The effect of iron supplementation on menstrual bleeding volume and hemoglobin level during menstrual bleeding : A randomized clinical trial.

BACKGROUND: Many women around the world avoid taking iron supplements during their menstrual bleeding, thinking that menstrual bleeding will increase after taking these supplements. Due to the lack of relevant scientific evidence in this regard, this study was performed to determine the effect of iron supplementation on menstrual blood volume and hemoglobin level during menstrual bleeding. MATERIALS AND METHODS: In this three-blind randomized clinical trial, 160 non-anemic female students of Rafsanjan University of Medical Sciences were selected through a public call and then they were randomly assigned to two intervention and control groups. The intervention group was given a ferrous sulfate tablet containsing 50 mg of elemental iron daily in the first four days of bleeding for three consecutive menstrual cycles, and the control group received a placebo simultaneously. Before and after the intervention, the level of hemoglobin was measured and the Higham chart was completed in each menstrual cycle by the participants of the two groups. The obtained data were analyzed using the SPSS software version 21 and Chi-square, independent t-test, paired t-test, analysis of variance with repeated measures, and nonparametric tests. RESULTS: Before performing the intervention, the mean Higham score and hemoglobin level of the two groups were not statistically significant (P = 0.307, P = 0.670). The mean Higham score after each intervention was not statistically significant between the two groups over time or when considering the interaction of the time group (P = 0.77, P = 0.916). The hemoglobin level of these two groups did not change significantly after the intervention compared with that before the intervention (P = 0.444). CONCLUSION: Compared with a placebo, taking iron supplements containing 50 mg of elemental iron during the first four days of menstrual bleeding in non-anemic women did not change the volume of menstrual bleeding and hemoglobin level.

Impact of COVID-19 pandemic on marriage, divorce, birth, and death in Kerman province, the ninth most populous province of Iran.

This study examined the impact of the COVID-19 pandemic on marriage, divorce, birth, and death rates using the Poisson regression model and an interrupted time-series Poisson regression model. Before the pandemic, marriage and birth rates were decreasing, while divorce and death rates were increasing, with only the trend in birth rates being statistically significant. The immediate effect of the pandemic was a significant decrease in the divorce rate, but there were non-significant effects on birth and marriage rates. However, in the months following the onset of the pandemic, there was a statistically significant sustained effect on increasing death and divorce rates. Forecasts based on pre-pandemic data showed that by the end of 2020, marriage, divorce, death, and birth rates were higher compared to pre-pandemic levels. In conclusion, the pandemic has greatly impacted society, particularly in terms of death and divorce rates. Birth rates were not immediately affected to the time lag between decisions and actual births. Fear of COVID-19 may have increased death rates as people avoided seeking medical help. Vaccination and effective treatment strategies are vital in reducing the pandemic's impact on mortality. Supporting families financially is important due to the role of economic issues in couples' decisions.

Image-Based Modeling of Drug Delivery during Intraperitoneal Chemotherapy in a Heterogeneous Tumor Nodule.

Intraperitoneal (IP) chemotherapy is a promising treatment approach for patients diagnosed with peritoneal carcinomatosis, allowing the direct delivery of therapeutic agents to the tumor site within the abdominal cavity. Nevertheless, limited drug penetration into the tumor remains a primary drawback of this method. The process of delivering drugs to the tumor entails numerous complications, primarily stemming from the specific pathophysiology of the tumor. Investigating drug delivery during IP chemotherapy and studying the parameters affecting it are challenging due to the limitations of experimental studies. In contrast, mathematical modeling, with its capabilities such as enabling single-parameter studies, and cost and time efficiency, emerges as a potent tool for this purpose. In this study, we developed a numerical model to investigate IP chemotherapy by incorporating an actual image of a tumor with heterogeneous vasculature. The tumor's geometry is reconstructed using image processing techniques. The model also incorporates drug binding and uptake by cancer cells. After 60 min of IP treatment with Doxorubicin, the area under the curve (AUC) of the average free drug concentration versus time curve, serving as an indicator of drug availability to the tumor, reached 295.18 mol·m-3·s-1. Additionally, the half-width parameter W1/2, which reflects drug penetration into the tumor, ranged from 0.11 to 0.14 mm. Furthermore, the treatment resulted in a fraction of killed cells reaching 20.4% by the end of the procedure. Analyzing the spatial distribution of interstitial fluid velocity, pressure, and drug concentration in the tumor revealed that the heterogeneous distribution of tumor vasculature influences the drug delivery process. Our findings underscore the significance of considering the specific vascular network of a tumor when modeling intraperitoneal chemotherapy. The proposed methodology holds promise for application in patient-specific studies.

Lead and arsenic contamination in henna samples marketed in Iran.

Since ancient times, people around the world have used natural cosmetics to improve or change the appearance of their nails, skin, and hair. Henna is a plant-based dye that has been used over the centuries for medical and cosmetic purposes. The present work was aimed to investigate the presence of lead (Pb) and arsenic (As) in various types of commonly consumed henna samples in Iran. A total of thirty-nine henna samples from both local and imported products (3 colors in 13 brands) were randomly collected from popular and herbal medicine markets. The atomic absorption spectrometry (AAS) technique was used for the analysis of the samples. The amount of Pb and As in 100% samples was higher than the calculated limit of quantitation (LOQ). The concentrations of Pb and As in the samples were at the ranges of 9.56-16.94 µg/g and 0.25-1.12 µg/g, respectively. The mean level of Pb was higher in black and red products, compared with the green henna. The levels of Pb and As in 53.85% and 7.7% of the henna samples exceeded the permissible limits recommended by the World Health Organization (WHO), respectively. In addition, the mean levels of Pb and As contamination in the imported samples were significantly higher, in comparison to the local henna samples. To our knowledge, this is the first study assessing Pb and As contamination in the henna samples consumed in Iran. Our study demonstrated that there is a potential risk of exposure to Pb through henna in the Iranian consumers.

An analysis of suicide rates in Kerman province, the largest province in Iran, before and after COVID-19: (2017-2020).

This study aimed to investigate the suicide incidence rate in Kerman before and after the pandemic and the characteristics of suicides. During four years, 642 suicide occurred in Kerman province. The suicide rate of suicide has increased in 2020 compared to previous years. Suicide among females, singles, people with bachelor's degrees, students, governmental, non-governmental occupations, and people without a history of mental illness, and suicide history increased in 2020. Identifying individuals at risk is crucial in order to get exceptional support from the government and society during crises like COVID-19.

Cost-effectiveness of remdesivir for the treatment of hospitalized patients with COVID-19: a systematic review.

BACKGROUND: Remdesivir is being studied and used to treat coronavirus disease 2019 (COVID-19). This study aimed to systematically identify, critically evaluate, and summarize the findings of the studies on the cost-effectiveness of remdesivir in the treatment of hospitalized patients with COVID-19. METHODS: In this systematic review, PubMed, EMBASE, Web of Science, SCOPUS, and the Cochrane Library were searched for studies published between 2019 and 2022. We included all full economic evaluations of remdesivir for the treatment of hospitalized patients with COVID-19. Data were summarized in a structured and narrative manner. RESULTS: Out of 616 articles obtained in this literature search, 12 studies were included in the final analysis. The mean score of the Quality of Health Economic Studies (QHES) for the studies was 87.66 (high quality). All studies were conducted in high-income countries (eight studies in the USA and one study in England), except for three studies from middle-to-high-income countries (China, South Africa, and Turkey). Six studies conducted their economic analysis in terms of a health system perspective; five studies conducted their economic analysis from a payer perspective; three studies from the perspective of a health care provider. The results of five studies showed that remdesivir was cost-effective compared to standard treatment. Furthermore, the therapeutic strategy of combining remdesivir with baricitinib was cost-effective compared to remdesivir alone. CONCLUSIONS: Based on the results of the present study, remdesivir appears to be cost-effective in comparison with the standard of care in China, Turkey, and South Africa. Studies conducted in the United States show conflicting results, and combining remdesivir with baricitinib is cost-effective compared with remdesivir alone. However, the cost-effectiveness of remdesivir in low-income countries remains unknown. Thus, more studies in different countries are required to determine the cost-effectiveness of this drug.

Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis.

BACKGROUND: Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention. AIMS: We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries. METHOD: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts. RESULTS: From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean. CONCLUSIONS: The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.

Prevalence and Risk Factors for Suicidal Ideation Following the COVID-19 Pandemic in Kerman Province: A Cross-Sectional Study.

BACKGROUND: Suicidal ideation (SI) serves as an important predictor of suicide. The prevalence of SI has increased following the COVID-19 pandemic. This study aims to investigate the prevalence and risk factors associated with SI after the pandemic in the Kerman province. METHODS: This cross-sectional study was conducted in 23 counties of the Kerman province between 2021 and 2022. The Beck Scale for Suicidal Ideation (BSSI) was utilized to estimate SI, while multiple logistic regression analysis was employed to examine the impact of various variables on SI. RESULTS: A total of 1421 individuals (47.7% men, 50.0% women and 2.3% unknown) with an average age of 35.17±9.47 years participated in this study. The estimated prevalence rate of SI was 9.2%, with variations ranging from 0% to 42% across different counties. Individuals with SI exhibited a significantly younger mean age and fewer family members. Furthermore, SI was significantly more prevalent among single participants, unemployed individuals, students, those with a history of mental illness, prior psychiatric medication use, and previous SI. Employed individuals had 87% lower odds of experiencing SI compared to the unemployed. Individuals with a history of prior SI had 239 times higher odds of SI than those without such a history. Additionally, each year increase in age corresponded to an 8.8% decrease in the odds of SI. CONCLUSION: The high prevalence of SI is concerning, and it is essential to remain vigilant regarding its health and social consequences as the pandemic continues. Therefore, it is imperative to provide enhanced mental health services, particularly targeting at-risk groups.

Resilience and Suicidal Thoughts in Young People: Based on the Rafsanjan Youth Cohort Study.

BACKGROUND: Suicide is a serious public health problem, and suicide attempt is defined as one of the important indicators of mental health in a society. The present study investigated the relationship between resilience and suicidal thoughts in Rafsanjani youth. METHODS: This cross-sectional descriptive study examined 3006 young people aged 15-35 who referred to Rafsanjan Cohort Study (RCS). Connor and Davidson's questionnaire was used to measure resilience. The data, including demographic characteristics and cases related to suicide, were extracted from the computer system, which is part of the Rafsanjan Youth Cohort Program. Independent t-test, one-way analysis of variance, Tukey's post-hoc test, Pearson's correlation coefficient and multiple linear regression model were used to analyze the data. RESULTS: A total of 3006 individuals were studied, of whom 1685 (56.1%) were women, and 1321 (43.9%) were men. The average age of the participants was 25.75±6.09 years. Men had a significantly higher average score of resilience (P<0.001) and suicidal thoughts (P=0.002) than women. In addition, the average score of suicidal thoughts in divorced and widowed people was significantly higher than single and married people (P=0.029). It was shown that older age groups had higher average resilience (P<0.001) and fewer suicidal thoughts (P=0.003), and people over 30 years had the lowest average suicidal thoughts. CONCLUSION: The results indicate an inverse and significant relationship between resilience and suicidal thoughts in both men and women. Therefore, more evaluations are necessary to investigate the factors affecting resilience and take measures to improve it among young people.

Predictors of the intention to receive the COVID 19 vaccine by Iranians 18-70 year old: Application of health belief model.

BACKGROUND: In terms of public health, vaccination is considered as the most effective approach against the infectious diseases. Accepting and receiving the first vaccine produced as an innovation may not be easy. Therefore, the present study was conducted to investigate the predictors of intention to receive COVID-19 vaccine by Iranians aged 18-70 years based on the health belief model in 2021. MATERIALS AND METHODS: This descriptive study was performed on 2365 people aged 18-70-year old in Iran by random cluster sampling. Receipt of data was done electronically questionnaire through the Porcelain system. Data were analyzed using SPSS software version 20 using Chi-square, one-way analysis of variance, independent t-test, and multiple regression analysis at a significance level of 0.05. RESULTS: The mean score of receiving the Iranian corona vaccine was 3.06 ± 1.30 out of 5 points. About 16.7% reported that they will definitely choose the Iranian vaccine. The highest correlation was between the intention to receive the vaccine with self-efficacy (r = 0.239, P < 0.001) and barriers to receiving the vaccine (r = -0.237, P < 0.001). Self-efficacy (ß = 0.114, P < 0.001), perceived barriers (ß = -0.126, P < 0.001), and benefits of vaccine (ß = 0.061, P = 0.022) were most important predictors the intention to receive the vaccine. CONCLUSION: Approximately 38% reported that they would definitely and probably not choose the Iranian corona vaccine. Therefore, it is suggested that more information should be provided about the features and benefits of domestically produced vaccines compared to foreign products.

Association between Suicide Rate and Human Development Index, Income, and the Political System in 46 Muslim-Majority Countries: An Ecological Study.

Very little has been researched assessing the relationship between the suicide rate and the ecological perspectives of the country, especially in the Muslim majority countries. We aimed to determine the association between suicide rate and the ecological parameters of 46 Muslim majority countries. We extracted the Muslim majority countries and their suicide rate, income distribution, distribution of the WHO region and continents, and Human Development Index (HDI). We assessed the correlation of the proportion of Muslim populations, the total population of the countries, number of suicides, continent, income group, political system, and HDI score with the suicide rate. The median suicide rate was 5.45 (IQR = 4.8); 2.9 (IQR = 4) in females and 7.45 (IQR = 8.2) in males per 100,000 population. The males had a significantly higher rate and the highest suicide rate was found in Africa. There are inverse associations between the total suicide rate, the rate in males, and females with HDI, and the income of the country. Furthermore, the suicide rate was significantly higher in countries with democratic systems compared to non-democratic countries. The findings suggest that ecological parameters may have an etiological role on suicides in Muslim countries where HDI and income are inversely associated with suicide rates.

Are Nonfatal Suicide Attempts Instrumental in Achieving Personal and Interpersonal Goals?

This study focused on the well-being of the survivors of suicide attempts and the well-being of their interpersonal relationships after the attempt. The data came from a sample of 392 college students from 10 Muslim majority countries who reported having attempted suicide in the last 4 years. Suicide was conceptualized as a goal-directed behavior embedded in a sociocultural context and motivated by personal or interpersonal goals. We tested a process that linked culturally shaped self-construal to the postsuicidal personal and interpersonal well-being. We posited that this process would operate through the attitudes towards suicide, motives for suicide, the strength of the intention to die. Our model indicated that the acceptability of suicide was positively associated with escape motives, and this association was even stronger for the individuals with interdependent self-construals. Escape motives were negatively associated with postsuicidal personal and interpersonal well-being, but communication motives were not associated with these outcomes. We also found evidence that having an interdependent self-construal might be beneficial for postsuicidal personal and interpersonal well-being. Our results further suggested that the postsuicidal personal and interpersonal well-being of highly interdependent individuals may depend on the interpretation of their act of suicide by their close others.

Contamination of breast milk with lead, mercury, arsenic, and cadmium in Iran: a systematic review and meta-analysis.

Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country.

Drug delivery through nanoparticles in solid tumors: a mechanistic understanding.

Aim: In this study, the main goal was to apply a multi-scale computational model in evaluating nano-sized drug-delivery systems, following extracellular drug release, into solid tumors in order to predict treatment efficacy. Methods: The impact of several parameters related to tumor (size, shape, vessel-wall pore size, and necrotic core size) and therapeutic agents (size of nanoparticles, binding affinity of drug, drug release rate from nanoparticles) are examined in detail. Results: This study illustrates that achieving a higher treatment efficacy requires smaller nanoparticles (NPs) or a low binding affinity and drug release rate. Long-term analysis finds that a slow release rate in extracellular space does not always improve treatment efficacy compared with a rapid release rate; NP size as well as binding affinity of drug are also highly influential. Conclusion: The presented methodology can be used as a step forward towards optimization of patient-specific nanomedicine plans.

Mathematical Modeling of Targeted Drug Delivery Using Magnetic Nanoparticles during Intraperitoneal Chemotherapy.

Intraperitoneal (IP) chemotherapy has emerged as a promising method for the treatment of peritoneal malignancies (PMs). However, microenvironmental barriers in the tumor limit the delivery of drug particles and their deep penetration into the tumor, leading to reduced efficiency of treatment. Therefore, new drug delivery systems should be developed to overcome these microenvironmental barriers. One promising technique is magnetically controlled drug targeting (MCDT) in which an external magnetic field is utilized to concentrate drug-coated magnetic nanoparticles (MNPs) to the desired area. In this work, a mathematical model is developed to investigate the efficacy of MCDT in IP chemotherapy. In this model, considering the mechanism of drug binding and internalization into cancer cells, the efficacy of drug delivery using MNPs is evaluated and compared with conventional IP chemotherapy. The results indicate that over 60 min of treatment with MNPs, drug penetration depth increased more than 13 times compared to conventional IPC. Moreover, the drug penetration area (DPA) increased more than 1.4 times compared to the conventional IP injection. The fraction of killed cells in the tumor in magnetic drug delivery was 6.5%, which shows an increase of more than 2.5 times compared to that of the conventional method (2.54%). Furthermore, the effects of magnetic strength, the distance of the magnet to the tumor, and the magnetic nanoparticles' size were evaluated. The results show that MDT can be used as an effective technique to increase the efficiency of IP chemotherapy.

Epidemiology of occupational injuries in Kerman province during 2012-2016.

BACKGROUND: According to the World Health Organization, occupational injuries are significant health issues globally that affect social lives and economic status. This study aimed to assess the situation of occupational injuries in the Kerman province. METHODS: In this cross-sectional study, all occupational injuries registered in the Department of Cooperatives Labor and Social Welfare of Kerman Province were investigated during 2012-2016. Data were retrieved from an institutional database, including the official institutional software reports of Cooperatives Labor and Social Welfare occupational inspectors. The study used ArcGIS 10.3 software to prepare the geographical distribution of the cumulative incidence of occupational injuries on the map for each city. Data were analyzed using SPSS software. RESULTS: A total of 2228 subjects with a mean age of 34 years and a mean work experience of 4.5years were injured during 5 years. 73.2% of them were married. 96.4% of them were Iranian, and 61.3% had insurance. The most number of injuries occurred in the construction industry, fractures being the typical outcome of the injuries. The most injured organ was the hands. Kerman has the highest number of injuries with 804 cases. Incidence rates ranged was 93 to 138 cases per 100,000 people in 5 years. The highest cumulative incidence rates of accidents occurred in Zarand and Kahnuj, respectively, in 5 years. CONCLUSIONS: Despite the decrease in occupational injuries in recent years, it is a severe problem in Kerman province. Occupational injuries cause irreparable damages to human resources, and it, directly and indirectly, imposes costs for the family and the government. Therefore, considering safety in occupational environments to prevent occupational injuries should be a priority in planning.

Iran's National Suicide Prevention Program.

Background and Aims: Iran is one of the few countries in the Eastern Mediterranean Region (EMR) to have developed a national suicide prevention program (NSPP). This report introduces Iran's NSPP to policy planners and researchers working in suicide prevention, and is intended to encourage other low- and middle-income countries to develop, implement, and evaluate their own NSPPs. Method: This was a case study of a NSPP in one country, integrating quantitative and qualitative data. Bibliographic searches were conducted using both international and national databases, supplemented by other documents. The study benefited from the experiential evidence provided by the senior author. Results: While the national incidence of suicide is low, there are higher rates among young adults, particularly women, in western regions. In 2010, Iran's NSPP was integrated into primary health care. A rigorous evaluation of Iran's suicide prevention program concluded that Iran has the potential to take a leadership role in suicide prevention within the EMR, although several challenges were identified. Limitation: The findings of this case study cannot be generalized to other contexts. Conclusion: Given Iran's unstable situation, the NSPP needs to be monitored, evaluated, and adjusted according to evidence and ongoing changing national and local needs.