Archives of Iranian Medicine
Volume:24 Issue: 10, Oct 2021

Liver cancer (LC) is among the most common and fatal cancers worldwide. A four-fold increasing trend is reported for LC age-standardized mortality rate (ASMR) in Iran within 1990–2015. In the present study, we aimed to report the incidence rate of LC during the 13-year establishment of the Golestan population-based cancer registry (GPCR).

Age-standardized incidence rate (ASIR) per 100 000 person-years was calculated using CanReg5 software. The Joint point regression analysis was used to assess the temporal trends in incidence rate of LC.

During the study period, GPCR registered 575 of LC cases, of which 373 (64.9%) were men and 297 (51.6%) lived in rural areas. The mean (SD) age of LC in men and women were 60.3 (17.2) and 58.0 (17.1), respectively. The ASIR of LC was significantly higher in men than women (4.7 vs. 2.6; P value < 0.01) and a minimal increasing trend in LC incidence was observed in both sexes. The incidence rate of LC was significantly higher in rural areas compared to the urbans (3.91 vs. 3.40; P value = 0.04). In the last 13 years, rural population had a significant increasing trend in ASIR of LC (average annual percent change [AAPC] = 7.85, P value = 0.005).

LC was more prevalent in men among both urban and rural populations. The results showed a significant increasing trend in rural areas that requires Golestan health care system to take action in controlling the burden of LC in rural areas.

Clinical manifestations of COVID–19 are different. There are some risk factors for COVID–19. This study aimed to describe the epidemiological features, symptoms and mortality of the patients with COVID–19 in Iran.

This were a cohort study performed on 103,179 patients with COVID–19. The demographic and clinical data were collected in selected provinces. The required data of all patients was extracted from the COVID registry system and analyzed using STATA version 14 and Excel 2016.

The mean age was 52.40 years for men and 52.41 years for women. About 55.2% of the study population were male and 44.8% were female. Totally, 60.9% (5085) of deaths happened in men and 39.1% (3263) in women. The mean time from onset of symptoms to hospitalization in men and women were 3.47 and 3.48 days, respectively. The mean time from onset of symptoms to isolation was 2.81 days in men and was 2.87 days in women, from onset of symptoms to death was 9.29 and 9.54 days, respectively, from onset of symptoms to discharge was 7.47 and 7.39 days, and from hospitalization to death was 6.76 and 7.05 days. Cough and shortness of breath were the most common symptoms in the patients.

According to the results, the overall mortality rate was higher in men than women. Women with cardiovascular disease and diabetes were more likely to die. The mean time from onset of symptoms to hospitalization, isolation, and discharge was similar in men and women.

The National Organization for Civil Registration (NOCR) of Iran has reported causes of death data by ICD-10 chapters for the first time in 2020.

We used this report to review the share of ICD chapters among all deaths in each province and compare them with the Global Burden of Disease (GBD) study.

There are major changes in the distribution of causes of death between 2017 and 2018, especially in D50-D89 (Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism) from 0.76% to 38.94%, and I00-I99 (Diseases of the circulatory system) from 39.27% to 7.09%. Such dramatic changes are probably the results of changes in coding practices or definitions or issues in analysis.

Causes of death reports should be timely, clear, and robust on methods. They should contain a minimum level of details, at least 3-digit ICD codes to be useful for public health and medical professionals.

Intellectual disability (ID) is a heterogonous disorder with complex etiology. The frequency of autosomal recessive inheritance defects was elevated in a consanguineous family.

In this study, high-throughput DNA sequencing was performed in an Iranian consanguineous family with two affected individuals to find potential causative variants. Whole-exome sequencing was carried out on the proband and Sanger sequencing was implemented for validation of the likely causative variant in the family members.

A novel homozygous missense mutation (p.Arg122Trp) was detected in the PTRHD1 gene.

PTRHD1 has been recently introduced as a candidate ID and Parkinsonism causing gene. Our findings are in agreement with the clinical spectrum of PTRHD1 mutations; however, our affected individuals suffer from ID manifestations.

A limited number of headache disability indices exist that can evaluate and manage different disabilities related to headache among Iranian patients.

This study aimed to translate and validate the Persian version of the Henry Ford headache disability inventory (HDI).

The original questionnaire was translated and culturally adapted to the Persian setting. A total of 250 patients with chronic headache were enrolled in this study. The questionnaire’s face validity, content validity, and convergent validity with Short- Form Health Survey (SF-36) were evaluated and a confirmatory factor analysis (CFA) was conducted. Its internal consistency was also assessed and its short- and long-term test-retest reliability were examined by intraclass correlation coefficient (ICC).

The content validity indices were 0.85, 0.99, and 0.97 for simplicity, relevance, and clarity, respectively. The content validity ratio was calculated as one for all items. The findings of CFA confirmed that this index had a good fit. Cronbach’s alpha was 0.91, 0.82, and 0.86 for the entire questionnaire as well as its functional and emotional subscales, respectively. The ICC was also calculated as 0.97 for the total inventory. The convergent validity showed significant negative correlations between HDI and short-form health survey items.

The validity and reliability of the Persian version of the HDI were confirmed. This questionnaire can explore the disabilities of Persian-speaking people with headache disorders.

Late preterm infants (LPIs) have increased steadily in all newborns delivery and they are the largest patient group requiring admission to the neonatal intensive care unit. Surfactant treatment is frequently used in LPIs in case of respiratory distress, but the procedure and the timing of surfactant administration are not well-known.

We aimed to evaluate the effect of surfactant administration techniques on pulmonary outcomes in LPIs with respiratory distress.

In this retrospective study, we compared the effects of the less invasive surfactant administration (LISA) technique and conventional treatment on respiratory and other morbidities in LPIs who have respiratory difficulties. We named these two groups as the LISA group and the conventional group (CG). Comparison of the mechanical ventilation (MV) rates between the groups was the primary outcome of our study.

There were 25 LPIs in each group. The duration of nasal continuous positive airway pressure (CPAP) and oxygenation were similar in both groups. The rate of MV and the duration of MV (P = 0.004 and P = 0.02) were lower in the LISA group. Also, the need for more than 1 dose of surfactant was higher in the MV requiring group, although it was not statistically significant between the groups (P = 0.21).

Using the LISA technique for surfactant instillation reduces any MV requirement. LISA is a very useful and reliable technique in experienced hands in LPIs as in very preterm infants.

Hepatitis C is a major cause of liver failure and liver transplantation. The known risk factors of this disease include blood transfusion, injection drug use, high risk sexual behaviors, tattoos, and use of shared blades and syringes. Due to the higher risk of viral hepatitis among people in prison, this study was done to find the seroprevalence of hepatitis C virus (HCV) and associated risk factors in Lakan Prison in Rasht.

Prisoners in Lakan Prison underwent a cross-sectional study in 2018. A questionnaire containing demographic information and risk factors was distributed to the inmates and they were asked complete them. High-risk individuals were selected and a blood sample was taken and tested. Data were collected and analyzed by SPSS18 software.

Out of 2215 prisoners, 1238 people had at least one risk factor, of whom 408 individuals were selected by random sampling. One hundred inmates were positive for anti-HCV antibody, yielding a prevalence of 24.5% (95% CI: 20.4%–28.7%) of whom 42.6% were people who injected drugs and 4 cases were found positive for the hepatitis B surface antigen, yielding a 1% prevalence (95% CI, 0.2%–2%.). A history of injecting drug use (OR 4.28, 95% CI: 2.55–7.17), and previous history of imprisonment (OR 2.94, 95% CI: 1.34–6.53) had association with HCV infection.

The present study shows that hepatitis C is prevalent in prisons and preventive and screening programs should be implemented with necessary training for inmates.

The aim of this study was to evaluate the potential effects of biliary drainage before pancreaticoduodenectomy on postoperative outcomes.

This study was conducted retrospectively on data from 820 cases of pancreaticoduodenectomy performed in the Gastrointestinal Surgery Department of Ankara City Hospital between April 1999 and August 2019. Twenty years of collected patient data were re-examined and 805 patients were divided into two groups as those who underwent preoperative biliary drainage (PBD) and those who did not (non-PBD). Demographic data of patients, and preoperative, operative and postoperative details, including morbidity, were collected and compared between the two groups.

There were 574 (71.3%) patients in the PBD group and 231 (28.6%) patients in the non-PBD group. Total complications according to Clavien-Dindo classification were significantly higher in the PBD group (P < 0.001). Intraabdominal hemorrhage, delayed gastric emptying and wound infection were found to be higher in the PBD group but the rate of pancreatic fistula was similar in both groups. There was no difference between the two groups in terms of complications according to preoperative bilirubin levels. In drained patients with normal bilirubin levels, wound infections were significantly higher in a group with diameter of common bile duct > 8 mm (P = 0.020).

PBD is not associated with anastomotic leakage after pancreaticoduodenectomy. Wound infection, delayed gastric emptying and intraabdominal hemorrhage were significantly associated with PBD. Preoperative bilirubin level had no effect on these results. In subgroup analysis, in patients undergoing drainage, if bilirubin falls below 5 mg/dL, the risk of wound infection was still high in patients with bile duct diameter > 8 mm.

Biological drugs are manufactured via some changes made to the living organisms by genetic engineering. Notably, biological drugs are very expensive and their importation can impose economic pressure, especially on poorer countries. Thereafter, manufacturing these drugs has been considered by policymakers in many countries, resulting in the production of biosimilars. Iran requires a wide range of biological drugs due to the growing number of patients with multiple sclerosis. On the other hand, the poor economic situation of Iran due to repeated sanctions has had a great impact on the health care system, which has prevented the allocation of sufficient financial resources in this regard. Therefore, manufacturing biosimilar drugs due to their lower cost has received much attention in various fields of treatment.

There is a possible association between celiac disease (CD) and juvenile idiopathic arthritis (JIA). Our aim was to evaluate the serological incidence of CD in patients with JIA. Children under 16 years of age with JIA who did not respond adequately to routine treatment, who referred to the pediatric centers of Tehran University of Medical Sciences (2017–2019), were enrolled in this study. Manifestations of CD were also evaluated. CD-related serological screening tests were measured. Seventy- eight patients were enrolled in the study. Their mean age was 7.9 ± 3.9 (1.6–16) years. Three patients with oligoarticular JIA had Anti-TTG-Ab levels above normal (prevalence = 3.8%). None of them had symptoms of CD. There were no significant statistical differences in terms of growth disorders, sex distribution, and different subtypes of JIA (P value ˃ 0.05) between the groups (sero- positive vs. sero-negative). In one case, CD was confirmed by pathology and the gluten-free diet was recommended. The absence of CD symptoms in patients with JIA does not rule out concomitant CD.