Oral Health and Oral Health-Related Quality of Life among Elderly People in Iran.

Background: The study aimed to investigate oral health status and its relationship with oral health-related quality of life in the elderly in Isfahan, Iran, in 2022. Materials and Methods: This cross-sectional study was conducted in Isfahan, with 460 elderly participants. During interviews with the participants, their demographic information, their medical and dental history, oral health-related behaviors, self-perceived oral health, and clinical examinations were collected, and the Geriatric Oral Health Assessment Index (GOHAI) was completed. The final conclusions were made using the Generalized Linear Model (GLM) test. Results: The mean (sd) scores were 45.05 (8.62) for GOHAI, 5.44 (2.96) for self-perceived oral health, and 18.11 (5.76) for DMFT (Decayed, Missing and Filled teeth). Moreover, the number of remaining teeth on average was 11.78 (11.89), 39.56% of the participants did not brush their teeth, 40% of the elderly had complete dentures, and 27.17% had dental insurance. After adjusting and modifying the variables, the GLM test revealed that strong predictors for higher GOHAI scores were the higher levels of education (p < .001), the higher frequency of remaining teeth (p = 0.002), more pleasant self-perceived oral health (p < .001), and dental insurance (p = 0.04). Conclusions: According to the findings, the elderly's oral health-related quality of life in Isfahan was low, which was caused by the following factors: edentulism, few numbers of remaining teeth, high DMFT score, elderly' non-adjustment with dentures and their low quality, inappropriate oral health-related behaviors, lack of complementary insurance for dentistry, and non-using dental services, and low levels of education.

Validity and reliability of parent assessments of pubertal maturation among adolescent girls in Isfahan, Iran.

OBJECTIVES: The current paper presents the steps considered for validation of a questionnaire for assessment of sexual maturity among Iranian adolescent girls. METHODS: This cross-sectional study was performed in 2022 in Isfahan, Iran. Based on the Growth and Development Questionnaire that included both the Pubertal Development Scale (PDS) and Sexual Maturation Scale (SMS), two Persian questionnaires were prepared. The face validity, content validity, criterion validity, and reliability of the questionnaire were assessed. We compared agreement of two parent-reported measures of puberty, SMS and PDS, with clinical Tanner stages (TSs) as the gold standard. Percent agreement, Cohen's kappa coefficient, and Kendall's τ b were used to assess the agreement between maternal assessments with clinical TS. The intraclass correlation coefficient (ICC) and the Cronbach's α coefficient were also calculated to evaluate the reliability of the questionnaire. RESULTS: A total of 150 students aged 6-17 years with mean (SD) age of 10 (2.04) completed this study. The percentages of agreement for the mother-reported SMS in relation to clinical TS for breast stage and pubic hair stage were 60 % and 53.8 %, respectively. The percentages of agreement of the mother-reported PDS in relation to clinical TS for breast stage and pubic hair stage were 55.8 and 66 %, respectively. The weighted kappa coefficients showed moderate agreement, with weighted kappa ranging from 0.52 to 0.61. The mother-reported SMS and PDS showed high reliability. The Cronbach's alpha of the PDS and the SMS was 0.88 and 0.83, respectively. The ICC of the mother-reported SMS and the mother-reported PDS was 0.95 (0.92-0.98) and 0.97 (0.94-0.98), respectively. CONCLUSIONS: This study indicated that a maternal assessment of sexual maturity using the PDS or SMS can reliably estimate pubertal development in adolescent girls in an Iranian population.

Evaluation of Cognitive Impairment in Refractory Temporal Lobe Epilepsy Patients Concerning Structural Brain Lesions.

Introduction: Temporal lobe epilepsy (TLE) is the most prevalent form of drug-resistant epilepsy with concurrent cognitive impairment. Prevention, earlier diagnosis, and personalized management of cognitive deficits in TLE require more understanding of underlying structural and functional brain Ialterations. No study has evaluated the performance of TLE patients in different cognitive domains based on their structural brain lesions. Methods: In this study, 69 refractory TLE patients underwent magnetic resonance imaging (MRI) epilepsy protocol and several neuropsychological tests, consisting of the Wechsler adult intelligence scale-revised, Rey-Osterrieth complex figure test, verbal fluency test, digit span test, spatial span test, Wechsler memory scale-III, design fluency test, Rey visual design learning test, auditory-verbal learning test, and trail making test. MRI findings were classified into the following groups: Focal cortical dysplasia, gliosis, atrophy, mesial temporal sclerosis (MTS), tumor, vascular malformation, and other lesions or normal. Results of neuropsychological tests were compared between MRI groups using a generalized linear model with gamma distribution and log link. Results: Patients with MTS showed better performance in general intellectual functioning, working memory, attentional span, and auditory-verbal learning compared to patients with non-MTS MRI lesions. Atrophy and focal cortical dysplasia had the largest differences from MTS. Conclusion: Cognitive performance of refractory TLE patients varies concerning structural brain alterations. Further neuroimaging studies of TLE lead to prevention and more accurate management of cognitive decline in clinical settings. Highlights: Cognitive status in temporal lobe epilepsy (TLE) varies concerning structural brain alterations.Patients with mesial temporal sclerosis (MTS) show better cognitive performance than those with non-MTS lesions.Among non-MTS findings, patients with atrophy have more severe cognitive deficits. Plain Language Summary: Temporal lobe epilepsy (TLE) is the most common form of epilepsy which does not respond to anti-seizure drugs and needs surgery of the brain lesions. One of the most important issues of TLE patients is their cognitive impairment. Cognition refers to the mental processes for thinking, understanding, and perception of the environment such as attention, memory, learning, language, etc. Prevention, earlier diagnosis, and treatment of cognitive deficits in TLE patients need more understanding of their brain changes. No study has evaluated the cognition of TLE patients in detail based on their brain lesions. In this study, 69 drug-resistant TLE patients have undergone brain magnetic resonance imaging (MRI) and several neuropsychological tests that assess cognition, consisting of the Wechsler adult intelligence scale-revised, Rey-Osterrieth complex figure test, verbal fluency test, digit span test, spatial span test, Wechsler memory scale-III, design fluency test, Rey visual design learning test, auditory-verbal learning test, and trail making test. MRI findings were classified into the following groups based on the type of brain lesion by an expert: Focal cortical dysplasia, gliosis, atrophy, mesial temporal sclerosis (MTS), tumor, vascular malformation, and other lesions or normal. Results of neuropsychological tests were compared between MRI groups using appropriate statistical methods. Patients with MTS, as the most common lesion in TLE, showed better results compared to patients with lesions other than MTS in intelligence, memory, attention, and learning tests. Patients with atrophy and focal cortical dysplasia had the largest differences from those with MTS. These results suggest that the cognitive performance of drug-resistant TLE patients is different based on their structural brain changes. As imaging, in particular brain MRI, is the most available technique in the clinic for the assessment of epilepsy, further brain imaging studies can lead to prevention and better management of cognitive decline in TLE.

The Effect of Add-on Memantine in New Onset Combat-Related Posttraumatic Stress Disorder Core Symptoms: A Pilot Study.

Objective: Studies using standard neuropsychological instrumentation have shown memory deficits in posttraumatic stress disorder (PTSD) patients. We examined the efficacy and safety of memantine in new cases of combat-related PTSD in the military by conducting a 16-week prospective double-blind randomized controlled trial. Method : Twenty-six new combat-related PTSD cases were recruited from among the military personnel based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Patients were assigned to memantine and Placebo groups. They were monitored at baseline, week eight, and week 16. Memantine was added to each patient's current medication with an initial dosage of 5 mg/day, raised by 5 mg/day every week until it reached the maintenance level of 20 mg/day. The concurrent drugs were essentially kept unchanged during the trial. The primary outcome was PTSD severity as assessed by the Clinician-administered PTSD Scale (CAPS). The CAPS is a valid and reliable tool for the diagnosis of PTSD and measurement of its severity according to the DSM-4. Results: CAPS mean score in baseline (P = 0.811) and weeks eight (P = 0.389) and 16 (P = 0.066) did not show any significant differences between the two groups. The mean CAPS score in the memantine group significantly (P = 0.006) decreased (Mean differences = -8.79) compared to the placebo group, showing that intervention with memantine was effective. The mean total CAPS in weeks eight (Mean differences = -14.21) and 16 (Mean differences = -27) were less than the baseline, which was significantly meaningful (P < 0.001). Conclusion: Findings of this study suggest that add-on memantine can be effective in veteran patients with PTSD. So our data provide useful insight into the management of new cases of combat-related PTSD.

Association between Sleep Duration and Early Pubertal Timing in Children and Adolescents: A Systematic Review and Meta-analysis.

BACKGROUND: Early puberty increases the risk of diverse health outcomes during adolescence and beyond. Several studies have explored the links between short sleep duration and early puberty worldwide. OBJECTIVE: The current systematic review and meta-analysis aimed to evaluate the association between sleep duration and early pubertal timing based on published evidence systematically. METHODS: We searched important electronic databases for articles that reported the association between childhood sleep duration and puberty timing up to October 2020. A total of 848 papers were identified from the databases and manual search. Finally, 10 studies including 23752 participants were included in the meta-analysis. We calculated the pooled effect sizes using a random or fixed effects model as appropriate. RESULTS: There was a significant inverse association between sleep duration and the risk of early puberty, longer duration of sleep was associated with 0.34% decreased odds of early puberty (OR = 0.66, 95% CI = 0.58-0.77, I2 = 96.6%). In a subgroup analysis, when pubertal status was assessed by physical examination compared with Pubertal Development Scale (PDS) or Sexual Maturation Scale (SMS), the associations between sleep duration and age of puberty were attenuated. The pooled OR (95% CI) of studies measuring pubertal timing by PDS/SMS and Tanner stage were 0.50(0.37-0.69) and 0.91(0.77-1.09), respectively. When pooling effect sizes was limited to studies that had BMI level adjustment, the association of sleep duration and early puberty was not statistically significant anymore (OR = 0.95, 95% CI = 0.89-1.01). CONCLUSION: Longer sleep duration is associated with a lower risk of early puberty in children. The association between sleep duration and risk of early puberty may be modified by other factors such as BMI. To clarify the effect of sleep duration on the risk of early puberty in children, further prospective studies are needed.

Perceived stress, anxiety, and depression in women with breast cancer: CIBC study.

BACKGROUND: Many breast cancer (BC) patients experience psychological reactions and may have psychiatric morbidities, especially anxiety and depressive disorders. The aim of this study was to evaluate perceived stress and factors affecting this stress in women with BC in Isfahan. MATERIAL AND METHODS: This analytical cross-sectional study was carried out among 197 females with BC who were newly diagnosed and referred to Isfahan Cardio-Oncology Clinic. Stress was measured by the Perceived Stress Scale Standard questionnaire. Generalized linear models (GLMs) with gamma distribution and Log Link Function were used for data analyzing. RESULTS: The mean age of the patients was 48.9 ± 10.9 years, and mean perceived stress in patients was 42.8 ± 16.5. The GLMs with Gamma distribution and Log Link Function showed interaction between anxiety and surgical type and also between depression and surgical type. Patients perceived stress with anxiety*nonsurgery were significantly 2.5% higher than normal anxiety and none surgery (P = 0.004), and patients with depression*lumpectomy had significantly 2% higher stress score compared to normal depression and nonsurgery (P =0.003). CONCLUSIONS: Early detection of anxiety and depression can contribute to managing the stress. Coordination between psychologists and oncologists in care and treatment of these patients is important for pursuing treatment and following the recommendations of doctors and ultimately affect the morbidity and survival in BC patients.

The Effect of Low-Grade Intraventricular Hemorrhage on the Neurodevelopment of Very Low Birth Weight Infants.

Objective: Intraventricular hemorrhage (IVH) is a significant concern for premature very low birth weight (VLBW) neonates worldwide. Recently, the popular theory of the benign nature of low-grade IVH has been argued with uncertain outcomes. This study aimed to assess the effect of low-grade IVH on the neurodevelopment of VLBW neonates. Materials & Methods: This six-month follow-up cohort study was conducted on VLBW neonates with and without grade I-II IVH diagnosed through brain ultrasonography. Participants were neurologically examined at birth and within six months. Neurodevelopment was assessed using the Bayley-III questionnaire, which includes evaluating cognition, receptive language, expressive language, fine motor, and gross motor performance. Results: A total of 100 VLBW neonates were recruited, including 40 cases with grade I-II IVH diagnosed through brain ultrasonography and 60 controls. Cases and controls were similar in terms of gestational age, body birth weight, hospitalization duration, gender distribution, and age at Bayley-III evaluation (P>0.05). The neurological assessments at birth showed no significant difference between the two groups (P=0.20), while controls showed significantly better results at the sixth month of age (P =0.004). Concerning different neurodevelopmental indices, after adjusting for demographic characteristics and respiratory-related variables at the time of Bayley-III evaluation, controls presented a higher performance in cognition and gross motor aspects compared to cases (P= 0.04 and 0.03, respectively). Conclusions: The low-grade IVH affected the sixth-month neurological examination and gross motor performance of the VLBW newborns. Notably, cognition and gross motor were the two affected subscales in the presence of low-grade IVH, independent of demographic factors.

The Effects of Oxytocin on Craving, Mental Health Parameters, and Stress Hormones in Methamphetamine-Dependent Patients Undergoing Matrix Treatment Model: A Randomized, Double-Blind Clinical Trial.

BACKGROUND: Methamphetamine (METH) dependence is an increasing public health problem with a wide range of mental and physical adverse effects. Recent studies report that oxytocin (OXT) has potential therapeutic properties in drug dependence. Hence, the present study was designed to evaluate the effects of OXT on craving, mental health (depression and anxiety), and stress hormones (ACTH and cortisol) in METH-dependent patients undergoing matrix treatment model (MTM), an intensive outpatient approach for stimulant abuse treatment. METHODS: This randomized placebo-controlled clinical trial was conducted in 42 METH-dependent patients undergoing MTM to receive either intranasal OXT 40 IU (n = 21) or normal saline as placebo (n = 21) for 4 weeks. Clinical and biochemical parameters were measured at baseline and end of trials in METH-dependent patients. RESULTS: Our findings indicated that OXT administration for 4 weeks is associated with a significant improvement in the craving and depression scores, respectively (p < 0.001 and p < 0.001), but there was no significant difference for anxiety scores compared with the placebo group. In addition, OXT administration significantly decreased cortisol (p < 0.001) and ACTH levels (p < 0.002). CONCLUSIONS: These findings suggest that OXT can be considered as a new potential therapeutic for the treatment of METH-dependent patients undergoing MTM. Further studies are required to explore the effectiveness and safety of OXT.

Self-Reported safety of the BBIBP-CorV (Sinopharm) COVID-19 vaccine among Iranian people with multiple sclerosis.

To affirm the short-term safety of the BBIBP-CorV (Sinopharm) COVID-19 vaccine among people with multiple sclerosis (pwMS), 517 vaccinated and 174 unvaccinated pwMS were interviewed. 16.2% of the vaccinated pwMS reported at least one neurological symptom in their respective vaccine-related at-risk periods (ARP) - a period from the first dose until two weeks after the second dose of the vaccine. In a multivariable logistic regression model, the presence of comorbidities (P = 0.01), use of natalizumab (P = 0.03), and experiencing post-vaccination myalgia (P < 0.01) predicted the development of post-vaccination neurological symptoms. One MS relapse, one COVID-19 contraction, and one ulcerative colitis flare after the first dose, and four MS relapses after the second dose of the vaccine were the only reported serious adverse events during the ARPs. To show if the vaccine provoked MS relapses, we compared the relapse rate of vaccinated pwMS in the vaccine-related ARP with the annualized relapse rate of unvaccinated pwMS in the prior year-a measure of baseline MS relapsing activity in the respective time-using a multivariable Poisson regression model accounting for possible confounders, which failed to show any statistically significant increase (P = 0.78). Hence, subject to replication-as the vaccinated and unvaccinated pwMS differed in baseline characteristics-the BBIBP-CorV vaccine does not seem to affect short-term MS activity. Furthermore, as 83.33% of the unvaccinated pwMS reported fear of possible adverse events to be the reason of their vaccination hesitancy, provision of evidence-based consultations to pwMS is encouraged. Limitations of our study briefly included lack of data for self-controlled analysis of relapse rates, possible presence of recall bias, and lack of on-site validations regarding the clinical outcomes due to the remote nature.

Relationship between cognitive profile and neuroradiographic parameters in patients with idiopathic normal pressure hydrocephalus.

Background: Normal pressure hydrocephalus (NPH) is a reversible type of dementia, which affects 0.2 to 5.9 percent of elders. It manifests with triad of gait disturbances, urinary incontinence, and cognitive decline. In this study, association between cognitive and neuroradiographic parameters of idiopathic NPH (iNPH) was appraised to find out possible biomarkers for preventive intervention. Methods: In a cross-sectional study, 16 patients with iNPH were evaluated for third and fourth ventricle diameter, diameter of temporal horn of lateral ventricle, Evans index (EI), callosal angle (CA), callosal bowing, and ballooning of frontal horn. The Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) was used to take cognitive profile. Relation between brain magnetic resonance imaging (MRI) indices and cognitive domains was extracted, using generalized linear model (GLM). Results: Patients with mild callosal bowing had better function in memory (P = 0.050) and language (P = 0.001) than those with moderate to severe callosal bowing. Negative or mild ballooning of frontal horn was also associated with higher scores in memory (P = 0.010), executive function (EF) (P = 0.029), and language (P = 0.036) than moderate to severe ballooning of frontal horn. Increased 3rd ventricle diameter was associated with decline in total cognition (P = 0.008), memory (P = 0.019), EF (P = 0.012), and language (P = 0.001). Relation between other radiographic indices and cognitive function was not significant. Conclusion: Third ventricular diameter, rounding of frontal horn of lateral ventricle, and callosal bowing are more accurate neuroradiographic parameters to predict cognitive decline in iNPH.

Cutaneous Leishmaniasis Based on Climate Regions in Iran (1998-2021): A Systematic Review and Meta-Analysis.

Background: Climate change can facilitate the expansion of leishmaniasis and create the suitable habitat for vector and reservoir species. The objective of this study was to estimate the prevalence of cutaneous leishmaniasis (CL) at the climatic regions of Iran. Materials and Methods: The literature search was conducted to identify all published studies reporting the prevalence or incidence of CL in humans in Iran. A total of 350 articles that reported leishmaniasis in Iran were retrieved, due to eligibility criteria, only 42 studies were selected to the final systematic review and meta-analysis procedure. Random effects meta-analysis was done with the estimate of heterogeneity being taken from an inverse-variance model. Subgroup analysis was conducted and it stratified the studies according to climatic regions. Between-study heterogeneity was assessed by using I 2 and Cochran's Q method I 2 value of heterogeneity. Meta regression was used to investigate factors potentially contributed the between-study heterogeneity. Results: Individual studies showed that prevalence per 100,000 population estimated the range from 1.5 to 318.7 with the overall random pooled prevalence of 83.3 (95% confidence interval 74.5-92.1). Subgroup analysis by climatic regions showed that many studies were conducted in the desert areas and also, it has more prevalent than the other climatic regions. Conclusions: Leishmaniasis was more prevalent in regions with dry and desert climates than the other climatic regions. One of the advantages of this work is that the majority of selected studies have been conducted on population-base. However, some of the studies have been designed poorly or have had a lack of internal validity.

Spatiotemporal analysis of COVID-19, air pollution, climate, and meteorological conditions in a metropolitan region of Iran.

The COVID-19 pandemic has a close relationship with local environmental conditions. This study explores the effects of climate characteristics and air pollution on COVID-19 in Isfahan province, Iran. A number of COVID-19 positive cases, main air pollutants, air quality index (AQI), and climatic variables were received from March 1, 2020, to January 19, 2021. Moreover, CO, NO2, and O3 tropospheric levels were collected using Sentinel-5P satellite data. The spatial distribution of variables was estimated by the ordinary Kriging and inverse weighted distance (IDW) models. A generalized linear model (GLM) was used to analyze the relationship between environmental variables and COVID-19. The seasonal trend of nitrogen dioxide (NO2), wind speed, solar energy, and rainfall like COVID-19 was upward in spring and summer. The high and low temperatures increased from April to August. All variables had a spatial autocorrelation and clustered pattern except AQI. Furthermore, COVID-19 showed a significant association with month, climate, solar energy, and NO2. Suitable policy implications are recommended to be performed for improving people's healthcare and control of the COVID-19 pandemic. This study could survey the local spread of COVID-19, with consideration of the effect of environmental variables, and provides helpful information to health ministry decisions for mitigating harmful effects of environmental change. By means of the proposed approach, probably the COVID-19 spread can be recognized by knowing the regional climate in major cities. The present study also finds that COVID-19 may have an effect on climatic condition and air pollutants.

Psychometrics of the Persian version of the COVID-19-related health literacy in the Iranian population.

Background: Since the occurrence of the COVID-19 pandemic, information dissemination has increased rapidly. Promoting health literacy is currently crucial to prepare people to respond quickly to situations, such as the COVID-19 pandemic. Due to the importance of health literacy in this critical situation, we are looking for a questionnaire to measure COVID-19 health literacy. The COVID-19 Germany Health Literacy Questionnaire (HLS-COVID-Q22) is an excellent tool, so the study aimed to create a cultural validity of this questionnaire for the Iranian population. Methods: In this validation study, 880 samples were enrolled using a convenient sampling method. The questionnaire was translated through a backward forwarding procedure. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were employed for Persian version validity. McDonald's omega (Ω), Cronbach's alpha, and average inter-item correlation (AIC) coefficients were assessed for reliability. Results: Using EFA on the random half sample (n = 440), the EFA indicated that the scale had four factors: accessing, understanding, appraising, and applying health-related information in the COVID-19 pandemic context, which explained 59.3% of the total variance. CFA was used for the sample's second part (n = 440) to evaluate the goodness of fit of the four-factor solution. CFA showed the model fit. All indices RMSEA = 0.067, CFI = 0.934, IFI = 0.934, PCFI = 0.772, PNFI = 0.747, and CMIN/DF = 2.972 confirmed the model fit. The convergent validity of the HLS-COVID-Q22 was confirmed. McDonald's omega and Cronbach's alpha were very good (α and Ω >0.80). Conclusion: The Persian version of the HLS-COVID-Q22 had acceptable psychometric properties and is applicable to measure COVID-19 health literacy.

Incidence and Associated Factors of Major Congenital Anomalies in Newborns in Chaharmahal and Bakhtiari, Southwest of Iran.

Background: Congenital anomalies are among the causes of disability and death in infants. This study aimed to determine the incidence of major congenital anomalies (MCA) recorded at birth and also their relationship with some related factors in neonates born. Methods: In this cross-sectional study, all infants born from March 2016 to March 2017 in the hospitals of Chaharmahal and Bakhtiari Province were evaluated for MCA at birth. Information recorded in the medical file including parent and infant characteristics is extracted from the maternal and newborn electronic files. Data were analyzed using Generalized Linear Model with function of Poisson. Results: Of the 19666 newborns studied, 63 (3.2 per 1000) had MCAs at birth. Variables such as number of pregnancies, parity, gestational age, neonatal birth weight, height, and head circumference were found to be significantly associated with MCA based on the crude model (P value < 0.05). Using adjusted model 1, the incidence of MCA was found to be significantly related to mother's place of residency and her parity. Finally, in adjusted model 2, the incidence of MCA was found to be related to gestational age, neonatal birth weight, and head circumference. Conclusions: In some MCA, early diagnosis and treatment can prevent disability. Consequently, the emphasis on public education to consider appropriate gestational age, proper nutrition before and during pregnancy, and prenatal care is necessary to inhibit MCA.

Factors related to glycemic control in children and adolescents with type 1 diabetes mellitus in Isfahan, Iran.

PURPOSE: Glycemic control is traditionally evaluated by monitoring of hemoglobin A1c (HbA1c). This study aims to explore factors related to glycemic control among pediatrics with type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional study was conducted among 454 students aged 6-18 years with T1DM in 2018. Demographic and disease related information were collected by a validated questionnaire. Generalized Linear Models (GLM) were used to investigate the association of explanatory variables with HbA1c concentration. RESULTS: The mean (SD) age of the participants was 11.7(± 3.3) years. The overall prevalence of suboptimal glycemic control was 85.5% (HbA1c ≥ 7%). Results showed that post pubertal children experienced a significant decrease in HbA1c levels compared to prepubertal children (ß =-0.83, p = 0.003). Underweight children had an increase of 1.32% in HBA1c concentration compared with normal weight children (ß = 1.32, P = 0.007). We also found that participants with passive smoking had higher HBA1c levels than those without (ß = 0.536, P = 0.022). CONCLUSIONS: The results indicated that age, BMI and passive smoking and were significantly associated with HbA1c levels. It is suggested that glycemic control is related to multiple factors and the interaction of these factors with each other may have positive or negative effects on it which should be investigated in future studies. Improved understanding in this area could lead to prevention of deterioration in glycemic control.

Comparison of Design Fluency Test Results among Patients with Parkinson's Disease, Frontotemporal Dementia, and the Control Group.

BACKGROUND: Design Fluency Test (DFT) is a nonverbal frame-free, nonstructured assessment of executive function (EF). Since previous studies evaluating EF in Parkinson's disease (PD) have mainly used verbal assessments for EF, this study aims to evaluate the pattern of executive domains in PD using DFT and to compare it with behavioral variant frontotemporal dementia (FTD) as a prototype for executive dysfunction and also with normal controls (NCs). MATERIALS AND METHODS: Twenty-eight patients with PD, 27 with FTD, and 27 NCs were included in the study in Ayatollah Kashani Neuropsychiatry Clinic affiliated to Isfahan University of Medical Sciences from September 2019 to February 2020. All participants were assessed via semi-structured neuropsychiatric interview, questionnaire for demographic profile (age, handedness, gender, education, and marital status), duration of illness, comorbid medical condition, comorbid psychiatric illnesses and medications, DFT, Short Parkinson's Evaluation Scale, Frontal Assessment Battery, Judgment of Line Orientation, and Neuropsychiatry Unit Cognitive Assessment Tool. RESULTS: Fixed condition novelty score was significantly different between FTD and PD (P < 0.001), FTD and control (P < 0.001), and also between PD and control (P = 0.001). When free and fixed condition novelty scores were considered to predict diagnostic attribution, multinomial logistic regression revealed that odds ratio for free condition novelty score was 0.705 (P = 0.005, 95% confidence interval [CI] = 0.553-0.899) and 0.494 (P = 0.001, 95% CI = 0.328-0.744) in PD and FTD, respectively. The odds ratio for fixed condition novelty score was 0.772 (P = 0.011, 95% CI = 0.632-0.942) and 0.449 (P = 0.00, 95% CI = 0.292-0.691). CONCLUSION: DFT subscores can be helpful in diagnosis and differentiation between FTD and PD.

Estimating the Lifetime and Age-Conditional Risk of an HIV Diagnosis in Iran, 2011-2015.

BACKGROUND: According to the importance of infectious diseases, especially HIV, the purpose of this study was to estimate lifetime and age-conditional risks of HIV diagnosis in Iran. METHODS: We used vital statistics, HIV surveillance and census data for 2011-2015 to calculate Age-specific HIV diagnosis and non-HIV death rates. These rates then converted to the probability of an HIV diagnosis considering the competing risk. Finally, the probabilities were applied to a hypothetical cohort of 10 million live births. The lifetime and age-conditional risk of HIV diagnosis in the total and general population of Iran were calculated by Dev Can software (version 6.7.4). RESULTS: Lifetime risk was 0.084% (95% CI: 0.081-0.088) or one in 1183 for females and 0.21% (95% CI: 0.201-0.211) or one in 483 for males in the total population. In the general population lifetime risk for men was 0.069% (95% CI: 0.066-0.072) or 1 in 1454 men and 0.066% (95%CI: 0.063-0.069) or one in 1523 for women. In the total and general population, the 10-yr age-conditional risk of HIV diagnosis showed that the highest risk of an HIV diagnosis is related to 30-yr -olds. CONCLUSION: The estimated risks differed based on gender, age, and type of population. Paying close attention to these differences is critical for infection control planning and policies.

GIS-based risk mapping of cutaneous leishmaniasis: a survey in an endemic area of Central Iran.

Cutaneous leishmaniasis (CL) is a vector-borne infectious disease that is affected by various environmental agents. The main objective of this study was to determine the spatial distribution of CL incidence by using Geographical Information System (GIS). This is a cross-sectional study that was conducted during 5 years from 2014 to 2018 in Isfahan, Iran. We used the required data on each leishmaniasis patient that were recorded from 44 counties of Isfahan in the databases and archive of the Provincial Health Centre. We used GIS for determining the incidence of CL in the high-risk foci. Moran index was used to identify high risk points (clustering in similar values) compared to the values of neighborhood points. Hot spot analysis was conducted by Getis-Ord-Gi. The highest incidence of the disease occurred in the age group of 18-64 years and 61.6% of patients were male. According to seasonal distribution, autumn (58.6%) had the highest frequency. Time trend of incidence showed that it had both decreasing and increasing, and there was a sudden upward trend of disease in 2018 except only two counties. The hot spots were involved the central areas of the Isfahan province slightly toward to the north and southeast of the province. Moran index showed that the differences for all points were not significant (p-value>0.05). Varzaneh (placed in southeast of Isfahan) was the hottest spot and had the worst position for leishmaniasis compared to all years and all cities.

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

BACKGROUND: COVID-19 is speculated to increase the likelihood of relapsing-remitting multiple sclerosis (RRMS) exacerbation. OBJECTIVE: To investigate the association between contraction of COVID-19 and incidence of acute MS attacks in RRMS patients six months post-infection. METHODS: This retrospective cohort study compares the risk of relapse in RRMS patients with (n=56) and without COVID-19 (n=69). Incidence of relapse was recorded for six-month following contraction of COVID-19. Incidence of RRMS exacerbation in patients with COVID-19 was compared to patients without COVID-19 (the independent control group) and the same patients six months prior to the COVID-19 pandemic. RESULTS: A lower incidence rate of RRMS exacerbation was observed in patients that contracted COVID-19 than in patients who did not contract COVID-19 (incidence rate ratio: 0.275; p=0.026). Self-controlled analysis showed no significant difference in relapse rates before the COVID-19 pandemic and after contracting COVID-19 (p=0.222). The relapse risk was not different between patients who had been hospitalized due to COVID-19 severity and those who had not (p=0.710). CONCLUSION: COVID-19 contraction may not increase the risk of acute MS attacks shortly following contraction. We hypothesize that COVID-19-associated lymphopenia may partly preclude the autoreactive memory cells from expansion and initiating relapses through a so-called bystander effect of COVID-19 infection.

Psychometric evaluation of a questionnaire for measuring factors related to mental health of women in an earthquake.

The current study was performed with the aim of the psychometric evaluation of a questionnaire for measuring factors related to women's mental health in an earthquake. This descriptive instrumental study was carried out on a population of 378 women with an earthquake experience in Kerman Province, Iran, in 2017-2018. The formal validity, content validity, criterion validity, factor analysis, and reliability of the questionnaire were measured using Cronbach's alpha coefficient. Moreover, descriptive statistics and Pearson's correlation coefficient were used to report data. In the content validity stage, 34out of 85 items of the questionnaire were eliminated. In the exploratory factor analysis (EFA) stage, 2 items out of the remaining 51 items were removed due to weak factor loading and 49 items were defined in 6 factors. The convergent and divergent validities of the questionnaire were confirmed in relation to the General Health Questionnaire (GHQ) (r = -0.23; P = .030) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) (r = 0.32;P = .001). Using Cronbach's alpha coefficient, the reliability of the questionnaire was obtained to be 0.91. The reliability and validity of the study questionnaire were at an appropriate level, and thus, it can be used to perform extensive surveys among women who have experienced earthquake.