optica spectrum disorder: A case series from Iran.

INTRODUCTION: Neuromyelitis optica spectrum disorder (NMOSD) is a disabling autoimmune disease of the central nervous system that can start at ages of 50 or more, when it is called late-onset NMOSD (LO-NMOSD). Data on this disorder are sparse. In this cross-sectional study, patient characteristics of the disease were studied. LO-NMOSD patients of a tertiary center in Tehran were studied from 2016 to 2020. CASE REPORTS: Eight patients were identified, half of whom were men. The diagnostic delay was from no time-lapse to three years (mean: 0.62, SD: 1.06), which was significantly shorter than in early-onset patients. Seven patients (87.5%) tested positive for AQP4-IgG which was significantly higher compared to early-onset patients (p-value=0.01). Four patients (50%) had both transverse myelitis and optic neuritis as presenting symptoms, while three (38%) had just myelitis and only one (12%) had optic neuritis. CONCLUSION: There is discrepancy regarding different aspects of LO-NMOSD. Further studies are needed to clarify the subject in order to enhance diagnosis and treatment.

Burden of musculoskeletal disorders in Iran during 1990-2017: estimates from the Global Burden of Disease Study 2017.

Musculoskeletal diseases (MSDs) are the leading cause of disability and facing them demands updated reports on their burden for efficient policymaking. We showed Iran had the highest female-to-male ratio and highest increase in the burden of musculoskeletal diseases, in the past three decades, worldwide. We further confirmed the role of population aging as the main cause. PURPOSE: MSDs comprise most of the top causes of years lived with disability (YLDs) worldwide and are rapidly increasing in lower- and middle-income countries. Here, we present disability and mortality due to MSDs in Iran at the national level from 1990 to 2017. METHODS: We used Global Burden of Disease (GBD) 2017 Study data and standard methodology and presented the burden of MSDs in rates of years of life lost (YLLs), YLDs, and disability-adjusted life years (DALYs) during 1990-2017, for population aged ≥ 5 years old. We further explored attributable risk factors and decomposed the changing trend in DALYs to assess underlying causes. RESULTS: In Iran, MSDs were responsible for 1.82 million (95%uncertainty interval [UI] 1.3-2.4) DALYs, in 2017. During the past 28 years, with 1.75% annualized percentage change (APC), Iran had the highest percentage increase in the all-ages MSD DALYs rate worldwide, while the age-standardized DALYs APC was negligible. Low back pain was the greatest contributor to DALYs and caused 4.5% of total DALYs. The female population is experiencing considerably higher burden of MSDs, with 115% and 48% higher all-ages YLLs and YLDs rates per 100,000, respectively (YLLs 28.7; YLDs 2629.1), than males (YLLs 13.2; YLDs 1766.1). However, due to wide UIs, difference was not significant. Only 17.6% of MSD YLDs are attributable to assessed risk factors. CONCLUSION: Despite that MSDs are rising as an important cause of disability in Iran, these conditions are not sufficiently addressed in health policies. There is urgent need for cross-sectoral engagement, especially addressing the MSDs in females.

Epidemiology of suicide and attempted suicide derived from the health system database in the Islamic Republic of Iran: 2001-2007.

Suicide is an important public health problem worldwide. A retrospective study from March 2001 to March 2007 examined some characteristics of cases of suicide and attempted suicide in the Islamic Republic of Iran based on the health system database of 41 medical universities. A total of 53100 cases of suicide and attempted suicide were analysed. Just over half were among women (55.0%). The most usual method of attempted suicide among both males and females was drug overdose. Self-burning was more frequent in females (5.8%) while hanging (4.5%), cutting (2.8%) and firearms (0.5%) were more common in males. There were 3883 (7.3%) completed (fatal) suicides. Hanging had the highest case fatality rate (76.5%) and drug overdose the lowest (2.3%). Older people had a higher mortality rate. Suicide and attempted suicides increased from 8.3 per 100 000 population in 2001 to 19.4 in 2005, then declined to 16.3 in 2007.

Epidemiology of suicide and attempted suicide derived from the health system database in the Islamic Republic of Iran: 2001-2007

Suicide is an important public health problem worldwide. A retrospective study from March 2001 to March 2007 examined some characteristics of cases of suicide and attempted suicide in the Islamic Republic of Iran based on the health system database of 41 medical universities. A total of 53 100 cases of suicide and attempted suicide were analysed. Just over half were among women [55.0%]. The most usual method of attempted suicide among both males and females was drug overdose. Self-burning was more frequent in females [5.8%] while hanging [4.5%], cutting [2.8%] and firearms [0.5%] were more common in males. There were 3883 [7.3%] completed [fatal] suicides. Hanging had the highest case fatality rate [76.5%] and drug overdose the lowest [2.3%]. Older people had a higher mortality rate. Suicide and attempted suicides increased from 8.3 per 100 000 population in 2001 to 19.4 in 2005, then declined to 16.3 in 2007

Epidemiology of suicide and attempted suicide derived from the health system database in the Islamic Republic of Iran: 2001-2007

Suicide is an important public health problem worldwide. A retrospective study from March 2001 to March 2007 examined some characteristics of cases of suicide and attempted suicide in the Islamic Republic of Iran based on the health system database of 41 medical universities. A total of 53 100 cases of suicide and attempted suicide were analysed. Just over half were among women [55.0%]. The most usual method of attempted suicide among both males and females was drug overdose. Self-burning was more frequent in females [5.8%] while hanging [4.5%], cutting [2.8%] and firearms [0.5%] were more common in males. There were 3883 [7.3%] completed [fatal] suicides. Hanging had the highest case fatality rate [76.5%] and drug overdose the lowest [2.3%]. Older people had a higher mortality rate. Suicide and attempted suicides increased from 8.3 per 100 000 population in 2001 to 19.4 in 2005, then declined to 16.3 in 2007