The prevalence of alcohol consumption and its related factors in adolescents: Findings from Global School-based Student Health Survey.

BACKGROUND: Alcohol consumption has become very common among adolescents in recent years and its prevalence varies in different countries. This study aimed to investigate the prevalence of alcohol consumption and related factors in adolescents aged 11 to 16 years. METHODS: This descriptive cross-sectional study was performed on 288385 adolescents (girls, 53.9% of total) aged 11 to 16 years. In the present study, the GSHS data (2003-2018) available to public on the websites of the US Centers for Disease Control and Prevention (CDC) and WHO was used. To investigate the factors affecting alcohol consumption, univariate and multivariate logistics models with 95% confidence limits were used. RESULTS: The overall prevalence of alcohol consumption in adolescents was 25.2%, which was 28.3% and 22.4% in boys and girls, respectively. Among the surveyed countries, the highest prevalence was in Seychelles (57.9%) and the lowest in Tajikistan (0.7). Multivariate analysis showed that the Age for 16 and more than 16 years old (OR = 3.08,95%CI: 2.54-3.74), truancy for more than 10 days (OR = 1.24, 95%CI: 1.08-1.43), loneliness at sometimes of the times (OR = 1.04, 95%CI: 1.01-1.07), insomnia at most of the times (OR = 1.85, 95%CI: 1.70-2.01), daily activity (OR = 1.03, 95%CI: 1.00-1.07), bullied for 1-9 Days in a month (OR = 1.24, 95%CI: 1.09-1.40), cigarette (OR = 4.01, 95%CI: 3.86-4.17), used marijuana for more than 10 days in a month (OR = 5.58, 95%CI: 4.59-7.78), had sex (OR = 2.76, 95%CI: 2.68-2.84), and suicide plan (OR = 1.48, 95%CI: 1.42-1.54) were important factors affecting drinking alcohol. (Table 4). In this study, the sensitivity, specificity, positive predictive value, and negative predictive value were 42.79%, 93.96%, 70.80%, and 82.75. CONCLUSIONS: According to the results of the present study, the prevalence of alcohol consumption among teenagers was high. Therefore, it is suggested that demographic, family, and psychological factors should be taken into consideration in health programs for the prevention and treatment of alcohol consumption in adolescents.

The Emerging Role of Exosomal miRNAs as Biomarkers for Early Cancer Detection: A Comprehensive Literature Review.

A significant number of cancer-related deaths are recorded globally each year, despite attempts to cure this illness. Medical science is working to develop new medication therapies as well as to find ways to identify this illness as early as possible, even using noninvasive techniques. Early detection of cancer can greatly aid its treatment. Studies into cancer diagnosis and therapy have recently shifted their focus to exosome (EXO) biomarkers, which comprise numerous RNA and proteins. EXOs are minuscule goblet vesicles that have a width of 30 to 140 nm and are released by a variety of cells, including immune, stem, and tumor cells, as well as bodily fluids. According to a growing body of research, EXOs, and cancer appear to be related. EXOs from tumors play a role in the genetic information transfer between tumor and basal cells, which controls angiogenesis and fosters tumor development and spread. To identify malignant activities early on, microRNAs (miRNAs) from cancers can be extracted from circulatory system EXOs. Specific markers can be used to identify cancer-derived EXOs containing miRNAs, which may be more reliable and precise for early detection. Conventional solid biopsy has become increasingly limited as precision and personalized medicine has advanced, while liquid biopsy offers a viable platform for noninvasive diagnosis and prognosis. Therefore, the use of body fluids such as serum, plasma, urine, and salivary secretions can help find cancer biomarkers using technologies related to EXOs.

The use of orthokine therapy for the treatment of post refractive surgery corneal ulcer, a case report.

Post refractive corneal ulcers is a disastrous complication, can affect healthy individuals, is cumbersome to treat, and sometimes has a poor prognosis with corneal scarring. Accurate diagnosis and prompt treatment of corneal infection is very important; however, until now, there has been no specific protocol for the management of this common eye disease and severe cases may require a corneal transplant. The patient is a 42-year-old male who suffered a corneal ulcer after photo refractive keratectomy (PRK) surgery in which the cornea was completely destroyed. None of the routine treatments were effective and, due to the progression of corneal melting, the patient became a candidate for tectonic corneal transplant. As a last option, topical orthokine treatment was prescribed for this patient which had a dramatic improvement in the clinical course with the control of inflammation. In this study, a new method of orthokine therapy was performed for a severe corneal ulcer and recovery was clearly evident in the patient follow-up. This is the first case report of treatment of a corneal wound infection with this method of orthokine therapy. It is suggested for consideration as a new treatment for such infectious disease.

Demographic, clinical, and laboratory findings of mushroom-poisoned patients in Kermanshah province, west of Iran.

BACKGROUND: Mushroom poisoning can cause gastrointestinal, renal, and hepatic symptoms and even death. This descriptive study examined the demographic, clinical, and laboratory findings of patients with fungal poisoning, a type of fungus causing the poisoning, and the incidence and mortality rates of fungal poisoning in Kermanshah province, western Iran, from 2014 to 2018. METHODS: The medical records of 193 patients with mushroom poisoning from 2014 to 2018 were evaluated. The liver and kidney function tests, electrolytes, abdominal and pelvic ultrasound, chest x-ray, coagulation tests, and coagulation factors (fibrinogen, prothrombin) were assessed. Data were collected from the medical records of patients admitted to the Poisoning Center of Imam Khomeini Hospital in Kermanshah, Iran using a researcher-made checklist. Data were analyzed by SPSS (version 16) using descriptive statistics, including mean, standard deviation, and frequency distribution tables. Trend analysis for proportion was done by chi-square statistics in STATA-14 software (ptrend command). RESULTS: Of cases, |51.3% were male, 92.6% were city dwellers, 38.3% were aged 21-40 years, and 92.5% were poisoned during the spring. The fungus that caused poisoning was Amanita virosa. The gastrointestinal, nervous, and visual systems were the most common systems involved. The most common gastrointestinal symptoms included nausea and vomiting (72.0%) and abdominal pain (71.0%). Vertigo (11.9%) and headache (9.3%) were the most common neurological symptoms. The most common visual manifestation was blurred vision (7.8%). Of cases, 23.7% had metabolic acidosis. The increased alkaline phosphatase level was the most common liver disorder in 98.7% of the cases. Increased blood urea nitrogen and creatinine levels were also reported in 21.0% and 17.7% of the cases, respectively. The serum lactic dehydrogenase and creatine phosphokinase levels also increased in 99.3% and 30.2% of the patients, respectively. The mortality rate was 1.6% (n = 3). CONCLUSION: The fungal poisoning diagnosis should always be considered in young patients referred to the emergency department with gastrointestinal complaints, a history of consuming wild self-picked mushrooms, and high liver and kidney test values. Since most fungal poisonings occur in the spring, it is necessary to inform the community of the dangers of consuming self-picked wild mushrooms, especially in this season.

Increased incidence of rhino-orbital mucormycosis in an educational therapeutic hospital during the COVID-19 pandemic in western Iran: An observational study.

BACKGROUND: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection. METHODS: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics. RESULTS: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID- 19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12). CONCLUSIONS: We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection; therefore, physicians should know the signs and symptoms of the disease so that a timely diagnosis and therapy can be performed.

Investigating factors affecting the interval between a burn and the start of treatment using data mining methods and logistic regression.

BACKGROUND: Burn is a tragic event for an individual, the family, and community. It can cause irreparable physical, mental, economic, and social injury. Researches well documented that a quick visit to a healthcare center can greatly reduce burn injuries. Therefore, the aim of this study is to identify the effective factors in the interval between a burn and start of treatment in burn patients by comparing three classification data mining methods and logistic regression. METHODS: This cross-sectional study conducted on 389 hospitalized patients in Imam Khomeini Hospital of Kermanshah city since 2012 to 2015. The data collection instrument was a three-part questionnaire, including demographic information, geographical information, and burn information. Four classification methods (decision tree (DT), random forest (RF), support vector machine (SVM) and logistic regression (LR)) were used to identify the effective factors in the interval between burn and start of treatment (less than two hours and equal or more than two hours). RESULTS: The mean total accuracy of all models is higher than 0.8. The DT model has the highest mean total accuracy (0.87), sensitivity (0.44), positive likelihood ratio (14.58), negative predictive value (0.89) and positive predictive value (0.71). However, the specificity of the SVM model and RF model (0.99) was higher than other models, and the mean negative likelihood ratio (0.98) of the SVM model are higher than other models. CONCLUSIONS: The results of this study shows that DT model performed better that data mining models in terms of total accuracy, sensitivity, positive likelihood ratio, negative predictive value and positive predictive value. Therefore, this method is a promising classifier for investigating the factors affecting the interval between a burn and the start of treatment in burn patients. Also, key factors based on DT model were location of transfer to hospital, place of occurrence, time of accident, religion, history and degree of burn, income, province of residence, burnt limbs and education.

Stage of Breast Cancer Screening Adoption; The Role of Cognitive Predictors.

Breast cancer is the most common cancer among women. The present study investigated the stage of breast cancer screening adoption and the role of some of the cognitive predictors in a sample of Iranian married women. There were a total of 334 married women clients of eight health centers in Kermanshah city, the west of Iran, were randomly selected to participate voluntarily. Women filled out a self-report questionnaire. Data were analyzed by SPSS version 20 using One-way ANOVA, χ2-test, Fisher's exact test, and bivariate correlations statistical tests at 95% significant level. The mean age was 39.75 years [SD: 7.73]. Nearly 58.4%, 26.9%, 3%, 9.6%, and 2.1% of the respondents were reported pre-contemplation, contemplation, preparation, action, and maintenance of breast cancer screening adoption, respectively. There was a significant association between age (P=0.005), and positive family history of breast cancer (P=0.037), perceived susceptibility (P=0.005), perceived severity (P=0.001) and knowledge of symptoms (P=0.018) with breast cancer stage of screening adoption. Our findings can provide better knowledge for the development and implementing of stage-targeted breast cancer screening adoption promotion programs. We conclude that it seems that the focus of health planner should be to rise to perceived severity; perceived susceptibility and knowledge of symptoms of breast cancer about the promotion of breast cancer screening adoption an Iranian woman.

Measuring Beliefs Related to Colorectal Cancer Screening Behavior among Iranian Middle-Aged and Elderly: a Psychometric Study

The annual fecal occult blood test is a very important method for colorectal cancer early detection through screening. Our aim was to assess psychometrics of instrument measuring beliefs related to fecal occult blood test uptake among Iranian middle-aged and elderly, based on the theory of planned behavior. This cross-sectional study was performed on 150 middle-aged and elderly who were randomly selected to participate voluntarily in Kermanshah, in the west of Iran. The studied constructs included attitude, subjective norms, perceived behavior control, and behavior intention. Data were analyzed with SPSS software (ver. 21.0). The mean age of the respondents was 59.1 years [SD: 6.73], in the range from 50 to 73. All of the loads of the exploratory factorial analysis were larger than 0.4. KMO was calculated as 0.756. Overall, four factors under investigation accounted for 82% of the variance in the hypothesized model. Cronbach's alpha for the measured constructs of attitude, subjective norms, perceived behavior control, and behavior intention were 0.92, 0.88, 0.70 and 0.88, respectively. Our findings indicated the final scale to be adequately reliable and valid for measurement of these constructs for prediction of fecal occult blood test uptake among Iranian middle-aged and elderly.

Prevalence, Cognitive and Socio-Demographic Determinants of Prostate Cancer Screening

Screening may be effective for reducing deaths due to prostate cancer. The aim of this study was determine the prevalence and determinants influencing prostate cancer early detection behaviors based on the theory planned behavior (TPB). In this cross-sectional study, conducted in the west of Iran, a total of 250 men aged 50 to 70 years old were randomly selected to participate. Of these, 200 (80%) signed the consent form and voluntarily agreed to take part. A structured questionnaire based on TPB constructs was applied for collecting data by interview. Analyses were conducted with SPSS version 16 using bivariate correlations, and logistic and linear regression. Some 26.5% of the participants demonstrated prostate cancer early detection behavior. Age higher than 60 (OR: 5.969), academic education (OR: 2.904), number of family members more than four (OR: 3.144), and knowledge about prostate cancer (OR: 3.693) were the most influential predictive factors for early detection behavior. Furthermore, among the TPB constructs, attitude (OR=1.090) and subjective norms (OR=1.280) were the most influential predictors. Attitude, subjective norms, and perceived behavioral control accounted for 43% of the variation in the outcome measure of the intention to screen for prostate cancer (adjusted R squared= 0.43, F= 49.270 and P < 0.001). Designing and implementation programs to increase positive attitudes and encourage subjective norms towards prostate cancer screening behavior may be useful for promotion of early detection.

Effect of Nutritional Habits on Dental Caries in Permanent Dentition among Schoolchildren Aged 10-12 Years: A Zero-Inflated Generalized Poisson Regression Model Approach.

BACKGROUND: The aim of this study was to assess the associations between nutrition and dental caries in permanent dentition among schoolchildren. METHODS: A cross-sectional survey was undertaken on 698 schoolchildren aged 10 to 12 yr from a random sample of primary schools in Kermanshah, western Iran, in 2014. The study was based on the data obtained from the questionnaire containing information on nutritional habits and the outcome of decayed/missing/filled teeth (DMFT) index. The association between predictors and dental caries was modeled using the Zero Inflated Generalized Poisson (ZIGP) regression model. RESULTS: Fourteen percent of the children were caries free. The model was shown that in female children, the odds of being in a caries susceptible sub-group was 1.23 (95% CI: 1.08-1.51) times more likely than boys (P=0.041). Additionally, mean caries count in children who consumed the fizzy soft beverages and sweet biscuits more than once daily was 1.41 (95% CI: 1.19-1.63) and 1.27 (95% CI: 1.18-1.37) times more than children that were in category of less than 3 times a week or never, respectively. CONCLUSIONS: Girls were at a higher risk of caries than boys were. Since our study showed that nutritional status may have significant effect on caries in permanent teeth, we recommend that health promotion activities in school should be emphasized on healthful eating practices; especially limiting beverages containing sugar to only occasionally between meals.

Loop-Mediated Isothermal Amplification as a Fast Noninvasive Method of Helicobacter pylori Diagnosis.

BACKGROUND: Helicobacter pylori infection is etiologically associated with some important health problems such as gastric cancer. Because of the high clinical importance of H. pylori infection, development of a noninvasive test for the detection of H. pylori is desirable. METHODS: In this study, a loop-mediated isothermal amplification (LAMP) targeted ureC of H. pylori was evaluated on 100 stool specimens and compared with a stool antigen test. Culture and rapid urease test were considered as gold standards. RESULTS: The overall detection rate of the fecal antigen test and LAMP was 58% and 82%, respectively. The analytical sensitivity of the fecal antigen test and LAMP was 500 and 10 H. pylori cells/g and 10 fg DNA/reaction, which is equal to six H. pylori genome. CONCLUSION: LAMP technique has been characterized by high sensitivity and low detection limit for the detection of H. pylori in stool specimen. Clinical diagnostic performance of LAMP was better than the stool antigen test.

Socio-demographic characteristics associated with cigarettes smoking, drug abuse and alcohol drinking among male medical university students in Iran.

BACKGROUND: Substance abuse is one of the most complicated social problems. Understanding socio-demographic characteristics of those who abuse substances could help deal with this problem more efficiently. The main objective of this study was to determine socio-demographic characteristics associated with alcohol drinking, cigarettes smoking and drug abuse among a sample of male medical university students in Iran. METHODS: This cross-sectional study was conducted in 2014 among 425 male medical college students randomly selected with the proportional to size among different faculties in Isfahan and Kermanshah medical universities in Iran. A self-report written questionnaire was applied to collect data. Data were analyzed by the SPSS-20. RESULTS: Mean age of the respondents was 19.9 yr (ranging from 18 to 22 yr). About 19.4%, 3.9%, and 10.1% of the respondents had history of cigarette smoking, drug use, and alcohol drinking during the past three months, respectively. Logistic regression showed that mother's educational level, living place, economic status, and parents' divorce were the most influential predictive factors on substance abuse. CONCLUSIONS: Considering the high prevalence of substance abuse (especially smoking and alcohol drinking), it seems essential to design educational interventions to prevent substance abuse, paying attention to predictive factors mentioned above, among college students.