Relative risk of childhood and adolescence cancer in Iran: spatiotemporal analysis from 1999 to 2016.

OBJECTIVE: Cancer is the third leading cause of death in the world with increasing trends in Iran. The study of epidemiology, trend, and geospatial distribution of pediatric cancers provides important information for screening as well as early detection of cancer and policy making. We aimed to assess the spatio-temporal disparity of childhood and adolescence cancer risk among provinces of Iran. METHODS: In this retrospective study, we estimated geospatial relative risk (RR) of childhood cancer in provinces of Iran using data from 29198 cases. We used BYM and its extended spatiotemporal model in Bayesian setting. This hierarchical model takes spatial and temporal effects into account in the incidence rate estimation simultaneously. RESULTS: The relative risk of cancer was > 1 for 45% of the provinces, where 27% of provinces had significantly ascending trend. North Khorasan, Yazd and Qazvin provinces had the highest risk rates while Sistan-Baluchistan province showed the lowest risk of cancer. However, the differential trends was highest in Sistan-Baluchistan, Bushehr, Hormozgan, and Kohgilouyeh-Boyerahmad. Both the point estimate and the trend of risk was high in Tehran. CONCLUSION: The geographic pattern and trend of cancer in children seems to be different from that in adults that urges further studies. This could lead to increased health system capacity and facilitate the access to effective detection, research, care and treatment of childhood cancer.

Melatonin Protects Mouse Type A Spermatogonial Stem Cells against Oxidative Stress via The Mitochondrial Thioredoxin System.

OBJECTIVE: Mitochondrial oxidative stress is an important factor in infertility. The mitochondrial thioredoxin system plays an important role in this condition. N-acetyl-5-methoxy tryptamine (melatonin) plays a role in reducing oxidative stress and apoptosis in spermatogonial stem cells (SSCs). In this study, we explore the probable protective effects of melatonin on the mitochondrial thioredoxin system [thioredoxin 2 (Trx2)/Txnip] in SSCs under oxidative stress. MATERIALS AND METHODS: In this experimental study, SSCs were co-cultured two-dimensionally (2D) with Sertoli cells in DMEM culture medium that contained 10% fetal bovine serum (FBS), 1% antibiotics, and 10 ng/ml glial cell-derived neurotrophic factor (GDNF) for 30 days. The cultured cells were subsequently divided into four groups: control; melatonin (250 µM, 24 hours); melatonin (250 µM, 24 hours)+hydrogen peroxide (H2O2, 50 µM, 24 hours); and H2O2 (50 µM, 24 hours). Intracellular reactive oxygen species (ROS) production was determined by flow cytometry. Malondialdehyde (MDA) levels were measured by Fluorometry. The expressions of apoptotic and antioxidant genes and nuclear factor erythroid 2-related factor 2 (Nrf2), Trx2, and nicotinamide nucleotide transhydrogenase (NNT) proteins were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. Adenosine triphosphate (ATP) levels were measured by fluorometry. RESULTS: Melatonin reduced H2O2-induced ROS levels and apoptosis in the SSCs. Melatonin also increased mRNA expression of Nrf2, Trx2, NNT, Sirtuin 3 (Sirt3), and decreased mRNA expression of Txnip, and increased protein expressions of Nrf2, Trx2, NNT thereby increasing activity of the mitochondrial thioredoxin system. In addition, melatonin increased ATP levels. CONCLUSION: Melatonin increased Trx2 expression through the Nrf2 pathway. This study suggests that melatonin may protect SSCs from oxidative stress in diseases related to infertility.

Internet Addiction Status and Related Factors among Medical Students: A Cross-Sectional Study in Western Iran.

BACKGROUND: In recent years, Internet and social media technology use have emerged as an integral tool of human society, and the evolution of technological integration, cyberspace, and web-technology has become a common practice in educational institutions. Internet usage among students has played an indispensable role in learning behavior; however, the excessive usage of the internet and social media leads to internet addiction. This original study has performed a focalized scrutiny on revealing relationships between internet addiction and associated factors among the students of medicine, dentistry, and pharmaceutical departments. METHODS: This descriptive and analytical study recruited medical students from the Self-governing Education Incubator of Kermanshah. This survey distributed questionnaires among the respondents' three departments, and this statistical data reported on 420 valid responses of the respondents. They represent first and second-semester medical students of the academic year 2017-2018. The study selected medical students by applying Cochran's Sample Size Formula through Stratified Random Sampling and cross-sectional research design. The survey has utilized a demographic questionnaire of Young's Internet Addiction Test (IAT) for the data collection. The study analyzed received data by using SPSS version 23 and performed the descriptive statistics, and analytical statistics (t-test and ANOVA). RESULTS: The results of the present study established that the majority of subjects were female students (53.3%), and the average age was 23.84 ± 2.14, including the students of all departments. Besides, findings specified that the overall mean and standard deviation scores were 3.34 and ±0.88. Internet addiction revealed mean and the standard deviation score measured for all students 3.29 ± 0.73, 3.17 ± 0.92, and 3.57 ± 0.64 correspondingly. The survey results illustrated that medical students' internet addiction substantially correlated with demographic variables, such as age, marital status, the field of study, academic term, significant time of consuming the internet, the key reason of utilizing the internet, and daily usage of the internet (p < .05). CONCLUSION: The results of the study specified that 25% of medical students showed internet addiction. The students are increasingly using the internet, and it has penetrated among students. The design and implementation of adequate educational programs and the application of internet-based efficiency interventions are essential for both knowledge acquisition and medical students' healthy behavior.

Factors affecting the health literacy status of patients with type 2 diabetes through demographic variables: A cross-sectional study.

BACKGROUND: Health literacy (HL) is the ability of a person to acquire the process, understand the necessary health information, and make the health services needed for conscious health decisions. Besides, diabetes is the most common metabolic disorder that affects patients' quantity and quality of life. This study focused on determining the factors that affect the HL status of patients with type 2 diabetes (T2D) through the role of the demographic variables. MATERIALS AND METHODS: This descriptive-analytical research survey recruited a sample based on 280 patients with T2D at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah in 2020. This study selected patients with T2D using a simple random sampling technique. The study applied the demographic information questionnaire and the Functional, Communicative, and Critical HL Scale to collect data from patients with T2D. This study used the SPSS version 23 on the received data sets to perform statistical analysis, including t-test, analysis of the variance, and multiple regression, to predict the factors affecting HL among diabetes patients. RESULTS: The study results showed that the mean age of the participating patients with T2D was 55.80 ± 13.04. The results indicated the mean score and standard deviation of total HL score in patients with T2D 2.70 ± 0.44. The findings specified a statistically significant relationship between HL, gender, education, occupation, income, and place of residence. Results indicated that ß-coefficients of the multiple regression analysis and the income variable (ß = 0.170), age (ß = 0.176), and employment variable (ß = 0.157). These are the most predictive of the HL of patients with T2D. CONCLUSION: The results of this study specified that the HL rate of individuals with diabetes type 2 is average. The potential communicative and critical HL influence is essential for communication and education for diabetes patients in the primary health-care system settings. The findings indicate that communicative and critical HL related to patients' management and functional HL looks passable in this study.

The relationship between major dietary patterns and disease activity of rheumatoid arthritis.

AIM: Rheumatoid arthritis is an inflammatory illness characterized by persistent and systemic inflammation. There is just a little amount of research on nutrition and RA progression. The goal of this research is to see whether there's a link between main eating trends and RA activity. METHODS: In Kermanshah, Iran, 183 individuals with RA were studied in cross-sectional research. The American College of Rheumatology's 2010 criteria were used to diagnose RA. The disease activity score 28 and nutritional information from a reliable 147-item food frequency questionnaire were used to assess RA activity. Factor analysis was used to extract dietary patterns. RESULTS: The researchers discovered three main eating trends, which they named. Individuals in the highest tertile of a high protein anti-inflammatory dietary pattern that emphasizes consumption of dairy products, red meats, white meats, vegetables oils, condiments, vegetables and fruits as well as low in salts and refined grain had lower DAS-28 scores than those in the first tertiles (T3 = 2.09 ± 0.14 vs. T1 = 3.75 ± 0.13; P-value = 0.001) after controlling for potential confounders. Patients in the top tertile of the low fiber dietary pattern had higher DAS-28 scores than those in the bottom tertile (T3 = 3.40 ± 0.15 vs. T1 = 2.95 ± 0.15; P-value = 0.036) than those in the bottom tertile. CONCLUSION: This research found an inverse connection between RA activity and adopting a high-protein anti-inflammatory dietary pattern. Furthermore, adopting a low-fiber dietary pattern may be linked to increased RA disease activity. To confirm such a relationship, further research is needed in the future.

Predicting the Physician's Specialty Using a Medical Prescription Database.

Purpose: The present study is aimed at predicting the physician's specialty based on the most frequent two medications prescribed simultaneously. The results of this study could be utilized in the imputation of the missing data in similar databases. Patients and Methods. The research is done through the KAy-means for MIxed LArge datasets (KAMILA) clustering and random forest (RF) model. The data used in the study were retrieved from outpatients' prescriptions in the second populous province of Iran (Khorasan Razavi) from April 2015 to March 2017. Results: The main findings of the study represent the importance of each combination in predicting the specialty. The final results showed that the combination of amoxicillin-metronidazole has the highest importance in making an accurate prediction. The findings are provided in a user-friendly R-shiny web application, which can be applied to any medical prescription database. Conclusion: Nowadays, a huge amount of data is produced in the field of medical prescriptions, which a significant section of that is missing in the specialty. Thus, imputing the missing variables can lead to valuable results for planning a medication with higher quality, improving healthcare quality, and decreasing expenses.

Relative Risk of Gastrointestinal Cancers in Isfahan County, Iran, 2005-2010.

Background: Spatial disease mapping is a widespread tool in ecological analysis to obtain accurate estimates for incidence, relative risks (RRs), prevalence, or mortality rates regarding to increase the incidence of gastrointestinal (GI) cancer in Isfahan in recent years. This study aimed to inspect the RR of GI cancer in Isfahan counties using empirical and full Bayesian model. Materials and Methods: Data of this ecological study were GI cancer cases which registered in health-care system of Isfahan University of Sciences during 2005-2010. We applied shared component model to model the spatial variation incidence rates of the GI cancers. We compared three models such as Gamma-Poisson, lognormal, and Besag, York, and Mollie (BYM) Bayesian. WinBUGS and GIS 10.1 software were used. Results: According to the fitted model, BYM model had best fit to the data. However, in general, ranks of RRs in most counties are identical; counties with higher RR in one map have higher RR in other maps. Geographical maps for three cancers in women were smoother than men. Isfahan has high RR in women, whereas this point is slightly different in men. Daran, FreidoonShahr, and Isfahan are cities which have high RR in esophagus, stomach, and colon cancer, respectively. Conclusions: Lognormal and BYM maps had very similar results. Despite some differences in estimation values, in nearly all maps arias Isfahan had high RR in GI cancer. It is recommended to promote the use of screening programs and increase awareness of people in high RR areas to reduce the incidence of GI cancer.

A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.

Background: Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive-compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive-compulsive patients. Materials and Methods: A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive-compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other's work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA). Results: Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups. Conclusion: ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive-compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

Self-oriented and Socially Prescribed Perfectionism: The Psychometric Properties of the Persian Version of the Eating Disorder Inventory-Perfectionism Scale.

Background: Perfectionism is a key construct for understanding psychopathology. In societies with varying cultures, studying the psychometric properties of tools can help with their external validity. This research aimed at standardization and validation of the Eating Disorder Inventory-Perfectionism (EDI-P) scale in Iran. Methods: The Persian version of EDI-P was formed through forward translation, reconciliation, and back translation. A total of 302 students were selected using convenience sampling method and' they completed a set of questionnaires, including the EDI-P, Weight Efficacy Lifestyle Questionnaire-Short Form (WEL-SF), Eating Attitude Test-16 (EAT-16), Self-esteem scale (SES), Difficulties in Emotion Regulation Scale-16 (DERS-16), and Self-compassion scale (SCS) Short Form. The construct validity of the EDI-P was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (2 weeks' interval) were applied to evaluate reliability. LISREL (version 8.8) and SSPS (version 22) software were used for data analysis purpose. Results: EDI-P scales and subscales were found to be a valid and reliable measure, with good internal consistency and good test-retest reliability in the nonclinical sample. Cronbach's alpha coefficient for the whole scale, socially prescribed, and self-oriented were found to be 0.74, 0.68, and 0.67, respectively. Test-retest reliability for the whole scale, socially prescribed, and self-oriented were found to be 0.88, 0.80, and 0.87, respectively. Convergent validity and divergent validity were good (Normed Fit Index [NFI] = 0.94, Incremental Fit Index = 0.95, root mean square error of approximation = 0.08, goodness of fit index = 0.97, Non-normed Fit Index [NNFI] = 0.91, and comparative fit index = 0.95). The results of this study provide support for the two-factor model of EDI-P. Conclusion: The EDI-P showed good validity and reliability and could be useful in assessing perfectionism in Iranian population. The EDI-P shows notable promise as a measure for use in eating research and clinical settings.

Investigating the structural model of procrastination based on transdiagnostic factors.

Background: Procrastination is a common and widespread phenomenon that affects 15-20% of the general population and 50% of students. Since developing and providing beneficial and effective interventions for procrastination needs a strong, comprehensive theoretical background explanation, the aim of the study was to assess the underlying transdiagnostic factors of procrastination and presenting a causal model. Methods: In this cross-sectional study, 390 college students were asked to fill out a packet of self-report measures, which included the Pure procrastination scale, Difficulties in emotion regulation scale, Depression-anxiety-stress scales, Frost multidimensional perfectionism scale, Rumination response scale, Penn state worry questionnaire, Acceptance and action questionnaire. The causal model was tested using structural equation modeling (SEM). Results: Results of the SEM indicate that perfectionism was significantly associated with increasing emotion dysregulation (ß=0.446, P<0.001) and emotion dysregulation was significantly associated with increasing anxiety (ß=0.499, P<0.001) and depression (ß=0.478, P<0.001), and then anxiety and depression with other variables, such as worry (ß=0.245, P<0.001; ß=0.004, P=0.935), rumination (ß=0.046, P=0.424; ß=0.418, P<0.001) and experiential avoidance (ß=0.277, P<0.001; ß=0.319, P<0.001) related to procrastination. Finally, worry has the most significant increasing effect on procrastination. The very small root mean square error of approximation (RMSEA=0.038), together with large values of comparative fit index (CFI=0.985), relative fit index (RFI=0.917), and normed fit index (NFI=0.979) indicated that the model was well fit. Conclusion: Perfectionism, emotion dysregulation, negative affects, worry, rumination, and experiential avoidance, known as transdiagnostic factors, had a causal relationship with procrastination, and reducing each transdiagnostic factor will improve procrastination. This study could be considered as a cornerstone for further studies on procrastination from a transdiagnostic approach.

Investigation of gene expression and genetic simultaneous control associated with erectile dysfunction and diabetes.

Diabetes can cause some diseases or abnormalities. One of the disorders caused by diabetes may be erectile dysfunction (ED). ED is sexual dysfunction characterized by the inability to establish or maintain an erect penis during sexual activity and is a common problem of men with chronic type 2 diabetes. These processes, disorders and diseases are highly influenced by the genetics of individuals. In this study, the relationship between genes and diabetes and ED has been explored by a system biology approach. For this purpose, the samples from ten control and diabetic-ED rats were collected. After a search in Gene Expression Omnibus (GEO), series with accession number GSE2457 comprising of 5 normal and 5 diabetic-ED rats were selected. Raw CEL files of these samples were normalized with robust multi-array average (RMA) expression measure method by using the linear models for microarray data (LIMMA) R package. The extracted probe IDs were transformed into 10451 unique and validated official gene symbols. Then, differentially expressed genes (DEGs) were identified between control and normal penile mucosa by employing the LIMMA R package. DEGs were classified by utilizing KEGG to underlying pathways by Enrichr. The expression values of DEGs were used to construct a gene regulatory network (GRN), by the GENEI3 R package. To analyze the topology of constructed GRNs, betweenness centrality was calculated. Genes with higher betweenness centrality scores were then identified, through the CytoNCA. We then took the commonality of DEGs genes and high-top ranking genes from CytoNCA via a predicted interaction network using GeneMANIA as the most likely important genes in erectile dysfunction. Among the 374 DEGs studied, 146 DEGs showed up-regulation and 228 DEGs displayed down-regulation expression in diabetic-ED rats. According to the Volcano plot, the dpp4, LOC102553868, Ndufa412, Oxct1, Atp2b3 and Zfp91 gene down-regulated and Lpl, Retsat, B4galt1 and Pdk4 genes up-regulated in ED and diabetic rats. Furthermore, genes like dpp4 acted as hubs in the inferred GRN.

Assessment of eating disorder psychopathology: The psychometric properties of the Persian version of the Eating Disorder Examination Questionnaire Short Form.

BACKGROUND: Eating disorders are complicated health problems that affect both the body and the mind. Eating disorders pose a serious challenge to mental health services because of their often chronic pathway. The current study was done to determine the psychometric properties of the Eating Disorder Examination Questionnaire Short Form (EDE-QS). MATERIALS AND METHODS: Persian version of the EDE-QS was produced through forward-translation, reconciliation, and back-translation. The design of this research was cross- sectional. A sample of 302 Tehran university's students in 2019-2020 was selected through convenience sampling method and completed a set of questionnaires, including the EDE-QS, Eating Attitude Test (EAT-16), Eating Beliefs Questionnaire-18 (EBQ-18), Self-Esteem Scale (SES), and Self-Compassion Scale (SCS) Short Form. The construct validity of the EDE-QS was assessed using confirmatory factor analysis and divergent and convergent validity. Internal Consistency and test-retest reliability were conducted to evaluate the reliability. Data analysis was conducted using SPSS (version 22) software and LISREL (version 8.8). RESULTS: EDE-QS was found to be valid and reliable measures, with good internal consistency and good test-retest reliability among students. Cronbach's alpha coefficient for the whole of scale was 0.85. Intraclass correlation coefficient for the whole of scale was 0.90. In terms of convergent validity, EDE-QS showed a significant positive correlation with self-report measures of EAT-16 and EBQ-18 (P < 05). EDE-QS showed a negative correlation with self-compassion and self-esteem, thus demonstrated a good divergent validity (P < 05). The results of this study also provide support for the one-factor model of the EDE-QS (root mean square error of approximation = 0.08, Normed Fit Index [NFI] = 0.90, Incremental Fit Index = 0.92, non-NFI = 0.90, and Comparative Fit Index = 0.92). CONCLUSION: The EDE-QS showed good validity and reliability and could be useful in assessing eating disorder psychopathology in a nonclinical population of students. The EDE-QS shows notable promise as a measure for use in eating disorder research and clinical settings.

Epidemiologic View and Spatial Analysis of the Mortality of Children under 5 Years of Age in Isfahan Province in 2011-2016.

BACKGROUND: Children's mortality rate reflects the health level of the community. Therefore, accurate mapping of child mortality is one of the most important ways to reduce this rate. The purpose of this study was to investigate the mortality rate of children under 5 in Isfahan province in 2011-2016. METHODS: In this analytical cross-sectional study, all mortalities of children under 5 of Isfahan province related to Child Death Care System Program during 2011-2016 were studied. Mortality rate of children was calculated. Relationship between variables [demographic characteristics, place of death (urban/rural), and underlying cause of death] and child mortality was analyzed using Chi-square test. Mortality rate in the cities of Isfahan province was plotted on a geographical map. RESULTS: Whole number of mortalities of children under 5 was 5247 cases. Most of the mortalities (60.1%) were occurred in neonatal. Mortality rate was higher in boys than girls (12.6 vs. 11.1 per 1000 live births) (P < 0.001); "mortality rate in non-Iranians who live in Iran was more than that of Iranians (21.4 vs. 11.5 per 1000 live birth) (P < 0.001) and rural areas more than urban areas (15.2 vs. 11.4 per thousand live births) (P < 0.001)." Certain conditions originating in the perinatal period were reported as the greatest causes of death (45.9%). Congenital malformations (27.4%) and external causes of morbidity and mortality (6.7%) were the second and third causes of death. Fereidun Shahr had the highest U5MR and Khansar had the lowest U5MR. CONCLUSIONS: Considering the major contribution of neonatal to the death of children under 5 and also the most important causes of death, interventions such as preventing early delivery, genetic counseling in high-risk couples, and parent training for accident prevention can play an effective role in reducing child mortality.

Eating Disorders Screening Tools: The Psychometric Properties of the Persian version of Eating Attitude Test.

BACKGROUND: Screening for eating disorders via reliable instruments is of high importance for clinical and preventive purposes. Examining the psychometric properties of tools in societies with differing dynamics can help with their external validity. This research specifically aimed at standardization and validation of the eating attitude test (EAT-16) in Iran. METHODS: The Persian version of the EAT-16 was produced through forward translation, reconciliation, and back translation. The current research design was descriptive cross-sectional (factor analysis). A total of 302 nonclinical students were selected through the convenience sampling method and completed a set of questionnaires. The questionnaires included, the EAT-16, eating beliefs questionnaire-18 (EBQ-18), difficulties in emotion regulation scale-16 (DERS-16), weight efficacy lifestyle questionnaire-short form, self-esteem scale, and self-compassion scale short-form. The construct validity of the EAT-16 was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (2 weeks' interval) were used to evaluate the reliability. Data analysis was conducted using LISREL (version 8.8) and SSPS (version 22) software. RESULTS: EAT-16 and subscales were found to be valid and reliable, with good internal consistency and good, test-retest reliability in a non-clinical sample. In terms of convergent validity, EAT-16 and subscales showed a positive correlation with the selfreport measures of EBQ-18 and DERS-16. EAT-16 and subscales showed a negative correlation with self-compassion, self-esteem and eating self-efficacy., Therefore, it demonstrated divergent validity with these constructs. The results of this study support the EAT-16 four-factor model. CONCLUSIONS: The EAT-16 showed good validity and reliability and could be useful in assessing eating disorders in Iranian populations. The EAT-16 is an efficient instrument that is suitable for screening purposes in the nonclinical samples.

Androgen regulated protein and pyruvate dehydrogenase kinase 4 in severe erectile dysfunction: A gene expression analysis, and computational study of protein structure.

Erectile dysfunction (ED) is one of the most common sexual disorders in men. During the past 30 years, there has been no new drug development for ED. Thus, exploring the genetic basis of ED deserves further study, in hope of developing new pharmacological treatments for ED. In this study, Real-Time PCR analysis was used to assess the expression of androgen regulatory protein (Andpro) and pyruvate dehydrogenase kinase 4 (Pdk4) genes in ED. For this purpose, the experiment was performed on 20 men with severe ED and 20 potent men. IIEF-15 was used to determine the ED severity. The study was conducted in the Department of Sexual Medicine of the Kermanshah University of Medical Sciences, Kermanshah, Iran. The EDTA-Na vacuum blood tube was taken from ED patients and controls. Informed consent was obtained from all participants. After blood sampling, RNA was extracted from whole blood. Then cDNA was synthesized. The gene expression was analyzed through the qPCR method. The ß-actin was used as a reference gene. To further study these two proteins, their three-dimensional structures were predicted through I-TASSER. Compared with controls, in ED patients, the expression of the Andpro gene decreased, while the expression of the Pdk4 gene increased (p<0.01). Predicting the structure of the protein showed that Pyruvate Dehydrogenase Kinase 4 had a double subunit and androgen-regulated protein had a single subunit.

Spatial Distribution of Congenital Hypothyroidism.

BACKGROUND: This study was designed and conducted to investigate the spatial distribution of permanent and temporary congenital hyperthyroidism (PCH and TCH) in Isfahan. METHODS: This study was conducted on neonates who were born from March 21, 2006 to March 20, 2011 and had undergone the congenital hypothyroidism (CH) screening program in counties affiliated to the Isfahan University of Medical Sciences. CH was diagnosed in 958 patients who treated with levothyroxine. The incidence rates of permanent and temporary congenital hypothyroidism in Isfahan province were calculated and their distribution was shown on the map. The space maps were drawn using the ArcGIS software version 9.3. RESULTS: Based on the data obtained from the screening program, the average incidence of congenital hypothyroidism in the province during the period of 2006-2011 was 2.40 infants per 1000 live births (including both PCH and TCH). The most common occurrence was in Ardestan County (10:1000) and the lowest overall incidence was observed in the Fereydounshahr county (1.39:1000). The incidence of PCH in the counties of Ardestan and Golpayegan had the highest rate in all years of study; and the greatest number of TCH cases in the five years were observed in Nain, Natanz, Khansar and Chadegan counties. CONCLUSION: Adding the time dimension and performing spatial-temporal analysis is suggested because of the following items: high prevalence of CH in Isfahan province, the important role of this disease in mental retardation and neuropsychiatric disorder, the necessity of conducting future medical researches to find possible factors of CH etiology in Isfahan province, as well as necessity of performing spatial analysis with advanced statistical methods.

Joint Disease Mapping of Breast, Uterine, and Ovarian Cancers in Cities of Isfahan Province from 2005 to 2010 Using Spatial Shared Component Model.

BACKGROUND: Breast, uterine, and ovarian cancers are the most prevalent types of cancers among women. The aim of this study was to estimate the relative risk of these cancers and recognizing spatial patterns of their shared and specific risk factors in cities of Isfahan province, one of the most populated provinces of Iran, using spatial shared component model. METHODS: In this ecological study, the population consisted of all the registered patients having breast, ovarian, and uterine cancers in the cities of Isfahan from 2005 to 2010. In order to simultaneously analyze these diseases and clarify common and specific patterns of disease, spatial Shared component model was applied. Model fitting was done using Bayesian inference in OpenBUGS software. RESULTS: The highest relative risk of breast cancer was seen in Isfahan (4.96), Shahreza (2.37), Dehaghan (5.01), Lenjan (2.33), and Najafabad (2.68), respectively. For ovarian cancer, Isfahan (4.29), Shahreza (2.51), Dehaghan (5.02), Lenjan (2.06), Najafabad (2.00), and Borkhar (2.39) had the highest relative risk, respectively. However, no significant difference was seen among the cities for uterine cancer (P > 0.05). CONCLUSIONS: Since ovarian and uterine cancers are the less prevalent disease in comparison with breast cancer, the preciseness of these estimates were improved remarkably over simple mapping models. Based on this model, the estimates were done according to the correlation between the diseases. After recognizing the spatial patterns of the shared and specific risk factors and reviewing of previous studies, regardless of risk factors data, environmental pollution arises as a potential risk factor.

Significant immunomodulatory and hepatoprotective impacts of Silymarin in MS patients: A double-blind placebo-controlled clinicaltrial.

Interferon beta (IFN-ß) has successfully been experimented with to treat multiple sclerosis (MS). However, patients sometimes do not respond effectively to treatment, and |adverse effects, including liver toxicity, accompany this therapy. |Accordingly, we decided to treat MS patients simultaneously with Silymarin (SM) as an immunomodulatory and hepatoprotective agent and IFN-ß in a clinical trial study. Complete blood count (CBC), liver enzyme levels, and the serum concentration of inflammatory and anti-inflammatory cytokines were measured. Also, the frequency of immune cells was determined by flow cytometry. Liver enzyme levels were significantly lower in the intervention group (p < 0.05). The percentage of Th17 cells in the intervention group was significantly reduced compared to the placebo group (P < 0.001). Also, the frequency of Treg cells after treatment with SM plus IFN-ß was significantly increased compared to the placebo group (p < 0.05). Furthermore, the IL-17 and IFNγ cytokine levels were significantly reduced in the intervention group (p < 0.05). Moreover, the levels of anti-inflammatory cytokines IL-10 and TGFß were significantly increased in the intervention group (P < 0.05).Overall, the results provide novel and supplementary information on SM's notable immunoregulatory effects on inflammatory response and liver function in MS patients. Clinical Trial Identifier Number: IRCTID: IRCT20171220037977N1.

The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study.

BACKGROUND: The adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D). METHODOLOGY: This descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient's home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis. RESULTS: The analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children's issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions. CONCLUSIONS: This study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.

Short-Term Impact of Two Kinds of Vegetables to Exogenous Total Nitrate and Nitrite Intake: Is Antibacterial Mouthwash Influential?

BACKGROUND: Nitrate is a compound with adverse effects on human health that can exist also in vegetables. This study aimed to determine the intake of total nitrate/nitrite from lettuce and carrot as high and low nitrate content, respectively. Moreover, the effect of chlorhexidine mouthwash on the elimination of the nitrite level in saliva and urine was surveyed. METHODS: This study was designed as a crossover based on the randomized selection method. Thirty-nine participants were divided into two groups; the lettuce and carrot juice consumers (control group). The case group was consumed these two vegetables, while they used antibacterial mouthwash. The background of nitrate/nitrite of the participants was determined before exposure. The intake of total nitrate and nitrite via lettuce and carrot juice consumption was investigated. The Griess colorimetric reaction was used for nitrate and nitrite determination in samples. RESULTS: Total nitrate concentrations in case and control groups were detected 0.79 and 0.78 mM in saliva and 1.78 and 1.38 mM in urine after lettuce consumption, respectively. However, it was determined 1.55 and 2.43 mM in saliva and 2.92 and 3.04 mM in urine after carrot ingestion. Salivary nitrite concentration 0.53 mM was decreased to 0.45 mM after antibacterial mouthwash application (P-value <0.05). CONCLUSIONS: This study indicated that the intake of total nitrate/nitrite via leafy vegetables was higher than rooty ones. The chlorhexidine mouthwash is an appropriate recommendation to reduce the nitrite concentration in the human body for preventing the probable side effects of nitrate metabolites such as N-nitrosamines forming.