nasrin borumandnia

Identifying key brain regions implicated in Parkinson’s disease (PD) can enhance both diagnostic accuracy and our understanding of disease mechanisms.

This study aims to compare three machine learning methods — least absolute shrinkage and selection operator (LASSO), random forest (RF), and recursive feature elimination (RFE) — for selecting influential regions of interest (ROIs) from functional magnetic resonance imaging (fMRI) data to distinguish PD patients from healthy controls.

This retrospective analysis used fMRI data from 15 patients with PD and 15 matched healthy controls, sourced from an open-access database. Three machine learning approaches were applied to identify significant ROIs associated with PD. The selected ROIs were subsequently evaluated using logistic regression models, assessing classification performance through area under the curve (AUC), sensitivity, and specificity. A comparative analysis of model performance was conducted using DeLong’s test.

The LASSO identified 9 ROIs, RF selected 10, and RFE identified 4 key ROIs. Logistic regression models constructed with these ROIs yielded AUC values of 0.96, 0.94, and 0.88 for LASSO, RF, and RFE, respectively. Both sensitivity and specificity were highest for LASSO (0.92 for both). DeLong’s test revealed statistically significant differences among the methods (P < 0.001), with LASSO outperforming RF and RFE.

This study demonstrates that LASSO, RFE, and RF machine learning techniques are promising for identifying key brain regions, showing preliminary alignment with clinical observations. Focusing on patients with PD, it highlights regions associated with executive function, memory, motor skills, and sensory processing. Early detection of abnormal connectivity in these areas may potentially inform exploratory preventive strategies for PD.

Tacrolimus is the mainstem of immunosuppressive therapy in kidney transplant patients. It has high intrapatient variability (Tac-IPV), which has been reported to affect graft function by predisposing patients to rejection or nephrotoxicity. We conducted this study with the aim of assessing the influence of Tac-IPV on 2-year graft function, biopsy-proven rejection, and infections in compliant renal recipients.

In this single-center retrospective analytic cross-sectional study, 250 patients who underwent transplantation from March 21, 2018, to March 20, 2020 and had at least three outpatient tacrolimus trough levels on the same daily dose 6 to 12 months after transplantation were recruited. Tac-IPV was defined as a coefficient variation of > 15%. Graft function, biopsy-proven rejection, cytomegalovirus (CMV) and BK virus viremia, and calcineurin inhibitor (CNI) toxicity were evaluated.

Of 202 transplant recipients, 128 were included with a mean age of 45.48 ± 13.14 years. The median Tac-IPV was 13.28% with 43.75% of patients with Tac-IPV > 15%. There were no significant differences in graft function, rejection, CNI toxicity, and CMV viremia among the groups during the 24-month study (P> .05). However, BK viremia was significantly higher among patients with Tac-IPV > 15% (13 vs. 2.9%, P = .042). The risk of antibody-mediated rejection alone (22.7 vs. 2.9%) or any kind of rejection (22.7 vs. 11.8%) was significantly higher in patients with higher Tac-IPV, and in those who had mean trough levels below 7 ng/mL (P = .015, .032; respectively).

Tac-IPV is low in adherent patients (with the median of 13.28%) and maintaining tacrolimus trough level above 7 ng/mL can overcome the adverse graft outcome of Tac-IPV in compliant kidney transplant recipients.

Traumatic brain injury (TBI) is one of the leading causes of death globally and one of the most important diseases indicated by the World Health Organization (WHO). Several studies have concluded that brain damage can dramatically increase functional connectivity (FC) in the brain. The effects of this hyper-connectivity are not yet fully understood and are being studied by neuroscientists. Accordingly, this study identifies areas of the brain where, after brain injury, an acute increase in FC in such areas is observed.

The data used in this study were downloaded from the accessible open functional magnetic resonance imaging (fMRI) site. The data included fMRI of 14 patients with severe TBI and 12 healthy individuals. The longitudinal model of variance components investigated the difference between FC in the baseline effect and the longitudinal trend between the TBI and control groups.

After fitting the longitudinal model of variance components, no difference was observed between the FC of the two groups due to the baseline effect. However, in the longitudinal trend of FC, there was a statistically significant difference between the three pairs of cerebellum left, cerebellum right, superior frontal gyrus left, superior frontal gyrus right, thalamus left, and thalamus right in the TBI group compared to the control group.

The results showed that FC was sharply increased in 3 pairs of areas in people with TBI. This hyper-connectivity can affect individuals' cognitive functions, including motor and sensory functions. The exact extent of this effect is unclear and requires further investigation by neuroscientists.

 Prevention of urinary stone recurrence is the ultimate goal in urolithiasis patients. In this study, we aimed to investigate the national prevalence rate and possible determinants of increased urolithiasis recurrence risk in a nationwide study in Iran.

 All data regarding stone occurrence and recurrence episodes were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of recurrence were evaluated in the subset of 2913 patients who had a positive history of at least one episode of urolithiasis.

 The national prevalence rate of recurrent urolithiasis was 2.6% (95% CI: 2.5, 2.8) in Iran. Moreover, the relative ratio of recurrent stone formers to all stone formers was 39.8% (95% CI: 38.0, 41.6). Our univariable truncated negative binomial regressions suggested that a positive history of urolithiasis in the patient’s father (prevalence ratio [PR] [95% CI]=1.83 [1.39, 2.41], P<0.001), mother (PR [95% CI]=1.92 [1.39, 2.66], P<0.001) or brother (PR [95% CI]=1.32 [1.03, 1.69], P=0.026); and residence in urban areas (PR [95% CI]=1.27 [1.04, 1.55], P=0.016) were significant predictors of repetitive recurrence episodes. However, when incorporated into a multivariable truncated negative binomial regression model, the only significant predictors of more frequent recurrence episodes were a positive history in father (PR [95% CI]=1.66 [1.24, 2.22], P<0.001) and mother (PR [95% CI]=1.68 [1.20, 2.36], P=0.002); and urban residence (PR [95% CI]=1.24 [1.01, 1.51], P=0.031).

 Our results indicate that a positive family history of urolithiasis in mother and father and residence in urban areas are the significant predictors of recurrence risk in urolithiasis patients in Iran.

Parkinson disease is a neurodegenerative disease that disrupts functional brain networks. Many neurodegenerative disorders are associated with changes in brain communication patterns. Resting-state functional connectivity studies can distinguish the topological structure of Parkinson patients from healthy individuals by analyzing patterns between different regions of the brain. Accordingly, the present study aimed to determine the brain topological features and functional connectivity in patients with Parkinson disease, using a Bayesian approach. 

The data of this study were downloaded from the open neuro site. These data include resting-state functional magnetic resonance imaging (rs-fMRI) of 11 healthy individuals and 11 Parkinson patients with mean ages of 64.36 and 63.73, respectively. An advanced nonparametric Bayesian model was used to evaluate topological characteristics, including clustering of brain regions and correlation coefficient of the clusters. The significance of functional relationships based on each edge between the two groups was examined through false discovery rate (FDR) and network-based statistics (NBS) methods. 

Brain connectivity results showed a major difference in terms of the number of regions in each cluster and the correlation coefficient between the patient and healthy groups. The largest clusters in the patient and control groups were 26 and 53 regions, respectively, with clustering correlation values of 0.36 and 0.26. Although there are 15 common areas across the two clusters, the intensity of the functional relationship between these areas was different in the two groups. Moreover, using NBS and FDR methods, no significant difference was observed for each edge between the patient and healthy groups (P>0.05). 

The results of this study show a different topological configuration of the brain network between the patient and healthy groups, indicating changes in the functional relationship between a set of areas of the brain.

Autism spectrum disorder is a neurodevelopmental condition in which impaired connectivity of the brain network. The functional magnetic resonance imaging (fMRI) technique can provide information on the early diagnosis of autism by evaluating communication patterns in the brain. The present study aimed to assess functional connectivity (FC) variations in autism patients.

Resting‑state fMRI data were obtained from the “ABIDE” website. These data include 294 autism patients with a mean (standard deviation) age of 16.49 (7.63) and 312 healthy individuals with a mean (standard deviation) age of 15.98 (6.31). In this study, changes in communication patterns across different brain regions in autism patients were investigated using graph‑based models.

The FC cluster of 17 regions in the brain, such as the hippocampus, cuneus, and inferior temporal, was different between the patient and healthy groups. Based on connectivity analysis of pair regions, 36 of the 136 correlations in the cluster were significantly different between the two groups. The middle temporal gyrus had more communication than the other regions. The largest difference between groups was – 0.112, which corresponding to the right middle temporal and right thalamus regions.

The findings of this study revealed functional relationship alterations in patients with autism compared to healthy individuals, indicating the disease’s effects on the brain connectivity network.

The efficacy of phosphodiesterase-5 inhibitors (PDE5Is) on the improvement of erectile dysfunction (ED) in second kidney transplant (KT) recipients has not been well investigated previously.

We aimed to compare the efficacy of tadalafil in three groups: hemodialysis (HD) patients, first KT recipients (KT1), and second KT recipients (KT2) with bilaterally ligated internal iliac arteries.

Age-matched men with erectile dysfunction were included in the study. Patients were divided into three groups: HD, KT1, and KT2. The International Index of Erectile Function 15 (IIEF-15) was used to assess baseline erectile function. Tadalafil was administered in a dose-escalation method for three months. Patients were reevaluated by the questionnaire at three months. The mean score evolution was compared between the study groups by one-way ANOVA.

The final analysis included 106 patients in three groups. There was no significant difference between the study groups regarding age, body mass index (BMI), blood pressure, and frequency of smoking, opium, or alcohol use. Tadalafil was safe and effective in all three groups. The mean IIEF score evolution in HD, KT1, and KT2 groups was 16.4 (58.7% increase from baseline), 19.3 (45.0% increase), and 20.4 (52.7% increase), respectively (P= 0.66).

Tadalafil is effective and safe in managing ED after the second kidney transplantation, where the internal iliac arteries are cut bilaterally. The response rate is similar to first kidney transplant recipients and hemodialysis patients.

Autism spectrum disorder is a neurodevelopmental condition in which impaired connectivity of the brain network. The functional magnetic resonance imaging (fMRI) technique can provide information on the early diagnosis of autism by evaluating communication patterns in the brain. The present study aimed to assess functional connectivity (FC) variations in autism patients.

Restingstate fMRI data were obtained from the “ABIDE” website. These data include 294 autism patients with a mean (standard deviation) age of 16.49 (7.63) and 312 healthy individuals with a mean (standard deviation) age of 15.98 (6.31). In this study, changes in communication patterns across different brain regions in autism patients were investigated using graphbasedmodels.

The FC cluster of 17 regions in the brain, such as the  ippocampus, cuneus, and inferior temporal, was different between the patient and healthy groups. Based on connectivity analysis of pair regions, 36 of the 136 correlations in the cluster were significantly different between the two groups. The middle temporal gyrus had more communication than the other regions. The largest difference between groups was – 0.112, which corresponding to the right middle temporal and right thalamus regions.

The findings of this study revealed functional relationship alterations in patients with autism compared to healthy individuals, indicating the disease’s effects on the brain connectivity network.

Each year, an estimated 15 million pre-term births occur worldwide, with the incidence of pre-term labor on the rise globally. Complications arising from pre-term labor are a leading cause of mortality among children under the age of 5. Despite this, there has been limited research on the trend of pre-term labor in Iran.

This study aimed to assess the trend of pre-term labor and identify influencing factors on pre-term labor in Arak city, Iran, from 2005 to 2019.

We analyzed a total of 89 307 live birth cases in Arak city from 2005 to 2019. The trend of pre-term labor over this study period was evaluated using statistical analysis software packages, specifically SPSS version 25. Linear trend analyses, as well as univariate and multivariate logistic regression analyses, were performed for statistical analysis.

Themeanpercentage of pre-term labor incidence during the first, second, and third 5-year periods was 8.9%, 10.3%, and 12.1%, respectively. Multivariate logistic regression analysis showed an increasing trend in pre-term labor incidence, even after adjusting for confounding factors (P < 0.001).

The observed increasing trend in pre-term labor incidence indicates the necessity for a comprehensive preventive strategy. This strategy should focus on identifying high-risk pregnancies and implementing effective interventions. The increasing incidence of pre-term labor in Arak city highlights the necessity for preventive measures to reduce the burden of this condition.

To estimate the current lifetime prevalence of urolithiasis at the national level in Iran and investigate the potential influential demographic factors in different geographical areas.

An epidemiological study was conducted between October 2020 and November 2022 in 31 provinces of Iran at the national level. Data was obtained through telephone interviews with households. Items in the interview included questions about the current and past episodes of urolithiasis, family history of urolithiasis, and demographic and environmental variables of potential interest in urolithiasis.

A total of 44186 participants were investigated from 31 provinces of Iran. The overall percentage of those with lifetime prevalence of urolithiasis was 6.6%, including 7.9% for males and 5.3% for females (P<.001). In addition, with regard to the residential location, men were 53% (7.9% vs. 5.2%) more susceptible than women to urinary stones in urban areas and 36% (7.8% vs. 5.7%) more susceptible in rural areas. Out of 31 provinces, the Sistan-baluchistan province had the highest lifetime prevalence (15.6%) and the Golestan province had the lowest (2.1%). The lifetime prevalence of urolithiasis in the rural areas was 6.8% versus 6.5% in the urban areas (P=.29). Regarding age differentiation, the lifetime urolithiasis prevalence has increased up to the age of 70 years. In addition, the most prominent increase in the lifetime prevalence was observed in the age range of 20 to 60 years (from 0.9% to 11.8%). The ethnicity with the highest lifetime prevalence rate of urolithiasis was the Baluch ethnicity (18%).

generally, 6.6% of Iranian population suffers from urinary stones during their lifetime. Urolithiasis prevalence has increased 0.06% annually compared to the latest national study that took place 15 years ago. This increasing trend seems to be less prominent than other countries. According to our findings, urinary stones are more prevalent in men than in women and in the third to sixth decade of life regardless of gender. Baluch ethnicity is associated with the highest lifetime prevalence rate of urolithiasis and there is no significant difference between rural and urban areas. However, the ratio of male to female risk of urolithiasis is higher in urban areas compared to rural areas.

To evaluate oncological outcomes in patient with positive surgical margin (PSM) following partial nephrectomy (PN).

In this retrospective study, we enrolled the data of patients who underwent PN between 2008 and 2017. The inclusion criteria were a definite diagnosis of kidney tumor who underwent PN with at least one year follow up.

From the 450 patients who underwent PN, The PSM was found in 35 (22 male/13 female) patients. 18/237 (7.6%) and 17/213 (7.9%) of them were in open and laparoscopic group, respectively. Clear cell RCC was the most prevalent pathology (18 patients) in the PSM patients. The mean time of follow up was 46 ± 2.02 months. Recurrence was developed in 5 (14.2%) patients. There was no correlation between recurrence and sex (p=1.00), surgery type (p = 0.658), age (p = 0.869), tumor size (p = 0.069), pathology (p = 0.258) and stage (p = 0.744) in PSM patients. Recurrence free survival was similar between the open and laparoscopy groups in PSM patients (p = 0.619).

Beside numerous advantages of minimally invasive techniques, laparoscopic approach would be comparable to conventional open partial nephrectomy in terms of oncologic outcomes. The rate of recurrence following partial nephrectomy in PSM patients is considerable and closely monitoring is mandatory.

Osteoarthritis of the knee is the most prevalent type of arthritis that causes persistent pain and reduces the quality of life. However, no treatment alleviates symptoms or stops the disease from progressing. Functional magnetic resonance imaging (fMRI) studies can provide information on neural mechanisms of pain by assessing correlation patterns among the different regions of the brain. This study aimed to determine brain connectivity patterns in patients with knee osteoarthritis compared to healthy individuals using advanced statistical models.

The data of this study were downloaded from https://openneuro.org/. These data included fMRI imaging of 36 knee osteoarthritis patients with a range age between 45-70 years old and 12 healthy individuals with a range age between 48-78 years old. Graph-based models were used to examine the brain functional alterations in knee osteoarthritis patients.

The results showed a disease-related cluster of eight regions in the brain, including the right Rolandic operculum, right amygdala, left caudate nucleus, left putamen, right putamen, left pallidum, and right pallidum. According to correlation comparisons in the cluster, the connectivity of 18 pair regions revealed a significant difference between the two groups. In comparison to the other regions, the right Rolandic and right amygdala had more communication.

Interestingly, in patients with knee osteoarthritis, the effect of chronic pain can cause functional alterations in the brain.

Following the COVID-19 pandemic, virtual education was adopted as the only way to prevent the cessation of educational processes. This study aimed to identify the challenges experienced by faculty members and students of the faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, during the COVID-19 pandemic in Tehran, Iran.

In this cross-sectional study, 218 students from all levels and 31 faculty members participated. Data were collected from February through March 2022, using two separate online questionnaires for students and faculty members to investigate potential problems and challenges in various educational areas. The results of the completed questionnaires were recorded in an Excel file and then transferred to the SPSS software (version 21) for statistical analysis.

Students were moderately satisfied with the quality of virtual education (P=0.02). Challenges related to “educational strategies” were the key challenges experienced by the students. Undergraduate students faced the most challenges (P=0.001). From the faculty members’ perspective, challenges related to “technical problems of virtual education” were the most important ones. Both faculty members and students viewed the challenges related to “policy-making, planning, and regulations” as the least important obstacles.

This study showed that the capacity development of students and faculty members to develop educational strategies and improving infrastructure to overcome technical problems in virtual education is probably the most important factor that needs to be addressed within the educational system.

To determine the effect of a probiotic supplement containing native Lactobacillus acidophilus (L. ac-idophilus) and Bifidobacterium animalis lactis (B. lactis) on 24-hour urine oxalate in recurrent calcium stone formers with hyperoxaluria. Moreover, the in-vitro oxalate degradation capacity and the intestinal colonization of consumed probiotics were evaluated.

The oxalate degrading activity of L. acidophilus and B. lactis were evaluated in-vitro. The presence of oxalyl-CoA decarboxylase (oxc) gene in the probiotic species was assessed. One hundred patients were randomized to receive the probiotic supplement or placebo for four weeks. The 24-hour urine oxalate and the colonization of consumed probiotics were assessed after weeks four and eight.

Although the oxc gene was present in both species, only L. acidophilus had a good oxalate degrading activity, in-vitro. Thirty-four patients from the probiotic and thirty patients from the placebo group finished the study. The urine oxalate changes were not significantly different between groups (57.21 ± 11.71 to 49.44 ± 18.14 mg/day for probiotic, and 56.43 ± 9.89 to 50.47 ± 18.04 mg/day for placebo) (P = .776). The probiotic consumption had no significant effect on urine oxalate, both in univariable (P = .771) and multivariable analyses (P = .490). The consumed probiotics were not detected in the stool samples of most participants.

Our results showed that the consumption of a probiotic supplement containing L. acidophilus and B. lactis did not affect urine oxalate. The results may be due to a lack of bacterial colonization in the intestine.

Medical and surgical priorities were dramatically changed during the COVID-19 pandemic. Thisstudy aimed to evaluate the impact of this pandemic on presentation to emergency department (ED) with uro-logic complaint.

This cross-sectional study was conducted at a tertiary urology referral center inTehran, Iran. The data of all ED admissions were collected and the frequency of admissions with urologic com-plain and their outcomes were compared between two 90-day periods (before and during COVID-19 era).Re-sults:480 ED admissions were studied. The number of patients visiting the ED with urologic complaint duringCOVID-19 era was significantly lower than the same period in the pre-COVID-19 period (125 vs. 355 admissions;p = 0.01). The mean hospitalization days for patients in the pre-COVID-19 period were significantly higher (5.6± 4.4 vs. 3.2 ± 4.2 days; p <0.001). The most common patient complaints before and during COVID-19 periodwere flank pain (32.7%) and gross hematuria (32.8%), respectively. The number of patients discharged againstmedical advice in the COVID-19 period was significantly higher than before (22 (17.6%) vs. 10(2.8%); p < 0.001).The number of patients who developed severe complications was significantly higher in the COVID-19 periodthan in the pre-COVID-19 period (p = 0.001).

During the COVID-19 pandemic we were faced withdecreasing frequency of admission with urologic complaint, change in the pattern of referrals, decrease in theduration of hospitalization, increase in the number of patients discharged against medical advice, and increasein the number of cases with irreversible urologic complications or complications requiring surgery due to de-ferred treatment.

Infertility is a global health issue and is reported differently worldwide.

To assess the longitudinal trends of primary and secondary infertility prevalence rate (PSIPR) per 100000 across all countries during past decades.

The PSIPR was extracted from the global burden of disease (GBD) database for 195 countries during 1993-2017. The longitudinal trends of PSIPR were explored across the seven epidemiological regions designated by GBD.

Globally, the PSIPR was lower among men than women. Over time, the prevalence of primary infertility in men and women had a decreasing trend of -9.3 and -11.6 in High-Income countries. Other regions have seen an increase, the highest being in South Asian women, and men of the Middle East and North Africa, with rates of 40.9 and 19.0, respectively. Over time, the secondary infertility prevalence in women of Central Asia, Central Europe and, Eastern Europe, as well as High-Income countries, has been declining, (rates of -16.9 and -11.7, respectively). Other regions have been on the rise, with the highest increase among women of Middle East, North Africa, and South Asia (trend of 119.9 and 83.4, respectively), and in South Asian men (trend of 48.4).

The overall trend of infertility prevalence shows a downward trajectory in high-income and developed countries and an upward trend in others. These findings might be explained by missed cases of infertility due to a low tendency for reproduction and the presence of more infertility treatment facilities in these regions.

Recently, it has been suggested that people’s chronotype is involved in regulating food intake and obesity. This study aimed to investigate the association between chronotypes with hormones related to appetite in adults in Tehran.

This cross -sectional study was conducted on 353 men and women aged 18 -60 years using convenience sampling in Tehran municipality community centers. Information on morningness -eveningness choronotype and physical activity (PA) level were collected by validated questionnaires. The data for anthropometric measurements and 3 -day food recalls were also collected. ELISA method was used to assess Neuropeptide Y (NPY) and leptin serum level.

The prevalence of eveningness, intermediate, and morningness chronotypes was 11%, 47.6%, and 41.4%, respectively. The participants with eveningness type were significantly younger (P = 0.001). The percentage of men with eveningness type was significantly higher than women ( P = 0.001). The mean values of height, weight, body mass index (BMI), waist circumference, total calorie intake, protein, carbohydrate, fat, and calorie intake from each of the main meals and snacks, were not different among three chronotypes. Leptin and NPY did not show any significant association with chronotypes.

Individual’s chronotype was not associated with NPY and leptin serum level. Further studies on a population with more varied work shifts are suggested.

Experts recommend us to keep a safety guidewire during the process of upper urinary tract endoscopy, though there is a lack of high-level evidence to support the efficacy and safety of this opinion. This study was conducted to compare the outcome of ureteral stone breakage in the presence or absence of a safety guidewire.

Patients candidate for endoscopic breakage of ureteral stone using a semi-rigid ureter - oscope, were randomly assigned in two groups based on keeping a safety guidewire (group1) or removing the guidewire (group2) before the process of breaking ureteral stone by lithoclast. Demographic factors, history of previous stone treatment, kidney function, stone location, symptoms duration and severity were recorded for each patient. Primary outcomes included success rate of stone treatment and secondary outcomes included number of attempts to enter to ureter, success rate of ureteral entry, success rate of stone achievement, stone migration rate and the success rate of ureteral stent insertion. The recorded data were entered to the SPSS software and descriptive statistical analysis including power calcu - lation and non-inferiority design for the primary and secondary outcomes, was performed. P-value less than 0.05 was considered significant.

From January 2016 till May 2018, 320 patients were randomized with 160 patients in each arm. Consider - ing the cases who were missed due to follow-up loss, there were 153 patients in group 1 and 147 patients in group 2 at the end of the study. Baseline data were equally distributed in both groups. Based on the initial analysis, the studied variables had no significant difference between two groups; though, according to the subgroup analysis of patients with proximal ureter stones, patients in Group 1 had higher rates of ureteral injury comparing to the patients in Group 2 ( p = 0.03).

According to our findings, keeping the safety guidewire through the process of endoscopic stone breakage (stone size: less than 1.5Cm) seems to add no significant benefit to the procedure outcome, while it in - creases the ureteral injuries in the proximal ureter stones, but not in mid or distal ureter stones

To study the prevalence of vitamin D deficiency in kidney stone formers and its predisposing factors and to assess the relationship between serum 25-Hydroxyvitamin D and urine metabolites.

Kidney stone formers were selected from the records of the kidney stone prevention clinic in Labbafinejad hospital, Tehran, Iran. Vitamin D deficiency was defined as 25-Hydroxyvitamin D < 20 ng/mL. The association between vitamin D deficiency and predisposing factors, serum, and urine metabolites was evaluated.

In 1005 patients (66.4% men and 33.6% women), the prevalence of vitamin D deficiency was 44.8%. Vitamin D deficiency was more prevalent in patients under 50 years (P < .001) and patients with hyperparathyroidism (P < .05). The lowest prevalence of hyperparathyroidism was in the 25-Hydroxyvitamin D range of 40 to 49.9 ng/mL, followed by the range of 30 to 39.9 and 20 to 29.9 ng/mL. Patients with vitamin D deficiency had lower serum creatinine (P < .02), lower 24-hour urine calcium (P < .01), and lower 24-hour urine oxalate (P < .05).

Iranian kidney stone formers have a relatively high prevalence of vitamin D deficiency. Our population seems to have different predisposing factors for vitamin D deficiency, i.e., higher prevalence among younger patients and no association between obesity and gender with vitamin D status. According to the parathyroid hormone, the favorable serum 25-Hydroxyvitamin D level was 20 to 49.9 ng/mL in our kidney stone formers.

The prevalence and risk factors of urinary tract infection (UTI) in neonates with unexplained hyperbilirubinemia are not studied thoroughly. Since the prevalence of UTI is highly variable in different areas and countries, this study aimed to review the existing data of Iranian neonates with UTI presented with unexplained hyperbilirubinemia.

This study is a meta-analysis of Iranian newborns with unexplained hyperbilirubinemia. We identified all studies indexed in international (Web of Science, PubMed, Scopus, Google Scholar) and national (Science Information Database, Magiran) databases from 2000-2018. Search terms included: Urinary Tract Infections OR UTI AND urine OR culture OR microbio, jaundice OR icter OR hyperbili, AND Iran.

Overall, 4210 neonates from 17 studies were included. The pooled prevalence of UTI in neonates with unexplained hyperbilirubinemia was 6.81% (95% CI: 4.86-8.77). Considering the subgroups analyses; the prevalence of UTI was higher in the prolonged vs. not-prolonged state (8.34% vs. 4.00%), low birth weight vs. normal birth weight (7.81% vs. 4.51%), and exclusive vs. non-exclusive breastfeeding (8.84% vs. 4.72%). Male gender and low birth weight increased the risk of UTI about two times compared to the female gender and normal birth weight, respectively. The results of the analyses in neonates with unconjugated hyperbilirubinemia also showed the above-mentioned subgroup differences.

Gestational diabetes is the most common antenatal medical complication that is associated with adverse short- and long-term maternal, fetal, and neonatal outcomes. Reducing maternal and fetal complications requires the early diagnosis of gestational diabetes. Unconjugated Estriol (UE) has led to insulin resistance under in vitro conditions.

This study aimed to determine the predictive power of unconjugated estriol in the diagnosis of gestational diabetes in Tehran, Iran.

The present historical cohort study was conducted on 523 pregnant women presenting to two university-affiliated hospitals in Tehran, Iran, 2017 - 2018. The level of unconjugated estriol was determined at the 14th - 17th week of pregnancy, and gestational diabetes was diagnosed at the 24th - 28th week of pregnancy using the oral glucose tolerance test with 75 grams of glucose. Data were collected through interviews and sampling was carried out using a convenience sampling method.

Out of 523 pregnant women examined, 63 (12%) were placed in the gestational diabetes group and 460 (88%) in the non-gestational diabetes group. The best cutoff point for unconjugated estriol was determined using the ROC curve as 0.965 MOM. We obtained 66.66% sensitivity, 54.78% specificity, 16.8% positive predictive value, and 92.30 negative predictive value for the UE test.

Given the acceptable sensitivity (66.66%) and specificity (54.78%) obtained for the UE test and the area under the ROC curve of 0.60, it appears that the UE test can be considered a new, accessible, and reliable screening test for gestational diabetes.

Cancer is among the most important causes of death worldwide. This disease is the third main cause of death in Iran. In the present study, mortality rates of Iranian men and women due to various cancers were analyzed using a database from 1990 to 2015 (in 5-year intervals), available in the Global Burden of Disease (GBD) study. For statistical modeling, Latent Growth Mixture Models (LGMMs) were used to determine the subgroups of cancers, in which cancers within each group had similar trends of mortality rates over the period of study. The LGMM identified 3 classes for both female and male data. For females, most cancers were allocated to the class with a slow increase in cancers mortality over time. Cancers in Class 2, including breast, stomach, trachea, bronchus and lung, colon and rectum, liver, brain, and nervous system, ovarian, and pancreatic had an increasing trend until 2000; then, they reached a fixed trend during 2000-2005, followed by showing an increasing trend once again. In the last class, leukemia showed a decreasing trend of mortality rate over time. For male data, most cancers were allocated to the class with a very slowly increasing trend in mortality rate over time. In both Class 2 (including bladder, brain and nervous system, liver, non-Hodgkin lymphoma, and pancreatic cancers) and Class 3 (including breast, larynx, leukemia, prostate, stomach, trachea, bronchus, and lung cancers), there was an increasing trend of mortality rate over time until 1995 and then it reached an almost stable trend during 1995-2005 followed by an increasing trend once again. Hence, the general status of cancer mortality rates shows an ascending trend. Therefore, it is necessary to provide programs for early detection, screening, preventing, public health program planning, and patient care improvement.

Paying attention to men’s health seems quite important for a variety of reasons. We evaluated the change of mortality rates due to various causes in Iranian men over the past decades. Study design: A cross-sectional study.

The mortality rates for deadliest causes of diseases among Iranian men during 1990-2016 were extracted from the Global Burden of Disease (GBD) study. Latent Growth Mixture Models (LGMM) were applied to determine subgroups’ cause of death. In this way, the causes within each group showed similar trends of mortality rates over time.

The LGMM clustered causes into 4 classes. Diabetes mellitus, hypertensive heart disease and neurological disorders have had increasing trend. Causes in class 2, including diarrhea, lower respiratory and other common infectious diseases, ischemic heart disease, ischemic stroke, neonatal disorders, and other non-communicable diseases manifested a slow decreasing trend. Most causes were allocated to 3rd class with a slow increase in mortality rates over time. Finally, within the last class, transport injuries and unintentional injuries revealed a decreasing trend.

Most factors have rising trend, despite the fact that some have shown a very slight downward trend. Consequently, according to the four distinguished clusters resulting from LGMM, it is essential to provide programs to attain the goal of access to prevention, treatment, and support for high-risk mortality factors.