Health-related quality of life variation by socioeconomic status: Evidence from an Iranian population-based study.

BACKGROUND: Health-Related Quality of Life (HRQoL) values based on the accurate and reliable European Quality of Life Five Dimension (EQ-5D) questionnaire gives health-state utilities as a helpful data set for studying socio-demographic and socio-economic inequalities in health status in the general population. We aimed to do a population-based study to see how HRQoL varies by socio-demographics and socioeconomic status (SES). MATERIALS AND METHODS: The study was a cross-sectional population-based study in Shiraz, Iran's southwest. Data was gathered utilizing a personal digital assistant (PDA). A trained interviewer administered the EQ-5D questionnaire to a representative sample of 1036 inhabitants. Principal component analysis (PCA) was used to create SES indices. Because of the skewed distribution, quantile regression was utilized to model the quartiles of HRQoL values. STATA 12.0 was used to perform all statistical analyses. P <0.05 was considered statistically significant. RESULTS: In 1036 study respondents, women had a mean HRQoL of 0.67 ± 0.28, whereas men had a mean HRQoL of 0.78 ± 0.25. Gender and age remained significant in all quartiles of HRQoL value. Participants with insurance showed 0.14 and 0.08 higher HRQoL values in the first and second HRQoL quartiles than those without coverage, respectively. Education [95% CI: 0.034, 0.111)], economy [95% CI: 0.013, 0.077], and assets [95% CI: 0.003, 0.069] all had an impact on HRQoL value in the lowest quintile. CONCLUSION: In all quartiles of HRQoL value, women had lower reported HRQoL than men. Insurance programs aimed at more disadvantaged groups with poorer HRQoL may help to minimize inequity. Education, economics, and assets all had an impact on the lower quartiles of HRQoL value, emphasizing the importance of general policies in determining public health status.

Study the charging process of moving quantum batteries inside cavity.

In quantum mechanics, quantum batteries are devices that can store energy by utilizing the principles of quantum mechanics. While quantum batteries has been investigated largely theoretical, recent research indicates that it may be possible to implement such a device using existing technologies. The environment plays an important role in the charging of quantum batteries. If a strong coupling exists between the environment and the battery, then battery can be charged properly. It has also been demonstrated that quantum battery can be charged even in weak coupling regime just by choosing a suitable initial state for battery and charger. In this study, we investigate the charging process of open quantum batteries mediated by a common dissipative environment. We will consider a wireless-like charging scenario, where there is no external power and direct interaction between charger and battery. Moreover, we consider the case in which the battery and charger move inside the environment with a particular speed. Our results demonstrate that the movement of the quantum battery inside the environment has a negative effect on the performance of the quantum batteries during the charging process. It is also shown that the non-Markovian environment has a positive effect on improving battery performance.

A systematic review and meta-analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non-UGI types.

Background and Aim: Crohn's disease is an inflammatory condition that affects the gastrointestinal (GI) system. This study aimed to determine the prevalence of upper gastrointestinal Crohn's disease (UGICD) and compare its features to non-UGICD types. Methods: We conducted a systematic search in the databases PubMed, Web of Science, Scopus, and Google Scholar. The heterogeneity of prevalence estimates was examined, subgroup analyses were carried out, and meta-analyses were conducted using random-effects modeling. Prognostic data were qualitatively reviewed and combined. Results: Two-thousand nine-hundred and forty studies were retrieved and 32 studies were included in the final analysis. Pooled prevalence of UGICD was 15% (CI: 11-18%) among 14 509 patients. UGICD prevalence did not show any significant increase with time (P = 0.45). The most prevalent (38%, CI: 30-47%) behavior of UGICD was B1 (nonstricturing-nonpenetrating), while the most common concurrent location was L3 (ileocolon) with a prevalence of 47% (CI: 34-59%). UGICD patients had higher stricturing phenotype (B2) compared to non-UGICD (0.38 vs 0.30; P = 0.03). There was no significant difference in the prevalence of UGICD between patients classified according to the Montreal or Vienna classification. Stricturing phenotype was more common among Asian patients compared to Western patients (0.44 vs 0.24; P < 0.001). UGICD was a risk factor for surgery and drug therapy and was associated with an aggressive course of the disease and more resections. Pooled prevalence of UGICD was 15%. Conclusion: Nonstricturing-nonpenetrating type was the most prevalent UGICD. UGICD patients had more complications and worse outcomes compared to non-UGICD patients.

Re-Evaluating Risk Factors, Incidence, and Outcome of Aneurysmal and Non-Aneurysmal Subarachnoid Hemorrhage.

OBJECTIVE: Subarachnoid hemorrhage (SAH) is one of the world's most life-threatening types of stroke. SAH can be classified into two main categories, aneurysmal (aSAH) and non-aneurysmal SAH (naSAH). In the present study, we aimed to prospectively evaluate SAH and its subcategories incidences, risk factors, complications, and outcomes in central Iran. METHODS: All SAH patients diagnosed between 2016 and 2020 were included in Isfahan SAH Registry. Demographic, clinical characteristics, incidence rates (based on age categories), and laboratory/imaging findings were collected and compared between aSAH and naSAH subgroups. Complications during hospital stay and outcomes were also analyzed. Binary logistic regression analysis was performed to investigate the predictors of aSAH versus naSAH. Kaplan-Meier curves and Cox regression were used to evaluate the survival probability. RESULTS: A total of 461 SAH patients were included through Isfahan SAH Registry. The SAH annual incidence rate was 3.11 per 100,000 person-years. aSAH had higher incidence rate than naSAH (2.08/100,000 vs. 0.9/100,000 person-years, respectively). In-hospital mortality was 18.2%. Hypertension (P = 0.003) and smoking (P = 0.03) were significantly associated with aSAH, whereas diabetes mellitus (P < 0.001) was more associated with naSAH. After Cox regression analysis, there were higher hazard ratios for reduced in-hospital survival in conditions including altered mental status, Glasgow Coma Scale ≤13, rebleeding, and seizures. CONCLUSIONS: This study provided an updated estimation of SAH and its subgroups incidences in central Iran. Risk factors for aSAH are comparable to the ones reported in the literature. It is noteworthy that diabetes mellitus was associated with a higher incidence of naSAH in our cohort.

A Comparative Study of Montelukast and Azelastine add on Therapy in Moderate to Severe Allergic Rhinitis Treatment: A Double-Blind Randomized Clinical Trial.

BACKGROUND: Allergic Rhinitis (AR) is a prevalent chronic inflammatory nasal condition with significant negative effects on the patients' quality of life. This study aimed to investigate the efficacy of Montelukast and intranasal antihistamine in combination with intranasal corticosteroid (INCS) in moderate to severe allergic rhinitis on the patients' quality of life and AR control. METHOD: This double-blind randomized clinical trial study was carried out on 66 moderate to severe AR patients referred to Namazi Hospital, Shiraz, Iran from 2020 to 2021, who were randomly divided into 3 groups. Group one received Montelukast add-on therapy and Budesonide nasal spray. The second group received intranasal antihistamine (Azelastine) add-on therapy and Budesonide nasal spray and the third group as the control group received intranasal Budesonide spray with a placebo tablet.To measure the impact of each medication on the patient's quality of life and AR control, we employed the Sino-Nasal Outcome Test-22 questionnaire (SNOT 22). We evaluated the symptoms and compared them at baseline, one and three months after the start of treatments. Spirometry was performed to investigate the possibility of co-morbid asthma at baseline and end of the study. RESULTS: The patients' mean age was 30.13 ± 12.7 years. Most patients experienced perennial AR (65.2%). Reduction of mean scores SNOT22 was statistically different between groups (P-value < 0.001). Three months after treatment, the mean decrease of SNOT-22 in the Azelastine group was statistically significant compared to both Montelukast (P-value < 0.001) and control groups (P-value < 0.001). No significant difference was observed between the Montelukast and control groups (P-value = 0.142). 23 of 66 patients were diagnosed with asthma and asthma treatment was initiated. The amount of FEV1 change after AR treatment was not statistically significant between the groups in asthmatic patients (P-value = 0.351). CONCLUSION: Based on our findings, we recommend Azelastine in conjunction with an intranasal corticosteroid for the treatment of moderate to severe allergic rhinitis. In moderate to severe AR or even asthma management, Montelukast has no greater impact than INCS.

The pattern of medication use, and determinants of the prevalence of polypharmacy among patients with a recent history of depressive disorder: results from the pars cohort study.

BACKGROUND: Inappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population. METHODS: Data was extracted from Pars Cohort Study (PCS) between 2016 and 2019. Participants were asked to bring all the medication they were using regularly, and history of DD during the last 12 months prior to study was obtained. The Anatomical Therapeutic Chemical classification was applied and polypharmacy was defined as concurrent use of five or more medications. Logistic regression models were developed to estimate the associations between polypharmacy and DD, adjusted for relevant covariates. The prevalence of consumption of each drug class was estimated among males, females, and elders. Logistic regression was applied and the adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated. RESULTS: A total of 9264 participants with a mean age of 52.6 (SD: 9.7) were enrolled. The prevalence of polypharmacy was 22.6% [95% CI (20.7-24.6)]. The most common drug classes were genitourinary system (55.4%) and nervous system (29.1%) medication, respectively. Recent history of DD was reported among 19.4% (n = 1795) participants, the majority of whom were females. Factors associated with polypharmacy include female gender (OR: 1.51), Fars ethnicity (OR: 1.52), lower physical activity (OR: 1.74), and higher socioeconomic status (OR: 1.40). The prevalence of antidepressant use among males was higher than females (P < 0.001). CONCLUSION: The prevalence of polypharmacy is high among patients with a recent history of depressive disorder. Females, individuals with higher socioeconomic status and lower physical activity, and those who use tobacco are more likely to be polymedicated. Surveillance measures need to be established to monitor the patterns of medication use among individuals with depressive disorders.

Temporal Trends of Incidence of Colorectal Cancer in Isfahan, Iran, 2000-2011.

BACKGROUND: Case finding was improved to the population-based method at the Isfahan Cancer Registry (ICR) during 2005-2008. However, its effects on the number of registered colorectal cancer (CRC) cases and patients' age are not investigated. Therefore, present study designed to investigate the effect of that improvement on the trend of incidence of CRC, and age of CRC cases in ICR's catchment area. METHODS: Data from the ICR were retrieved by years for 2000-2011. Annual age-standardized incidence rates (ASRs), truncated ASRs and 95% confidence intervals (95% CIs) were estimated for both genders. Rates were standardized based on the 2000 world standard population. Trends were analyzed, and significant change-points were identified using Joinpoint Regression software. Age of CRC cases compared between periods before and after the improvement. RESULTS: A total of 2902 CRC cases had been registered by ICR. Estimated ASRs (95% CI) for 2000 and 2011 were 3.47 (3.45, 3.50) and 10.22 (10.19, 1025) per 100,000 persons, respectively. Two significant change-points were identified (i.e., at 2003 and 2006). However, estimated average annual percent change was as 11. There was no significant difference between mean of patients' age before and after the time of improvement (P = 0.88). CONCLUSIONS: Trends of incidence of CRC had been rising in central Iran for males and females, during 2000-2011. It seems that the estimated slope for this trend had been partially artificial and significantly affected by the improvement of case-finding method. However, the improvement had no effect on the patients' age.

Estimation and Projection of Prevalence of Colorectal Cancer in Iran, 2015-2020.

BACKGROUND: Population aging and more prevalent westernized lifestyle would be expected to result in a markedly rising burden of colorectal cancer (CRC) in the future years. The aim of this study is to estimate the limited-time prevalence of CRC in Iran between 2015 and 2020. MATERIALS AND METHODS: Aggregated CRC incidence data were extracted from the Iranian national cancer registry (IR.NCR) reports for 2003-2009 and from GLOBOCAN-2012 database for 2012. Incidence trends were analyzed by age groups, genders, histopathologic, and topographic subtypes to estimate annual percentage changes. Incidence was projected for 2020. The prevalence was estimated applying an adopted version of a previously introduced equation to estimate limited-time prevalence based on the incidence and survival data. Monte Carlo sensitivity analyses were applied to estimate 95% uncertainty levels (ULs). In each scenario, incidence, survival, annual percentage changes, and completeness of case ascertainment at IR.NCR were replaced under pre-assumed distributions. RESULTS: Number of estimated within 1, 2-3 and 4-5-year CRC patients in 2015 were 13676 (95% UL: 10051-18807), 20964 (15835-28268), and 14485 (11188-19293), respectively. Estimated 5-year prevalence for 2020 (99463; 75150-134744) was 2.03 times of that for 2015. Highest 5-year prevalence was estimated in ages 55-59 for females and 75 + for males. Adenocarcinoma (41376; 31227 55898) was the most prevalent histologic subtype. The most prevalent tumor location was colon (30822, 23262-41638). CONCLUSION: A substantial growth in the prevalence of CRC survivors is highly expected for future years in Iran. Establishment of specialized institutes is highly recommended to provide medical and especially social supports for Iranian CRC survivors.

Lung Cancer Prevalence in Iran by Histologic Subtypes.

BACKGROUND: Prevalence statistics are essential for cancer control in addition to incidence and mortality data. As we know, there is no published report regarding lung cancer (LC) prevalence in Iran. Herein, we provide model-based estimates of limited time LC prevalence in Iran, 2015. MATERIALS AND METHODS: Incidence numbers of LC were extracted from Iranian National Cancer Registry reports for 2003-2009. Trends were analyzed by joinpoint regression, assuming a logarithmic poisson model. Incidence numbers were projected up to 2015, using linear regression models which were trained by corrected annual percentage changes. A Monte Carlo-based model was generated, and absolute survival rates, number of incident cases, and incompleteness of Iranian cancer registry for LC were included into it. Limited-time prevalence (within 1, 2-3, and 4-5 years from diagnosis) and its respective 95% uncertainty level (UL) were estimated by age, gender, and histopathological type. RESULTS: Five-year prevalence was estimated to be 4.21 (95% UL: 3.37-5.38) per 100,000 adult person, with a male:female ratio of 2.01. Estimated number of patients within 1, 2-3, and 4-5 years from diagnosis were 1871 (1497-2392), 993 (770-1285), and 420 (322-550), respectively. Most prevalent form of LC were squamous cell carcinoma (802; 579-999) and adenocarcinoma (319; 230-389) in males and females, respectively. CONCLUSION: According to our results, the most plausible estimates of number of alive LC patients within initial treatment, clinical follow-up, and cure phases were 2392, 1285, and 550 cases in Iran in 2015.

Can We Rely on GLOBOCAN and GBD Cancer Estimates? Case Study of Lung Cancer Incidence and Mortality Rates and Trends in Iran.

BACKGROUND: Around half of input data in the global burden of disease cancer collaboration (GBDCC) and GLOBOCAN projects come from low quality sources, mainly from developing countries. This may lead to loss of precision in estimates. Our question was: Are the absolute values and trends of the GBDCC and GLOBOCAN estimates for lung cancer (LC) in Iran consistent with available statistics?. MATERIALS AND METHODS: Incidence and mortality statistics were extracted from national reports (N.IRs and N.MRs) and GBDCC (GBDincidence and mortality) and GLOBOCAN databases for 19902013 where available. Trends were analyzed and absolute values and annual percentage changes (APCs) were estimated and compared. Incompleteness of case ascertainment at the Iranian national cancer registry and Iranian national civil registration was assessed for better understanding. RESULTS: Trends of N.IRs were significantly rising for males (APC: 19.4; 95% CI: 12.526.7) and females (23.2; 16.030.8). Trends of GBDincidence were stable for males (0.2; 1.51.1) and females (1.0; 2.30.4). Absolute N.IRs were less than GBDincidence steadily except for 2009. Trend of N.MRs was increasing up to 2004, but stable thereafter. Trends of GBDmortality were also stable. Absolute N.MRs were less than GBDmortality for years up to 2003 and more than GBDmortality since 2005. The estimates of GLOBOCAN were more than N.IRs and N.MRs. CONCLUSIONS: The GBDCC and GLOBOCAN values for LC in Iran are underestimates. Generation of data quality indices to present along with country specific estimates is highly recommended.

Relative effect of socio-economic status on the health-related quality of life in type 2 diabetic patients in Iran.

INTRODUCTION AND AIMS: Type II diabetes mellitus (T2DM) is a progressing epidemic and a major cause of mortality and morbidity worldwide. The quality of life (QoL) of diabetic patients has been strongly influenced by socioeconomic status (SES) in developed countries. Therefore, the QoL improvement is considered to be a major goal in diabetes control program. In this context, there is no reliable evidence for developing countries. In this study, the relative association of SES with health-related quality of life (HRQoL) was assessed in patients with T2DM in Iran. METHOD: The "Cost estimation of Type 2 Diabetes in Iran" was used for secondary data analysis. The socio-economic status has been assessed by Categorical principal component analysis (CATPCA) techniques and HRQoL, using EQ-5D Visual Analog Scale, modified for digit preferences. Age, gender, education, occupation, SES, marital status, residency, education (T2DM related), diagnostic methods, number of annual care, type of treatment and Duration of disease awareness were used as independent variables in the multivariable linear regression model. Statistical analysis was performed using Stata software version 11.2. RESULTS: The response rate was 88.6%. Out of 3472 patients, 2128 were female and about 78.7% were from urban areas. All variables associated with T2DM were significant at the level of 0.05 except, the type of treatment, residency and education. Standardized regression coefficient for SES was estimated as 0.106 (p-value<0.0001). CONCLUSION: It seems that the SES of households in developing countries has a meaningful effect on the HRQoL of patients with T2DM as well as developed countries.

Occupational injuries in a synthetic fibre factory in Iran.

BACKGROUND: A lack of information on the overall characteristics of work-related injuries in Iran holds back the development of effective injury prevention strategies. AIM: To evaluate characteristics of work-related injuries in a synthetic fibre factory in Iran. METHODS: This study reports a 16-year (1991-2007) experience of ongoing surveillance of work-related injuries in a large synthetic fibre factory. Descriptive statistics were used to show the overall characteristics of work-related injuries. Associations between external causes of injury and the odds of an accident occurring that led to hospital referral were examined using logistic regression analyses. RESULTS: In total, 836 injury events were reported. Almost half of these (46%) involved injury to hand/wrist, while about a quarter (24%) of injuries were to the head and 10% to ankle/foot. Hospital referral after an injury was related mainly to falls [odds ratio (OR) 3.24, 95% confidence interval (CI) 1.72-6.12, P < 0.001] and to work involving moving machinery (OR 1.99, 95% CI 1.12-3.55, P = 0.01). CONCLUSIONS: This study demonstrates that falls are a serious safety concern in the workplace. The results also show that 80% of injury events affected hand/wrist, ankle/foot or head; a finding which could be used in injury prevention efforts.