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Background: Our meta-analysis aimed to evaluate the diagnostic performance of ⁶⁸Ga-PSMA-11 PET/MRI for biochemical recurrence of prostate cancer.

Methods: We systematically and comprehensively searched all available studies until May 2023 in the PubMed and Embase databases. Studies evaluating ⁶⁸Ga-PSMA-11 PET/MRI in men with prostate cancer biochemical recurrence were included. We appraised the quality of studies using a tailored Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. For each meta-analysis, we used the DerSimonian and Laird method. We first transformed proportions with the Freeman-Tukey double arcsine transformation, and then confidence intervals were calculated using the Jackson method. Meta-regression and sensitivity analysis were conducted to explore heterogeneity sources. Furthermore, we conducted subgroup analysis according to the PSA levels.

Results: Overall, 13 studies with 738 patients were included in the analysis. The pooled overall detection rates of ⁶⁸Ga-PSMA-11 PET/MRI in detecting recurrent PCa after definitive treatment were 74% (95% CI, 68%-79%). For patients with PSA under 0.5 ng/mL, the detection rate was 55 %. The detection rates were 79 %, 76 % and 87 % for the subgroup PSA levels of 0.5−0.99, 1.0–1.99 and over 2.0 ng/mL.

Conclusion: ⁶⁸Ga-PSMA-11 PET/MRI has a good detection rate for biochemical recurrence of prostate cancer. However, large sample, multi-center studies are still needed to verify and expand on our conclusion.

Colorectal cancer (CRC) is a major contributor to global cancer cases and deaths, making it a significant public health concern. As the number of CRC survivors continues to rise, understanding the impact of CRC and its treatment on their quality of life (QoL) has become increasingly important. The determinants of QoL in CRC patients are multifaceted and include physical health, physical fitness, physical activity, healthy eating, psychological health, social support, the availability of high-quality medical care, and QoL at the end of life. These factors interact to shape the overall well-being of CRC survivors. To enhance the QoL of CRC patients, a comprehensive approach is needed. This includes tailoring treatments to individual patient characteristics, providing psychological support and symptom management, promoting post-treatment rehabilitation, organizing support groups, emphasizing early detection, and effectively managing CRC-related symptoms. Addressing these aspects can significantly improve the QOL and well-being of CRC survivors, helping them adapt to life after treatment and thrive in the face of the challenges they may encounter.

Background: This meta-analysis aimed to systematically investigate the efficacy of drug-loaded gel adjuncts in the treatment of periodontitis.

Methods: A comprehensive search was conducted in six databases, i.e., the China National Knowledge Infrastructure, WanFang Data, VIP Chinese Science and Technology Periodical Database, China Biology Medicine Disc, Cochrane Library, PubMed, and Web of Science, from the inception until Jun 2023. The search focused on randomized controlled trials that examined the application of drug-loaded gels in the treatment of periodontitis. Periodontal probing depth and clinical attachment level were the primary and secondary outcomes, respectively. Stata 15.0 and Review Manager 5.4 were employed to perform the meta-analysis using the selected articles that met the predefined criteria.

Results: This study included 16 randomized controlled trials involving 1146 participants. Subgroup analyses based on the follow-up period revealed that the gel-based drug-assisted subgingival root planning intervention had more favorable effects on periodontal probing depth (standardized mean difference=0.50, 95% confidence interval=[0.32, 0.68], I²=56.0%, P=0.001) and clinical attachment level (standardized mean difference=0.47, 95% confidence interval=[0.29, 0.66], I²=57.0%, P=0.0007) than the subgingival root planning intervention alone. However, subgroup analysis based on the action mechanism of gel drugs showed no statistically significant differences in periodontal probing depth and clinical attachment level between groups.

Conclusion: The application of the drug-loaded gel as adjunctive therapy for periodontitis effectively reduced periodontal probing depth and promoted clinical attachment level recovery. The findings provide evidence-based support for the efficacy, security, and rational use of drug-loaded gel in the treatment of periodontitis.

Background: Various studies have highlighted the usefulness of environmental scanning in assessing community needs and developing programs and policies. We aimed to find the most practical model of using such scanning in the healthcare literature.

Methods: We conducted a scoping review based on the PRISMA guideline to ensure a comprehensive and systematic approach in 2023. To develop a comprehensive search strategy, we worked with experienced librarians and the research team. We then completed a search of five electronic databases, including Web of Science, PubMed, Scopus, Cochrane, and Embase databases. Two independent reviewers screened titles, abstracts, and full-text articles to select studies that met our inclusion criteria. The data was then analyzed and presented in a tabular format to facilitate easy interpretation and understanding.

Results: We retrieved 7243 articles from various databases and sources. After removing 2755 articles due to duplication, we excluded 4380 more articles during the title and abstract screening phase. In the full-text review process, we ruled out an additional 103 articles. Finally, only 5 articles that were directly relevant to the study were included. The model that Bednar and colleagues have in their article is the latest model. Most studies propose six main steps to conduct an environmental survey in the healthcare system.

Conclusion: Since the most important task of managers and policy makers of the health system is to make decisions, they can use our proposed model to collect, analyze and interpret data, identify important patterns and trends so that they can make evidence-based decisions.

Keywords: ; Scan; Model;; ;

Background: Neonatal mortality remains a critical global challenge, with preventable instances prevailing. The initial stride in mitigating neonatal mortality involves elucidating its underlying causes.

Methods: This study utilized an umbrella review approach to discern factors associated with neonatal mortality. Five international databases, namely Pub Med, Web of Science, Scopus, CINAHL, and EMBASE, were meticulously searched to achieve this.

Results: The initial search yielded 12,631 articles using a search strategy centered on keywords related to factors contributing to neonatal mortality. Ultimately, 95 articles met the criteria incorporated into this study.

Conclusion: This study endeavors to identify the primary risk factors contributing to neonatal mortality. The discerned risk factors have been systematically categorized into four groups: maternal factors, neonatal factors, aspects linked to healthcare systems, and socio-economic factors. As such, it is imperative for policymakers to take heed of these identified risk factors and formulate comprehensive strategies encompassing both long-term and short-term initiatives. Effective interventions spanning various sectors are crucial for the prevention of neonatal mortality.

Background: Mobile phone addiction in adolescents is a serious social problem that not only negatively affects physical and mental health but also hinders social stability and development. However, studies on interventions for mobile phone addiction in adolescents are still few. Therefore, exploring interventions for mobile phone addiction in adolescents and scrutinizing the corresponding mechanism of action are crucial.

Methods: A questionnaire survey was conducted on 800 adolescents who were recruited using random sampling from communities in Hubei Province, China in 2023, and 232 of them were identified to have mobile phone addiction. Then, they were randomly divided into the experiment group, comprising 119 members, and the control group, composed of 113 members. The experiment group was given a 3-month intervention under the Health Action Process Approach (HAPA) model, whereas the control group was given no intervention.

Results: This intervention significantly reduced the level of mobile phone addiction in adolescents (P<0.05). It also significantly improved self-efficacy in adolescents with mobile phone addiction (P<0.05). The intervention can significantly improved life satisfaction in adolescents with mobile phone addiction (P<0.05). Self-efficacy and life satisfaction had a chain mediating effect (P<0.001).

Conclusion: The HAPA model is conducive to alleviating mobile phone addiction. It further enhances the intervention effect by improving self-efficacy and life satisfaction in adolescents.

Background: Healthy nutrition and good quality sleep are one of the most important factors for growth and development in a child. Digital game addiction may cause some problematic behaviors and affect children's nutrition and sleep. We aimed to investigate the relationship between digital game addiction, eating behavior, and sleep disorders in children.

Methods: The study was conducted with 252 mothers with children between the ages of 4-7 years, selected by convenient sampling methods. The Digital Game Addiction Scale, Children's Eating Behavior Questionnaire and The Sleep Disturbance Scale for Children (SDSC) were used to collect data. The correlation coefficient and the decision tree CHAID algorithm were used in the data analysis.

Results: Digital game addiction negatively affects children's eating behavior and sleep patterns. It was found that there was a mostly positive but weakly significant relationship between digital game addiction and children's eating behaviors (P<.01; P<.05) and a highly significant relationship was found between the sleep disorder scale sleep hyperhidrosis sub-dimension (P<.05). While digital game addiction is affected by gender, the mother's education level, and eating behavior are affected by the mother's age, the parent's education level, and the child's gender (P<.05). The child's age is the variable that affects the children's sleep disorder (P<.05).

Conclusion: Intervention programs for children and families can be created for the causes of digital game addiction, its effects on child development and the correct use of the digital world.

Background: The purpose of this cross-sectional study was to assess the relationship between oral health, unmet dental needs and health-related quality of life in South Korea older adults.

Methods: The present study used raw data from the 2019~2020 Korea National Health and Nutrition Examination Survey, and analyzed 4956 participants aged over 65 yr. Hierarchical multiple regression analysis was used for associations between oral health, unmet dental needs, and HRQoL.

Results: The EQ-5D index differed according to tooth pain, chewing difficulty, speaking problem, subjective oral health status, oral examination, and unmet dental care needs (P<0.001). In the model 2, male, under 75 yr of age, high school graduate or higher, employed, living with a spouse, no stress, good subjective health status, no speaking problem, and no unmet dental care needs were associated with higher EQ-5D index (Adj R² = 27.6%, P<0.001).

Conclusion: To improve the HRQoL of older adults in South Korea, oral health problems need to be minimized through oral disease prevention and oral health education programs.

Background: To explore the perioperative effect of the evaluation system of nursing quality in otorhinolaryngology patients.

Methods: A total of 100 patients hospitalized in the Department of Otorhinolaryngology of the Third Affiliated Hospital of Qiqihar Medical College, Qiqihar City, China in 2019 were selected as the control group, and routine nursing mode was adopted. The control group was data before the implementation of this study. A total of 100 patients (experimental group) hospitalized in the Department of Otolaryngology in 2020 were selected to adopt the nursing model constructed by nursing quality evaluation system. The adverse mood of patients in the two groups were evaluated at admission and discharge, and postoperative pain and satisfaction were compared between the two groups.

Results: Anxiety, depression and quality of life scores were improved in both groups, but the degree of improvement in experimental group was significantly higher than that in control group (t=481.759, 353.502, P＜0.05）, and the postoperative pain score in experimental group was lower than that in control group (t=54.086, P＜0.05). The satisfaction of experimental group was better than that of control group (χ2=30.327, P＜0.05).

Conclusion: The nursing model based on the evaluation system of the nursing quality of otorhinolaryngology can relieve patients' adverse emotions, relieve postoperative pain of otorhinolaryngology patients, and improve patient satisfaction. Therefore, it is worth popularizing and applying in the future.

Background: This study aimed to examine the quality of life and the factors that determine the quality of life of infertile couples.

Methods: The research was conducted as a cross-sectional study at the Gynecology and Obstetrics Clinic "Narodni Front" in Belgrade, the Special Gynecology Hospital "Ferona" in Novi Sad, the Special Hospital for the Treatment of Sterility and In Vitro Fertilization "Spebo Medikal" in Leskovac and the General Hospital in Valjevo, Serbia in 2022, on a sample of 378 infertile couples. The data were collected by means of a questionnaire, the integral part of which is the standardized FertiQoL scale. Independent t-test and one-way ANOVA were used to determine differences. A value of P<0.05 was considered statistically significant.

Results: Women achieve a significantly lower score on the quality of life questionnaire (69.34±11.05) compared to men (73.96±9.87). Women exhibit significantly lower scores in the area of physical, emotional and social functioning (P<0.05). Men who live in the countryside show a lower quality of life score in the emotional (P=0.029) and social (P=0.042) domains. In addition, men over 40 years of age and with a high level of education have a lower quality of life (P=0.08).

Conclusion: Women have a lower quality of life, as do men from rural areas and over 40 years of age. A multidisciplinary approach and community education, as well as the provision of social support with a special emphasis on emotional and material support, would significantly contribute to improving the quality of life of infertile couples.

Background: Liver hepatocellular carcinoma (LIHC) is a common cancer with a poor prognosis and high recurrence rate. We aimed to identify potential biomarkers for LIHC by investigating the involvement of hub genes, microRNAs (miRNAs), transcription factors (TFs), and protein kinases (PKs) in its occurrence.

Methods: we conducted a bioinformatics analysis using microarray datasets, the TCGA-LIHC dataset, and text mining to identify differentially expressed genes (DEGs) associated with LIHC. They then performed functional enrichment analysis and gene-disease association analysis. The protein-protein interaction network of the genes was established, and hub genes were identified. The expression levels and survival analysis of these hub genes were evaluated, and their association with miRNAs, TFs, and PKs was assessed.

Results: The analysis identified 122 common genes involved in LIHC pathogenesis. Ten hub genes were filtered out, including CDK1, CCNB1, CCNB2, CCNA2, ASPM, NCAPG, BIRC5, RRM2, KIF20A, and CENPF. The expression level of all hub genes was confirmed, and high expression levels of all hub genes were correlated with poor overall survival of LIHC patients.

Conclusion: Identifying potential biomarkers for LIHC can aid in the design of targeted treatments and improve the survival of LIHC patients. The findings of this study provide a basis for further research in the field of LIHC and contribute to the understanding of its molecular pathogenesis.

Background: We aimed to explore the effect of multi-sensory stimulation on apathy symptoms in elderly patients with Alzheimer's disease (AD).

Methods: Eighty elderly patients with AD admitted to the Third Affiliated Hospital of Qiqihar Medical University, China from January 2022 to February 2023 were selected as the research objects by convenient sampling method. According to the random number table, they were divided into intervention group and control group, with 40 cases in each group. The control group was given routine nursing, while the intervention group was given multi-sensory stimulation based on this nursing. Apathy evaluation scale (AES), Behavioral pathology in Alzheimer’s disease rating scale (BEHAVE-AD) and Quality of Life Scale for dementia patients（QoL-AD） were used to compare the results.

Results: Compared with the control group, the scores of AES and BEHAVE-AD in intervention group were lower (t was -7.312 and 11.88 respectively, P < 0.05), and the scores of QoL-AD in intervention group were significantly higher than those in control group were (t was -15.311, P < 0.01).

Conclusion: Multi-sensory stimulation can relieve apathy symptoms, mental and behavioral symptoms and improve the quality of life of elderly patients with AD, which is worth popularizing in clinical practice.

Background: The research was designed to investigate the perceptions and attitudes of immigrants towards extra medical support programs that Immigrant Support Centers (ISC) offer. We aimed to find how they evaluate such medical support in terms of helpfulness for social integration in the host country.

Methods: The study was performed in South Korea during May-June 2023. A questionnaire was prepared in six languages, with 132 participants. The survey categorized the respondents into three groups, group (A) that received only medical support, group (B) that received only cultural support, and group (C) that received both. The statistical program SPSS windows 22.0 was used for the analysis, and finding the most effective way of medical and cultural support programs was verified through inter-group analysis.

Results: The analysis of the results shows that the immigrants find the biggest hardship in the new country when a health problem occurs. The most significant barriers were language differences and cultural differences. The immigrants’ participation in the extra medical support programs can address those barriers. However, time, age, and length of stay were significant factors, and most of the participants found the extra cultural support more effective at the earlier stage of their stay in Korea.

Discussion: The study suggests that it is important to provide both medical and cultural support in the early stage of the immigrants staying in another country. Indeed, this might be a way to use medical support to induce them to further adaptation. Besides, providing culturally oriented medical support is likely to foster social integration through medical support.

Background: Although the prevalence of HUA is increasing, epidemiologic studies on HUA in the middle-aged and elderly population are limited. The present study aimed to calculate the prevalence and evaluate the sex-related associations between metabolic parameters and hyperuricemia (HUA) among middle-aged and elderly adults.

Methods: This was a population-based cross-sectional study from 2018 to 2019 in rural areas of Nakhon Nayok Province, Thailand. We enrolled 780 subjects aged 40 yr and over for health check-ups and examination surveys. The age-standardized prevalence of HUA was estimated by the direct method. A multiple logistic regression was performed to identify the potential risk factors associated with HUA.

Results: The prevalence of HUA were 30.9% (42% in males vs. 20% in females). Elderly adults were associated with a 35% increase in the risk of HUA. Obesity was found to be strongly associated with an increased prevalence of HUA in both sexes. Hypertriglyceridemia (51% increase in males vs. 23% increase in females), and high fasting glucose (90% increase in males vs. 49% increase in females) were also associated risk factors for HUA in both sexes. However, low high-density lipoprotein was only associated with a 67% increase in the risk of HUA in females.

Conclusion: The age-standardized prevalence of HUA among females is relatively lower than in males. This study also revealed that obesity is strongly associated with HUA in both sexes.

Background: The poor are vulnerable when they fall seriously ill and require hospitalization. The study aimed to analyze the factors related to hospital inpatients among the poor in Indonesia.

Methods: We analysed the 2018 Indonesian Basic Health Survey data. This cross-sectional study examined 233778 respondents through stratification and multistage random sampling. We used seven independent variables age, gender, marital status, education, employment, and health insurance, in addition to the hospital inpatient, as a dependent variable. We employed binary logistic regression to evaluate the data.

Results: The poor in urban areas were 1.315 times more likely to be hospital inpatients than those in rural areas (95%CI 1.249-1.385). Age, gender, and marital status were related to the hospital inpatients. The better the education level, the higher the hospital inpatient proportion. Meanwhile, the employed were 40% less likely than the unemployed to be hospital inpatients (95%CI 0.565-0.634). Furthermore, the insured were 3.513 times more likely than the uninsured to be hospital inpatients (95%CI 3.264-3.780).

Conclusion: Seven variables were related to hospital inpatients among the poor in Indonesia: residence, age, gender, marital status, education, employment, and health insurance. Health insurance was the main factor associated with hospital inpatients among low-income people. The government must increase the subsidy quota for the poor's participation in National Health Insurance.

Background: Brucellosis is one of the common diseases between humans and animals. We aimed to assess the annual incidence rate, the geographical distribution of Malta fever using GIS and its time trend.

Methods: This was an ecology study carried out in exploratory mixed design. The study population was the individuals with brucellosis in Iran during the years 2009-2018. Data analysis has been done using Joinpoint regression analysis and GIS at a significant level of α = 0.05.

Results: The average annual incidence rate of the disease rate was 19.91 per one hundred thousand people. The trend of the changes in the incidence between 2009 and 2018 has increased and the Annual Average Percent Change increased by 4.6%. However, a joinpoint was observed in 2014 and the incidence has changed significantly at this point in time, so that the annual incidence of the disease has increased more strongly between 2009 and 2014 (APC=17.1%) and then from 2014 to 2018, the incidence of the disease has decrease (APC=-9.2%). The spatial distribution showed that the western and northwestern provinces have high incidence rate, but the northern and southern provinces have low incidence rate.

Conclusion: The incidence of brucellosis in Iran is higher than in developed countries and similar to developing countries. Ten-year trend of disease incidence increased slightly, but it has decreased in recent years. It is necessary to improve the surveillance system and increase facilities for prevention and treatment in the high-risk areas including the west and northwest of Iran.

Background: We aimed to determine the level of serum vitamin D and serum ferritin in four groups’ children and adolescents.

Methods: This descriptive/analytical study was conducted in 2019 on children and adolescents with thalassemia aged 7-18 years in Ahvaz, Iran. Overall, 160 patients with the target inclusion and exclusion criteria were assigned into four groups (n=40) of people with thalassemia minor, thalassemia major, iron deficiency anemia and healthy individuals. The level of ferritin and vitamin D was assessed. Mann-Whitney test, Wilcoxon test and Spearman's correlation test were used as well as SPSS Statistics V21.

Results: The mean age of the participants was 13.07 ± 3.82 yr and 100 people (62.5%) were male. In terms of vitamin D deficiency, 16 people (40%) had severe deficiency in iron deficiency group. The highest level of ferritin was found in thalassemia major group and the lowest in iron deficiency group. Regarding the level of vitamin D and ferritin in the healthy group, there was a statistically significant difference between mean vitamin D and serum ferritin levels (P=0.027). In iron deficiency group, this level of ferritin was observed with mild deficiency (P=0.017). In thalassemia major group, the increase in ferritin was associated with severe vitamin D deficiency (P=0.05.

Conclusion: Severe vitamin D is seen in thalassemia major due to the increase in ferritin, but moderate deficiency of this vitamin in healthy people and mild deficiency in iron deficiency anemia group was observed considering the normal levels of ferritin.

Background: Sickle cell disease (SCD) is one of the hematological disorders characterized by a defect in the structure and function of globin chains. Hereditary factors play an important role in the pathogenesis of SCD. We aimed to investigate the genes and pathways related to the pathogenesis of SCD.

Methods: Microarray dataset was downloaded from the Gene Expression Omnibus (GEO) database. LIMMA package of R-software was used to detect UP and Down regulations between SCD and control subjects. Enrichment analysis and Protein-protein interaction (PPI) networks were performed using GeneCodis4 software and GeneMANIA database, respectively. PrognoScan database was used to evaluate the relationship between the hub genes and patients' survival.

Results: Overall, 447 DEGs were identified in SCD patients compared to control subjects. Out of 447 DEGs, 345 genes were up-regulated and 102 genes were down-regulated. Effective hub genes in SCD pathogenesis include SLC4A1, DTL, EPB42, SNCA, and TOP2A. In addition, hub genes had a high diagnostic value.

Conclusion: Evaluation of hub genes in SCD can be used as a diagnostic panel to detect high-risk patients. In addition, by identifying the UP and Down stream pathways, treatment strategies in the monitoring and treatment of patients can be designed.

Background: The intriguing area of paleopathology merges the disciplines of archeology and biological studies. Using this line of research, it is possible to identify diseases that have left skeletal traces in the past. In addition, diseases such as various anemia that occur in childhood, when bone tissue is soft and retains evidence, can be identified in ancient bones. Cribra orbitalia (Co), cribra cranii (Cc), and porotic hyperostosis (Ph) were ancient skeletal remains' most common degenerative anomalies.

Methods: Shahr-i Sokhta dated back to 3200-1800 BCE, is the subject of our research; it is located in Sistan and Baluchistan province (Iran). The research was done on the archaeological data collected during the MAIPS expeditions at Shahr-i Sokhta (2017–2021) kept at the storage of the excavated materials on the site. The skeletal remains were examined for bone abnormalities such as Co, Cc, and Ph. These symptoms were analyzed to obtain traces of anemia-related diseases at this site. Data has been utilized following the Data Collection Codebook

Results: Ninety-six adults were studied while the anemic signs of CC and Co are respectively seen in 27/72 (37.5 %) and 10/57 (17; 5 %), and these samples have been kept for future analysis.

Conclusion: Bones may narrate a person's life, their gender and how old they were when they died besides the diseases they had. Some of the skeletons show signs of anemia, Classical paleopathology lets us to reconfirm studying diseases by further targeted sampling using molecular methods.

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Background: We aimed to investigate the relationship between lifestyle status and metabolic syndrome (MetS) components across gender and age groups of the older population, specifically focusing on identifying the association between MetS and lifestyle factors in classified age groups in older individuals.

Methods: Overall, 582 older people with MetS in Yazd (Iran) urban primary health care centers were randomly included from 10 health centers and invited to participate in the study in 2022. During the phone invitation, eligible interested people were asked to refer to health care centers for clinical assessments by trained health researchers. MetS components, dietary intakes using validated frequency food questionnaire, and physical activity by International physical activity questionnaire (IPAQ-short form) were measured.

Results: Women with Mets under 75 yr had significantly higher BMI, weight, and FBS than men and men had significantly higher WC than women. Among patients over 75 yr old, women had significantly higher weight than men had and lower WC and lower HDL_C than men. There were significant differences between gender groups of the aging patient under 75 yr old in terms of vigorous physical activity, total metabolic equivalent of activity, total fat intake, PUFA, and sodium intake, with men reporting level of mentioned lifestyle factors than women.

Conclusion: There were significant gender differences between two aged groups (>75 and <75 yr old) of patients for MetS components and lifestyle risk factors. Weight and WC showed noteworthy gender differences, with variations in both age groups.

Background: Brucellosis is one of the common diseases between humans and animals. We aimed to assess the annual incidence rate, the geographical distribution of Malta fever using GIS and its time trend.

Methods: This was an ecology study carried out in exploratory mixed design. The study population was the individuals with brucellosis in Iran during the years 2009-2018. Data analysis has been done using Joinpoint regression analysis and GIS at a significant level of α = 0.05.

Results: The average annual incidence rate of the disease rate was 19.91 per one hundred thousand people. The trend of the changes in the incidence between 2009 and 2018 has increased and the Annual Average Percent Change increased by 4.6%. However, a joinpoint was observed in 2014 and the incidence has changed significantly at this point in time, so that the annual incidence of the disease has increased more strongly between 2009 and 2014 (APC=17.1%) and then from 2014 to 2018, the incidence of the disease has decrease (APC=-9.2%). The spatial distribution showed that the western and northwestern provinces have high incidence rate, but the northern and southern provinces have low incidence rate.

Conclusion: The incidence of brucellosis in Iran is higher than in developed countries and similar to developing countries. Ten-year trend of disease incidence increased slightly, but it has decreased in recent years. It is necessary to improve the surveillance system and increase facilities for prevention and treatment in the high-risk areas including the west and northwest of Iran.

Background: Treating and changing patterns of low sexual desire and dysfunctions can be done in various ways. However, it is important to recognize the value of integrated approaches when it comes to addressing these issues. To this end, we conducted a randomized clinical trial study to compare the effectiveness of an integrated approach with that of Masters-Johnson Sex Therapy (MJST) for treating hypoactive sexual desire disorder (HSDD) in Iranian couples from Mar 2016 to May 2018.

 Methods: We conducted a clinical trial on 24 couples who were experiencing HSDD. The couples were randomly divided into two groups. The intervention group was given an integrative approach, while the control group received MJST for ten sessions. We collected data using standard questionnaires before, immediately after, and eight weeks after the intervention.

Results: There was no significant difference in sexual desire and function among men between the MJST and integrative approach groups. However, women in the integrative approach group showed more improvement in sexual desire and dysfunction compared to those in the MJST group. The improvement in sexual function for women and sexual desire for both men and women were maintained at the eight-week follow-up in the integrative approach.

Conclusion: Our study found that using an integrative approach effectively treated HSDD in couples.

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