Background: Limited studies have focused on the association between the protein tyrosine phosphates non-receptor type 22 (PTPN22) genetic polymorphisms and Juvenile idiopathic arthritis (JIA) susceptibility in different populations, but the results were inconclusive. Therefore, this meta-analysis of PTPN22 polymorphism (1858 C＞T) was performed to get a precise systematic estimation. The "rs" number  of the PTPN22 polymorphism (1858 C＞T) is 4.

Methods: A systematic literature search strategy was carried out using English databases (PubMed, Embase.) for the eligible studies. We ultimately identified 11 records from 10 articles involving the relationship between PTPN22 genetic polymorphisms and JIA risk from PubMed and Embase databases. Overall, 4552 cases and 10161 controls were investigated in this study to evaluate the association between PTPN22 (C allele vs. T allele) genotype and JIA susceptibility.

Results: Analysis using random effects model showed an increased risk of JIA with T allele of rs2476601 vs. A allele (P<0.001). Subgroup analysis suggested that the PTPN22 polymorphism (1858C＞T) was significantly associated with JIA risk in America population (OR=1.52, 95%CI:1.30-1.78). Additionally, the subgroup analysis also showed that the associations were still significant in case number more than 500 (OR=1.38, 95% CI: 1.04-1.83), while in the case number less than 500 was OR=1.55, 95% CI: 1.39-1.72.

Conclusions: SNPs of PTPN22 (1858C＞T) showed an increased risk of developing JIA.

Background: Cancer-screening programs are effective in reducing cancer prevalence and mortality; however, cancer remains the leading cause of death in elderly people in Korea. The aim of this study was to identify the factors associated with elders’ participation in the National Cancer Screening Program (NCSP) and differences in screening rates by gender.

Methods: Original data from the Korea National Health and Nutrition and Examination Survey were analyzed by logistic regression analysis. The sample consisted of 5,505 elderly individuals over age 60. Selected demographic variables, cancer screening participation, physical and psychological health status, and lifestyle were examined.

Results: The NCSP participation rates decreased in both men and women as age increased. Private medical insurance (OR 95% CI: 1.04–1.78), one or more chronic disease (OR 95% CI: 1.07–1.71), and current smoker (OR 95% CI: 0.52–0.94) had the strongest associations with cancer screening participation among men after multivariate adjustment. In contrast, cancer screening participation among women was significantly associated only with living place (OR 95% CI: 1.06–2.203) after multivariate adjustment.

Conclusions: Effective health promoting interventions for elders require individualized programs that address gender-related factors associated with elders’ participation in cancer screening programs.

Background: Rhoptries are unique secretory/excretory organelles that are found exclusively in the Apicomplexa, and their contents are discharged at the time of invasion and are critical in the establishment of productive infection. Several rhoptry proteins have been identified in Toxoplasma gondii, Plasmodium falciparum and Neospora caninum and have been linked not only with the parasites’ adhesion and invasion processes but also with their intracellular pathways. To date, only one Cryptosporidium parvum rhoptry protein candidate related to TgRON1 of T. gondii and PfASP of P. falciparum has been reported.

Methods: Subcellular fractionation of sporozoites was performed to obtain highly purified organelles. One-dimensional sodium dodecyl sulfate–polyacrylamide gel electrophoresis followed by liquid chromatography coupled with mass spectrometry was applied for fraction analysis, and 22 potential novel rhoptry proteins were detected by protein domain analysis using online softwares.

Results: Twenty-two potential novel rhoptry proteins were detected. A protein with T. gondii and N. caninum rhoptry protein homologs and some proteins with domains similar to that of T. gondii rhoptry proteins were identified.

Conclusion: These novel candidate proteins may be considered targets for researching the invasion pathway of C. parvum and the pathogenic mechanisms of rhoptry proteins. The present work provides a starting point towards the elucidation of the repertoire and function of C. parvum rhoptry proteins.

Background: We aimed to analyze the association between lipid variables and the extent and severity of coronary artery disease (CAD) in non-diabetic Turkish Cypriots.

Methods: Overall, 412 patients (mean (SD) age: 58.8 (10.5) yr, 50.1% male) who underwent diagnostic coronary angiography were included in this single-center, cross-sectional study. The Friesinger index (FI) was used to assess the extent and severity of CAD. The lipid variables [total cholesterol, LDL-c, HDL-c, triglyceride (TG) levels and the TG/HDL-C ratio] were categorized into quartiles and evaluated regarding extensive/severe CAD. Potential risk factors in the Turkish Cypriot cohort were evaluated as predictors of CAD in univariate and multivariate logistic regression models. The population of this study are non-diabetic Turkish Cypriots which are administrated North Cyprus.

Results: The mean (SD) Friesinger index was 6.9 (4.4), and 59.0% of the patients exhibited a Friesinger index category of ≥5. In the univariate analysis, extensive/severe CAD was directly related to total triglycerides (P=0.01) and TG/HDL-c quartiiles (P=0.001) and inversely related to HDL-c quartiles (P=0.001). In the multivariate model, diabetes (OR: 4.9; 95% CI: 1.3 - 19.2; P=0.02), male gender (OR: 3.1; 95% CI: 0.95 - 10.3; P=0.06) and high TG/HDL-c ratio (OR: 2.2; 95% CI: 1.3 - 3.8; P=0.004 in the overall population and OR: 1.9; 95% CI: 1.4 - 2.3; P=0.003 except diabetics) were the significant predictors of CAD.

Conclusion: We found a significant relationship between the lipid quartiles and the extent and severity of CAD based on the Friesinger index. Male gender, co-morbid diabetes and the TG/HDL-C ratio also played significant roles in predicting CAD risk in non-diabetic Turkish Cypriots.

Background: Considering population aging in Iran and the importance of cataract surgery in the old age, this study was performed to show the cataract surgical rate (CSR) between 2006 and 2010 in Tehran Province.

Methods: Eighteen centers were randomly selected from cataract surgery centers in Tehran. In each center, one week in every season was randomly selected and the number of cataract surgeries in the week was calculated. In total, 20 weeks were selected in each center in five years.

Results: The CSR increased linearly from 8011 cases per 1,000,000 population in 2006 to 12465 cases per 1,000,000 population in 2010. As for patients below 40 years of age, the percentage of the male patients was more while after the age of 40 years, the percentage of the female patients was more in all age groups. At least 96.2% of the surgeries in each year were performed using the phacoemulsification method. From 2006 to 2010, the percentage of outpatient surgery increased from 48.7% to 72.5%. On the other hand, hospitalization for one night or more had a decreasing trend from 2006 to 2010.

Conclusion: During 2006-2010, the CSR was acceptable in Tehran in comparison with other studies. However, attention should be paid to the increase in the population of the elderly people. Although more than 95% of the surgeries in the Province of Tehran are performed using the phacoemulsification method, the rate should increase to 100% in the eligible cases.

Background: High prevalence and increasing rate of asthmatic patients around the word witnesses the high burden of asthma. We have limited data on asthma burden and economic costs in Iran. This study aimed to find direct and indirect economic costs of asthma and their association with some background factors in one of the referral tertiary centers for adult patients with asthma.

Methods: We surveyed asthma related economic costs of 197 adult patients who referred to Milad Hospital, Tehran, Iran from Jun 2007 to January 2010. The patients were followed up for a period of one-year ±1 month and asthma related costs and its control status were registered.

Results: Patients were consisted of 125 (64.1%) females and 70 (35.9%) males. Total cost of asthma was 590.22 ±32.18 USD for one patient per one year, the cost of drug, paraclinic, doctor visit, hospitalization, emergency, transportation, and absent days were 327.02, 4.76, 35.44, 3.82, 0.26, 113.03, 105.89 USD respectively. Men showed a significant elevation in their total (P=0.009) and drug costs (P=0.028). In addition, we found significant differences between total asthma costs and asthma control status (P=0.002).

Conclusions: According to the high proportion of asthma, related cost compare to Total Income of an Iranian family, the necessity of public coverage of health assurance is quite clear. We suggest that improving asthma management and accessibility to specialized treatment centers can result in decreasing asthma medication and transportation costs as major direct and indirect asthma related costs.

Background: The aim of this study was to conduct a sero-epidemiological survey in Isfahan City and suburb areas, central Iran to detect the rate of human hydatidosis using ELISA test.

Methods: Overall, 635 serum samples were collected from subjects referred to different health centers in urban and rural regions of the city. Sera were analyzed using Ag-B ELISA test. Ten μg/ml antigens, serum dilutions of 1:500 and conjugate anti-human coombs with 1:10000 dilutions were utilized to perform the test. All subjects filled out a questionnaire and an informed consent. Data analysis was conducted using SPSS 18 software. Cut-off was calculated as X+3 SD.

Results: Cut-off value was calculated 0.19. Seven cases (1.1%) were seropositive for hydatidosis by ELISA test. The sero-prevalence of hydatidosis was 0.27% among females and 2.24% among males (P=0.019). Age group of 60-69 years old, with 2.59% as prevalence had the highest rate of positivity. There was no significant difference as regards age groups, job, residency, contact by dog and literacy. According to job, self-employed people had the highest rate of infection as 3.05%. The sero-prevalence of infection was 1.14% in diploma and 1.13% in illiterates. As regards residency, urban life (1.49%) showed no significant difference with rural life.

Conclusion: The rate of prevalence in this region showed that necessary cautions should be taken into account to monitor the spread of human hydatidosis in this region. In comparison with other studies, the rate of infection was roughly less than other regions.

Background: Although breast cancer imposes a considerable economic burden on high-income countries, there is limited knowledge about its economic burden in low- and middle-income countries (LMCs), including Iran. In this study, we estimated the economic burden of breast cancer in Iran in 2010.

Methods: We used the prevalence-based approach and estimated the direct and indirect costs of all breast cancer cases in 2010. We used several data sources, including national cancer registry reports, hospital records, occupational data, and interviews with experts.

Result: The economic burden of breast cancer was US$947,374,468. Most of the cost (77%) pertained to the productivity lost due to breast cancer deaths and the direct medical cost accounted for 18.56% of the estimated total cost. Out of the US$175,860,607 as the direct medical cost, the chemotherapy cost constituted the main part ($76,755,740), of which prescriptions of trastuzumab accounted for 41% ($31,529,280).

Conclusion: The economic burden of breast cancer in Iran is substantial and is expected to increase significantly due to the increasing incidence rate. Strategies for the prevention and early detection of breast cancer should be prioritized in the national cancer control program.

Background: In this study, the impact of self-citation (Journal and Author) on impact factor of Iranian English Medical journals in two international citation databases, Web of Science (WoS) and Islamic world science citation center (ISC), were compared by citation analysis.

Methods: Twelve journals in WoS and 26 journals in ISC databases indexed between the years (2006-2009) were selected and compared. For comparison of self-citation rate in two databases, we used Wilcoxon and Mann-whitney tests. We used Pearson test for correlation of self-citation and IF in WoS, and the Spearman’s correlation coefficient for the ISC database.  Covariance analysis was used for comparison of two correlation tests. P. value was 0.05 in all of tests.

Results: There was no significant difference between self-citation rates in two databases (P>0.05). Findings also showed no significant difference between the correlation of Journal self-citation and impact factor in two databases (P=0.526) however, there was significant difference between the author’s self-citation and impact factor in these databases (P<0.001).

Conclusion: The impact of Author’s self-citation in the Impact Factor of WoS was higher than the ISC.

Background: This study aimed to calculate the child labor rate and establish the factors affecting this phenomenon in the less developed provinces of Iran.

Methods: This study has used the secondary data of population and housing census gathered by Iranian Statistical Center in 2011. The data belonged to 14859 children between 10 and 14 of 9 less developed provinces of Iran. A multiple regression model was hypothesized drawing on related literature and accordingly using data; the logistic regression was estimated. Data cleaning process was also conducted prior to the analysis.

Results: The child labor force participation rate for all children between 10 and 14 years old was 1.7%, of which boys’ child labor rate was higher than girls’ (2.4% over 1%). As such, the mothers’ fertility rate and education were of the strongest, yet converse, effect on child labor supply in the country.

Conclusion: A little proportion of children in less developed regions of Iran was suffering from child labor. However, given the diminishing and rising effects of, respectively, variables such as mothers’ literacy and working on the child labor; the authorities could restrict child labor attending more to such a group. The factors identified could also be of a high value for the policy-makers at both national and international level such as the Health and Welfare ministries, EMRO, ILO and UNICEF.

Background: The present study aimed to identify the spatial distribution of tuberculosis and determine the TB control program parameters in the regions supervised by Shiraz University of Medical Sciences in 2006-2012.

Methods: The present ecological study was performed on 1797 TB patients in Shiraz University in 2006-2012 which were recorded by health centers using TB Register software. The study data were collected through over-counting and analyzed using the SPSS statistical software (ver. 19). Besides, the maps were drawn by ArcGIS, version 10.

Results: The incidence rate of TB was 4.8 in 100,000 at the end of 2012. Success in treatment was adequate only in 2012 (89.7%). However, recovery of pulmonary TB was not adequate in any of the study years. In our study, the majority of the patients belonged to the 25-34 years age group that constitutes the active faction of the society.  Moreover, the maps provided by GIS showed a high incidence rate of extra pulmonary TB in Firozabad Township during 7 years (2.7 in 100000 populations).

Conclusion: Incidence of TB in the regions supervised by Shiraz University of Medical Sciences follows a specific pattern, which requires exclusive studies for further evaluation of the incidence determinatives in various environmental and social conditions.

Background: As regards multilocus sequence typing (MLST) method directly analyze the polymorphism within DNA sequences; we performed the first nationwide study on the genotypic relationships of Candida albicans strains obtained from oropharynx and bronchoalveolar lavage (BAL) samples from immunocompromised patients.

Methods: Fourteen epidemiologically unrelated clinical strains of C. albicans were obtained from three hospitals in Mazandaran Province, Iran (2006 to 2012) from seven patients with pulmonary infections and the rest with oropharyngeal samples of immunocompromised patients. Seven loci of housekeeping genes were sequenced for all fourteen isolates.

Results: MLST was applied to a subset of 14 unrelated isolates. Seventy-one (2.5%) nucleotide sites were found to be variable. Accordingly, 60 different alleles were identified in seven loci among the isolates, among which two new alleles were obtained. Furthermore, 12 independent diploid sequence types (DSTs) including five novel DSTs were identified. The fourteen unrelated isolates were placed in 10 clonal clusters (CC) while two isolates were singletons, by eBURST analysis. Most of the isolates belonged to CC461 of eBURST analysis from the clade 11 and two isolates assigned to CC172 from the clade 15.

Conclusion: Pathogen distribution and relatedness for determining the epidemiology of nosocomial infections is highly recommended for pathogen control methods.

Background: The aim of this study was to investigate the effects of High-Intensity Interval Training (HIIT) on nitric oxide metabolites (NO2^-, NO3^-) and myocardial infarct size after Ischemia/Reperfusion (I/R) injury in healthy male rats.

Methods: A total of 44 Wistar rats were randomly divided into 4 groups including HIIT (n=8), HIIT + IR protocol (n=14), control (n=8), and control + IR (n=14). Each training session of HIIT consisted of 1 hour of exercise in three stages: 6-minute running at 50-60% VO2max for warm-up; 7 intervals of 7-minute running on treadmill with a slope of 5⁰ to 20° (4 minutes with an intensity of 80-100% VO2max and 3 minutes at 50-60% VO2max); and 5-minute running at 50-60% VO2max for cool-down. The control group did not participate in any exercise program. Nitric Oxide (NO) and its metabolites were measured by using Griess reaction test.  

Results: The results showed that eight weeks of exercise training exerted a significantly increasing effect on nitrite (8.55 µmol per liter, equivalent to 34.79%), nitrate (62.02 µmol per liter, equivalent to 149.48%), and NOx (66 µmol per liter, equivalent to 98.11%) in the HIIT group compared with the control group. The results showed myocardial infract size (IS) was significantly smaller (23.2%, P<0.001) in the exercise training group compared with the control group.

Conclusion: Incremental changes in NO-NO₃^-, NO₂^- axis are one of mechanisms through which HIIT program can protect the heart from I/R injury and decrease myocardial infarction. 

Background: Hydatidosis is the most important zoonotic disease that causes significant economic losses and public health problems worldwide. This study was conducted to evaluate retrospectively 136 patients diagnosed with hydatid cyst disease at two university medical centers between 2007 and 2013 in in Zanjan area, northwest Iran.

Methods: We surveyed medical records of infected patients with hydatid cyst who had been operated in two hospitals in Zanjan City, northwest, Iran. Several parameters were studied including age, sex, place of habitation, and the location of cysts.

Results: Of 136 cases, 54.4% were female with the mean age of 45 yr (4– 86). The most affected age group was 21-40 yr old (36.02% of the cases). Cysts were localized in liver and lung in 64% and 23.5% of cases, respectively. Single organ involvement was seen in the majority of patients and 13 (9.5%) cases had multiple involvement. In 69.9% of cases, there was only one cyst, 8.1% had two cysts, 17.6% with three cysts, and 4.4% had four cysts or more. The distribution of residence of patients showed that 33 (24.3%) of them were urban residents.

Conclusion: The prevalence of hydatidosis is high in this city and further studies are required to determine the prevalence, economic impact and risk factors of the disease in the area.

Isolated renal hydatid disease is a rare endemic infestation caused by larval form of Echinococcus granulosus. Hydatiduria is an uncommon presentation of renal hydatid disease. In 2012 a 34-year-old female referred to Razi Hospital, Rasht, Iran with complaints of right flank pain and grape-like material in urine. Diagnosis was made by ultrasonography and CT scan. The patient was treated surgically with nephrectomy in combination with perioperative chemotherapy with albendazol. 

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