Bayesian spatial analysis of age differences and geographical variations in illicit-drug-related mortality in the Islamic Republic of Iran.

Background: Drug use disorders are significant social and public health concerns in the Islamic Republic of Iran; however, little is known about drug-related mortality. Aims: We quantified the spatial and age distribution of direct illicit-drug-related mortality in the Islamic Republic of Iran, to inform harm reduction policies and interventions. Methods: We modelled and mapped registered illicit-drug-related deaths from March 2016 to March 2017. Data were obtained from the Iranian Forensic Medicine Organization. Besag-York-Mollie models were fitted using Bayesian spatial analysis to estimate the relative risk of illicit-drug-related mortality across different provinces and age groups. Results: There were 2203 registered illicit-drug-related deaths during the study period, 1289 (58.5%) occurred in people aged 20-39 years and among men (n = 2013; 91.4%). The overall relative risk (95% credible interval) of illicit-drug-related mortality in the provinces of Hamadan (3.37; 2.88-3.91), Kermanshah (1.90; 1.55-2.28), Tehran (1.80; 1.67-1.94), Lorestan (1.71; 1.37-2.09), Isfahan (1.40; 1.21-1.60), and Razavi Khorasan (1.18; 1.04-1.33) was significantly higher than in the rest of the country. Conclusion: We found evidence of age differences and spatial variations in illicit-drug-related mortality across different provinces in the Islamic Republic of Iran. Our findings highlight the urgent need to revisit existing drug-use treatment and harm reduction policies and ensure that overdose prevention programmes are adequately available for different age groups and settings.

Expression analysis of a panel of long non-coding RNAs (lncRNAs) revealed their potential as diagnostic biomarkers in bladder cancer.

INTRODUCTION: Long non-coding RNAs (lncRNAs) have fundamental roles in cell migration, proliferation, invasion and metastasis. METHODS: In the current study, we evaluated expression of a panel of lncRNAs in bladder cancer tissues, adjacent non-cancerous tissues (ANCTs) and normal bladder tissues to evaluate their diagnostic power. RESULTS: PV1 was down-regulated in tumor tissues compared with both ANCTs and normal controls (Expression ratios of 0.48 and 0.14; P values of 0.4 and <0.001 respectively). HOTAIR, NEAT1, TUG1 and FAS-AS1 were significantly down-regulated in tumor tissues compared with normal controls (Expression ratios of 0.4, 0.68, 0.54 and 0.11; P values of 0.04, 0.02, 0.02 and <0.001 respectively). CONCLUSION: Combination of transcript levels of seven lncRNAs improved both sensitivity and specificity values to 100%. The current study shows dysregulation of lncRNAs in bladder cancer and implies their role as diagnostic markers in this malignancy.

Co-Administration of Progesterone and Melatonin Attenuates Ischemia-Induced Hippocampal Damage in Rats.

Stroke is the second leading reason for death worldwide and is one of the fundamental causes of long-term disabilities. The aim of this investigation was to assess the impact of combined administration progesterone (PROG) and melatonin (MEL) on stroke complications. Male Wistar rats (9-10 weeks) weighing 250-300 g were used as a part of this examination. They were randomly separated into eight groups (nine rats for every group). Common carotid arteries on the two sides clamped (BCCAO model) with non-traumatic clips for 20 min. At that point, the rats were treated with 8 mg/kg PROG, 10 mg/kg MEL, and vehicles (sesamoid and normal saline). Morris water maze testing was performed following 2 weeks. At that point, the rats were euthanized, and histological examination was directed. The outcome demonstrated that utilization of PROG and MEL in treatment groups essentially increases the quantity of pyramidal cells and enhances spatial memory compared to non-treatment groups (p < 0.05). Moreover, the neuroleptic factor gene expression and protein concentration were significantly enhanced in the treated groups (p < 0.05). As indicated by the outcomes, co-administration of PROG and MEL can enhance learning and memory by surviving the pyramidal neurons and diminishing neural death by means of increasing neuroleptic factors in the hippocampal CA1 zone.

Trend of years of life lost due to suicide in Iran (2006-2015).

OBJECTIVES: Suicide is a major global public health problem and much burden in the societies. This study aims to calculate the years of life lost (YLL) due to suicide and investigate its trend in Iran. METHODS: Information on deaths due to suicide in Iran was extracted from Iran Legal Medicine Organization. The years of life lost was calculated in each year according to gender and age-groups. To examine the trend for different years, joinpoint regression was used. RESULTS: The 35,297 deaths due to suicide were recorded in 2006-2015. The total YLL in the 10-year period was 34.52 per 1000 persons in males, 13.61 per 1000 persons in females and 23.35 per 1000 persons in both sexes. Hanging comprised the largest YLL of suicide. The annual percent change of YLL rate was 3.3%. CONCLUSIONS: The results revealed that male shows an increasing trend in YLL specifically among youth and adult, while there is no improvement in females. There is a national need to implement an effective health policy intervention in Iran.

Modeling spatio-temporal variations of substance abuse mortality in Iran using a log-Gaussian Cox point process.

Substance use disorder is one of the main mental health problems in Iran. In this paper, the six-monthly counts of deaths due to substance abuse in Iran at provincial level between March 21, 2005, and March 20, 2014, were modeled using a log-Gaussian Cox point process model. By assuming population density as the exposure variable, the considered model incorporated known and unknown influential factors in order to describe spatio-temporal variations in the relative risk of substance abuse mortality. We found evidence of spatial heterogeneity and inequality by gender in deaths related to substance abuse across Iran. This study provides the first evidence in Iran on the spatio-temporal heterogeneity in mortality caused by substance use disorders.

The comparison of spiritual health and self-esteem in women with and without sexual violence.

BACKGROUND AND AIM: Sexual violence is a serious public health problem which is common around the world. The aim of this study was to evaluate spiritual health and self-esteem in sexual violence victims. METHODS: This cross-sectional study was performed on 66 subjects in the group of sexual violence women and 147 subjects in the group of women with no experience of sexual violence who referred to Tehran Forensic Medical Center and the health centers of Shahid Beheshti University of Medical Sciences respectively, in 2015, in Tehran, Iran. Sexual violence was considered as vaginal or anal penetration. Paloutzian & Ellison spiritual health questionnaire and Rosenberg self-esteem scale were used for data collecting. Data were analyzed using IBM-SPSS version 21. The Kolmogorov Simonov test was used for normality distribution of variables. Descriptive and the Mann-Whitney tests were used to analyze the data. Statistical significance was set to p<0.05. RESULTS: Sexual activity in both groups was started at 20 years old. Most of the abused subjects were single (48.8%), with education level below diploma (55.2%), unemployed (67%) and with an average annual income of 200 million Rials ($7,000). Familiarity with the offender was mostly as friendship (42.4%), and the offence had occurred through deception (37.8%). No significant difference was found between the total mean scores of self-esteem in the two groups (M1: 21.89, M2: 21.02; p=0.76) while a significant difference was seen between the mean scores of spiritual health, which indicates a lower level of spiritual health in women with sexual violence (M1: 74.59 (2.03), M2: 86.39 (3.12); p<0.001). CONCLUSION: The results of the present study highlight the importance of spirituality in sexual violence so policies to promote spiritual health are recommended to protect women.

Comparison of endoscopic versus conventional internal mammary harvesting regarding unligated side branches.

BACKGROUND: In an effort to minimise access in cardiac surgery, endoscopic vessel harvesting has become more popular. The endoscopic approach, however, allows for only the harvest of the mid to distal internal mammary artery (IMA), leaving the more proximal branches of the conduit available for collateral flow away from the coronary bed. AIM: To compare the number and anatomic variation of remaining side branches in thoracoscopic vs. conventional IMA harvesting. METHODS: 199 fresh cadavers were randomly divided into two groups. Group A (n = 100) underwent endoscopic IMA harvesting. In Group B (n = 99), IMAs were harvested using an open conventional approach. In both groups during surgery, side branches of the IMA were isolated and identified. RESULTS: The two groups were comparable with regard to mean age and age distribution, male sex (56% vs. 63%, respectively), cause of death and coronary risk factors including smoking, diabetes, dyslipidaemia and hypertension. 24 of 199 cadavers(12%) had a lateral costal branch. The left IMA arose from the third part of the subclavian artery in 6%, and from the thyrocervical trunk in 7% of the cadavers. There were significantly more unligated side branches in Group B compared to Group A (14 branches vs. 3 branches, p < 0.01). The first intercostal artery and lateral costal artery were found unligated in 3% and 5% of cadavers in Group B, whereas no side branch remained unligated in Group A. There was no subclavian artery or IMA injury in either group. Internal mammary vein was damaged in 2% of cadavers in Group B. CONCLUSIONS: Thoracoscopic left IMA harvesting is more accurate in finding and ligating the side branches of IMA.

The value of radius bone in prediction of sex and height in the Iranian population.

OBJECTIVE: Measurement of anthropometric parameters of long bones can be applied in sex determination and height prediction. The aim of this study was to investigate the value of length of the radius in forensic identification. MATERIALS AND METHODS: Cross-sectional analysis of anthropometric parameters of the radius was done by Legal Medicine Organization of Tehran, Iran studying fresh cadavers of Iranian population during 2009 and 2010. RESULTS: This study surveyed length of radius of 106 fresh Iranian cadavers, 61 men and 45 women, in the age range of 10-85 years old. The study showed that genders can be distinguished using the length of radius with a sensitivity of 83% and specificity of 96%. Using the regression test, there was significant relation between the height of persons and the length of radius bone. The equations were obtained to estimate the height of the individuals on the basis of radius bone length in different age groups, with an exception in females of 40-64 Years old. CONCLUSION: In the cases of fresh cadavers, by using the length of radius, we could be able to determine the length of height and gender with high confidence.

The anatomical relation between the superior sagittal sinus and the sagittal suture with surgical considerations.

OBJECTIVE: Localization of superior sagittal sinus before craniotomy is very crucial to prevent the complications of surgery. The goal of this study was to verify the anatomical relationship between the sagittal suture and the superior sagittal sinus (SSS). METHODS: Fifty adult cadavers were included in this descriptive analytic study. The length of sagittal suture and the width of sagittal suture and SSS were measured in three points: (bregma), (lambda) and midpoint of sagittal suture. Anatomical relationship between SSS and sagittal suture was analyzed. RESULTS: Superior sagittal sinus was deviated to the right side of the sagittal suture in 54% of cases at bregma and 64% of cases at the midpoint of sagittal suture and lambda. SSS was located at the right side of sagittal suture about 3.5mm at bregma, 4.5mm at midpoint of sagittal suture and 5.7 mm at lambda. The right transverse sinus was dominant in 76% of cases. No gender-associated difference was noticed. CONCLUSION: Our study demonstrates that SSS is deviated to the right side of sagittal suture in the majority of cases. Maximum deviation of SSS to the right side is about 10mm. Neurosurgeons are advised to be aware of this anatomical relation while operating around SSS.

Vascular supply to the acetabular labrum.

BACKGROUND: The acetabular labrum plays an important role in hip joint stability and protection of the articular cartilage of the hip. Despite this, few investigators have evaluated its microscopic vasculature and, to our knowledge, none has assessed its macroscopic blood supply. The purposes of this study were to identify the origin and course of the vascular supply to the acetabular labrum to determine if this blood supply is affected by a labral tear. METHODS: Colored silicone was injected into the vascular tree proximal to thirty-five hips in twenty-eight fresh cadavers. Twenty-four hours after injection, anatomic dissection was performed and the vessels supplying the labrum were followed from their origin to their final distribution. Additionally, labral segments of fifteen randomly selected hips were resected to assess the acetabular rim's vascular contribution, and fifteen hips were dislocated for complete intra-articular inspection of the labrum. RESULTS: Radial branches of a previously described periacetabular periosteal vascular ring were identified as the source of labral blood supply in all thirty-five hips. These branches coursed toward the hip joint on the periosteal surface, penetrated the joint capsule near its innominate insertion, and continued within a loose connective-tissue layer on the capsular surface of the labrum. No contribution from the hip capsule, synovial lining, or osseous acetabular rim could be demonstrated. An intact vascular supply was identified in all seven hips with a labral tear. CONCLUSIONS: The acetabular labrum receives its blood supply from radial branches of a periacetabular periosteal vascular ring that traverses the osseolabral junction on its capsular side and continues toward the labrum's free edge. The hip capsule, the synovial lining, and the osseous acetabular rim do not appear to provide substantial contributions to the labral blood supply.

Anatomic variations of midfacial muscles and nasolabial crease: a survey on 52 hemifacial dissections in fresh Persian cadavers.

BACKGROUND: The midfacial region is a challenging area for plastic surgeons and may vary among different races. OBJECTIVES: The aim of this study was to determine the patterns of midfacial muscles in Persian (Iranian) subjects. METHODS: Hemifacial fresh cadaver dissection was performed. For each cadaver, demographics, side of dissection, variation in midfacial muscles (levator alae nasi, levator labii superioris, zygomaticus major [single and bifid], zygomaticus minor, and risorius), midfacial pattern (based on Pessa classification), nasolabial shape (concave, convex, straight) and length were obtained. RESULTS: Fifty-two hemifacial dissections were performed on 27 cadavers, of which 22 were male (81.4%). The mean age of the subjects was 40.1 +/- 14.8 years. The mean of nasolabial length was 46.4 +/- 8.3 mm (ranged from 28 to 63 mm). Straight form of nasolabial crease was the most frequent type (n = 26.50%). Levator alae nasi, levator labii superioris, and zygomaticus major were found in 100% of the subjects; however, it was not the same regarding other muscles. The incidence of bifid zygomaticus major was 19.2% (10 hemifacials) in our series. Midfacial pattern type 3 was the most common in our study, which found this type in 21 hemifacials (40.3%). We also found a new type of facial pattern in three cadavers. In this type, which is relatively similar to the type 5 of Pessa's classification, zygomaticus minor was absent and the zygomaticus major was bifid. CONCLUSIONS: This study revealed that midfacial pattern and nasolabial crease shape are different between Persian (Iranian) and Western subjects. It seems that based on these differences and some other unknown anatomic diversity between different races, some of the defined cosmetic frames may need minor revisions to be applicable for Persian faces. More studies in this field are recommended.

Study of the normal internal organ weights in Tehran's population.

OBJECTIVE: Examine the normal adult internal organ weight and its relationship with body height, body weight, body mass index and age. MATERIALS AND METHODS: Prospective analysis of data from 1222 autopsies in Legal Medicine Organization of Iran from 1st January, 2007 to 1st September, 2008. All the subjects were adult residents of Tehran died from external causes and showed no pathological changes. RESULTS: The weight of the brain, heart, lungs, liver, spleen, pancreas, kidneys, thyroid gland, the pituitary gland, the suprarenal glands, testes, prostate, ovaries and the uterus were collected from 914 males and 308 females between 15 and 88 years. The weight of all the organs was correlated statistically with at least one external parameter with the exception of the pancreas in men, the uterus, the spleen and the thyroid in women. Organ weights decreased with age except for the heart and the prostate, and increased in relation to body height and/or BMI. Except for the brain, the organ weight showed a better statistical correlation with the BMI than the body height. CONCLUSION: These results can be used as standard organ weights to determine abnormal evidences in Forensic and Pathologic corpses. However such results have to be regularly updated by pathologists in order to keep organ weight as a good criterion used in postmortem diagnosis.

The cerebral arterial circle (circulus arteriosus cerebri): an anatomical study in fetus and infant samples.

BACKGROUND: Many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle while a few have addressed the variations of the cerebral arterial circle as a whole. METHODS: Thirty brains of recently deceased Iranian infants and fetuses were dissected. The dissection process was filmed and digitized so as to be readily available for further studies. The variations of the circle as a whole and segmental variations were evaluated. RESULTS: Variants with uni- and bilateral hypoplasia of posterior communicating arteries (PcoAs) were the most common in our study, similar to previous works. No aplasia of the precommunicating part of the anterior cerebral artery (A1), the precommunicating part of the posterior cerebral artery (P1) and anterior communicating artery was seen. Hypoplasia of the right and left PcoA was observed in 8 and 5 cases, respectively. Aplasia of the right PcoA was found in 16.6% and of the left PcoA in 3.3%. CONCLUSION: In this study, we confirmed the previously described finding that the symmetrical, circular configuration of the circulus arteriosus cerebri is present in only about 42.1%. The main differences between the fetal and adult disposition are the diameter of the PcoA and the circular part of the posterior cerebral artery. According to previous studies, the fetal brain older than 4 months has anatomical characteristics very similar to the adult's circle; our finding was mostly similar to adult samples as most samples were from infants, not fetuses.

Are the distributions of variations of circle of Willis different in different populations? - Results of an anatomical study and review of literature.

BACKGROUND: Previous studies have proposed correlation between variants of the cerebral arterial circle (also known as circle of Willis) and some cerebrovascular diseases. Differences in the incidence of these diseases in different populations have also been investigated. The study of variations in the anatomy of the cerebral arterial circle may partially explain differences in the incidence of some of the cerebrovascular diseases in different ethnic or racial groups. While many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle, few have addressed the variants of the cerebral arterial circle as a whole. Similarly, the frequency of occurrence of such variants in different ethnic or racial groups has not been compared. METHODS: 102 brains of recently deceased Iranian males were dissected, in order to observe variations in the anatomy of the cerebral arterial circle. The dissection process was recorded on film and digitized. One resized picture from each dissection, showing complete circle has been made available online. The variations of the circle as whole and segmental variations were compared with previous studies. RESULTS: On the whole, the frequencies of the different variants of the entire cerebral arterial circle and segmental variations were comparable with previous studies.More specifically variants with uni- and bilateral hypoplasia of posterior communicating arteries were the most common in our study, similar to the previous works. No hypoplasia of the precommunicating part of the left anterior cerebral artery (A1), aplasia of A1 or the precommunicating part of the posterior cerebral artery (P1) was seen. In 3% both right and left posterior communcating arteries were absent. CONCLUSION: The anatomical variations found in the cerebral arterial circle of the Iranian males in the current study were not significantly different to those of more diverse populations reported in the literature. While taking into account potential confounding factors, the authors conclude that based on available studies, there is no evidence suggesting that the distributions of the variations of cerebral arterial circle differ in different populations.