Iranian Journal of Public Health
Year:2023 | Volume:52 | Issue:1|Papers Count:25

Ever since the first Neanderthal fossils were found in a mine in Germany in 1856, paleontolo-gists have been puzzled by the research question: how those early humans were related to modern humans and what made them different. The re-lease of the Neanderthal genome opened the door to finding answers. Ancient DNA suffers from chemical damage and is usually present at very low levels in samples. This DNA can easily be contaminated by the DNA of the scientists working with them, making it difficult to distin-guish ancient genes from modern genes. Bacteria can also leave DNA in fossils, forcing scientists to learn how to isolate these genes. . .

Background: Cell transplantation is a promising therapeutic strategy for pulmonary fibrosis. In order to clarify the alveolar type II epithelial cell potential utility in the treatment of lung disease, we conducted a meta-analysis, to evaluate alveolar type II epithelial cells in animal models of lung injury and pulmonary fibrosis. Methods: This review followed the recommendations from the PRISMA statements, Comprehensive retrieval method was used to search Embase, PubMed, Cochrane, Chinese Knowledge Infrastructure, VIP and Wanfang databases. A total of 7 studies and 286 model rats were included. Two researchers independently screened the identified studies, based on inclusion and exclusion criteria. All analyses were conducted using Review Manager V. 5. 3 software. The combined standard mean difference (SMD) and 95% confidence interval (CI) of data from the included studies were calculated using fixed or random-effects models. Results: The analysis of three outcome indexes showed that the heterogeneity of the oxygen saturation group was high (I2=85%), the lung weight group (I2=64%) was close to moderate heterogeneity, and the lung hydrox-yproline content group (I2=0) was not heterogeneous. Conclusion: Meta-analysis showed that transplantation of alveolar type II epithelial cells has beneficial effects, and no obvious adverse reactions. Alveolar type II epithelial cell transplantation can significantly reduce the intervention group and lung hydroxyproline content weight, improve the blood oxygen saturation, lung histo-pathology showed significant improvement in pulmonary fibrosis.

Background: We aimed to evaluate the effect of dignity therapy on the dignity, distress, and quality of life of terminally-ill adult patients. Methods: All randomized controlled trials published prior to Jan 2021 were searched through database, includ-ing PubMed, Medline, OVID, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest Central, KMBASE, KoreaMed, NDSL, and RISS. The RoB 2 was used to assess risk of bias. Effect sizes, Hedge's g and Higgins I2–, statistics were used for meta-analysis. Results: We finally identified 10 studies for a systematic review, and eight studies out of them were selected for a meta-analysis. Overall, 776 participants were included in the meta-analysis. There were significant differences between with and without dignity therapy groups in dignity and anxiety (SMD =-0. 3805, Cl =-0. 5606,-0. 2004,SMD =-0. 1932, Cl =-0. 3774,-0. 0090, respectively) while there was no significant difference in quality of life and depression (SMD=0. 4678, Cl =-0. 0989, 1. 0345,SMD=-0. 0513, Cl=-0. 2461, 0. 1434, respectively). Conclusion: Dignity therapy may be effective for terminally ill patients on dignity and anxiety. We suggested further empirical studies with dignity therapy and repetitive meta-analysis in the future due to heterogeneity of the studies.

Background: In this study, the diagnostic efficacy of antigen test and antibody test were assessed. Additional-ly, the difference of sensitivity, specificity, and diagnostic odds ratio were compared concerning efficacy of an-tibody test versus antigen test for Corona Virus Disease 2019 (COVID-19) diagnosis. Methods: Online databases were searched for full-text publications and STATA software was used for data pooling and analysis before Sep 1st, 2022. Forrest plot was used to show the pooled sensitivity, specificity and diagnostic odds ratio. Combined receiver operating characteristic (ROC) curve was used to show the area of under curve of complex data. Results: Overall, 25 studies were included. The sensitivity (0. 68, 95% CI: 0. 53-0. 80) and specificity (0. 99, 95% CI: 0. 98-0. 99) in antibody or antigen was calculated. The time point of test lead to heterogeneity. The area un-der curve (AUC) was 0. 98 (95% CI: 0. 96-0. 99), and the diagnostic odds ratio (DOR) was 299. 54 (95% CI: 135. 61-661. 64). Subgroup analysis indicated antibody test with sensitivity (0. 59, 95% CI: 0. 44-0. 73) and speci-ficity (0. 98, 95% CI: 0. 95-0. 99) and antigen test with sensitivity of 0. 77 (95% CI: 0. 53-0. 91) and specificity of 0. 99 (95% CI: 0. 98-1. 00). Higher AUC and DOR were proved in antigen test. Conclusion: The present study compared the efficacy of antibody test versus antigen test for COVID-19 di-agnosis. Better diagnostic efficacy, lower heterogeneity, and less publication bias of rapid antigen testing was suggested in this study. This study would help us to make better strategy about choosing rapid and reliable test-ing method in diagnosis of the COVID-19 disease.

Background: Iron deficiency anemia in children or women in pregnancy, is a public health problem in some countries. The World Health Organization (WHO) has called on all countries to achieve a 5% re-duction in anemia in women of childbearing age, including adolescent girls, by 2025. One of the pro-grams is iron supplementation. The success depends on the adherence of adolescent girls to consume iron tablets. This systematic review aimed to find the level of compliance to iron supplementation con-sumption among adolescent girls and explore barriers and facilitator factors to such adherence. Methods: This article was a systematic review and conducted a multi-database search. The articles passed the PRISMA flow diagram process. The inclusion and exclusion rules decided the qualification of studies included. Of 1066 articles, we obtained 20 studies for the systematic review. Result: The lowest compliance found were 26. 2% and 26. 3%, and was high (>80%) in intervention stud-ies involving supervision and monitoring and peer educator. All articles' barrier and facilitator factors were classified into four categories,personal, social, environmental, and regimen. Conclusion: Efforts to improve adolescent compliance to take iron tablets should consider all of these factors.

Background: Sexual and marital satisfaction play an important role in the stability of couples' relationships, so it is necessary to take a proper approach to promote them. This study aimed to identify and categorize psycho-logical interventions affecting sexual satisfaction and marital satisfaction of women in Iran. Methods: An electronic systematic review search was conducted using the Persian and English databases of SID, Embase, PubMed, Scopus, Web of Science, Medline, Cochran library, and Google Scholar motor engine until 2021 to identify all relevant clinical trials and experimental and quasi-experimental studies assessing the effect of psychological interventions on sexual and marital satisfaction. Results: Totally, we retrieved 528 studies from the previously mentioned databases, of which, 38 met the eligi-bility criteria. The subgroup meta-analysis of 4 studies conducted showed that interventions based on individual consultations increase sexual satisfaction (MD: 2. 94, 95% CI: −, 0. 36 to 6. 24, P=. 23), (I2 =30. 83%). The subgroup meta-analysis of 10 studies conducted revealed that couple-based consultations increase marital satisfaction (MD: 5. 93, 95% CI:-2. 59 to 9. 27, P=. 95), (I2 = 0%). Conclusion: The results of meta-analysis demonstrated the effect of counseling-based psychological interven-tions on increasing sexual and marital satisfaction of couples. However, further clinical trials are required before making a definitive conclusion.

Background: Selenium (Se) is an essential element playing a vital role in the metabolism of organisms. Se can generally be discharged in the potable water through natural and anthropogenic activities. Both excess and shortage of Se can cause significant adverse health effects in humans. Excess values of se may stimulate toxici-ty, leading to selenosis and alkali disease in humans and grazing animals, respectively. Methods: A review search was systematically carried out from the databases Embase, PubMed/MEDLINE, Scopus, PubMed Central (PMC), Google Scholar, as well as medRxiv by using the following keywords: “, waste water”, , “, bioremediation”, , “, selenium removal”, , “, adsorption”, , and “, drinking water”, . This study provides a re-view of the recent literature covering the period between 2011 and 2021. After screening the full text of the articles, 27 papers were enrolled. This study reviews the reported techniques for Se removal from water and wastewater, including adsorption, biological treatment, microbial reduction, bioreactors, fungal bioreactor, algal treatment, phytoremediation, and photocatalysis. Results: Biological and bioremediation techniques, such as microbial reduction, biotransformation, and fluid-ized bed reactor have removal efficiency about 100%. The highest Se concentration of 15-7600 μ, g/L was achieved in ground waters in Ethiopia and the lowest level of 0. 07 μ, g /L in Finland. Conclusion: The combination of biological treatment with chemical or physical technologies is envisaged to optimize se elimination and to ensure ecological protection and human health safety.

Background: Smartwatches are a consumer wearable device offering a potential, practical, and affordable method to collect personal health data in healthy adults. For patients with chronic diseases, this would enable symptom monitoring and aid clinical decision making. Therefore, providing customized checklists to recommend smartwatches is beneficial. However, few studies have evaluated the practical functions of smartwatches and their influence on user acceptance. We aimed at developing a reliable tool to assess the quality of smartwatches from the users’,perspective. Methods: To develop the smartwatch rating scale (SWRS), we conducted a comprehensive literature review as well as reviewed relevant websites. The SWRS includes 22 items for the usability (usability, functionality, safety, material, and display) and five items for the acceptance and adoption domain (satisfaction and intention). We measured the scale’, s internal consistency and inter-rater reliability by evaluating seven smartwatches. Results: The overall scale demonstrated an excellent level of internal consistency (Cronbach’, s alpha = 0. 91), with each subscale’, s internal consistency above good level (0. 74 ~ 0. 92). Inter-rater reliability using intraclass correlation coefficients (ICC) was at good level (2-way random ICC = 0. 82, 95% CI 0. 09 –,0. 97). Conclusions: The SWRS is reliable, which can meet the need for assessment of smartwatch technology for utilizing in personal healthcare. Accounting for users’,perspectives will help make the most of technology without impairing the human aspects of care, this study can help consumers choose a smartwatch based on their prefer-ences and provide guidelines for developing user-friendly wearable devices aimed at health behavior changes.

Background: High-intensity competition pressure leads to psychological problems for athletes, which need to be improved through intervention. We aimed to explore the influences of PETTLEP (physical, environment, task, timing, learning, emotion, perspective) intervention on the psychological state of athletes, and provide references for their psychological improvement. Methods: Overall, 120 basketball players were enrolled through the convenience sampling method from Shaanxi, Yunnan, Fujian, and the national basketball team in China from April to June 2022. PETTLEP-based imagery intervention was given to all athletes, and their psychological resilience, training state, psychological skills, anxiety, and depression before and after the intervention were evaluated using a questionnaire survey. Results: The psychological resilience value of athletes after the intervention was higher than that before the intervention (P<0. 05). The psychological resilience index of athletes who trained for more than three years was higher than that of athletes who trained for less than 3 years (P<0. 05). The athletes who trained for over three years felt better after the intervention concerning good feelings, self-efficacy, self-adjustment, and physical fit-ness recovery than before the intervention (P<0. 05). No statistical differences in self-confidence, coordination ability, and motivation were observed among the athletes trained for different years before and after the inter-vention (P>0. 05). The athletes who trained for over three years have shown better results regarding focal atten-tion and cognitive regulation after the intervention than before the intervention (P<0. 05). Conclusion: The PETTLEP-based imagery intervention can improve the athletes’,psychological skills, relieves anxiety and depression, and enhance their psychological resilience.

Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a disease with high morbidity and mortality, which is an important health problem in the world. Therefore, we aimed to evaluate the effects of plasma fetu-in-A (FA) level, which is a new parameter in terms of prognosis and mortality of CCHF. Methods: A total of 87 patients were included who presented to the Emergency Department, Bağ, cı, lar Training and Research Hospital, İ, stanbul, Turkey with the diagnosis of CCHF from Feb 1, 2019 to Feb 1, 2020. The patients were divided into three groups as tick bite, contact history, and endemic area travel according to the transmission type, and two groups according to the presence of mortality or not. The laboratory data of the patients were compared within these groups. Relationship of hemogram, C-reactive protein (CRP), D-Dimer, sedimentation, lactate, and FA levels between groups were evaluated. Results: The average age of the patients was 62. 52±, 14. 94 years and 27(31%) of them were women. Mortality rates were in 6(6. 9%) patients from endemic areas (P=0. 015). While the FA level of the mortality group was 171. 6±, 30. 0 mg/L, it was 230. 3±, 25. 0 mg/L in the survivors (P=0. 001). There was a moderate and strong nega-tive correlation of FA level with mortality, tick history, and hospitalization. In ROC curve analysis of mortality and FA levels, parameters were determined as sensitivity 97. 4% and specificity 96. 2%. Conclusion: In addition to FA levels, as anticipated by our hypothesis, lactate, CRP, and sedimentation values can be used to predict prognosis and mortality in cases of CCHF.

Background: The imbalance of immune response between helper Th1 and Th2 cells is the direct cause of asthma. It was closely related to abnormal expression of lncRNAs. However, whether lncRNAs can regulate Th1/Th2 balance in pediatric asthma remains to be investigated. Methods: Peripheral blood samples were collected from children with asthma and normal volunteers at the Children’, s Hospital of Shaanxi Provincial People’, s Hospital (Xi’, an, China) in 2020. The qRT-PCR was used to detect the expression of lncRNA NEAT1, miR-217 and GATA3 in peripheral blood samples. The effects of lncRNA NEAT1, miR-217, and GATA3 on CD4+T cell population were detected in vitro. Meanwhile, the regulatory effect of lncRNA NEAT1/miR-217/GATA3 was evaluated through the dual luciferase report assay, functional assays and animal experiments. Results: We investigated that lncRNA NEAT1 and GATA3 was significantly up-regulated in CD4+T cells in peripheral blood of children with asthma (P<0. 001). Knockdown of lncRNA NEAT1 or GATA3 significantly reduced Th2-related cytokines (P<0. 05), but had no effect on Th1 cells. Importantly, the interactions of lncRNA NEAT1 with miR-217 and miR-217 with GATA3 were confirmed by dual luciferase report assay. Meanwhile, functional assays and animal experiments demonstrated that lncRNA NEAT1 regulated GATA3 expression through sponge miR-217, thereby regulating Th1/Th2 balance in CD4+T cells in pediatric asthma. Conclusion: lncRNA NEAT1/miR-217/GATA3 axis may reveal the immunological mechanism of pediatric asthma, which has potential clinical application value in the future.

Background: The study aimed to determine the impact of the burden of cardiovascular diseases on Gross Do-mestic Product (GDP) in Turkey. Methods: GDP was taken as the dependent variable and the burden of cardiovascular diseases was taken as the independent variable. The variables were analyzed within the frame of Panel Data Analysis. Results: Significant relationships were found between GDP and burden of cardiovascular diseases. The unidirec-tional Granger causality relationship was determined from burden of cardiovascular diseases to GDP and revealed that they acted together in the long term. The analysis that made with using econometric regression models re-vealed that generally 1 unit increased in per capita of cardiovascular diseases decreased GDP by between 477651. 8 –,624485. 6 units (PPP$). Conclusion: The empirical results of the study revealed that the cardiovascular disease burden was one of the reasons for the decrease in GDP and their economic effects would continue in the long term in Turkey. From this perspective establishing and implementing policies to improve the burden of cardiovascular diseases in Turkey could be an important approach for the economic development.

Background: To explore Arsenic trioxide (As2O3) and its regulated miR-885-5p/CDC73 signaling pathway involved in the development of gastric cancer. Methods: Fifty-two healthy patients and patients with gastric cancer were enrolled 2019-2020 in He Xian Memorial Hospital, Guangzhou, China. The patients with gastric cancer were divided into control group and As2O3 administration group. After 2 courses of treatment, their peripheral blood was collected to analyze the therapeutic effect. miR-885-5p expression in peripheral blood was analyzed by qRT-PCR. As2O3 was added into MGC-803 gastric cancer cell line at 0, 10, 20, 40 and 80 μ, mol/L. The proliferation rate and 48h IC50 val-ue of gastric cancer cells were investigated by CCK-8, and the effect of As2O3 on miR-885-5p expression in the cells was analyzed. Results: After 4 weeks of treatment, the objective efficiency of control group and As2O3 administration group was 17. 3% and 13. 4%, respectively, without significant statistical difference. The overall benefit rate of As2O3 administration group was significantly higher than that of the normal treatment group (P=0. 049). qRT-PCR experiment results found that miR-885-5p significantly highly expressed in peripheral blood in the As2O3 ad-ministration group, while miR-885-5p in gastric cancer was lower compared with normal people. Adding As2O3 to the gastric cancer cells could significantly inhibit miR-885-5p expression, while miR-885-5p in gastric cancer cells affected cell expression by targeted regulation, affecting cell proliferation. Conclusion: As2O3 may be used as a drug treatment program for gastric cancer, and mainly regulates the pro-liferation of gastric cancer cells by affecting the miR-885-5p/CDC73 target axis to participate in the develop-ment of gastric cancer.

Background: The aim of this study was to quantify perceived human rights status and put it into perspective to identify areas for monitoring action and progress. Methods: The subjects of this cross-sectional study included a sample of 703 respondents (369 males and 334 females) aged between 18 and 82 yr, divided into four age groups. The research was conducted from 23 Apr to 9 Nov 2021 and respondents from all 24 municipalities of Montenegro were included. The sample of variables contained the system of 19 general attitudes, which give a review of human rights accomplishments (modeled by a seven-point Likert scale). The variables were analyzed using ANOVA, MANOVA, and LSD Post Hoc test. Results: There were differences in the perceived human rights status for different age groups when the interin-dividual level of interaction (most negative answers in-group IV) and the principle of human rights legislation participation (most negative answers in group I) were considered. Conclusion: This fact indicates the existence of vulnerable age groups. Members of the oldest age category do not succeed in accomplishing adequate interpersonal communication with the persons from their nearest envi-ronment, while the opinion of the youngest age category is not respected enough and the possibility to participate equally in the making of important decisions is not being provided to them.

Background: We aimed to determine whether NLRP 3 inflammasomes in peripheral blood mononuclear cells (PBMC) were associated with carotid plaque instability in carotid atherosclerosis Methods: Consecutive 38 carotid atherosclerosis with vulnerable plaques, 22 carotid atherosclerosis with stable plaques, and 40 healthy subjects with no carotid or coronary artery stenosis were enrolled. They were referred to the Second Hospital of Dalian Medical University from 2013-2019. Carotid plaques were evaluated by modi-fied plaque vulnerability risk score (MPVRS) and pathological assessment. The mRNA and protein expression of NLRP3 inflammasome components in PBMC were determined by quantitative real time PCR and Western blot analysis or ELISA. Results: When consecutive study subjects undergoing carotid endarterectomy were divided into stable (≤, 4) and unstable (>4) plaque groups according to the MPVRS, the unstable plaque group had significantly raised mRNA and protein expression of NLRP3 inflammasome components in PBMC as compared with the stable plaque group and healthy subject group. Furthermore, subjects with higher NLRP3 protein expression in PBMC had greater incidence of cerebrovascular events. Conclusions: Increased NLRP3 inflammasome components in PBMC is associated with instability of human carotid atherosclerotic plaques, suggesting NLRP3 inflammasome as a potential biomarker for monitoring ca-rotid plaque instability.

Background: We aimed to evaluate the frequency of frailty and the affecting factors in people living in our society over 65 yr old. Methods: Our descriptive and cross sectional study included 261 individuals aged 65 and over who applied to Ankara Training and Research Hospital family practice centers and district polyclinics from 1 Jan to 1 Feb 2020. The participants were asked to complete a s ociodemographic data form, FRAIL Scale, Katz Daily Living Activities Scale, Lawton&Brody Instrumental Activities of Daily Living Scale and Geriatric Depression Scale Short Form. Results: According to the FRAIL Scale results: 35 people were found to be frai l ( 13. 4%), 115 to be pre frail 44. 1%). No frailty was observed in 111 people ( 42. 5%). While the mean score of the Katz Activities of Daily Living Scale was found to be 5. 65±, 0. 71, the mean score of the Lawton & Brody Instrumental Activities of dialy Living Scale was found to be 6. 65±, 1. 69. In the geriatric depression evaluation, mild, medium or severe pression was detected in 87 participants ( 33. 2%33. 2%). As the level of frailty increased, the Geriatric Depression Scale score climbed significantly ( P 0. 001 ). In f rail individuals, Lawton&Brody Scale scores were significantly lower P 0. 001 ). In our study: a correlation was found between frailty and female gender, being single, low income, low educational level, obesity, polypharmacy and decreased physical activity. Additionally, as the number of children increase frailty in women increases therewithal. Conclusion: Elderly people had high frailty. Polypharmacy, depression and reduced physical activity were the more frequent in frail elderly. In frail females, the number of children was significantly higher.

Background: In 2017, the American Academy of Pediatrics (AAP) updated clinical practice guidelines for the diagnosis and management of hypertension in children. The present study aimed to assess the prevalence of hypertension in Iranian chil-dren based on the latest guidelines. Methods: Data on 7301 student participants (3589 boys and 3712 girls) aged between 7-12 yr were assessed. The data were extracted from the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN V) school-based study conducted in the 30 provinces of Iran in 2015. Blood pressure (BP) was classified as nor-mal, elevated BP, and stage 1 and 2 hypertension using weighted analysis and the 2017 AAP guidelines. All analyses were performed in STATA 14. 0 statistical software, with findings presented in terms of prevalence. Results: The overall prevalence of high BP in Iranian children was 14. 7%. In addition, 15. 1% of boys had high BP, with 9. 4% and 1. 7% of them with stage 1 and 2 hypertension, respectively. Moreover, 14. 3% of girls had high BP, of which 10% had stage 1 and 1. 3% with stage 2 hypertension. For elevated hypertension, it was observed in 4% of boys and 3% of girls. Conclusion: Using the 2017 AAP guidelines demonstrated a higher prevalence of hypertension in children (14. 7%) in Iran. The prevalence of hypertension in boys was slightly higher compared to girls.

Background: Intensive Care Unit (ICU) has the highest mortality rate in the world. ICU has special equipment that leads to the hospital's most costly parts. The length of stay in the ICU is a special issue, and reducing this time is a practical approach. We aimed to use artificial intelligence to help early and timely diagnosis of the dis-ease to help with health. Methods: We designed a rule-based intelligent system to predict the length of stay and the mortality rate of trauma patients in ICU. A neuro-Fuzzy and eight machine learning models were used to predict the mortality rate in trauma patients in ICU. The performances of these techniques were evaluated with accuracy, sensitivity, specificity, and area under the ROC curve. Decision-Table was used to predict the length of stay in trauma pa-tients in ICU. For comparison, eight machine learning models were used. The method is compared based on Mean absolute error and relative absolute error (%). Results: Neuro-Fuzzy expert system and Decision-Table showed better results than other techniques. Accura-cy, sensitivity, specificity, and ROC Area of Nero-Fuzzy are 83. 6735, 0. 9744, 0. 3000, 0. 8379, and 1, respective-ly. The mean absolute error and Relative absolute error (%) of the Decision-Table model are 4. 5426 and 65. 4391, respectively. Conclusion: Neuro-Fuzzy expert system with the highest level of accuracy and a Decision-Table with the low-est Mean absolute error, which are rule-based models, are the best models. Therefore, these models are rec-ommended as a valuable tool for prediction parameters of ICU as well as medical decision-making.

Background: The emission of volatile organic compounds (VOCs) in industrial and urban areas has adverse effects on the environment and human health. Toluene, the main pollutant among the VOCs, has wide appli-cations in different industries such as plastics, adhesives, silicone sealant, paint, etc. This study aimed to re-move of toluene from the air by using TiO2 nanoparticles supported on the natural zeolite using the photo-catalytic process. Methods: This is an experimental study that was conducted in 2017 in the Chemical Agents Laboratory of the Occupational Health Engineering Department at Jundishapur University in Ahvaz. Toluene vapour decompo-sition was carried out using UV/ZE, UV/TiO2, and UV/TiO2-ZE under continuous flows conditions. The effects of toluene initial concentration, retention time, and nanocomposite surface weight on toluene vapour decomposition were also investigated. Results: When UV/TiO2 and UV/TiO2-ZE systems are performed, increasing the initial toluene concentra-tion reduces the efficiency of photocatalytic decomposition. The SEM images of TiO2-ZE catalyst show that zeolite pores were occupied by titanium dioxide nanoparticles. Moreover, the combination of titanium dioxide nanoparticles and zeolite has an incremental effect on toluene decomposition. Increasing retention time raises toluene decomposition, and the increased nanocomposite surface weight raises decomposition to the maxi-mum level (70%) at 33. 68 mg/cm2 weight and then decreases. Conclusion: The increasing toluene decomposition rate by using the TiO2-ZE nanocomposite can be due to the incremental effect of absorption and photocatalytic decomposition.

Background: Despite of the remarkable achievement in control of tuberculosis, it is still a challenging health problem in Iran. Success in any health program depends on monitor the diseases epidemiology and finding the gaps. We aimed to describe the epidemiological profile of TB patients in Iran to find the gaps in the TB pro-gram and using the finding to set the program activities. Methods: This cross-sectional study was performed based on the data of tuberculosis patients registered in Iran in 2016-2017. The information of all TB patients is registered in the TB registry software. The patients were followed during the treatment phase. The data were analyzed by SPSS 23 software using Chi-Square test. Results: Overall 12% of cases were Afghans and 72. 3% of patients had pulmonary tuberculosis. There was a significant difference in the success rate of treatment in smear-positive pulmonary patients by gender, HIV sta-tus, marital status, history of hospitalization and incarceration (P <0. 01). The highest prevalence of antibiotic resistance was related to isoniazid (9. 9%). In close contact persons who requiring prophylaxis, 65. 3% of adults and 73. 6% of children received full period of prophylaxis, Conclusion: Despite of the TB treatment success and low prevalence of MDR cases, TB incidence has not been decreased significantly in Iran. Delay in diagnosis, high TB burden in refugees and close contact investiga-tion and prophylaxis are important issues in the TB control program in Iran to be considered in the control planning.

Internal hernias (IH) are rare situations that account for 0. 5–, 3% of all cases of intestinal obstruction. Transomental hernia is a rare subtype, hardly diagnosed, and represents approximately only 2% of internal hernias. In 2018, a 41-year-old female patient presented to Marmara University Hospital emergency service with abdominal pain, nausea, and vomiting. Her medical history included asthma, and she had no abdominal surgery. With the preliminary diagnosis of small bowel obstruction, laparotomy was done and showed a loop of ileum was herniated through into an unusual defect of the omentum. The obstructed loop of the small intestine into the hernia site was reduced. It was seen as viable, so no resection was necessitated. We divided the greater omentum into two parts from the edge of the defect area to prevent recurrences. The patient's postoperative period was uneventful, and she was discharged on the second postoperative day. Small bowel strangulation is more seen in transomental hernia than in other internal hernia types. So it is related to high morbidity and mortality. Surgery should not be delayed to reduce complications.

Although superficial heat therapy is most often used as a physical therapy for treating low back pain (LBP), it has a disadvantage that it has a great effect of heating the skin and subcutaneous tissue and cannot penetrate deep tissue. Deep heat treat-ments such as microwave diathermy (MWD) are more effective in order to penetrate deep into the muscles and have a relaxing effect on the tissues (1). MWD uses electromagnetic energy to increase the kinetic energy of molecules and convert it into thermal energy to generate deep heat (2). MWD does not stimulate sensory and motor nerves due to its short pulsation period, and there is no risk of electrolyte burns (3). Despite the many benefits of MWD, few studies have specifically investi-gated the effects of MWD combined with exercise therapy. Therefore, this study was conducted to investigate the effect of MWD combined with trunk balance exercise on pain and function in chronic LBP pa-tients. Subjects were 20 outpatients with chronic LBP, and were randomly assigned to the experimental group (MWD + trunk balance exercise) (n = 10) or control group (sham MWD + trunk balance ex-ercise) (n = 10). The therapeutic dose of MWD in this study was an intermediate dose (80W) and was performed for 20 min at a time, 3 times a week, and for 6 weeks. It was applied without turning on the mi-crowave for the sham treatment, but the patients received it in a prone position, and the MWD have little sense of treatment, so they did not notice the sham treatment. The trunk balance exercise performed by the sub-jects included hip extension by lifting the pelvis in a supine position, quadruped position with one arm and the opposite leg extension, and balancing by lifting both feet off the floor with only one hip on the table. The trunk balance exercise was per-formed for 15 min immediately after MWD. Differences in general characteristics between the experimental group and the control group before intervention were compared using the Mann-Whitney tests and chi-square tests. The Wilcoxon signed-rank tests were performed to assess the be-fore and after effects in each group. The Mann-Whitney tests were used to assess differences be-tween real MWD and sham MWD. For all anal-yses, P values <0. 05 were considered significant and statistical analysis was performed using SPSS version 20. 0 (IBM Corp., Armonk, NY, USA). . .

Candidemia is one of the most common forms of Candida infections in hospitalized patients and depending on the species, the mortality rate may vary from 30->50% (1). An increasing clinical failure, morbidity, and mortality of candidemia caused by non-Candida albicans Candida (NCAC) species is reported (2). Moreover, the lack of ap-propriate identification tools allowed the domi-nance of one of the scariest Candida species, which nowadays is a matter of public health con-cern in developing countries. Candida blankii as a novel Candida species first reported in 1968 (3). Recently, these species have been recorded as one of the newly emerging pathogenic Candida species that in some cases has led to candidemia, particularly in patients with cystic fibrosis (4). The first human case of C. blankii was reported in the 1990 decade by a prospective candidemia study in Norway (5). In addition, C. blankii was isolated from atopic dermatitis of a two-month-old neonate in Russia (6). Subsequently, can-didemia caused by C. blankii was diagnosed from a 14-year-old boy patient with cystic fibrosis whose this yeast was isolated from his respiratory specimens in 2015 (7). In the next report, the sit-uation was a little different. The patient was a 27-week-old preterm neonate in Kuwait who had necrotizing enterocolitis and needed surgery. unfortunately, after the surgery, the patient was suf-fering from a blood infection. Preliminary blood culture results showed bacterial infection with Staphylococcus epidermidis and Enterococcus faecalis, which led to the administration of antibiotic ther-apy. Before the second operation, the results of a blood culture showed that there was a Candida species. After various tests, it was determined as C. blankii (8). In India, by sequencing of internal transcribed spacer (ITS) and D1/D2 regions had diagnosed C. blankii fungemia in nine infants. All nine neonates received fluconazole as a treatment but four of them died (9). Despite these limited reports, it can be assumed that C. blankii is not limited to people with cystic fibrosis. C. blankii is not a normal flora of human skin and mucosal membranes but it may colonize damaged skin as it was isolated from the skin of an atopic dermatitis patient (6). Like C. auris, C. blankii can adhere to plastic surfaces and form biofilms, so great care must be taken with the plastic equipment used in these patients, especial-ly catheters (5, 9). C. blankii can tolerate high temperatures and high salt concentration so it is able to be a human colonizer and pathogen (9). The pathogenicity of C. blankii was compared with C. albicans in the Galleria mellonella insect model. C. blankii was significantly less virulent than the C. albicans (4). In vitek2 yeast identifica-tion system, C. blankii was misidentified as Stepha-noascus cifferi with 89% probability (8). Mostly, C. blankii remained unidentified by MALDI-TOF mass spectrometry (8). In fact, not all MALDI-TOF MS libraries can identify C. blankii. In a study, a MALDI-TOF in-house database was created using the first two molecularly identified strains (9). C. blankii produces typical yeast-like white to cream colonies with a smooth surface and entire margins in sabouraud dextrose agar, and initially developed pink colonies in CHROM agar Candida. Thus they both have almost the same colony with the difference that C. blankii subsequently developed into dark metallic blue similar to C. tropicalis (4, 8). However, the best method to identify C. blankii is sequence analysis of the internal transcribed spacer 1 and D1/D2 region from the 26S subunit of the rRNA. Various antifungals by using mi-crodilution and E-test methods were tested against this species, altogether micafungin and amphotericin B had potent activity against this species (4, 5, 7-9). As the number of studies and recorded cases are very limited, it is expected that there will be no accurate and complete infor-mation about the treatment of patients with C. blankii infection (4). In some neonate cases, the patient expired despite using fluconazole and mi-cafungin in the early days of diagnosis. However, one of the evidence recorded is that amphotericin B had strong in vitro activity against C. blankii and is recommended for the treatment of C. blankii infections. In conclusion, due to the decreased antifungal susceptibility of C. blankii, treatment failure has incremented. However, more diagnosis and treatment considerations should be taken for suspected C. blankii candidemia cases.

Preterm birth is a childbirth occurring at less than 37 completed weeks and about 120 million babies are born worldwide each year (1). According to statistics, an average of 32 million low birth weight babies are born each year in low-income countries, which two-thirds of them are in Asia (2). The WHO also reported a 10 percent prevalence of low birth weight in Iran (1)...

Lichen planus (LP) is a chronic inflammatory dis-ease that typically affects the skin and mucous membranes. Inflammation has been shown to affect lipid and carbohydrate metabolism, insulin signaling, and adipogenesis (1). Adipose tissue is an active endocrine organ that secrete numerous factors such as adiponectin, which influence carbohydrate and lipid metabo-lism (2). Low plasma adiponectin levels have been reported in a variety of conditions, includ-ing obesity, type 2 diabetes, and LP (2, 3). How-ever, whether these differences in adiponectin levels in LP are due to the high prevalence of comorbidities such as diabetes and obesity or the sole effects of disease on adiponectin is not ob-vious. In this study, we examined the lipid profile and serum adiponectin levels in patients with LP and healthy controls. Thirty-nine patients diagnosed with LP and 19 controls were included. All participants signed an informed consent form before the study. This report was approved by the local ethics commit-tee. Blood samples were taken after a 12 hour fast. An enzyme-linked immunosorbent assay (ELISA) method was applied to determine serum adiponectin levels. Dyslipidemia was defined as total cholesterol (TC) > 200 mg / dl, low-density lipoprotein cho-lesterol (LDL) > 130 mg / dl, triglyceride (TG) > 150 mg / dl and high-density lipoprotein choles-terol (HDL) < 40 mg / dl in men or HDL < 50 mg / dl in women (4). Central obesity was de-fined as a waist circumference of at least 88 cm in women and 102 cm in men (5). The independent t-test, chi-square test, correla-tion analysis, and regression were used to exam-ine differences between the two groups. Statisti-cal analysis was performed with SPSS version 19 (IBM Corp., Armonk, NY, USA). Of 39 patients, 20 (51. 3%) had oral involvement and 19 (48. 7%) had cutaneous involvement. The patient and control groups showed no significant differences in terms of age and gender. The patients had a significantly larger mean waist circumference than the controls (P= 0. 013). Ac-cording to the frequency of participants with cen-tral obesity or dyslipidemia, no significant differ-ences were found between patients and controls. Serum TG levels were significantly higher in pa-tients than in controls (P = 0. 030). In addition, the patients had significantly lower serum adi-ponectin levels than the controls (P=0. 004). There was a positive correlation between serum adiponectin and HDL levels in patients (correla-tion (r) = 0. 346,P= 0. 031). A backward linear regression model showed that LP was associated with adiponectin levels even after adjusting for dyslipidemia, FBS, and obesity (B = 0. 307,β,= 0. 373,t = 3. 006,P= 0. 004). However, concerning the above parameters, no significant differences were observed between patients with oral and cutaneous involvement. Various interleukins (ILs) are elevated in LP pa-tients, which may play an essential role in the de-velopment of dyslipidemia (6). Panchal et al ob-served significantly higher TC, TG, and LDL lev-els and lower HDL levels in LP patients com-pared to controls (7). Conversely, Ö, zkur et al found no significant differences in serum levels of TC, LDL, and TG between patients with LP and controls (8). Our study showed significantly higher TG levels in patients with LP than in controls. However, no significant differences were observed between the two groups concerning other parameters of the lipid profile. The different ranges of LP duration in this study may have influenced lipid profiles of patients. Our study also showed that patients with LP had significantly lower serum adiponectin levels than controls. Similarly, Ismail et al found significantly lower serum adiponectin levels in LP patients (3). The prevalence of comorbidities such as diabetes and dyslipidemia is higher in patients with LP (1). Patients with obesity, diabetes, and dyslipidemia often have low levels of adiponectin (9). Howev-er, we found that LP was associated with lower plasma adiponectin levels regardless of dyslipidemia, diabetes, and obesity. We suggest that lower adiponectin levels in LP patients are not entirely due to the high rate of comorbidities in LP, but rather to a unique effect of LP on adi-pose tissue function and adiponectin signaling. These results may be due to the complex interac-tions between elevated levels of various cytokines and adipose tissue in LP. In conclusion, early lipid profile screening in LP patients may not be of great value and inflamma-tion present in LP may be associated with adi-pose tissue dysfunction.