Archives of Iranian Medicine最新文献

A patient with longstanding rheumatoid arthritis (RA) complained of spinal cord symptoms after RA relapse. Contrast MRI demonstrated neuromyelitis in the upper thoracic spinal cord, and anti-aquaporin-4 (anti-AQP4) antibody was positive in the serum and cerebrospinal fluid (CSF). Neuromyelitis optica spectrum disorder (NMOSD) was diagnosed after excluding central nervous system (CNS) infection and tumor, and spinal cord symptoms were relieved after high dose of glucocorticoid and immunosuppressant were initiated for treatment.

Background: This study investigates suicide literacy, help-seeking attitudes, and related factors among medical residents.

Methods: The study utilized a cross-sectional design and included all medical residents in Kerman University of Medical Sciences in 2023‒2024. We obtained demographic information, psychiatric history, and administered questionnaires about literacy of suicide (LOSS) and the Attitudes Toward Seeking Professional Psychological Help (ATSPPH-SF).

Results: A total of 157 residents with a mean age of 28.97±2.55 years participated. The prevalence of any psychiatric history was 17.83% (95% CI: 12.1‒23.56). Notably, more educated males displayed higher suicidal literacy (95% CI: 0.231‒0.567, P=0.032), while there was no significant difference in help-seeking attitudes between genders (P=0.755). Surgical residents scored lower than non-surgical specialties like pediatrics (mean difference=2.63, 95% CI: 0.23-5.03, P=0.023, effect size d=0.589). Older age positively correlated with help-seeking attitudes (r=0.158, P=0.049). Additionally, marital status, residency level, history of psychiatric illnesses and their types, previous use of psychiatric medications, and history of self-harm or suicide had no significant impact on suicide literacy scores or attitude toward help-seeking. A moderate association (r=0.367) was found between the suicide literacy and help-seeking attitude questionnaire scores.

Conclusion: Despite relatively high suicide literacy, medical residents displayed average help-seeking attitudes, positioning them as a high-risk group. Urgent interventions are needed to enhance awareness of the importance of psychological support and to reduce stress and work pressure, indirectly mitigating the risk of suicide in this vulnerable population.

Background: Drug data has been used to estimate the prevalence of chronic diseases. Disease registries and annual surveys are lacking, especially in less-developed regions. At the same time, insurance drug data and self-reports of medications are easily accessible and inexpensive. We aim to investigate the similarity of prevalence estimation between self-report data of some chronic diseases and drug data in a less developed setting in southwestern Iran.

Methods: Baseline data from the Pars Cohort Study (PCS) was re-analyzed. The use of disease-related drugs were compared against self-report of each disease (hypertension [HTN], diabetes mellitus [DM], heart disease, stroke, chronic obstructive pulmonary disease [COPD], sleep disorder, anxiety, depression, gastroesophageal reflux disease [GERD], irritable bowel syndrome [IBS], and functional constipation [FC]). We used sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the Jaccard similarity index.

Results: The top five similarities were observed in DM (54%), HTN (53%), heart disease (32%), COPD (30%), and GERD (15%). The similarity between drug use and self-report was found to be low in IBS (2%), stroke (5%), depression (9%), sleep disorders (10%), and anxiety disorders (11%).

Conclusion: Self-reports of diseases and the drug data show a different picture of most diseases' prevalence in our setting. It seems that drug data alone cannot estimate the prevalence of diseases in settings similar to ours. We recommend using drug data in combination with self-report data for epidemiological investigation in the less-developed setting.

Background: This study was conducted to assess the prospective association between dietary polyphenols intakes and risk of metabolic syndrome (MetS) and its components.

Methods: Participants in this study (n=4559) were selected from among the adults of the Tehran Lipid and Glucose Study (TLGS) with an average follow-up of 5.9+2.5 years. Biochemical and anthropometric variables were measured at baseline and follow-up examinations. A reliable and valid semi-quantitative food frequency questionnaire was used to evaluate dietary intakes. The incidence of MetS and its components in relation to polyphenols and its subclasses (phenolic acids, flavonoids, lignans, and stilbenes) was evaluated using multivariable Cox proportional hazard regression models.

Results: Of the 4559 subjects who enrolled in the present study, 1765 were male aged 38.6+14.2 y and 2794 were female aged 35.9+11.7 y. The hazard ratios of MetS were 25% lower in Q2 (HR, 95% CI: 0.75, 0.64‒0.88), 22% lower in Q3 (HR, 95% CI: 0.78, 0.65‒0.94) and 24% lower in Q4 (HR, 95% CI: 0.76, 0.61‒0.95) in comparison to Q1, whereas the results for subclasses of polyphenol were non-significant. The risk of high blood pressure (BP) reduced from quartiles 1 to 4 for phenolic acid (HR: 1.00, 0.88, 0.79, 0.80, P_trend=0.03). The risk of low high-density lipoprotein cholesterol (HDL-C) increased across quartiles of phenolic acid (HR: 1.00, 1.22, 1.07, 1.30, P_trend=0.02).

Conclusion: This study highlights the potential protective role of total dietary polyphenols in the prevention of MetS. These findings could be the starting point of upcoming trials to illuminate the optimal level of polyphenols deriving from the intake of polyphenol-rich diets to prevent MetS.

Background: Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) marked by rectal and colon inflammation, leading to relapsing symptoms. Its prevalence is increasing, particularly in developed nations, impacting patients' health. While its exact cause remains unclear, genetic and environmental factors are implicated, elevating the risk of colorectal cancer (CRC). Colectomy, though declining, is still performed in select UC cases, necessitating further study.

Methods: We analyzed data from the Iranian Registry of Crohn's and Colitis (IRCC) to examine UC patients undergoing colectomy. We collected demographic and clinical data from 91 patients, focusing on dysplasia. Statistical analyses assessed dysplasia risk factors.

Results: Patients with dysplasia were older at diagnosis and surgery compared to those without dysplasia. Age emerged as a significant risk factor for dysplasia in UC patients undergoing colectomy. No significant associations were found between dysplasia and other factors.

Conclusion: Age plays a crucial role in dysplasia risk among UC patients undergoing colectomy. Older age at diagnosis and surgery may indicate a higher risk of dysplasia and CRC. Clinicians should consider age when managing UC patients and implementing screening protocols. Further research with larger samples is needed to confirm these findings.

With the allied invasion, the southern half of Iran became the scene of a large presence of British and American occupation forces. The negative consequences of the styling of foreign elements during all the years of war and even afterward affected these areas in various dimensions of their health. The negative consequences of the occupation of southern Iran, the health and healthcare system of this part of Iran suffered problems in various forms of shortage of medicines, equipment, and treatment staff, especially the spread of various infectious and communicable diseases. The article aims to examine the effects of World War II on the southern, southwestern, and eastern regions of Iran from 1939 to 1945 and its consequences in the spread of infectious diseases in these regions. The research with an analytical-historical method relies on the library method and is based on the study of the data of unpublished documents from the archives of the National Archives and Library Organization, medical and economic social publications, and various local and public newspapers of Iran during this period. The study of documents and publications shows that due to Allied restrictive policies and successive waves of famine and widespread malnutrition, epidemic diseases, and drug monopoly, these areas experienced a period of severe decline in public health and spread of various infectious diseases.

Background: Considering the limited information on suicide determinants, especially in low- and middle-income countries, the establishment and promotion of a suicide registration system are among the prominent strategies for suicide prevention programs around the world. The multicenter suicide registry is designed to collect standardized data from the two provinces of Iran according to the latest World Health Organization (WHO) guidelines.

Methods: The Suicidal Behavior Registration Program is a multicenter study designed in five stages, including literature review, infrastructure establishment, database design, training, data analysis, and examining opportunities and challenges. The research samples cases of suicide attempts and self-harm from hospitals in the provinces of Tehran and Ilam.

Results: The multicenter suicide registration program was carried out for 8 months in the two provinces of Tehran and Ilam. During the study period, data of 1382 people were registered, of which 7 cases in Ilam resulted in death. The study uncovered significant differences in socio-demographic, psychological status, and suicide characteristics in the two provinces.

Conclusion: The design and implementation of the suicide registration program help researchers and policymakers make more innovative and effective interventions to prevent suicide by creating a comprehensive database of suicidal behavior determinants.

Background: Given the significant occurrence of skin cancer in the Middle East and the existing research gap concerning its incidence and trends, this research aimed to study the epidemiology and trend changes of skin cancer in the Golestan province, Northeastern Iran.

Methods: The Golestan Population-based Cancer Registry's (GPCR's) data bank was utilized to gather information on confirmed skin cancer cases in the province during 2005-2018. We used Poisson regression analysis for comparing incidence rates between groups. P values less than 0.05 were considered statistically significant.

Results: Of 1690 patients (mean age: 62.05±15.83 years), most were male (60.1%) and resided in urban areas (61.5%). The age-standardized rate (ASR) of non-melanoma and melanoma skin cancer was 8.49 and 0.56 per 100000 persons-year, respectively. A notably higher ASR for non-melanoma skin cancer (NMSC) was observed in men (ASR: 10.60; 95% CI: 9.91-11.29) (P<0.01) and urban residents (ASR: 10.19; 95% CI: 9.52-10.82) (P<0.01). There was no significant difference in the ASR of melanoma skin cancer based on gender (P=0.24) and place of residence (P=0.48). The incidence trend of melanoma (estimated annual percent change [EAPC]: -3.28; 95% CI: -18.54 to 14.83) and NMSC (EAPC: 0.39; 95% CI: -3.99 to 4.97) did not differ significantly.

Conclusion: During the 14-year study period, the ASR of both types of skin cancer exhibited a consistent pattern, except for NMSC, which showed higher rates among men and urban residents. This should be taken into consideration when formulating preventive and control strategies in the study area.