Vol 54 No 4 (2025)

Review Article(s)

  • XML | PDF | pages: 675-687

    Background: Adropin, a peptide hormone has role in various various physiological processes, including metabolic regulation and cardiovascular health. This systematic review aimed to synthesize findings from observational studies on the involvement of adropin in neurological disorders and cognitive performance.
    Methods: An extensive literature search was conducted across PubMed, Scopus, Web of Science, Embase, CORE, and Google Scholar using terms such as "adropin," "Neurological Disorders," "cognitive function," "Alzheimer's disease," "Parkinson's disease," "cognition," and "brain function." Studies published from 2020 to 2024 were selected and reviewed. The search and selection process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Out of 127 screened articles, 5 met the inclusion criteria for this review.
    Results: The combined research findings suggest a consistent link between decreased adropin levels and a range of neurological disorders and cognitive impairments. In particular, reduced adropin levels were seen in individuals with dementia, cognitive impairment, bipolar disorder, Parkinson's disease, and multiple sclerosis. These findings highlight adropin's potential role in modulating neurological health and cognitive function.
    Conclusion: This systematic review underscores the importance of adropin in neurological health and its potential as a therapeutic agent. Based on the observed connections, adropin might serve as a new focus for treating neurological disorders, prompting the need for more research and trials.

  • XML | PDF | pages: 688-700

    Background: The world has experienced numerous natural and man-made disasters throughout history. Due to these unforeseen circumstances, children and adolescents have reported significant psychopathologies in response to traumatic experiences. We aimed to investigate the surge of internalizing and externalizing psychopathologies during COVID-19 and to assess the efficacy of single-session therapies used to treat mental health issues during this period.
    Methods: Overall, 270 articles were retrieved across both phases of the study, with 250 articles identified in Phase I and 20 in Phase II. Following the PRISMA flowchart guidelines, approximately 30 studies were selected to meet the objective of Phase I, while 10 studies were chosen to address the objective of Phase II. The articles were retrieved from various databases, including PubMed, Google Scholar, Scopus, Ovid, CENTRAL, JSTOR, NCBI, and Science Direct. Only articles published between 2019 and 2022 were included in the study.
    Results: The findings of first phase of study indicated a surge in internalizing psychopathologies (such as anxiety, depression, loneliness, and somatic problems) and externalizing psychopathologies (including conduct/oppositional disorders, sleep disturbances, suicidal ideation, ADHD, and substance abuse) over the past four years. Additionally, according to the findings of the second phase of the study, single-session therapies were found to be effective in mitigating symptoms of depression and anxiety.
    Conclusion: The study's findings are discussed in the context of counseling adolescents, highlighting the importance of addressing mental health issues in this demographic.

  • XML | PDF | pages: 701-709

    Hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complication in both high and low-middle-income countries. The age-standardized incidence rate and the absolute incidence number of HDP in low-middle-income countries are 2-fold and 4-fold higher than in high-income countries in 2021, respectively.  However, the reduction in the age-standardized prevalence rate (-41.1% vs. -8.7%) and incidence rate (-40.8% vs. -7.1%) of HDP is ≈5-fold faster in low-middle income countries compared with high-income countries between 1990 and 2021. Moreover, HDP is significantly associated with the increased risk of adverse perinatal outcomes, including preterm birth, low birth weight, and perinatal mortality in both high and low-middle-income countries. In the current review, we have highlighted the prevalence, incidence, and temporal trend of HDP and its association with adverse perinatal outcomes in high and low-middle-income countries. 

  • XML | PDF | pages: 710-722

    NTRK gene is responsible for encoding TRK, which consists of three family members: NTRK1, NTRK2, and NTRK3. These family members encode different proteins known as TRKA, TRKB, and TRKC, respectively. NTRK fusion genes are the clearest driving factor for carcinogenesis. NTRK gene fusion detection and TRK inhibitors are effective measures for the treatment of malignant tumors. The development of anti-tumor drugs targeting TRK proteins has been favored by various scientific research institutions and pharmaceutical companies. The first-generation TRK inhibitors, larotrectinib and entrectinib, have been approved for the treatment of pediatric and adult patients with metastatic or locally advanced solid tumors harboring NTRK fusion proteins, demonstrating remarkable anticancer efficacy in clinical settings. However, the issue of acquired resistance to TRK inhibitors has emerged. Currently, efforts are underway to develop next-generation TRK inhibitors based on sequence, structural, and kinetic methodologies, as well as to explore the intracellular signaling pathways of TRK and the mechanisms underlying resistance. The main focus of this review was to discuss the fusion of NTRK genes and the application of TRK inhibitor treatment.

  • XML | PDF | pages: 723-738

    Background: Numerous studies have aimed to compare the effects of glucose (Glu) consumption with those of glucose-fructose (Glu-Fru) consumption on oxidation rates during exercise. However, divergent outcomes have surfaced due to variations in exercise protocols and concurrent substance ingestion, leading to a lack of consensus. This systematic review and meta-analysis investigated the comparative effects of Glu and Glu-Fru on total carbohydrate oxidation, endogenous carbohydrate oxidation, exogenous carbohydrate oxidation, and total fat oxidation rates during exercise.
    Methods: A systematic search of PubMed, Scopus, and Web of Science databases up to February 2023.  The search yielded 14 randomized controlled trials involving 125 endurance athletes.
    Results: The meta-analyses revealed that Glu supplementation significantly increased total carbohydrate oxidation (WMD: 0.21 g/min) compared to Glu-Fru. Endogenous carbohydrate oxidation significantly increased with Glu (WMD: -0.12), while Glu-Fru led to increased exogenous carbohydrate oxidation (WMD: 0.27 g/min). Total fat oxidation decr eased with Glu-Fru (WMD: -0.06 g/min).
    Conclusion: By investigating athletic nutrition complexities, our findings shed light on metabolic responses to Glu-Fru versus Glu supplementation. Tailoring hydration strategies, athletes should select an optimal Glu-Fru to Glu ratio for maximal oxidation and enhanced performance. Future research could explore dose-response relationships for optimal metabolic benefits during exercise.

  • XML | PDF | pages: 739-750

     Background: Despite the implementation of some experimental and temporary telemedicine projects in Iran in recent years, it has not been deployed in formal healthcare services. The first step in establishment of this technology in health system is identification of barriers of this area. Therefore, this study aimed to identify the barriers to telemedicine establishment in Iran health system.
    Methods: A systematic review was conducted according to PRISMA guidelines. Searches were conducted in PubMed, Web of Sciences, Scopus, Cochrane Library, Iranmedex, Magiran, SID and Google Scholar. The inclusion criteria were studies that reported barriers to telemedicine in Iran, non-review studies, published studies in English and Persian between Nov 22, 2010 and Mar 20, 2022. Data were analyzed using narrative synthesis and deductive-inductive thematic analysis and the World Health Organization building blocks framework was used in this regard.
    Results: Out of 1148 studies identified, 21 studies met the inclusion criteria for review. The findings fell into four themes, including governance/leadership, financing, health workers, and health information system besides 11 sub-themes. No specific findings were derived from the building blocks of service delivery and medical product, vaccines and technologies.
    Conclusion: Governance is an integral part of other building blocks of the health systems. Hence, overcoming the barriers in this field can be prioritized. Therefore, ensuring the existence of strategic policy frameworks along with some other factors such as effective supervision, coalition building, laws and regulations, and community participation can be the first solutions for establishment of telemedicine in Iran.

Original Article(s)

  • XML | PDF | pages: 751-761

    Background: Neonatal hypoglycemia (NH) is one of the most prevalent neonatal problems. We aimed to describe frequency and patterns of NH in neonates at risk of hypoglycemia.
    Methods: In this single-center retrospective descriptive cross-sectional study, the incidence of hypoglycemia in newborns at risk of NH born at Mersin University Hospital between Jan 2017 and Jan 2023, was investigated. The blood glucose level being lower than 40 mg/dL was defined as NH.
    Results: Overall, 506 neonates at risk of hypoglycemia were included: 53 SGA infants (10.5%), 127 LGA infants (25.1%), 212 infants of diabetic mothers (41.9%), and 230 late preterm infants (45.5%). Hypoglycemia developed in 113 out of 506 at-risk newborns (22.3%). Symptomatic hypoglycemia developed in nine infants (1.8%), while asymptomatic hypoglycemia developed in 104 infants (20.5%). Recurrent hypoglycemia incidence was 4.2%. Severe hypoglycemia developed in 13 infants (2.6%). All symptomatic hypoglycemic infants and 8 asymptomatic hypoglycemic infants requiring IV glucose, 17 infants (17/506, 3.4%), were hospitalized in the NICU. The targeted blood glucose level was reached in 1 hour at the latest in all hypoglycemic infants.
    Conclusion: With the algorithm applied, we did not see recurrent hypoglycemia after the first day of life in risky newborns, and we reached the targeted glucose values in hypoglycemic newborns within the desired period.

  • XML | PDF | pages: 762-774

     Background: This study aimed to investigate the prognostic value of TRP ion channel genes (TRPICGs) in colorectal adenocarcinoma (COAD) and explore its related mechanisms.
    Methods: The COAD dataset was downloaded from the Cancer Genome Atlas (TCGA) database. The differential expression genes (DEGs) were screened between COAD and normal samples. The differentially expressed TRPICGs (DE-TRPICGs) were obtained via intersection of DEGs and 28 TRPICGs. The Kaplan-Meier (K-M) survival curve was used to screen DE-TRPICGs with survival differences as prognostic markers. Afterward, the correlation of prognostic marker with clinical, immune cell, copy number variation were explored. Finally, immunohistochemistry (IHC) was used to verify the expression of prognostic marker.
    Results: Overall, 6003 DEGs were screened, and 6 DE-TRPICGs were obtained. Only TRPA1 was identified as prognostic biomarker. Survival and clinical correlation analyses implied that TRPA1 played an inhibitory role in colon adenocarcinoma pathogenesis and progression. Gene Set Enrichment Analysis (GSEA) indicated that TRPA1 was associated with cell cycle and immune-related pathways. Immune infiltration analysis showed that TRPA1 expression was significantly correlated with the infiltration of B cells, CD4+ T cells, CD8+ T cells, neutrophils and dendritic cells. Eventually, TRPA1 expression was down-regulated at the protein level in COAD samples, which presented consistent results with expression in the database.
    Conclusion: TRPA1 was identified in COAD as a prognostic marker associated with TRP ion channels, which provided a powerful reference value and a new direction for the diagnosis and treatment of COAD.

  • XML | PDF | pages: 775-784

    Background: Medication non-adherence in hypertensive patients induced disease progressivity. Several factors contribute to non-adherence to treatment, such as multidrug prescription, the relationship between doctors and patients, and barriers in health services. We aimed to analyze determinants of medication non-adherence in productive-aged hypertensive patients in Indonesia.
    Methods: A cross-sectional study was conducted among 58,148 respondents across Indonesia. Covariates are gender, age, education, occupation, residence, smoking status, family member, and history of stroke, cardiovascular and diabetes mellitus. Chi-square and Binary Logistic were performed using SPSS version 21.
    Results: More than half of the 58,148 hypertension patients in Indonesia (53.9%) are not taking their medication regularly. Chi-square analysis found that male gender, age groups (25 to 34, 35 to 44, 45 to 55, 56 to 64), graduated senior high school, employed workers, living in urban, smokers, four family members, and disease history correlated with non-adherence to treatment. However, Binary Logistic is obtained that age groups age groups (25 to 34, 35 to 44, 45 to 55 and 56 to 64; AOR=1.251, 1.609, 2.179, 2.424, respectively), employed workers (AOR=0.912), urban lived (AOR=1.085), smokers (AOR=0.853), more than four family members (AOR=1.146), stroke history (AOR=1.793), cardiovascular history (AOR=1.623), and diabetes mellitus history (AOR=1.489) found their significance level at 0.00. Two variables, gender and education, are not of significant.
    Conclusion: Medication non-adherence in hypertensive patients has multifactorial aspects, such as in this study, including age, employed workers, living in urban areas, smokers, more prominent family members, and the history of the disease.

  • XML | PDF | pages: 785-794

    Background: We aimed to indicate whether the regional disparity in the general mortality rate from cardiovascular (CVDs) and chronic respiratory (CRDs) diseases correlates with the trends of the average annual values of PM10 particles in selected cities in Montenegro.
    Methods: We used descriptive statistics together with correlation tests. The paper deals with the regional distribution of mortality caused by CVDs and chronic respiratory (CRDs) diseases in Montenegro from 2011 to 2019, while the correlation of mortality in selected cities with PM10 particles covers the period from 2011 to 2019.
    Results: The selected cities from different regions of Montenegro, such as Pljevlja and Niksic, exhibited significant correlations between increased pollution concentrations and mortality from cardiovascular diseases. In Pljevlja, a strong correlation was found between PM10 concentrations and CVD mortality (r = 0.8), while in Niksic, the association between PM10 particles and CVD mortality in women was relatively strong (β=2.7). Similar, but weaker correlations were observed in Podgorica (r=0.5) and Bar (r=0.4). Regarding respiratory diseases, the correlations with PM10 particles were negative and weaker in all cities, with the lowest coefficients observed in Podgorica (r = -0.2) and Nikšić (r = -0.3), suggesting a lesser impact of pollution on mortality from respiratory diseases compared to cardiovascular diseases.
    Conclusion: Mortality trends particularly for cardiovascular diseases, show a strong correlation with poor air quality in certain cities, especially Pljevlja and Niksic. Reducing pollutant emissions would significantly contribute to improving public health in Montenegro. Future research must include established measuring stations network for air quality analysis in Montenegro.

     

  • XML | PDF | pages: 795-800

    Background: We investigated trends in acute respiratory illnesses and influenza activity in Singapore throughout the COVID-19 pandemic.
    Methods: Publicly available data from the Ministry of Health, Singapore was used to estimate the number of daily acute respiratory illnesses (ARI) and influenza cases between 2019 and Jun 2023. Overseas travel activity was obtained from the Department of Statistics, Singapore. Trends in ARI and influenza activity during different phases of the COVID-19 pandemic with changes in key public health measures were compared.
    Results: Pre-pandemic influenza activity exhibited seasonal peaks in Jan and Jul, with daily estimated cases exceeding 40 during these periods. During the early pandemic, influenza cases declined sharply to close to zero and remained at these levels until mid-2022, even after public health measures were eased. ARI cases followed a similar initial decline but gradually returned to pre-pandemic levels by 2023, with peaks occurring outside the usual seasonal pattern. These trends corresponded with phases of public health measures, including mask-wearing and travel restrictions.
    Conclusion: Several hypotheses for these contrasting trends were explored, including increased public health awareness, higher influenza vaccination rates, and potential virus-virus interactions.

     

  • XML | PDF | pages: 801-809

     Background: We explored the perceptions, value, and social visibility of public toilets by comparing the implementation of public restrooms at the 2020 and 2024 Olympics. We specifically examined how sociocultural factors influenced restroom policies and development.
    Methods: We conducted a survey of the history of public toilets as a form of public hygiene management in Japan and France during the Olympics. The analyses compare Paris’s eco-friendly and Tokyo’s culture-oriented approaches.
    Results: The 2020 Tokyo Olympics demonstrated how public restrooms can promote cleanliness and hygiene. However, the 2024 Paris Olympics adopted a practical, eco-friendly approach in response to the climate crisis. Thus, the public restrooms in both cities provided novel examples of public health policies, integrating scientific and cultural perspectives.
    Conclusion: Although Tokyo successfully implemented its sanitation culture in its public restrooms, challenges related to sustainability remained. In Paris, the perceptions of public restrooms have not yet been fully addressed. Nevertheless, the innovative approaches of both cities are expected to yield constructive outcomes for the 2028 Games, demonstrating the future value of such policies.

     

  • XML | PDF | pages: 810-819

    Background: Undernutrition disorder is a prevalent comorbidity (up to 25%) in type 2 diabetes (T2D) patients which significantly compromises their health. We aimed to assess the association between single nucleotide polymorphysms (SNPs) adiponectin (ADIPOQ) +276 (G/T) and resistin (RETN) -420 (C/G) with the risk of developing T2D and undernutrition in patients with T2D.
    Methods: The research was conducted as prospective case-control study among 106 patients with T2D and 106 healthy control individuals in the territory of the Bosnia and Herzegovina from Sep 1st 2022 to May 1st 2023. For assessing the nutritional status, the mini nutritional assessment (MNA) was used. DNA analysis was carried out by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) method. The data were analyzed using chi-square test, t-test for independent samples and binary multivariate logistic regression.
    Results: The research included 212 subjects of which 124 (58.5%) were male. The mean age of the subjects was 68.48±4,67 yr. Almost 20% of subjects were undernourished, significantly more T2D patients when compared to controls (33% vs. 6.6%; P<0.001). ADIPOQ +276 GT genotype was identified as significant predictor of T2D (OR: 3.454; 95% CI: 1.400-8.521; P=0.007) and undernutrition disorder (OR: 3.453; 95% CI: 1.331-8.961; P=0.011) in T2D population, while the presence of RETN -420 CG genotype had protective effect against occurrence of T2D (OR: 0.353; 95% CI: 0.144-0.867; P=0.023). However, RETN genotypes were not associated with undernutrition disorder.
    Conclusion: ADIPOQ +276 gene polymorphism represent a significant predictor for development of T2D and undernutrition disorder in T2D population, while RETN -420 gene polymorphism was identified as a significant factor associated with a reduced risk for T2D, but was not associated with undernutrition.

  • XML | PDF | pages: 820-829

    Background: We investigated the effects of self-leadership, resilience, and communication ability on the intention to keep one’s nursing job among Korean nurses.
    Methods: Data were collected from 245 nurses from hospitals in Jeollanam-do Province, Republic of Korea in 2022. The collected data were analyzed using independent t-tests, one-way analyses of variance, post-hoc tests, Pearson’s correlation coefficients, and stepwise multiple regression.
    Results: The intention to keep one’s nursing job was positively correlated with self-leadership (r=0.34, P<0.001), resilience (r=0.45, P<0.001), and communication ability (r=0.34, P<0.001). Positive correlations were also found between self-leadership and resilience (r=0.65, P<0.001), communication ability and self-leadership (r=0.49, P<0.001), and resilience and communication ability (r=0.69, P<0.001). Furthermore, resilience (β=0.27, P=0.001), age (β=0.26, P<0.001), welfare satisfaction (β=0.17, P=0.003), and communication ability (β=0.16, P=0.031) influenced nurses’ intention to keep their jobs. The regression model was statistically significant (F=24.94, P<0.001), and the explanatory power was 29.4%.
    Conclusion: Nurses’ intention to keep their jobs can be strengthened by improving their treatment, welfare, and communication abilities. Accordingly, educational programs are needed to create an efficient nursing environment and improve nurses’ resilience and communication abilities.

  • XML | PDF | pages: 830-838

    Background: Information Technology (IT) workers have long experienced high-intensity work pressure and overwork, thus bringing severe challenges to managing their mental health. As a key predictor of IT workers’ mental health, perceived stress significantly affects their tendency to experience depression. Self-esteem and self-control are important factors that influence individuals to regulate their behaviors and emotions and cope with challenges, thereby playing a possible chain mediating role in the relationship between perceived stress and depression.
    Methods: In this study, 708 IT workers in Shaanxi Province were investigated anonymously through questionnaires. The perceived stress scale, depression scale, self-esteem scale, and self-control scale were used to examine the influence of perceived stress on IT workers’ depression. Subsequently, the chain mediating role of self-esteem and self-control in this relationship was tested.
    Results: Perceived stress is found to influence IT workers’ depression (P < 0.01). Furthermore, self-esteem and self-control play a chain mediating role in the relationship between perceived stress and IT workers’ depression (P < 0.01). In addition, the duration of occupation in IT work influences the depression of IT workers significantly (P < 0.01). Conclusion: This study revealed the chain mediating roles of self-esteem and self-control in the influence of perceived stress on IT workers’ depression. This finding is of great reference value for reducing the depression risk of IT workers and implementing mental health intervention.
    Conclusion: Accurate evaluation of the governance ability of urban public health can provide guidance and policy propositions to improve the governance system of public health.

  • XML | PDF | pages: 839-849

    Background: We aimed to verify effects of a self-efficacy-based breastfeeding support program (SBP) through a 1:1 face-to-face education and non-face-to-face education via phone counselling on breastfeeding and postnatal depression in primiparous women.
    Methods: This is a nonequivalent control group pre-posttest design study and primiparous women who gave birth at a tertiary general hospital in South Korea from May to Oct 2022 participated. Participants in the experimental group were provided with SBP (6 educational sessions) by the researcher for 4 wk after birth. Pre and post-test measures included breastfeeding knowledge, breastfeeding self-efficacy, adaption, breastfeeding rate, and postnatal depression.
    Results: The participants were 48, with 26 in the SBP experimental group and 22 in the control group. Breastfeeding knowledge, breastfeeding self-efficacy, and adaption scores level of increase were significantly higher in the experimental group than in the control group (P<.001, P=.010, and P=.012). Breastfeeding rate was significantly higher in the experimental group than in the control group (P=.011). The score of postnatal depression was significantly lower in the experimental group than in the control group (P=.032).
    Conclusion: The SBP was validated as a program that could promote the continuation of self-directed breastfeeding even after discharge by primiparous women experiencing breastfeeding for the first time and ultimately improve the health of both mother and infant, thereby providing evidence for effective breastfeeding intervention strategies for nursing in practice.

  • XML | PDF | pages: 850-859

    Background: Neisseria gonorrhoeae, the second most common sexually transmitted infection (STI) worldwide, affects one million people daily. We aimed to investigate the prevalence of gonorrhea in females with genital infections in Tehran, Iran.
    Methods: First, a bioinformatic study was conducted to identify a conserved and high-prevalent gene marker for detection of N. gonorrhoeae. One desirable marker was selected and a pair of specific primers was designed to amplify it. The reliability of the primer pair was evaluated in silico and in vitro. Subsequently, 172 patients with genitourinary symptoms were enrolled and an endocervical swab specimen was obtained from each patient to evaluate the presence of N. gonorrhoeae in clinical specimens using the specific primers.
    Results: Restriction endonuclease subunit S (resS, WP_003687768.1) was selected as a specific detection marker. The designed primer pair targeting resS showed specific and reliable detection of N. gonorrhoeae in silico and in vitro. Out of 172 clinical samples, seven (4.06%) cases were infected by N. gonorrhoeae. Statistical analysis of clinical manifestations showed that there was a significant association between the occurrence of N. gonorrhoeae and dysuria (P= 0.043), pelvic pain (P= 0.017), and fever (P = 0.045).
    Conclusion: Three promising markers were introduced for development of point-of-care testing approaches. Moreover, this study highlights a 4% prevalence of gonorrhea among women with genitourinary symptoms in Iran, which reminds the urgent need for routine surveillance and new policies in management of STIs, particularly gonorrhea.

     

  • XML | PDF | pages: 860-869

    Background: Suicide is a serious global public health issue, which is the fourth-leading cause of death for young people between the ages of 15 and 29. This study aimed to be conducted to investigate the factors affecting suicide reattempts.
    Methods: This cross-sectional study used data from the Sina Electronic Health Registration System and the HIS of Mashhad University of Medical Sciences, Mashhad, Iran covering around 90% of suicide attempts in Mashhad’s government hospitals (2019–2022). The study population included all Mashhad residents with documented suicide attempts in this period. Descriptive analysis was followed by a Poisson multivariable regression to identify factors affecting suicide attempt frequency, with analyses conducted in Stata version 14 and significance set at P<0.05.
    Results: Among 5,737 participants, 3,157 (55.0%) were men. The overall rate of suicide reattempt was 10.1% (n=580). Suicide reattempts were more prevalent among men (55.5% of reattempts, n=322), individuals with mental disorders (16.0%, n=93), substance users (7.8%, n=45), single persons (66.6%, n=386), those with high school education (47.6%, n=276), and self-employed individuals (45.7%, n=265). Poisson regression analysis revealed that substance users had a 43% higher likelihood of reattempting suicide compared to non-users (IRR=1.43, 95% CI: 1.27-1.61, p<0.001), after adjusting for other variables.
    Conclusion: Identifying risk factors for suicide reattempt, such as drug abuse, may be effective in identifying high-risk groups and preventing suicide reattempts.

  • XML | PDF | pages: 870-880

    Background: Several factors can affect the survival of patients with breast cancer (BC). We estimated BC patients' 5-, 10-, and 15-year survival rates and influential factors in a single medical center during the last three decades.
    Methods: We enrolled patients diagnosed with BC managed in the Cancer Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran from 1991 to 2018. All patients were followed to check the patients' status. The data were analyzed regarding demographic, clinical, pathological, and molecular biology characteristics. Descriptive and survival analyses were performed. Kaplan Meier and Cox proportional hazards regression models were used for survival analysis.
    Results: Overall, 4, 429 women were included. The mean age was 49. 11 (±11. 98) yr. Nearly 70% of the patients had high school degrees. Totally, 35% of patients were diagnosed in the advanced stages of BC. Estrogen Receptor (ER), Progesterone Receptor (PR), and human epidermal growth factor receptor 2 (HER2) were positive in 72. 50%, 66. 90%, and 16. 20% of the cases, respectively. About 11. 6% of patients died. The overall 5-, 10-, and 15-year survival rates of BC were 90%, 83%, and 75%, respectively. In the Cox proportional hazard analysis, the survival rate was affected by literacy level, positive lymph nodes, lymphovascular invasion, ER, tumor size, and pathological grade.
    Conclusion: This is the first report on the 15-year survival rate of BC and its influential factors, from a medical center in Iran. The results were acceptable and comparable with those of developed countries due to scientific protocols, teamwork, and effective follow-up in a developing country.

  • XML | PDF | pages: 881-884

    Nosocomial infections remain one of the most severe public health issues, infecting millions of patients worldwide each year.  The global prevalence of nosocomial infections varies between 3.0% and 20.7%, with an incidence rate ranging from 5% to 10%. In this short article, we have tried to present a different perspective on the future of nosocomial infections from the author's viewpoint. According to our assessment, due to megatrends such as global exposure, population aging, and augmenting drug resistance, nosocomial infections are expected to become more severe in the future. On the other hand, advancements in health technologies such as e-health, Artificial Intelligence, the Internet of Things, and less invasive interventions form a new generation of hospitals capable of preventing and controlling nosocomial infections. Presenting novel approaches to nosocomial infection management will transform medicine. Therefore, it seems that in the following years, nosocomial infections will follow a different trend.