Morphometrical and molecular identification of Echinococcus granulosus genotypes in wild canids in north of Iran.

BACKGROUND/OBJECTIVE: The cestode Echinococcus granulosus causes cystic echinococcosis, a zoonotic parasitic infection that constitutes a significant public health risk. This parasite has been documented to have potential reservoirs and carriers among wild canids, namely wolves, foxes and jackals. This study aimed to determine the prevalence and molecular characteristics of E. granulosus sensu lato species/genotypes among wild canids in three northern, northeastern and north-western Iran regions. METHODS: From 2019 to 2022, 93 wild canid carcasses (69 jackals), (22 foxes) and (2 wolves) were collected that were killed in car accidents or illnesses. Analyses of morphology and morphometry were performed to verify the presence of E. granulosus. To determine E. granulosus s.l. species/genotypes, polymerase chain reaction (PCR)-RFLP (ITS1) was performed utilizing the Bsh1236I (BstUI) restriction enzyme. COX1, NADH1 and ITS1 gene sequencing were also performed to confirm the PCR-RFLP results. RESULTS: During this study, 93 wild canids were examined, and 3.2% (95% CI: 0%-7%) of the 93 were infected with Echinococcus. The north-western region of Iran showed two out of 30 jackals (6.6%) infected with adult Echinococcus compared to one out of 35 jackals (2.8%) in the northern region. DNA from Echinococcus was detected in these individuals by PCR. Based on PCR-RFLP analysis of the ITS1 gene and sequencing of COX1, NADH1 and ITS1 gene, E. granulosus sensu stricto genotype was confirmed in the jackals that had been infected. CONCLUSION: Evidence shows that E. granulosus occurs in jackals in Iran, with the E. granulosus s.s. genotype being the most common. This parasite has been identified as a zoonotic parasite with a genotype that can be transmitted to livestock and humans. Establishing effective control measures to prevent the spread of echinococcosis and ensure public health is crucial.

Non-injection drug use among incarcerated people in Iran: Findings from three consecutive national bio-behavioral surveys.

BACKGROUND: Prisons often serve as high-risk environments for drug use, and incarcerated people are at a high risk for substance use-related mental and physical harms. This study aimed to determine the prevalence of non-injection drug use inside the prison and its related factors among incarcerated people in Iran. METHODS: We utilized data from three national bio-behavioral surveillance surveys conducted among incarcerated people in Iran in 2009, 2013, and 2017. Eligibility criteria were being ≥ 18 years old, providing informed consent, and being incarcerated for over a week. Overall, 17,228 participants across all surveys were recruited through a multi-stage random sampling approach. Each participant underwent a face-to-face interview and HIV test. The primary objective of the study was to assess self-reported non-injection drug use within the prison environment within the last month. A multivariable logistic regression model was built to determine associated covariates with drug use inside prison and an adjusted odds ratio (aOR) with 95% confidence intervals (CI) were reported. RESULT: The prevalence of non-injection drug use inside the prison was 24.1% (95% CI 23.5, 24.7) with a significant decreasing trend (39.7% in 2009, 17.8% in 2013, 14.0% in 2017; p-value < 0.001). Overall, 44.0% of those who used drugs were also receiving opioid agonist therapy (OAT) and we noted that in 2017, 75.1% of those on OAT used stimulants. In the multivariable logistic regression model, the year of interview (2013: aOR = 1.43 and 2009: aOR = 5.60), younger age (19-29: aOR = 1.14 and 30-40: aOR = 1.37), male sex (aOR = 3.35), < high school education (aOR = 1.31), having a history of previous incarceration (aOR = 1.26), and having a history of lifetime HIV testing (aOR = 1.76) were significantly and positively associated with recent non-injection drug use inside the prison. CONCLUSIONS: Approximately one in four incarcerated people in Iran reported drug use within the last month inside prisons. While a declining trend in non-injection drug use was noted, substantial gaps persist in harm reduction programs within Iranian prisons. In particular, there is a pressing need for improvements in drug treatment programs, focusing on the integration of initiatives specifically designed for people who use stimulants.

Exploring the prevalence and impact of Ligula intestinalis infection across fish species in Sistan region, Iran.

Fisheries play a crucial role in aquatic ecosystems, a resource with ecological and economic importance. Measuring parasite prevalence is necessary to assess these fish species' health and well-being. Within the Sistan region, this study sought to estimate the prevalence and intensity of infection with plerocercoid Ligula intestinalis (L. intestinalis) in seven fish species and identify factors such as fish weight, seasonality, and fishing location that might influence infection rates. 2800 fish from seven species were obtained in the Sistan region throughout four seasons. Fish samples from three weight categories (<200gr, 200-400gr, 400gr<) were examined parasitologically. Ligula intestinalis was detected in 96/2800 (3.4%) of fishs. There was a variation in prevalence among fish species. Alburnus charusini (A. charusini), Hypophthalmichthys molitrix (H. molitrix), Hypophthalmichthys nobilis (H. nobilis), and Schizocypris altidorsalis (S. altidorsalis) showed no infection. Schizothorax zarudnyi (S. zarudnyi) showed a prevalence of 1.5% (6/400), Cyprinus carpio (C. carpio) 15% (60/400), and Ctenopharyngodon idella (C. idella) 7.5% (30/400). It was found that infection prevalence was significantly influenced by fish weight in C . carpio and C . idella. A higher prevalence was found in fish with lower weight. Infection rates significantly fluctuated with season across species, but fishing locations had no significant difference. The present study highlights the significant prevalence of L. intestinalis infections in fish populations within Iran's Sistan region, underscoring the need for ongoing monitoring and research to inform effective fishery management strategies. Future studies should focus on long-term monitoring efforts and consider the broader global context of fish parasitology to understand parasite-host interactions better and inform conservation measures worldwide.

Oropharyngeal tularemia outbreak linked to drinking contaminated tap water in North-Western Iran.

Tularemia is a widespread bacterial disease caused by Francisella tularensis. Iran is an endemic country for this zoonosis. In this report, we present a 2020 tularemia outbreak in a village in northwestern Iran involving 15 patients with the oropharyngeal form of the disease. This outbreak was probably linked to the consumption of contaminated drinking water.

A rare case of reduction en masse of incarcerated inguinal hernia: A case report.

INTRODUCTION AND IMPORTANCE: Reduction en masse is a rare complication of incarcerated inguinal hernias, occurring when the herniated sac, along with the trapped hernia, returns to the preperitoneal space. CASE PRESENTATION: In this study, we describe a 74-year-old male patient who presented to the hospital with a history of manual hernia reduction and complaints of nausea, vomiting, and constipation for two weeks. After undergoing paraclinical tests, he underwent open surgery with a diagnosis of hernia reduction en masse, during which the hernia sac was separated from the surrounding structures. Abdominal and peritoneal defects were also repaired intra-abdominally. After his condition stabilized, the patient was discharged with prescription medications. DISCUSSION: Reduction en masse in inguinal hernia cases is rare, where the hernia sac and intestinal contents are reduced while the intestine remains incarcerated. Computed tomography (CT) scans can aid in diagnosis, revealing characteristic features such as closed-loop obstruction and inguinal soft tissue changes. Treatment options include open laparotomy and laparoscopy, with laparoscopy being preferred depending on surgeon expertise, assessment of intestinal viability post-reduction, and patient stability. CONCLUSIONS: The potential complications of hernia reduction en masse should be emphasized to patients who choose not to remain under medical supervision, as well as to physicians and surgeons when patients re-present following manual hernia reduction. Increasing awareness about this condition at relevant times is crucial.

Sero-prevalence of Toxoplasma gondii before and during the COVID-19 pandemic in Northwestern Iran.

BACKGROUND: Toxoplasma gondii (T. gondii) is a ubiquitous protozoan parasite on our planet that causes toxoplasmosis. This study evaluated the seroprevalence and related risk factors for T. gondii infection in a population referred to healthcare centers in Meshkin-Shahr, Northwest Iran. METHODS: A total of 400 blood samples were randomly collected from the general population and assessed using the anti-Toxoplasma antibodies, Immunoglobulin G and M (IgG and IgM) Enzyme-linked immunosorbent assay (ELISA) Kits in two steps before and during the coronavirus disease 2019 (COVID-19) pandemic, 2019-2020. The results were analyzed through logistic regression via SPSS 26 software. RESULTS: Before the COVID-19 pandemic, anti-toxoplasma antibodies were detected in 39% of individuals (IgG: 38%, IgM: 0.5%, and IgG-IgM: 0.5%). Among the eleven risk factors evaluated, contact with soil and people awareness were significantly associated with T. gondii infection (p < 0.05). However, factors such as females, 20-39 age groups, junior high schools, housewives, rural areas, raw meat or vegetable consumption, vegetable or fruits washed by water, not detergent, and cat owners did not show a significant relationship with seropositivity (p > 0.05). After the outbreak of the COVID-19 pandemic, the overall seroprevalence for anti-T. gondii antibody increased to 49.7% (IgG: 47.7%, IgM: 0.5%, and IgG and IgM: 1.5%). Among these patients, 26% were positive for COVID-19. Additionally, before the COVID-19 pandemic, 40 samples were negative for anti-T. gondii antibodies but later became positive. The crude and adjusted models suggested that toxoplasmosis may be a possible risk factor for increased susceptibility to COVID-19, with an odds ratio (OR) of 1.28 (95% confidence interval (CI), 0.82-1.99; P < 0.05). Conversely, a non-significant protective effect against latent toxoplasmosis was observed in COVID-19-positive individuals (OR = 0.99; 95% CI, 0.51-1.92; P > 0.05), and COVID-19 positivity did not increase the levels of anti-T. gondii IgG antibodies. CONCLUSIONS: The general population in this region had a moderate seroprevalence of T. gondii. The increased number of COVID-19-positive patients with latent toxoplasmosis highlights the need to pay attention to the early diagnosis and proper treatment of toxoplasmosis in these patients and implement preventive programs in these areas for future possible viral infections.

Psychometric Assessment of the Farsi Version of Perceived Barriers to Healthcare-Seeking Decision in Iranian Cardiovascular Patients.

Background and Purpose: This study was undertaken to assess the psychometric properties of the Perceived Barriers to Healthcare-Seeking Decision (PBHSD) scale in Iranian patients with acute coronary syndromes (ACS). Methods: In this methodological study conducted from February to June 2022, 255 patients with ACS completed the Farsi version of the PBHSD scale. The study focused on evaluating the face, content, and construct validity of this scale. Additionally, reliability was assessed through measures of internal consistency, including Cronbach's alpha (α) and McDonald's omega, and stability through test-retest analysis. Results: The mean age of the patients in the study was 47.12 (SD = 17.25). Construct validity analysis revealed a single independent factor with an eigenvalue greater than 1, explaining 61.23% of the extracted variance. Cronbach's α and intraclass correlation coefficient were both greater than 0.70 that proved validity of the PBHSD scale. Conclusions: The study's findings indicate that the Farsi version of the PBHSD is both valid and reliable. Consequently, it can be effective to assess and evaluate healthcare-seeking decisions in Iranian patients with ACS.

Investigating the implementation challenges of the research doctoral program and providing related solutions: a qualitative study.

BACKGROUND: Doctoral programs have consistently garnered the attention of policymakers in medical education systems due to their significant impact on the socio-economic advancement of countries. Therefore, various doctoral programs have been implemented with diverse goals. In Iran, a research doctorate program, known as PhD by Research, was introduced primarily to engage in applied research related to healthcare needs. Nevertheless, the achievement of the program's goals has been questioned. This study aimed to identify the implementation challenges of the Research Doctorate Program and its solutions in Iran. METHOD: This descriptive qualitative study followed the Standards for Reporting Qualitative Research: A Synthesis of Recommendations and was conducted in two steps. Firstly, the challenges of the Iranian Ph.D. by research program were identified through the perspectives of the program's students and graduates. In the second step, relevant solutions to these challenges were determined by focus groups of key informant experts. The transcripts were analyzed using qualitative content analysis. RESULTS: Five students and six graduates were interviewed in the first step and seven experts participated in the second one. The challenges and related solutions are explored in four main themes, including: (1) admission criteria, (2) program goals and expected outcomes, (3) curricula, and (4) financial and human resources. The study showed that various dimensions of the doctoral program are not aligned with each other and how to adapt the program in these dimensions. CONCLUSION: The study revealed the importance of a systematic approach in defining various dimensions of doctoral programs according to program goals and provided specific solutions for defining a research doctorate program in the context of a low- and middle-income country.

Anthropogenic vs. climatic drivers: Dissecting Lake desiccation on the Iranian plateau.

Lakes are indispensable to ecological balance, supporting biodiversity and human welfare. Despite their importance, lakes around the globe are diminishing at an alarming rate, presenting substantial environmental challenges exacerbated by climate variability and human-induced pressures, such as unsustainable land management and excessive water withdrawals. This study offers an extensive analysis of the desiccation phenomena affecting major lakes on the Iranian plateau, dissecting the complex interplay of contributing factors. We examine meteorological, hydrological, and agricultural drought conditions using indices like SPI, SDI, and SPEI to gain nuanced insights into drought dynamics. This study sheds light on the factors that contribute to the drying up of lakes and quantifies the impact of anthropogenic and climatic drivers on this phenomenon. The findings indicate that the area of all lakes has declined dramatically after the change point, ranging from 51% in the Urmia Lake to an impressive rate (i.e. 100%) in Southern Hamun. Despite the stable rate of meteorological droughts (increasing in temperature by about 1 °C since the 90s and stable precipitation patterns across most basins), the research highlights the ongoing struggle against severe hydrological and agricultural drought conditions. The study delineates the predominant role of anthropogenic activities in the diminishing lake inflows and the consequential drying of the lake, accounting for approximately 100 % in five of the seven lakes.

Spatial Distribution and Birth Prevalence of Congenital Heart Disease in Iran: A Systematic Review and Hierarchical Bayesian Meta-analysis.

BACKGROUND: This study aimed to comprehensively analyze the overall congenital heart disease (CHD) prevalence in live births and children in Iran, along with evaluating the spatial distribution of CHD birth prevalence across various geographical regions within the country. METHODS: A Bayesian hierarchical meta-analysis (PROSPERO 2022: CRD42022331281) was performed to determine the pooled prevalence. A systematic search was conducted using Web of Science, ScienceDirect, PubMed, Iranian Research Institute for Information Science and Technology (IranDoc), Scientific Information Database (SID), and Magiran until October 4, 2023. Cross-sectional and cohort studies in both English and Persian languages, focusing on the age range of 0-10 years, were considered for the study population. The study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) Risk of Bias tool. Heterogeneity was assessed by I2 and τ2 statistics, and publication bias by Egger's and Begg's tests. RESULTS: The meta-analysis included 62 studies, revealing an overall CHD prevalence of 2.5 per 1000 births. Over time, CHD birth prevalence in Iran has consistently increased. Spatial distribution analysis, including spatial autocorrelation and local spatial autocorrelation, indicated no spatial clustering (P=.46) or aggregation (P=.65) among Iran's provinces. Geographic disparities were significant (P=.000), with the northern and eastern regions showing the highest and lowest CHD prevalence, respectively. CONCLUSION: The overall CHD prevalence in Iran is lower than global rates, but it continues to rise. Furthermore, there are variations in birth prevalence among different regions of Iran. Environmental, genetic, socioeconomic, and diagnostic accessibility differences are possibly involved in regional variation. The limitations like heterogeneity among studies, the potential inaccuracy of reports due to limited use of accurate diagnostic methods in some studies, and the absence of population-based models to investigate prevalence, underscore the urgent need for standardized diagnostic approaches, and the utilization of population-wide birth defect registries to accurately assess CHD prevalence in Iran.

Sociodemographic disparities in postnatal care coverage at comprehensive health centers in Hamedan City.

Background: Postnatal care (PNC) is a crucial component of continuous healthcare and can be influenced by sociodemographic factors. This study aimed to examine the sociodemographic disparities in PNC coverage in Hamedan City. Methods: In this cross-sectional study, we utilized existing data recorded in the Health Integrated System of Hamedan City, located in Iran, from 2020 to 2021. The study population consisted of 853 women who were over 15 years old and had given birth within the past 42 days. The Health Equity Assessment Toolkit (HEAT) software was used to evaluate the socioeconomic inequalities in PNC coverage. Results: Overall, 531 (62.3%) of the women received three postnatal visits. The absolute concentration index (ACI) indicates that women aged 20-35 years, illiterate women, housewives, insured individuals, and urban residents experience a higher magnitude of inequality in PNC coverage. The negative values of the ACI suggest that the health index is concentrated among disadvantaged groups, with educational level inequalities being more pronounced than those related to age. Conclusion: Postnatal care coverage among mothers was relatively adequate; however, sociodemographic inequalities existed in the utilization of PNC services. It is recommended that policymakers make efforts to increase access to PNC services for mothers from low socio-economic groups.

How Mobile Health Can Change the Contexts of Living With HIV and Engaging With Treatment and Care in Iran: A Realist-Informed Qualitative Study.

Mobile health (mHealth) interventions are increasingly used to address the challenges of living with HIV and engaging with antiretroviral therapy. A wealth of evidence supports the efficacy of mHealth in supporting living with HIV. Yet, there is a dearth of evidence on how mHealth improves outcomes, which features are effective, and why these work in a particular setting. This study uses stakeholder views, including patients, providers, peer supporters, counsellors, and program directors, to conceptualize how specific mHealth features could interact with contexts of living with HIV and mechanisms that shape engagement with treatment. The study is part of an ongoing research project on engagement with HIV care in Iran. We draw on the perspectives of recently diagnosed and more treatment-experienced patients and their providers, using purposive sampling, conducting 9 focus group discussions with a total of 66 participants, in addition to 17 interviews. Our findings suggest that mHealth designs that feature provider connection, proactive care, and privacy and personalization are expected to dilute the harsh contexts of living with HIV. We build on previously identified socioecological pathways that disrupt antiretroviral therapy in Iran and find that mHealth can enhance the relation between the health system and patients. Our findings suggest that personalized mHealth features and provisions can partially mitigate the compounded impacts of harsh socioecological pathways that impede treatment success in Iran. Our social constructivist study was augmented with realist-informed analysis and could have transferability to similar contexts that trigger similar mechanisms of treatment disruption.

The Relationship Between Body Image and Meaning of Life Among Women with Breast Cancer in Kerman, Iran.

We aimed to examine the relationship between body image and the meaning of life among women with breast cancer. The analytic sample included 142 women with breast cancer, and data were collected using a standardized questionnaire through face-to-face interviews. We used Kolmogorov-Smirnov test, Pearson test, Spearman and Mann-Whitney U test to determine the relationship between the research variables. We found an association between the mean score of body image and the mean score of the meaning of life. As the average score of body image increases, the score of the meaning of life increases (p < 0.05). Findings indicated that the body image score increases by increasing the score of the meaning of life and its dimensions, especially existential vacuum and acceptance of death. Future research and targeted treatments should consider the role of body image in shaping the meaning of life among women with breast cancer.

Prevalence and Characteristics of Metabolic Dysfunction-Associated Fatty Liver Disease among an Iranian Adult Population with Ethnic and Genetic Diversity: Results of the PolyIran-Liver Study.

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a rising global public health concern. It has been demonstrated that its prevalence and characteristics vary by region and racial/ethnicity. We aimed to investigate the prevalence of MAFLD and its characteristics among Turkmen and non-Turkmen ethnic groups in a multiethnic population region of Iran. Methods: In this cross-sectional study, we analyzed baseline data for 1614 participants, aged above 50 years, from the PolyIran-Liver trial who were randomly selected from Gonabad city and determined the prevalence of MAFLD and its demographic and metabolic disorders for both the Turkmen and non-Turkmen ethnic groups. Multivariate binary logistic regressions were applied to identify MAFLD-associated factors for men and women separately for the Turkmen and non-Turkmen populations. Results: The mean (SD) age of the participants was 59.1(6.7) years. Of the participants, 51.5% (n=831) were men, and 52.9% (n=854) were Turkmen. The prevalence of MAFLD among the overall study population was 39.8% (n=614). It was more common among women (45.8% vs. 34.1% in men, P<0.001), non-Turkmens (43.9% vs. 36.1% in Turkmens, P<0.001), and at age 50-64 (41.5% vs.36.1% in age≥65 P=0.004). The fully adjusted multivariate analysis in sex strata exhibited an independent negative association between Turkmen ethnicity only among men but not among women. The increased waist circumference (WC) was the most common metabolic disorder, observed in more than 95.5% of patients with MAFLD (P<0.001). Multivariate analysis in sex/ethnic strata with adjustment for potential confounders revealed an independent association of MAFLD with increased WC, insulin resistance, impaired fasting glucose/diabetes type 2, and high alanine aminotransferase (ALT) among women in both ethnic groups while with elevated triglyceride (TG) only among Turkmen and high body mass index (BMI) only among non-Turkmen women. Increased WC had the strongest independent association with MAFLD among women and the highest odds ratio (OR) with MAFLD in Turkmen women (OR: 6.10; 95% CI 1.56-23.86 vs. 4.80 in non-Turkmen women). Among men, MAFLD was independently associated with insulin resistance, high BMI, and high ALT in both ethnic groups and elevated TG only in non-Turkmen men (all P<0.001). Insulin resistance had the strongest independent OR with MAFLD among men with similar size in both ethnic groups (4.68 [95% CI 2.56-8.55]) in non-Turkmen men and 4.37 (95% CI 2.27-8.42 in Turkmen men). Conclusion: This study revealed the high prevalence of MAFLD with a sex and ethnic disparity in the middle-aged population of Gonabad city. Further research is needed to understand the factors contributing to the higher prevalence of MAFLD in this region, particularly in women. Furthermore, considering the diverse ethnic population of Iran, it is suggested that future investigations on the sex and ethnic aspects of MAFLD in the Iranian population be conducted to provide targeted prevention strategies better suited for the Iranian population.

Bone and Soft Tissue Sarcoma Epidemiology in Iranian Elderly Population; an Analysis of the Iranian National Registry for Cancer (2009-2014 Years).

Background: We aimed to investigate the patterns of incidence and prevalence of bone sarcoma (BS) and soft tissue sarcoma (STS), morphology as well as geographical distribution in the elderly in Iran. Methods: By the primary site of the tumor and the morphological types, whole cases of cancer were classified. Then, the WHO classification (2018) and the third revision of the standard International Classification of Diseases for Oncology (ICD-O-3) were used to assign a code to them. The estimated incidence rates were obtained as the frequency of the newly-diagnosed cases within one year divided by the calculated population of the mid-year Iranian residents as estimated by the Iranian Bureau of Statistics. The age-standardized incidence rates were also estimated for both bone and soft tissue sarcoma. Results: The annual crude incidence rates of sarcomas in males (0.80 per 100,000) were more than in females (0.55 per 100,000) in all years. The total combined crude incidence in 2014 years was obtained at 0.67 per 100,000 people. In terms of disease grade majority of the patients were of grade 3 (11.5 %). In terms of tumor location, the Lower extremity was 16.8%, the Visceral (including gastrointestinal & uterus) 15.8%, the Thoracic 12.8%, and the Pelvic & abdominal wall 9.7%. Conclusion: Even though such sarcoma is more prevalent in elderly men, its incidence was also observed in lower-aged female groups. In addition, the incidence rate of BS was lower in comparison with that of STS, and the patients often exhibited an unknown degree of sarcoma.

Tracking of Infectious Diseases and Deadly Injuries through Signs Observed in Excavated Human Skeletons of 2000 BC/Iron Age in Iran.

Background: Throughout history, many wars have occurred for various reasons, and many empires and kings have fallen or many people killed by wars. Wars were not always due to the conquest of the country. in the Iron Age, societies were governed by tribes at the head of the tribe, and war was only for to seize property, slaves, and food. Our research area is the same period as the Medes Kingdom, which included the union of small, large tribes, wars between tribes existed in that period, and their signs can be seen on the remains of the people of that period. Methods: Our research is related to human remains from Sagezabad cemetery, Qazvin plain, which dates back to 2000 BC (Iron Age 2 and 3) in Iran. Results: The blows on the remains were very serious and caused death. We have discussed how to kill by "considering the injured body". Conclusion: Our investigation of how people were killed in war based on injury marks and bullet holes in bones, and simulating those injuries to body tissues and organs also, people who had bone cuts from the war and survived and had bone repair and died due to lack of nutrients and infection were also discussed.

Epidemiology and antimicrobial resistance of toxin-producing Klebsiella oxytoca clinical isolates from children admitted to the oncology chemotherapy center in Mofid Children's Hospital in Tehran, Iran: A cross-sectional study.

Background and Aims: Klebsiella oxytoca (K. oxytoca) is the second bacterial cause of nosocomial infections in the general population after K. pneumoniae. This study surveyed the frequency of cytotoxin-producing strains of K. oxytoca and their antibiotic susceptibility profile in a cohort of children admitted to a referral hospital with different malignancies. Methods: The Stool samples of children admitted to the Cancer Chemotherapy Unit of the Mofid Children's Hospital, Tehran, Iran were analyzed using conventional biochemical tests and polymerase chain reaction targeting the pehX gene to identify K. oxytoca. The antibiotic susceptibility profile of isolated K. oxytoca against commonly prescribed antibiotics used in treating infection at the facility was determined using the Kirby-Bauer disk diffusion technique. Also, the prevalence of genes encoding toxins among K. oxytoca was identified by PCR assay. Results: The Stool samples of 280 participants were taken for the study of which 38 samples [(55.3% (21/38) 42 males and 44.7% (17/38) females)] tested positive for various Klebsiella spp. Out of this, K. oxytoca was identified in 2.5% (7/280) stools using cultures and conventional biochemical tests. Also, the stools of 2.9% (8/280) of the participants tested positive for K. oxytoca using PCR assay. Using PCR, (2/7) of the K. oxytoca isolates tested positive for the npsA and npsB genes and were identified as toxigenic K. oxytoca strains. Conclusion: The prevalence of toxin-producing K. oxytoca strains in stool samples of children diagnosed with cancer in Iran is relatively low. Most of the K. oxytoca isolates were susceptible to tested antibiotics. Globally, active surveillance of toxigenic K. oxytoca strains in patients with different malignancies or immunocompromised patients is recommended in healthcare settings.

Evaluation of Occupational Burnout and Job Satisfaction among Endodontists in Iran.

Introduction: Occupational burnout has been introduced as one of the most critical social problems. The present study aimed to evaluate occupational burnout among a group of Iranian endodontists. Material and Methods: Seventy-two Iranian endodontists participated in this cross-sectional study by completing the abbreviated Maslach Burnout Inventory (aMBI), consisting of one questionnaire in three domains. The data were analyzed with SPSS 21, using the chi-squared test, correlation test, and linear regression. Results: Concerning occupational burnout, 2.9% of the participants had severe emotional exhaustion, 4.2% exhibited an intense feeling of decreased accomplishment, 67.2% exhibited moderate occupational burnout, and 78.9% of the participants were satisfied with their job. Of all the variables, only the years elapsed since graduation had an inverse and significant correlation with occupational burnout among endodontists. Conclusion: The overall mean scores of endodontists showed a moderate rate of occupational burnout compared to the standard mean scores in this field. Recent graduates exhibited higher scores.

Prevalence of hepatitis B, hepatitis C, and tuberculosis among people living with HIV in Iran: a systematic review and meta-analysis.

BACKGROUND: Up to now several studies estimate the prevalence of HBV, HCV, and TB among people living with HIV (PLWH) in Iran; however, their results are inconsistent. This study aimed to estimate the overall prevalence of HBV, HVC, and TB among Iranian PLWH. METHODS: In this systematic review and meta-analysis six databases including Medline, Web of Science, Scopus, MagIran, Scientific Information Database (SID), and Barakat Knowledge network system were searched up to October 2023 with no language restriction. All studies estimated the prevalence of HBV, HCV, and TB among PLWH in Iran were included. The random-effects model was used to report the study estimates. Results were reported at a 95% confidence interval (CI). RESULTS: Out of 1050 retrieved references, 58 articles met the eligibility criteria. Overall among PLWH, HBV prevalence was 13.0% (95% CI: 11.0, 15.0), HCV prevalence was 54% (95% CI: 45.0, 64.0), and TB prevalence was 19% (95% CI: 13.0, 24.0). The results from multivariate meta-regression analysis showed no statistically significant association between HBV and TB prevalence with the year of study, quality of studies, age, gender, and persons who inject drugs (PWID). HCV prevalence was significantly associated with PWID. CONCLUSION: We found HBV, HCV, and TB infections are common among PLWH in Iran and required to be screened and treated with effective and timely services.

Effectiveness of Logotherapy on the Organization-Based Self-Esteem and Job Satisfaction of Employed Midwives.

Background: Midwives as one of the most effective members of the health systems play a key role in delivering health services to mothers and children who are vulnerable groups of the society. This research aimed to investigate the effect of Logotherapy on job satisfaction and Organization-Based Self-Esteem (OBSE) of employed midwives. Materials and Methods: This is a quasi-experimental study with the pretest and posttest design and a control group from all midwives employed in the public hospital of Rasht City in Iran. Fifty-six midwives fulfilling the inclusion criteria were selected and randomly divided into two groups of intervention and control. They filled job satisfaction, OBSE questionnaires, and demographic information checklist, and then, the intervention group attended Logotherapy for six sessions/90 minutes. Finally, both groups answered the instruments as posttest. Results: Results showed that the mean difference between OBSE (F 6,83 = 27, p < 0.05) and job satisfaction (t 2,62 = 27, p < 0.01) scores before and after the sessions in the intervention group was significantly more than the control group. Conclusions: Group Logotherapy increased job satisfaction and OBSE among midwives. It can be recommended for use in the clinical settings for healthcare providers.