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Airborne particulate matter in Tehran�s ambient air
No full textIn recent decades, particulate matter (PM) concentrations in Tehran have exceeded the World Health Organization�s (WHO) guideline on most days. In this study, a search protocol was defined by identifying the keywords, to carry out a systematic review of the concentrations and composition of PM in Tehran�s ambient air. For this purpose, searches were done in Scopus, PubMed, and Web of Science in 2019. Among the founded articles (197 in Scopus, 61 in PubMed, and 153 in Web of Science). The results show that in Tehran, the annual average PM10 exceeded the WHO guidelines and for more than 50.0 of the days, the PM2.5 concentration was more than WHO 24-h guidance value. The PM concentration in Tehran has two seasonal peaks due to poorer dispersion and suspension from dry land, respectively. Tehran has two daily PM peaks due to traffic and changes in boundary-layer heights; one just after midnight and the other during morning rush hour. Indoor concentrations of PM10 and PM2.5 in Tehran were 10.6 and 21.8 times higher than the corresponding values in ambient air. Tehran represents a unique case of problems of controlling PM because of its geographical setting, emission sources, and land use. This review provided a comprehensive assessment for decision makers to assist them in making appropriate policy decisions to improve the air quality. Considering factors such as diversity of resources, temporal and spatial variations, and urban location is essential in developing control plans. Also future studies should focus more on PM reduction plans. © 2021, Springer Nature Switzerland AG
Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS)
Get PDFBackground: The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran. Methods: This study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome. Results: Overall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50�65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6). Hypertension RR: 5.1 (4.7,5.5), waist circumference (WC) equal or more than 90 cm RR: 3.6 (3.3,3.9), and family history RR: 2.3 (2.2,2.5) were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years RR: 2.6 (2.4,2.8), BMI 30 kg/m2 or higher RR: 1.9 (1.8,2.0), hypertension and WC of 90 cm or higher RR: 1.7 (1.6,1.8). The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes. Conclusions: Prediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran. © 2021, The Author(s)
Assessing research misconduct in Iran: a perspective from Iranian medical faculty members
Get PDFBackground: Research misconduct is a global concern in biomedical science. There are no comprehensive data regarding the perception and situation of scientific misconduct among the Iranian medical faculty members. We conducted a nationwide survey to assess the research misconduct among the medical faculty members in Iran. Methods: We used the Persian version of the research misconduct questionnaire (PRMQ) on the Google Forms platform. We sent the survey link to a systematic random sample of medical faculty members in Iran (N = 4986). Descriptive analyses were performed on the individual items of the PRMQ, with frequencies and percentages for categorical and Likert-type response items, and means and standard deviation (S.D.) for continuous variables. Chi-square analysis was conducted to test hypotheses examining differences in the frequency of responses related to factors influencing misconduct. We also defined four tenure categories (TC) based on the working years of the participants as tenured faculty members. All the analyses were performed using R 3.6.0. Results: The response rate was 13.8 (692 responses). Nearly 70 of the respondents agreed that their publication output would be of higher quality if there were no publication pressure. Approximately three-quarters (N =499, 72.1) of the respondents had been aware of some instances of research misconduct during the previous year according to their understanding of misconduct. Among the participants, 18.5 perceived the effectiveness of their associated organisation�s rules for reducing research misconduct to be high or very high. Pressure for tenure was identified as the item most frequently perceived with a strong behavioural influence on engaging in research misconduct (80.2). Conclusions: This study confirms that research misconduct needs to be actively addressed among the medical faculty members. Making policies with a focus on boosting awareness regarding the occasions of scientific misconduct and its management seems to be indispensable in the future in Iran. © 2021, The Author(s)
Correction to: The health-related quality of life in Iranian patients with COVID-19 (BMC Infectious Diseases, (2021), 21, 1, (459), 10.1186/s12879-021-06170-z)
Get PDFAfter publication of the original article 1, an error was identified in two authors� names. The incorrect names are: Sima Pourteymour; Hassan Mahmoudi The correct names are: Sima Pourteimour; Hassan Mahmoodi The original article has been corrected. © The Author(s). 202
Risk factors for transient and permanent congenital hypothyroidism: a population-based case-control study
Get PDFBackground: Congenital hypothyroidism (CH) is the most important cause of mental and physical retardation in newborns. The prevalence of CH has been reported high in East Azerbaijan province of Iran. However, the risk factors for CH are poorly understood. This study aimed to determine and compare risk factors for permanent and transient CH in East Azerbaijan, Iran. Methods: A case-control study was conducted in the Iranian national screening program for CH. This study included 680 neonates: 340 neonates with confirmed CH and 340 matched healthy controls born at the same period and from the same residential area as the cases. Multiple logistic regression analyses were used to estimate the crude and adjusted odds ratios and 95 confidence intervals for the association between different risk factors and transient and permanent CH. Results: Out of the 680 participants, 364 (53.53) were male. Family history of CH (OR = 5.09, 95 CI: 1.66�15.63), neonatal jaundice (OR = 3.89, 95 CI: 2.36�6.43) and parental consanguineous relation (OR = 2.19, 95 CI: 1.51�3.17) were associated with an increased risk of permanent CH. Likewise, the use of Betadine in pregnancy (OR = 4.87, 95 CI: 1.45�16.28), family history of CH (OR = 5.98, 95 CI: 2.04�17.48), neonatal jaundice (OR = 2.81, 95 CI: 1.75�4.52), parental consanguineous relation (OR = 3.86, 95 CI: 1.92�5.74), and gestational age at birth (OR = 3.2, 95 CI: 1.90�5.41) were identified as risk factors for transient CH. Conclusion: Family history, neonatal jaundice, gestational age at birth, and Betadine usage in pregnancy are associated with CH. © 2021, The Author(s)
Complete genotype and clinical phenotype of hemophilia B: A study on iranian patients
No full textBackground: Hemophilia B which refers to the deficiency or functional defect of factor IX (FIX) is typically an X-linked bleeding condition that arises from heterogeneous mutations of the FIX gene (F9). The number of hemophilia cases in Iran is considerable and currently, about 1118 Iranian patients are suffering from hemophilia B, although a small number of them underwent genetic investigations. Here we assessed molecular defects and also laboratory and clinical findings of 10 Iranian cases with hemophilia B. Materials and Methods: A total of 10 cases with hemophilia B were enrolled in the study. Patients were clinically examined by a hematologist and their previous medical documents were surveyed carefully. Routine coagulation tests and FIX activity and antigen assays were performed for the studied patients. Genotyping of F9 for identifying genetic mutations was conducted by the Sanger sequencing method following PCR amplification of the promoter region and all the eight exons of the F9 gene. Results: The mean age of patients was 4 years (9 months to 16 years) and consanguinity was reported in 80 of cases. Patients were commonly manifested by hematoma (90), epistaxis (80), and hemarthrosis (70) and the severity of the disorder was severe (70) or moderate (30). In nine out of 10 patients a genetic defect in F9 gene we detected including three missense (c.304T>C, c.1007T>A, c.191G>A) and three nonsense mutations (c.892C>T, c.880C>T, c.1113C>A). Based on the FIX variant database (http://www.factorix.org), five mutations have been reported previously, but mutation c.1007T>A (p.Ile336Asn) seems to be a novel mutation. Conclusion: Our results indicated the heterogeneous molecular defects of hemophilia B in Iran, as recorded in the FIX mutation database. Moreover, no specific genotype-phenotype association was observed in studied subjects. © 2017 University of Bahrain. All rights reserved
Effects of dexmedetomidine on clinical outcomes and renal function after CABG
No full textBackground: This study was carried out to determine the effects of dexmedetomidine on clinical outcomes and renal function after coronary artery bypass grafting (CABG) to address the increased rate of CABG? and the importance of modification in stress responses and control of adverse effects on renal function and with the aim of cost reduction. Materials and Methods: This double-blind randomized clinical trial was carried out with the participation of 129 subjects under elective CABG in Rajaei Heart Center, Tehran, Iran in 2017. Patients were randomly assigned to four groups with simple randomization including one placebo (normal saline infusion) group and three dexmedetomidine groups; 0.5 µg/kg/h on CPB, 0.5 µg/kg/h in 24 hours, and 0.75 µg/kg/h in 24 hours. The blood pressure, blood urea nitrogen (BUN), serum creatinine, transfused blood volume, urine volume, and hemofiltration on pump and lactate were assessed at different time intervals. Results: Results showed more stability especially in central venous pressure (CVP) (p=0.001) and systolic blood pressure (p=0.006) in the groups receiving dexmedetomidine 0.75 µg/kg/h per 24 hours. But diastolic blood pressure and heart rate were the same across the groups (p>0.05). All other variables including hepatic and renal function tests were the same across the groups (P>0.05). Conclusion: Overall, according to the obtained results in the current study, it may be concluded that dexmedetomidine would have some promising effects on hemodynamic stability but there are no obvious renoprotective effects for this medication. © 2021 Journal of Cellular and Molecular Anesthesia. All rights reserved
Prediction of neonatal deaths in NICUs: development and validation of machine learning models
Get PDFBackground: Prediction of neonatal deaths in NICUs is important for benchmarking and evaluating healthcare services in NICUs. Application of machine learning techniques can improve physicians� ability to predict the neonatal deaths. The aim of this study was to present a neonatal death risk prediction model using machine learning techniques. Methods: This study was conducted in Tehran, Iran in two phases. Initially, important risk factors in neonatal death were identified and then several machine learning models including Artificial Neural Network (ANN), decision tree (Random Forest (RF), C5.0 and CHART tree), Support Vector Machine (SVM), Bayesian Network and Ensemble models were developed. Finally, we prospectively applied these models to predict neonatal death in a NICU and followed up the neonates to compare the outcomes of these neonates with real outcomes. Results: 17 factors were considered important in neonatal mortality prediction. The highest Area Under the Curve (AUC) was achieved for the SVM and Ensemble models with 0.98. The best precision and specificity were 0.98 and 0.94, respectively for the RF model. The highest accuracy, sensitivity and F-score were achieved for the SVM model with 0.94, 0.95 and 0.96, respectively. The best performance of models in prospective evaluation was for the ANN, C5.0 and CHAID tree models. Conclusion: Using the developed machine learning models can help physicians predict the neonatal deaths in NICUs. © 2021, The Author(s)
Comparing the efficacy and side-effects of PDLASTA® (Pegfilgrastim) with PDGRASTIM® (Filgrastim) in breast cancer patients: a non-inferiority randomized clinical trial
Get PDFBackground: The objective of this study was to compare the efficacy and side effects of a single dose (Pegfilgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial. Methods: In this randomized clinical trial, 80 patients were recruited and allocated randomly to two equal arms. In one group, a single subcutaneous dose of PDL was injected the day after receiving the chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of PDG for six consecutive days in each cycle of treatment. The side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight cycles of chemotherapy. Results: Hematologic parameters showed no significant differences in any of the treatment courses between the two study groups. The comparison of WBC (p = 0.527), Hgb (p = 0.075), Platelet (p = 0.819), Neutrophil (p = 0.575), Lymphocyte (p = 705) and ANC (p = 0.675) changes during the eight courses of treatment also revealed no statistically significant difference between the two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs. Conclusion: It seems that PDL is non-inferior in efficacy and also less toxic than PDG. Since PDL can be administered in a single dose and is also less costly, it can be regarded as a cost-effective drug for the treatment of chemotherapy-induced neutropenia. Trial registration: IRCT20190504043465N1, May 2019. © 2021, The Author(s)
Up-regulation of sex-determining region Y-box 9 (SOX9) in growth hormone-secreting pituitary adenomas
Get PDFBackground: Pituitary adenomas are benign brain tumors that cause considerable morbidity and neurological symptoms. SOX9 as a regulatory transcriptional mediator affects normal and tumor cell growth with an undefined role in pituitary adenomas pathogenesis. Thus, in the present study, the expression pattern of SOX9 in GH-secreting pituitary tumors and normal pituitary tissues is investigated. Methods: The SOX9 gene expression level was evaluated in 60 pituitary tissues including different types of GH-secreting adenomas and normal pituitary tissues through Real-Time PCR. The protein level of SOX9 was assessed using immunohistochemistry. The correlations of SOX9 gene and protein expression level with the patient�s clinical and pathological features were considered. Results: The SOX9 over-expression was detected in GH-secreting adenomas tumor tissues compared to normal pituitary tissues which were accompanied by overexpression of SOX9 protein in tumor tissues. The over-expression of SOX9 had a significant impact on GH-secreting adenomas tumor incidence with the odds ratio of 8.4 and the diagnostic value of SOX9 was considerable. The higher level of SOX9 expression was associated with invasive and macro tumors in GH-secreting pituitary adenoma patients. The positive correlation of SOX9 gene and protein level was observed and the tumor size and tumor invasive features were valuable in predicting SOX9 expression level in GH-producing pituitary tumors. Conclusion: The study provided the first shreds of evidence regarding the expression pattern of SOX9 in the GH- secreting pituitary adenomas at both gene and protein levels which may emphasize the possible involvement of SOX9 as a mediator in pituitary adenoma tumor formation also open up new intrinsic molecular mechanism regarding pituitary adenoma pathogenesis. © 2021, The Author(s)