The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis.

BACKGROUND: Seat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers. METHODS: The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis. RESULTS: Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis. CONCLUSIONS: In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.

Epidemiological and clinical risk factors related to severe COVID-19 in Iran: a multi-center study.

BACKGROUND: Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors related to the severity of COVID-19 in one of the less privileged areas in Iran. METHODS: In a multi-center study, all patients admitted to Zahedan University of Medical Sciences hospitals in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological, and clinical data of patients were extracted from medical records. Bivariate and multivariate logistic regression models were used to explore the risk factors associated with the severity of COVID-19. RESULTS: Among the 413 patients, 55.5% were male, and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 2.27; 95% CI 1.41-3.65), substance abuse (OR 2.49; 95% CI 1.14-5.43), having one underlying disease (OR 1.52; 95% CI 0.90-2.55), having two underlying disease (OR 2.31; 95% CI 1.19-4.50), and having three or more underlying disease (OR 2.60; 95% CI 1.19-5.66). CONCLUSIONS: COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with the underlying disease. Understanding the factors affecting the disease severity can help the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.

Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016.

BACKGROUND: The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases. METHODS: We used the Global Burden of Disease (GBD) Study 2016 estimates of stroke incidence and the competing risks of death from any cause other than stroke to calculate the cumulative lifetime risks of first stroke, ischemic stroke, or hemorrhagic stroke among adults 25 years of age or older. Estimates of the lifetime risks in the years 1990 and 2016 were compared. Countries were categorized into quintiles of the sociodemographic index (SDI) used in the GBD Study, and the risks were compared across quintiles. Comparisons were made with the use of point estimates and uncertainty intervals representing the 2.5th and 97.5th percentiles around the estimate. RESULTS: The estimated global lifetime risk of stroke from the age of 25 years onward was 24.9% (95% uncertainty interval, 23.5 to 26.2); the risk among men was 24.7% (95% uncertainty interval, 23.3 to 26.0), and the risk among women was 25.1% (95% uncertainty interval, 23.7 to 26.5). The risk of ischemic stroke was 18.3%, and the risk of hemorrhagic stroke was 8.2%. In high-SDI, high-middle-SDI, and low-SDI countries, the estimated lifetime risk of stroke was 23.5%, 31.1% (highest risk), and 13.2% (lowest risk), respectively; the 95% uncertainty intervals did not overlap between these categories. The highest estimated lifetime risks of stroke according to GBD region were in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk was in eastern sub-Saharan Africa (11.8%). The mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% uncertainty interval, 6.2 to 11.5); the competing risk of death from any cause other than stroke was considered in this calculation. CONCLUSIONS: In 2016, the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. There was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe. (Funded by the Bill and Melinda Gates Foundation.).

Neurological features and outcome in COVID-19: dementia can predict severe disease.

The COVID-19 pandemic has infected more than 22 million people worldwide. Although much has been learned about COVID-19, we do not know much about its neurological features and their outcome. This observational study was conducted on the patients of Imam Hossein Hospital, and 361 adult patients (214 males) with confirmed diagnosis of COVID-19 from March 5, 2020 to April 3, 2020, were enrolled. Data was gathered on age, sex, comorbidities, initial symptoms, symptoms during the disease course, neurological symptoms, and outcome. The mean age of the patients was 61.90 ± 16.76 years. The most common initial symptoms were cough, fever, and dyspnea. In 21 patients (5.8%), the initial symptom was neurological. History of dementia was associated with severe COVID-19 disease (odds ratio = 1.28). During the course of the disease, 186 patients (51.52%) had at least one neurological symptom, the most common being headache (109 [30.2%]), followed by anosmia/ageusia (69, [19.1%]), and dizziness (54, [15%]). Also, 31 patients had neurological complications (8.58%). Anosmia, ageusia, dizziness, and headache were associated with favorable outcome (P < 0.001), while altered mental status and hemiparesis were associated with poor outcome. The mortality rate of patients who had neurological complications was more than twice than that of patients without neurological complication (P = 0.008). Almost half of the patients experienced at least one neurological symptom, which may be the initial presentation of COVID-19. Dementia appears to be associated with severe COVID-19. Mortality was higher in patients with neurological complications, and these patients needed more intensive care.

The economic burden of tuberculosis in Sistan: a high-risk region in Iran.

INTRODUCTION: To estimate the economic burden of tuberculosis treatment in Sistan, the region with the highest number of tuberculosis cases in Iran. METHODS: All patients with smear-positive pulmonary tuberculosis who had contracted tuberculosis in 2018 and successfully completed their treatment were interviewed. RESULTS: Ninety patients with a mean age of 57 ± 18 years were interviewed. Most of them were women (58%), housewives (57%) and resided in rural areas (84%). The mean cost of treatment for tuberculosis was estimated as 6800 USD per patient. Direct costs were 87% of the total cost. Twenty-two patients lost an average income of 530 USD (8514590 rials) during treatment. The results showed the significant correlation of direct and indirect costs with sex, age, place of residence and education (P < 0.05). CONCLUSION: It appears essential to improve social protection and implement interventions to promote knowledge in rural areas.

Enhanced Estimation of Root Zone Soil Moisture at 1 km Resolution Using SMAR Model and MODIS-Based Downscaled AMSR2 Soil Moisture Data.

Root zone soil moisture (RZSM) is an essential variable for weather and hydrological prediction models. Satellite-based microwave observations have been frequently utilized for the estimation of surface soil moisture (SSM) at various spatio-temporal resolutions. Moreover, previous studies have shown that satellite-based SSM products, coupled with the soil moisture analytical relationship (SMAR) can estimate RZSM variations. However, satellite-based SSM products are of low-resolution, rendering the application of the above-mentioned approach for local and pointwise applications problematic. This study initially attempted to estimate SSM at a finer resolution (1 km) using a downscaling technique based on a linear equation between AMSR2 SM data (25 km) with three MODIS parameters (NDVI, LST, and Albedo); then used the downscaled SSM in the SMAR model to monitor the RZSM for Rafsanjan Plain (RP), Iran. The performance of the proposed method was evaluated by measuring the soil moisture profile at ten stations in RP. The results of this study revealed that the downscaled AMSR2 SM data had a higher accuracy in relation to the ground-based SSM data in terms of MAE (↓0.021), RMSE (↓0.02), and R (↑0.199) metrics. Moreover, the SMAR model was run using three different SSM input data with different spatial resolution: (a) ground-based SSM, (b) conventional AMSR2, and (c) downscaled AMSR2 products. The results showed that while the SMAR model itself was capable of estimating RZSM from the variation of ground-based SSM data, its performance increased when using downscaled SSM data suggesting the potential benefits of proposed method in different hydrological applications.

Systematic review and meta-analysis of hospital acquired infections rate in a middle east country (1995-2020).

Background: Hospital-acquired infections (HAIs) are a global problem in hospitals and significant causes of mortality and morbidity regardless of advances in supportive care, antimicrobial therapy and prevention. The study aimed to determine a comprehensive estimate of the HAIs prevalence, influential factors, and types of these infections in Iran. Methods: A systematic literature review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the online databases; Medline, EMBASE, Scopus, Cochrane, SID, Magiran, and Medlib from January 1995 to September 2020 using a combination of medical subject heading terms ('Nosocomial infection [Mesh] OR '' Hospital infection [Mesh] OR Hospital Acquired Infection[Mesh] OR Healthcare-associated infection ''AND ('Iran' [Mesh]) among observational and interventional studies. SPSS version 25 and STATA version 11 were used for data analysis. Results: A total of 66 (cross-sectional, cohort, and case-control) observational studies were identified. More of the studies had been done before 2014(43 papers or 65%). Based on the random-effects model, the overall prevalence of HAIs in Iran was 0.111 [95% CI: 0.105 - 0.116] with a high, statistically significant heterogeneity (I2= 99.9%). The infection rate was 0.157 and 0.089 before and after the Iranian Health Transformation Plan (HTP), respectively. HAIs rates reported more in the South and West of Iran rather than other regions (0.231 and 0.164) (p= 0.001). Escherichia coli and klebsiella infections were reported in 53 and 52 papers (0.239 and 0.180, respectively). In addition, respiratory and urinary infections were reported 0.296 and 0.286 in 51 and 38 papers, respectively. Conclusion: The prevalence of HAIs in Iran is relatively high. Preventing and decreasing hospital nosocomial infections can considerably affect reducing mortality and health-related costs. This should be taken into consideration by health policymakers for pathology and revision of some previous programs and standards as well as the development of appropriate and evidence-based control and education programs to reduce this health problem.

Comorbidity of metabolic syndrome components in a population-based screening program: A latent class analysis.

Background: The prevalence of metabolic syndrome (MS) is rapidly increasing in the world. Thus, the aim of the present study was to identify the latent subgroups of Iranian male adults based on MS components and investigate the effect of abnormal alanine aminotransferase (ALT) and aspartate aminotransferase (AST), high total cholesterol (TC), and low-density lipoprotein (LDL) on the odds of membership in each class. Methods: In the present study, we used the data of a population-based screening program conducted on 823 urban adult men aged 25 years and older in city of Qom in 2014. Abdominal obesity, fasting blood sugar (FBS), blood pressure, and serum lipid profile were measured in participants after for at least 8 hours. MS was defined according to the Adults Treatment Panel III criteria. Latent class analysis was used to achieve the aims of study. Analyses were conducted using PROC LCA in SAS 9.2 software. In all analysis, p value < 0.05 was considered statistically significant. Results: There were 3 different latent classes among participants. Latent class 1, non-MS, 55.1%; latent lass 2, at risk, 21.3%; and finally latent class 3, MS, with 23.6% of the participants. Age (OR=0.98, 95% CI: 0.98-0.99, high LDL (OR=0.27, 95% CI: 0.13-0.56), high TC (OR=8.12, 95% CI: 4.40-15.00), and abnormal ALT (OR=2.25, 95% CI 1.49-3.41) were associated with at risk class. Also, only age (OR=1.02, 95% CI: 1.01-1.04) was associated with MS class. The most prevalent components among the participants were having low HDL (34.0%) and high WC (33.9%). Conclusion: Notable percent of samples fell in "at risk" and "MS" classes, which stress the necessity of designing preventive interventions for these specific stratums of population.

Association between the flap endonuclease 1 gene polymorphisms and cancer susceptibility: An updated meta-analysis.

Flap endonuclease 1 (FEN1) has emerged as an important enzyme in the maintenance of genomic instability and preventing carcinogenesis. The relationship between FEN1 -69G>A (rs174538)+4150G>T (rs4246215) polymorphisms and cancer susceptibility has been reported; however, results were inconclusive. In the present study, a meta-analysis of data from eligible reports was carried out to summarize the possible relationship between FEN1 polymorphisms and cancer risk. A total of 11 articles, including 20 studies with 7366 cases and 9028 controls and 18 studies with 6649 cases and 8325 controls for FEN1 rs174538 and FEN1 rs4246215 polymorphisms, respectively, were recruited for meta-analysis. Overall, meta-analyses showed that FEN1 rs174538 and rs4246215 polymorphisms are significantly associated with the decreased risk of cancer. The stratified analysis proposed that both variants were associated with protection against gastrointestinal cancer, breast cancer, hepatocellular cancer, esophageal cancer, gastric cancer, colorectal cancer, and lung cancer. In conclusion, this meta-analysis revealed an association between FEN1 polymorphisms and cancer risk. Additional studies in a larger study population that include subjects from a variety of ethnicities are warranted to further verify our findings.

Exome sequencing revealed a p.G299R mutation in the COMP gene in an Iranian family suffering from pseudoachondroplasia.

BACKGROUND: Short-stature (SS) is multifactorial pathologic condition that originates from either genetic or environmental factors. The diagnosis is based on family history, clinical findings, radiological examination and genetic analysis. A variety of genes have been reported for SS, among which FGFR-3 was the main gene in achondroplasia and hypochondroplasia. In other forms of SS, the gene involved varies from one patient to another. Whole exome sequencing (WES) and comparative genomic hybridization (CGH) have recently introduced a growing body of genes annually. The present study performed a WES analysis on an Iranian family suffering from an inherited form of SS aiming to diagnose the causative gene. The father and all of his four sons were diagnosed as SS. METHODS: The blood samples were collected from the proband and his available family members. Genomic DNA was extracted using salting-out method. The DNA of the proband was analyzed using WES and confirmed through polymerase chain reaction (PCR)-sequencing. The WES-extracted variant was evaluated in silico using software aiming to determine whether this nucleotide change is pathogenic. The presence of the variant was traced in other affected family members using PCR-sequencing. RESULTS: Following segregation analysis, variant c.896 G>A of the COMP gene was found in all of the affected individuals in a heterozygous form. This variant resulted in substitution of glycine 299 with arginine and was previously predicted as pathogenic in the Human Gene Mutation Database dataset, although it represents the first report in Iran. CONCLUSIONS: The findings of the present study suggest consideration of the c.896 G>A variant of the COMP gene with respect to the genetic counseling of inherited skeletal dysplasia in Iran.

The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: A randomized double-blind controlled trial.

BACKGROUND: The current study was designed to assess the effect of supplementation with a 14-strain probiotic mixture on episodic and chronic migraine characteristics. METHODS: Forty episodic and 39 chronic migraine patients who completed this randomized double-blind controlled trial received two capsules of multispecies probiotic or placebo. The migraine severity was assessed by visual analog scale (VAS). The number of abortive drugs consumed, migraine days, frequency and duration of attacks were recorded on paper-based headache diaries. Serum tumor necrosis factor alpha (TNF-α) and C- reactive protein (CRP) levels were measured at baseline and the end of the intervention. RESULTS: After a 10-week intervention, among episodic migraineurs the mean frequency of migraine attacks significantly reduced in the probiotic group compare to the placebo group (mean change: -2.64 vs. 0.06; respectively, p < 0.001). A significant reduction was also evident in the migraine severity (mean decrease: -2.14 in the probiotic group and 0.11 in the placebo group; p < 0.001). Episodic migraineurs who received the probiotic also showed significant reduction in abortive drug usage per week (mean change: -0.72; p < 0.001) compare to baseline, while there was no significant changes within the placebo group. In chronic migraine patients, after an 8-week intervention, the mean frequency of migraine attacks significantly reduced in the probiotic compared to the placebo group (mean change: -9.67 vs. -0.22; p ≤ 0.001). In contrast to the placebo, probiotic supplementation significantly decreased the severity (mean changes: -2.69; p ≤ 0.001), duration (mean changes: -0.59; p ≤ 0.034) of attacks and the number of abortive drugs taken per day (mean changes: -1.02; p < 0.001), in chronic migraine patients. We failed to detect any significant differences in the serum levels of inflammatory markers at the end of the study either in chronic or in episodic migraineurs. DISCUSSION: The results of this study showed that the 14-strain probiotic mixture could be an effective and beneficial supplement to improve migraine headache in both chronic and episodic migraineurs. Further research is required to confirm our observations.

The association between dietary tryptophan intake and migraine.

Migraineurs have been identified to have chronically decreased serotonin levels while its concentrations markedly increase during ictal periods. Regarding the importance of adequate tryptophan intake in regulating serotonin homeostasis and subsequent effect on migraine attacks, we designed the current study. The migraine group (n = 514, diagnosed according to the ICHDIII criteria) was recruited from a tertiary headache clinic. The controls consisted of 582 sex-matched healthy volunteers who were randomly selected from general population. After collecting demographic and anthropometric data, a validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used for dietary intake assessments. Multiple regression models were applied to explore the relationship between migraine and tryptophan intake. The mean (SD) of the age of participants in the controls and migraine group was 44.85 (13.84) and 36.20 (9.78) years, respectively. The multiple regression models were adjusted for age (year), sex, body mass index (BMI) (kg/m2), total daily energy intake (kcal/day), dietary intakes of total carbohydrates (g/day), animal-based protein (g/day), plant-based protein (g/day), total fat (g/day), saturated fat (g/day), and cholesterol (mg/day). It was shown that there is a negative association between tryptophan intake and migraine risk ((OR in the 3rd quartile = 0.46; 95% CI = 0.25-0.85) (OR in the 4th quartile = 0.40; 95% CI = 0.16-0.98) compared with the first quartile; P for trend = 0.045). Therefore, our results showed that subjects who had a median intake of 0.84-1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54-60%, relative to those consumed ≤ 0.56 g/day.

Three Cases of Trigeminal Neuralgia with Radiographic Absence of Meckel's Cave.

Trigeminal neuralgia (TN) is a debilitating but treatable disease. Classic TN has referable vascular compression of the trigeminal nerve, but rarely secondary sources of anatomic compression will present, including vascular malformations, aneurysms, or tumors. Understanding the etiology of the patients' symptoms leads to targeted treatment. Three patients presented with symptoms consistent with TN: shooting, paroxysmal pains in the distribution of the trigeminal nerve. However, imaging revealed no vascular conflict at the root entry zone of the trigeminal nerve. Instead, on the affected side Meckel's cave was absent. No other compressive mass lesion was identified. In all three cases, patients were offered both Gamma Knife Radiosurgery and surgical decompression of Meckel's cave. All 3 patients elected to proceed with stereotactic radiation and reported improvement in pain. Many cases of classic TN can be explained by neurovascular conflict at the trigeminal root entry zone, but secondary sources of compression or restriction along the nerve can result in similar symptomology. In this case series, an absent or hypoplastic ipsilateral Meckel's cave may have produced symptoms consistent with TN. Imaging with fine cuts through Meckel's cave is an important diagnostic tool.

Climate data clustering effects on arid and semi-arid rainfed wheat yield: a comparison of artificial intelligence and K-means approaches.

Clustering algorithms are critical data mining techniques used to analyze a wide range of data. This study compares the utility of ant colony optimization (ACO), genetic algorithm (GA), and K-means methods to cluster climatic variables affecting the yield of rainfed wheat in northeast Iran from 1984 to 2010 (27 years). These variables included sunshine hours, wind speed, relative humidity, precipitation, maximum temperature, minimum temperature, and the number of wet days. Seven climatic factors with higher correlations with detrended rainfed wheat yield were selected based on Pearson correlation coefficient significance (P value < 0.1). Three variables (i.e., sunshine hours, wind, and average relative humidity) were excluded for clustering. In the next step based on Pearson correlation (P value < 0.05) between the yield, and the seven climate attributes, fitness function, and silhouette index, only four attributes with higher correlation in its cluster were selected for reclustering. Four climate attributes had an extensive association with yield, so we used four-dimensional clustering to describe the common characteristics of low-, medium-, and high-yielding years, and this is the significance of this research that we have done four-dimensional clustering. The silhouette index showed that the best number of clusters for each station was equal to three clusters. At the last step, reclustering was done through the best-selected method. The results yielded that GA was the best method.

Intimate partner violence against Iranian women.

Background: . WHO has identified intimate partner violence (IPV) as a health priority as it has considerable consequences on the physical and psychological health of women. We aimed to evaluate the prevalence of IPV in women of one of the central cities of Iran in addition to examining the effect of a women's job and spousal addiction on IPV. Methods: We did a cross-sectional study on 240 homemakers and nurse women, selected by a multistage random sampling method. Data were collected by a modified version of domestic violence CTS-2 of Straus questionnaire and were analysed by chi-square test and t test. Multivariate logistic regression was used to assess the predictors of physical IPV as the most important type of violence. Results: The mean (SD) age of the women and their husbands was 33.1 (8) and 37.8 (8.7) years, respectively. Verbal (95.4%) and psychological (80.8%) violence were the most common while injury (14.6%) was the least prevalent. The prevalence of physical violence was 28.8%. Based on the regression model, economic problems, history of divorce in the woman's family and spousal addiction were the highest predictors of violence (p<0.05). Discussion: Spousal addiction was related to higher violence against women in physical, psychological and injury dimensions. Increase of family support, removal of economic disparities and tackling drug addiction could be effective in decreasing violence.

The effect of a care program and social support on anxiety level in mothers of late preterm infants in Sistan and Baluchestan, Iran.

Late and moderate preterm (LAMP) neonates are at risk of developing severe complications that can lead to anxiety in mothers. The aim of this study was to determine the effectiveness of a care program on the anxiety level of mothers with LAMP babies and to determine the effectiveness of the care program on the level of anxiety of new mothers in the presence of social support. This quasi-experimental study was conducted on 80 mothers whose late preterm infants were admitted to neonatal intensive care unit at Ali-ibn Abi Talib Hospital, Zahedan. Data were gathered between July 10 and October 13, 2016. The intervention group received the care program. Anxiety and social support were evaluated using the State-Trait Anxiety Inventory and Multidimensional Scale of Perceived Social Support (MSPSS), respectively. After receiving the intervention, the mean MSPSS was higher for the mothers in the intervention group (p = .0025). Additionally, they experienced less state anxiety 72 hours after discharge and 1 month after delivery (p < .0025). Regression analysis showed that mothers with higher social support were 39 percent more likely to be in the "no to moderate STAI" (<51) group. Perceived social support can mediate the effect of care programs on diminishing anxiety.

The spatial analysis of annual measles incidence and transition threat assessment in Iran in 2016.

Background: During the past years, due to the increase in immunization coverage and promotion of surveillance data, the incidence of measles decreased. This study aimed to determine the measles incidence risk, to conduct spatial mapping of annual measles incidence, and to assess the transition threat in different districts of Iran. Methods: A historical cohort study with retrospective data was conducted. The measles surveillance data containing 14 294 cases suspected of having measles in Iran were analyzed during 2014-2016. WHO Measles Programmatic Risk Assessment Tool was applied to calculate and map the incidence of measles in each district, to determine the annual incidence rate, and to conduct spatial threat assessment risk. Threat assessment was measured based on factors influencing the exposure and transmission of measles virus in the population. The annual measles incidence rate and spatial mapping of incidence in each Iranian district was conducted by Measles Programmatic Risk Assessment Tool. Data were analyzed by descriptive statistics in Excel 2013 and Arc GIS 10.3. Results: Of 14 294 suspected cases, 0.6% (CI 95%: 0.599-0.619) were identified as clinically compatible measles, 0.280 (CI 95%: 0.275-0.284) as confirmed rubella, 0.52% (CI 95%: 0.516-0.533) as epi-linked measles, 4.6% (CI 95%: 0.450-0.464) as lab-confirmed measles, and 94% (CI 95%: 93.93-94.11) were discarded. The annual incidence rate in cases per 100 000 populations increased from 0.0726, (CI 95%; 0.0714-0.0738) in 2014 to 0.1154 (CI 95%; 0.1135-0.1173) in 2016, and the 3-year incidence rate during the study period was 1.032 (CI 95%; 1.017-1.047) and the annual average was 0.3442 (CI 95%; 0.3387-0.3496). Conclusion: The average annual incidence rate of measles in Iran was low, but after a 11-fold increase in the number of measles cases in 2015, the number of measles cases decreased to more than 7-times in 2016. However, maintaning a high immunization coverage of measles and timely vaccination can be effective in reaching the goal of measles elimination.

Decisional conflict and regret: shared decision-making about pregnancy affected by ß-thalassemia major in Southeast of Iran.

To study the effect of shared decision-making (SDM) on decisional conflict (DC) scores immediately after consultation and to assess the decisional regret (DR) scores in the first 3 months following women's decision regarding termination of pregnancy. This quasi-experimental study was conducted during August 3rd-February 20th, 2016. We included 80 women whose fetuses were diagnosed with ß-thalassemia major (ß-TM) through chorionic villi sampling and were referred to the only prenatal diagnosis center at Ali-Asghar Hospital, Zahedan, Iran. While the control group went through the routine procedures, the intervention group received a 90-min counseling session based on SDM. The demographic characteristics form and DC scale were filled out immediately after the consultation session. After 3 months, the women were contacted via telephone call to collect data on their level of DR. The mean DC score was significantly (P = < 0.0025) lower in the intervention group (8.47 ± 4.63) compared with the control group (44.10 ± 14.5). Moreover, the mean score of DR was significantly (P = 0.004) lower in the intervention group (9.37 ± 15.44) compared with the control group (24.37 ± 23.42). SDM consultation can help women experience significantly lower levels of DC and DR.

Cloning of ompA gene from Acinetobacter baumannii into the eukaryotic expression vector pBudCE4.1 as DNA vaccine.

Antibiotic resistant features of Acinetobacter baumannii is partly due to the decreased outer membrane proteins (OMPs) permeability. The OmpA is one of the most conserved proteins among A. baumannii with a considerable antigenic potential to stimulate the multidimensional immune system responses. The present study was aimed to clone the ompA gene into the eukaryotic expression vector with potential as DNA vaccine. The ompA gene of A. baumannii was amplified using polymerase chain reaction (PCR). The target DNA was cloned and sub-cloned into the pTZ57R/T and pBudCE4.1 vectors, respectively. The recombinant vectors containing ompA were then validated using colony PCR, vector sequencing and double-digestion strategies. The pBudCE4.1-ompA recombinant plasmid was transfected into the human dermal fibroblast cells (HDF) and presence of ompA transcript and protein was evaluated using reverse transcribed-PCR (RT-PCR) and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Our finding from colony PCR, sequencing and enzyme double digestion result confirmed that target gene has been successfully inserted into the pTZ57RT and pBudCE4.1. The presence of an expected band (1112 bp) in RT-PCR as wells as a ~ 38 kDa band during SDS-PAGE showed that the recombinant pBudCE4.1-ompA construct was efficiently transfected into the HDF cells and expressed. Altogether, our observation demonstrated that the recombinant pBudCE4.1-ompA construct was successfully produced although further experiments are needed.

Association of Helicobacter pylori infection with metabolic parameters and dietary habits among medical undergraduate students in southeastern of Iran.

BACKGROUND: To date, there is still inconclusive evidence on the extra-gastric manifestations of Helicobacter pylori (H.pylori) infection. This study aimed to determine whether there is an association between H.pylori infection with metabolic syndrome and dietary habits among medical undergraduate students in south-eastern of Iran, Zahedan. MATERIALS AND METHODS: This cross-sectional study was done among 363 undergraduate students in Zahedan University of Medical Sciences during spring 2014. All subjects completed a questionnaire including demographic factors and dietary habits. Serum H. pylori-specific IgG antibodies, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and fasting blood sugar (FBS) levels were measured after an overnight fast. RESULTS: The seroprevalence of H. pylori infection was 45.7%. H. pylori-positive subjects had lower mean levels of TC and TG and higher levels of HDL-C compared to H. pylori-negative subjects. In addition, lower levels of LDL-C (P = 0.044) and FBS (P = 0.05) were observed among subjects with positive H pylori infection. Only rare consumption of raw vegetables (odds ratio [OR] =3.74, 95% confidence interval [CI] =1.37-5.24) as well as higher levels of FBS (OR = 1.031, 95% CI = 1.001-1.99) were significantly associated with higher odds of H. pylori infection in both the univariate and multiple logistic regression analysis. CONCLUSION: In a small population of young students in southeastern of Iran, H. pylori infection was associated with low consumption of raw vegetables and higher serum blood glucose.