Archives of Iranian Medicine
Volume:26 Issue: 8, Aug 2023

Multiple sclerosis (MS) may be affected by socioeconomic status (SES). This study aims to explore the determinants of SES among Iranian patients with MS and examine how these factors relate to disability and disease progression.

All patients with MS listed in the nationwide MS registry of Iran (NMSRI) until January 8, 2022, were included in this population-based study.

Among the 5153 patients, most were female (74.5%), married (70.8%), and did not hold an academic degree (53.8%). Unemployment (OR: 3.75) and being unmarried (OR: 2.60) were significantly associated with Expanded Disability Status Scale (EDSS) ≥ 6, and the time to progression was shorter in the unemployed group (P value: 0.03). There was also a significant negative correlation between the time to progression and the age at disease onset.

The study suggests that providing financial and social support to MS patients and their families through investment could reduce both individual and societal burdens.

Cervical cancer is the fourth most common cancer in women, and human papillomavirus (HPV) is the leading cause of cervical cancer. Cervical cancer screening and HPV vaccination are important factors in the incidence of cervical cancer.

This study was performed on liquid base cytology (LBC) samples of 1214 women in Mashhad who were referred for cervical cancer screening in 2015-2020. Samples were examined by single-step polymerase chain reaction (PCR) and reverse line blot for HPV genotyping.

Totally, 386 women (31.8%) were HPV PCR positive. HPV genotyping of 277 samples showed that HPV 31 (3%), 16 (2.5%), 51 (2.2%), 18 (2%), and 66 (1.8%) were the most prevalent high-risk HPV (hrHPV) genotypes. Among low-risk HPV (lrHPV) genotypes, HPV 6 (9.2%), 53 (4.7%), and 42 (2.8%) were the most common genotypes. The range of multiple infections varied between two to eight genotypes and the prevalence of multiple HPV infections (12.4%) was higher than single infections (10.4%). Among women with single HPV infections, HPV 31 and 66 were equally the most common hrHPV genotypes, followed by HPV 16 and 39. In women with multiple HPV infections, HPV 31 was the most common hrHPV genotype, followed by HPV 51 and 16. For both single and multiple HPV infections, HPV 6 was the most common lrHPV genotype, followed by HPV 53 and 42.

In conclusion, given the high prevalence of single and multiple HPV infections, the need for governmentally supported HPV vaccination and cervical cancer screening should be emphasized to prevent cervical cancer.

Vaccination seems to be the most critical means of halting the COVID-19 pandemic. It is crucial to understand the factors that influence COVID-19 vaccine acceptance to avoid low vaccination rates. This study intended to monitor the COVID-19 vaccine acceptance and its association with socio-demographic factors and prior diagnosis of COVID-19 in Iranian adults during the COVID-19 pandemic.

The study utilized data from the COVID-19 Population Survey of Iran (COPSIR), a repeated national survey designed to monitor COVID-19-related behavioral insights. From April 2020 to November 2021, thirteen iterations of a series of cross-sectional studies involving computer-assisted telephone interviews were conducted.

The COVID-19 vaccine acceptance rate remained above 80% until the ninth wave in February 2021, when it dropped to 62.9%. However, throughout the next four surveys, it rose gradually from 72.0% to 85.7%. The multilevel regression model revealed that the COVID-19 vaccine acceptance was significantly and positively linked with age and education.

Despite the relatively high COVID-19 vaccine acceptance rate among Iranian adults, after the emergence of vaccines on the global market and controversies about their safety in Iran, the initially high vaccine acceptance rate dropped significantly, and then increased over time and returned to its peak level (85%). According to the Commodity Theory, this rise in vaccine acceptance can be attributed to the COVID-19 vaccine shortage in the country between January and July 2022. For Iranian adults to accept vaccines more readily, health promotion programs should target the youth and the less literate adults.

Isolated terminal ileal ulcers (ITIUs) may be a clue to hidden intestinal diseases. However, there are no specific guidelines for ITIUs.

We retrospectively screened subjects undergoing colonoscopy at The First Affiliated Hospital, Zhejiang University from March 2014 to July 2019, and included patients with ITIUs in the study. Some patients underwent further examination of the entire small intestine. Subsequently, patients with undetermined ITIUs received empiric therapy or observational follow-up. At least one year after baseline colonoscopy, telephone follow-up was performed to collect prognostic information.

A total of 120 (0.3%) patients undergoing colonoscopy in our center were found with ITIUs. Fourteen patients underwent further examination of the entire small intestine, six of whom were found with additional small bowel ulcers, but it did not significantly help the diagnosis. We obtained follow-up information from 41 undiagnosed patients. Over an average follow-up of 35.4 months, there was no significant difference in the prognosis of patients receiving empiric therapy or observational follow-up. The clinical and endoscopic outcomes improved or remain unchanged in most patients. In logistic regression analysis, gender, age, chief complaint, number of ulcers, and follow-up strategy had no significant impact on prognosis.

Patients with nonspecific ITIUs usually improve without any therapy, and observational follow-up may be a reasonable strategy.

miRNAs are non-coding RNAs participating actively in the post-translational regulation of oncogenes, tumor suppressor, and DNA repair genes implicated in colorectal cancer (CRC). This study aims to examine the association of the variants miR-27a (rs895819 A > G), miR-196a2 (rs11614913 T > G) and miR-146a (rs2910164 C > G) in Mexican CRC patients.

DNA samples from 183 patients and 186 healthy Mexican subjects were analyzed. Variants were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. Association was calculated by the odds ratio (OR) and adjusted by the Bonferroni test.

Patients carrying the G/G genotype of the rs895819 variant in the miR-27a gene showed an increased risk of CRC (19% vs 12%, P = 0.013). A similar tendency was noticed for patients younger than 50 years carrying A/G (48% vs 41%, P = 0.014). The A/G genotype in TNM stages I + II (55.7% vs 40.8%, P = 0.011) and tumor location in the colon (69.5 vs 40.8%, P = 0.001) were also increased. For the variant rs11614913 of the miR-196a2 gene, carriers of the C/C genotype showed an increased risk of CRC (32% vs 22%, P = 0.009). This genotype was more frequent in TNM stage III + IV (36.8% vs 22.5%, P = 0.007) and the tumor had a more recurrent location in the rectum (31.6% vs 22.5%, P = 0.013). The rs2910164 variant of the miR-146a gene was found to have no significant risk associations.

Our results reveal that the rs895819 variant in miR-27a and rs11614913 in miR-196a2 have a substantial impact on the development of CRC.

Colorectal cancer (CRC) is a major cause of cancer-associated death universally. Currently, the diagnosis, prognosis, and treatment monitoring of CRC mostly depends on endoscopy integrated with tissue biopsy. Recently, liquid biopsy has gained more and more attention in the area of molecular detection and monitoring of tumors due to ease of sampling, and its safe, non-invasive, and dynamic nature. Platelets, despite their role in hemostasis and thrombosis, are known to have an active, bifacial relationship with cancers. Platelets are the second most common type of cell in the blood and are one of the wealthy liquid biopsy biosources. These cells have the potential to absorb nucleic acids and proteins and modify their transcriptome with regard to external signals, which are termed tumor-educated platelets (TEPs). Liquid biopsies depend on TEPs’ biomarkers which can be used to screen and also detect cancer in terms of prognosis, personalized treatment, monitoring, and prediction of recurrence. The value of TEPs as an origin of tumor biomarkers is relatively new, but platelets are commonly isolated using formidable and rapid techniques in clinical practice. Numerous preclinical researches have emphasized the potential of platelets as a new liquid biopsy biosource for detecting several types of tumors. This review discusses the potential use of platelets as a liquid biopsy for CRC.

Duodenal web is complete or incomplete obstruction of the duodenum due to a membranous web or intraluminal diverticulum. This abnormality is one of the main causes of intestinal obstruction in children. The symptoms of this disease may rarely appear in older age and cause gastric outlet obstruction in adults. In the present paper, we report a 69-year-old male patient with heartburn, abdominal discomfort, frequent non-bilious, non-bloody vomiting for the past 6 months. Furthermore, the patient had experienced a weight loss of 12 kg during this period. He had been taking aspirin daily for years due to his ischemic heart disease. After performing contrast-enhanced CT imaging, esophagogastroduodenoscopy and barium meal examination, the patient was diagnosed to suffer from duodenal web. Since surgery is currently the mainstay of treatment in the management of this disease, the patient finally underwent a gastrojejunostomy.

To report the study protocol, methodology and latest enrollment data of a large epidemiological multi-central eye cohort named PERSIAN Eye Cohort Study (PECS), originating from the ongoing PERSIAN Cohort Study, to investigate the distribution of ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature.

A central committee designed the study and equipped six chosen centers (Khameneh, Some’e Sara, Hoveizeh, Yazd, Rafsanjan and Zahedan). A focal point in each center conducted the study under close supervision of the central committee.

This ongoing study was launched in 2014. Out of 65,580 eligible participants of the PERSIAN Cohort, 48,618 individuals aged 35-70 have been enrolled in the PECS (response rate: 74.13%) until June 2021. Slit lamp and fundus photography were performed for 28,702 (59.03%) and 27,437 (56.43%) individuals, respectively.

This large epidemiological multi-central eye cohort can improve our epidemiological knowledge of the prevalent ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature. This will be very useful for future planned nationwide and global interventions.