Western Region Of Iran Research Articles

Nursing Care Experiences of People Living with HIV/AIDS (PLWHA): A Phenomenological Study from the West of Iran

IntroductionNursing care for people living with HIV/AIDS (PLWHA) can be challenging and is dependent on the context. However, there is a lack of information about nurses’ experiences in caring for PLWHA in the western region of Iran. Therefore, this study aimed to describe the experiences of nurses in caring for PLWHA in Kermanshah, Iran. MethodsIn this qualitative descriptive phenomenological study, data were gathered via semi-structured, in-depth interviews. The sample comprised 15 nurses employed at hospitals affiliated with Kermanshah University of Medical Sciences, selected through purposive sampling. Colaizzi's seven-step method was employed to analyze the data, and MAXQDA 10 software was used for data management. ResultsIn this study, we obtained 579 codes and four main themes of "caring with fear", "Care ethics", "protective precautions" and "duality of feeling ". ConclusionAccording to the results, nurses confront numerous difficulties, challenges, fears, and stress when dealing with PLWHA. Participants’ perceptions and practical experiences of AIDS patients enable patients to receive appropriate and high-quality care and provide valuable insights for nursing managers to enhance the preparedness of HIV ward nurses. To gain a comprehensive understanding of HIV nursing care, nurses require further education and awareness on this subject.

Prevalence of Self-reported Domestic Elder Abuse and Its Relation with Personality Traits of Older People and Their Family Caregivers.

Elder abuse (EA) is a serious public health issue recognized as a healthcare priority. Personality traits can influence social behaviors. This study aimed to determine the prevalence of self-reported domestic EA and its relationship with personality traits of older people and their family caregivers. A cross-sectional study was conducted in 2022. The research population included older people living in the urban community of the Lorestan Province (in the western region of Iran) selected by multistage cluster sampling. In general, 998 older people and their family caregivers were sampled. The data collection tool was a three-part questionnaire: a. demographic characteristics of the older people, b. questionnaire on the incidence of elder abuse, and c. short version of the NEO Five-Factor Inventory-Revised (NEO-FFI-R) for measuring the personality traits of the older people or family caregivers. The statistical software used was Stata 14. The present study reported that the prevalence of EA at home was 37.78%. In the present study, older age, female gender, unmarried/single status, lower education, unemployment, and rented house characteristics were predictors of EA. High agreeableness, high extroversion, and low neuroticism reduce conflict and tension in older people with their relatives and family, which appear to be protective factors against EA. Policymakers and health experts should prepare training and screening programs to consider these factors so that older people exposed to EA can be identified more quickly and early interventions can be used to improve their health status and increase their quality of life.

Earthquake, flood and resilience management through spatial planning, decision and information system

Assessment and planning of crisis management with the natural disasters approach include many components. In this regard, floods and earthquakes are some of the fundamental pillars in this field. With this view, paying attention to the current and future planning and research priorities of the world shows that crisis management in flood-prone and earthquake-prone areas and increasing resilience are the most important priorities for sustainable development studies and planning in the world. The western region of Iran (Lorestan province) has a special place due to the prominent features of flood and seismicity. This study aims to investigate the current situation regarding floods and earthquakes and increase the resilience of settlements with emphasis on the study area. After studying the current structure of flood and earthquake zoning according to multi-factor criteria, zoning was performed based on the integration of GIS and AHP information systems, and at the output of the work, high-risk settlements were determined separately for rural and urban areas with geographical coordinates, and then areas with low, very low, medium, high, and very high resilience were presented separately for rural and urban settlements. Also, after analyzing the SWOT model, strategies to increase the resilience of settlements to floods and earthquakes were presented. The study method of this research and the results, strategies, and operational options presented while being used in the study area are also applicable in other areas.

Developed analytic hierarchy process and multi criteria decision support system for wind farm site selection using GIS: A regional-scale application with environmental responsibility

As determined by empirical analysis, renewable energy sources account for less than 1.73 percent of the developing countries energy market. The western region of Iran, or province of Kermanshah, presents significant opportunities for power exports to neighboring country (Iraq). In this research, an appropriate location for wind farms in Western Iran is determined with the assistance of a combined method of Geographic Information Systems (GIS) and Multi-Criteria Decision Making (MCDM) description. Electrical, techno-economic, environmental, and geo-infrastructure aspects, as well as their respective sub-criteria, were subjected to a comprehensive analysis and weighting in this study. The Analytical Hierarchy Process (AHP) was utilized to achieve this result. The aforementioned conclusions were reached through an extensive examination of insightful interviews conducted with esteemed experts in the domain of wind energy. Significant suitability for the potential installation of large-scale wind turbines or wind farms is evident in six critical areas, encompassing more than 20 % of the evaluated region, according to the findings of this paper. Conversely, it was deduced that precisely 80 % of the areas examined were deemed inappropriate for such endeavors. The assessment yielded four locations that were deemed suitable, denoted as A, B, C, and D. The southern, western, and central regions of the province contain these locations. The proposed total capacity is 216 MW, which is determined by the combined surface areas of these regions (19 km2, 55 km2, 64 km2, and 40 km2, respectively). An anticipated reduction of 1,262,471 tons in greenhouse gas emissions is anticipated as a result of the implementation and substitution of the proposed wind farms for the gas turbine power plants that presently predominate in Iran's thermal power plant sector. The method used in this article can be extended to all cases of other faculties to measure the potential of wind farm resources.

Summer heat waves and their mortality risk over a 14-year period in a western region of Iran.

Compared to previous decade, impact of heat waves (HWs) on mortality in recent years needs to be discussed in Iran. We investigated temporal change in added impact of summer HWs on mortality in eight cities of Iran. The pooled length of HWs was compared between 2015-2022 and 2008-2014 using random and fixed-effects of meta-analysis regression model. The temporal change in impact of HWs was evaluated through interaction effect between crossbasis function of HW and year in a two-stage time varying model. In order to pool the reduced coefficients of each period, multivariate meta-regression model, including city-specific temperature and temperature range as heterogenicity factors, was used. In addition to relative risk (RR), attributable fraction (AF) of HW in the two periods was also estimated in each city. In the last years, the frequency of all HWs was higher and the weak HWs were significantly longer. The only significant RR was related to the lowest and low severe HWs which was observed in the second period. In terms of AF, compared to the strong HWs, all weak HWs caused a considerable excess mortality in all cities and second period. The subgroup analysis revealed that the significant impact in the second period was mainly related to females and elderlies. The increased risk and AF due to more frequent and longer HWs (weak HWs) in the last years highlights the need for mitigation strategies in the region. Because of uncertainty in the results of severe HWs, further elaborately investigation of the HWs is need.

Phonological development in first language Laki-speaking children aged 3 to 5 years: A pilot study

Purpose To date there are no studies of speech sound acquisition in Laki, a language spoken in western regions of Iran. Thus, we set out a pilot study to investigate the speech development of 56 first language Laki-speaking children (aged 3–5 years). Method Single words were elicited through a picture naming test specifically developed for this study. After recording and transcribing of speech samples, percentage of consonants correct (PCC), percentage of vowels correct (PVC), and proportion of whole word proximity (PWP) were documented in four age groups (36–41, 42–47, 48–53, and 54–59 months) and both genders. Children’s phonetic inventories and consonant and vowel accuracy were also described. Result All the sounds were considered as emerging by 53 months of age. For speech sound accuracy, all the speech sounds except /ɢ, z, ŋ, ʒ/ were mastered by 5 years. The effect of age on PCC values was significant. Also, age groups showed significant differences for PWP but were not significant for PVC. Boys and girls did not differ for PCC, PVC, and PWP values. Conclusion From a theoretical perspective, findings contribute to theories about phonological acquisition in general and will enable crosslinguistic comparisons. From an applied standpoint, language-specific characteristics are identified, which are much needed for clinical practice with Laki-speaking children.

The Success of a New Protocol for Early Diagnosis and Management of Congenital Atrioventricular Block: A Follow-up Study of 15 Fetuses from November 2007 to August 2022

Background: Congenital atrioventricular heart block (CAVB) is a relatively rare condition that can lead to long-term complications. Early diagnosis and management of CAVB is currently the ideal goal, particularly in high-risk pregnancies. Methods: The Fetal Heart Center at Kurdistan University serves as the primary referral center for pregnant mothers residing in the western region of Iran. Fifteen fetuses with CAVB were admitted between November 2007 and August 2022. They were referred for one or more of the following reasons: Fetal bradycardia or arrhythmia, abnormal ultrasound findings, and previous maternal or fetal risk factors. After obtaining a complete medical history, we conducted fetal echocardiography and ordered testing for maternal Lo/Ra autoantibodies. Our therapeutic approach was based on the type of atrioventricular block (AVB), serum titer of Lo/Ra antibodies, and specific risk factors associated with each type of AVB. Consequently, we used a combination of different medications, including dexamethasone, Hydroxychloroquine (HCQ), IVIG, beta-agonists, and inotropes. Results: We admitted 15 fetuses with CAVB, including seven females (47%) and eight males (53%). Most of our cases had positive tests for Lo and Ra autoantibodies, with varying degrees of AVB. A previous fetal death was common in our case series, accounting for 47% of cases. Moderate and high antibody titers were present in 80% of our cases. Mild bradycardia was a relatively common finding in our cases of first and second-degree atrioventricular block (AVB), occurring in 33% of patients. All of the above-mentioned findings, commonly referred to as major risk factors, were used for either early evaluation or therapeutic goals. No cases with first-degree AVB developed a higher grade of AVB after our therapeutic approach. One fetus with second-degree AVB developed CCHB, and another with mixed second/third-degree AVB reverted to second-degree AVB with the use of appropriate medications. Conclusions: Our therapeutic approach for the current cases yielded satisfactory results. Subsequently, we attempted to develop a rudimentary approach for early managing and treating fetuses with various types of CAVB. We are looking forward to future multicenter studies.

Risk Factors and Spatiotemporal Distribution of Lumpy Skin Disease Occurrence in the Asian Continent during 2012–2022: An Ecological Niche Model

Lumpy skin disease (LSD) is an emerging transboundary infectious disease of animals with high morbidity and low mortality rates. The infection occurs in cattle, buffalo, and some closely related wild animals, with cattle and buffalo showing higher susceptibility than other species. The primary mode of disease transmission is the mechanical dispersion of bloodsucking insects. The disease symptoms, including animal fur damage, weight loss, decline in milk production, infertility, and miscarriage, lead to huge economic losses in regions and countries with LSD outbreaks. The present study aimed to analyze the incidence data of LSD in the Asian continent from January 2012 to September 2022, identify spatiotemporal clusters and risk factors of the disease, and establish a maximum entropy ecological niche model to predict high-risk areas for disease outbreaks. The studied variables included bioclimatic factors, land type, and population density. Following the screening process, 12 variables were included in the maximum entropy model. Among them, the variable contribution rates of cattle density, land cover, isothermality, buffalo density, and maximum temperature of the warmest month were 53.8%, 10.9%, 9.2%, 8.9%, and 8%, respectively. Accounting for more than 90% of the total variable contribution rate, these five variables were considered to be the important influencing factors of LSD outbreaks. According to the results, nine spatiotemporal clusters approximately matched the high-risk areas predicted by the model. The Caucasus region of Russia; the Russian border areas of Kazakhstan, Turkey, Syria, Lebanon, Palestine, and Israel; and the western regions of Iran, India, and Southeast Asia were predicted to be high-risk areas. Thus, this study provides the spatiotemporal clusters, risk factors, and high-risk areas of LSD outbreaks in the Asian continent, which can help formulate more effective disease prevention and control policies.

Monthly streamflow forecasting by machine learning methods using dynamic weather prediction model outputs over Iran

Seasonal hydrological forecasts play a critical role in water resources management. The Copernicus Climate Change Service (C3S) data store provides open access to monthly hydrological forecasts for up to six-months. This study aims to evaluate, for the first time, 1- to 3-month runoff forecasts using the European Centre for Medium-Range Weather Forecasts (ECMWF) ensembles of precipitation, runoff, and temperature in 1981–2015 period over a total of 30 s-level basins in Iran. We adopted the 5th, 50th and 95th ECMWF ensemble quantiles for each variable that represent low, medium and high probability of occurrence, respectively. Pearson correlation analysis (Pca), Recursive Feature Elimination (RFE) via random forest (RF) model, and Bayesian Networks (BN) feature selection algorithms were used in order to reduce input variable dimension and select potential predictors to be fed to the machine learning models. Multiple Linear Regression (MLR), Artificial Neural Networks (ANN), Support Vector Regression (SVR), Random Forest (RF), and eXtreme Gradient Boosting (XGBoost) machine learning models were used with Repeated K-Fold cross validation (rK-Fold CV) while model efficiency was evaluated using modified Kling-Gupta efficiency coefficient (KGE’), Nash-Sutcliffe Efficiency coefficient (NSE), and Normalized Root Mean Square Error (NRMSE). Results of this study revealed that C3S runoff ensembles have the highest impact on forecast accuracy of streamflow, followed by precipitation and temperature. Overall, model performance yield a best-to-worst ranking of ANN, XGBoost, RF, MLR, and SVR with KGE’ values of 0.70, 0.68, 0.66, 0.57, and 0.41, respectively. The predictive performance of all models decreased with lead times beyond 1-month, where ANN and XGBoost outperformed other models with KGE’ of 0.65 for 2-month lead time and 0.60 for 3-month lead time. The three superior models of XGBoost, ANN, and RF, were employed with RFE and BN FSAs most frequently across Iran’s 30 s level basins in all lead times. Almost all models in the arid central region of Iran showed the lowest performance while highest skills were achieved in the western regions of Iran. Finally, for all models and over all regions, the model performance reduced by increase in lead-time.

Molecular Investigation of Brucella Species Belongs to Sheep and Goats in Seropositive Samples from an Endemic Area of Hamedan Province; Famenin Brucellosis Cohort Study.

Brucellosis is a zoonotic infectious disease in western regions of Iran, especially in Hamedan province. Following the Famenin brucellosis cohort study, the main aim of the current study was the molecular detection of Brucella species (spp.) in sheep and goats from Famenin, Hamedan, Iran. A total of 23 Brucella-seropositive samples (sheep=21 and goats=2), which had been screened from 1,660 animals in the Famenin cohort study, were used to detect Brucella-DNA using the BCSP31 target gene and IS711 locus. In total, 20 of 23 samples were positive for Brucella infection by using specific primers. Additionally, Brucella melitensis (B. melitensis) and Brucella abortus (B. abortus) were confirmed in 90% (n=18) and 10% (n=2) of positive samples, respectively. There was no sample with the co-infection of B. abortus and B. melitensis. In this study, B. abortus was isolated from one of the goat samples. This is the first report on Brucella spp. in animals in the region. It was found that B. melitensis is the dominant spp. responsible for brucellosis in animals from Famenin. Molecular techniques are reliable tools to detect Brucella infection, especially in cases without serology findings and conclusive results.

Investigation of the Proportion of Brucella abortus and Brucella melitensis in Sheep and Goat Milk.

Despite the implementation of brucellosis eradication programs in Iran, this disease is still endemic and highly prevalent among ruminants in this country. The infection of small ruminants with Brucella abortus may play a significant role in the continuation of brucellosis among the herds of ruminants. This study investigated the proportion of B. abortus and Brucella melitensis in 150 samples of sheep and goat's raw milk which were obtained from Lorestan and Hamadan provinces in the western part of Iran using the PCR method. The results revealed that among the Brucella spp. positive samples, 26.5% and 73.4% of the samples were infected with B. abortus and B. melitensis, respectively. The incidence rates of B. abortus among the sheep and goats samples were 6.8% and 12.5%, respectively. There was a significant difference between goats and sheep regarding the proportion of B. abortus. Three samples (2%) (2 goats and one sheep) were simultaneously infected with both B. melitensis and B. abortus. This article renews our knowledge about the causative agent of brucellosis in small ruminants and shows that B. abortus has a relatively high prevalence among those animals in the western regions of Iran, and its role as one of the main factors of abortion among small ruminants should not be ignored. The information provided in the present study is important for the surveillance program, as eradication programs and strategies to prevent the spread of B. abortus among small ruminants that have not been vaccinated against this microorganism may be adapted accordingly.

The Prevalence of Celiac Disease in Children Suffering Chronic Constipation: A Study in the Western Region of Iran

The Prevalence of Celiac Disease in Children Suffering Chronic Constipation: A Study in the Western Region of Iran

Antileishmanial Activity of New Steroidal Saponin Isolated from the Flowers of Allium Austroiranicum

Background & Objective: Plants are reservoirs of bioactive compounds, which are known to be chemically balanced, effective and least injurious as compared to synthetic medicines. The current resistance and the toxic effects of the available drugs have brought the trend to assess the antileishmanial effect of various plant extracts and their purified compound/s. Alliums are rich sources of steroidal saponins, flavonoids, and sulphuric compounds of which steroidal saponins have recently received more attention due to their important pharmacological activities. Allium austroiranicum is a common edible vegetable in western regions of Iran, especially in “Chaharmahal and Bakhtiari” province, where it is named “Lopo” and is considerably used as a raw vegetable, flavoring agent, and as a medicinal plant.
 Materials & Methods: The chloroform-methanolic extract was fractionated using MPLC, and the appropriate fractions were then subjected to isolation and purification of the constituents by HPLC. Structure elucidation was done using comprehensive spectroscopic methods including 1D and 2D NMR. Antileishmanial effects of the isolated compound against the promastigotes of Leishmania major were evaluated using MTT method.
 Results: Phytochemical investigation of chloroform-methanol extract of the plant resulted in the isolation and identification of a Nicotianoside C related steroidal saponin and its chemical structure was determined as (25S)-5α-Spirostan-1β,3βdiol-3-O-{α-L-rhamnopyranosyl-(1→2)-{α-L-rhamnopyranosyl-(1→4)}-[β-D-glucopyranoside}. Investigation of in vitro antileishmanial activity of the isolated compound, in 10 and 50 and 100 μg/mL concentrations, exhibited significant leishmanicidal effects against the promastigotes of Leishmania major.
 Conclusion: The results established a valuable basis for further studies about A. austroiranicum and anti-parasitic activity of steroidal saponins.

Women's awareness of ovarian cancer risk factors and symptoms in Western Iran in 2020–2021

ObjectivesThis study aimed to investigate awareness of women living in the western region of Iran about warning signs and risk factors for ovarian cancer.MethodsThis cross-sectional, descriptive-analytical study was conducted in Sanandaj and Kermanshah, Iran, 2020 and 2021. In this study, 1081 women aged 18–70 years were selected as the sample to fill out the electronic version of the Ovarian Cancer Awareness Measure (OCAM) to identify the significant variables of ovarian cancer warning signs and risk factors. The obtained data were statistically analyzed by descriptive statistics and ordinal logistic regression in SPSS 19.ResultsIn this study, 60.9% of the participants had medium awareness of the subject. The results indicated that participants with higher educational attainment (P < 0.05) and those with a history of cancer (P < 0.001) showed higher knowledge of cancer. The lowest level of awareness of symptoms was associated with acute symptoms such as dysphagia (swallowing problems) most days, persistent bloating, a sense of abdominal fullness or heaviness, and frequent urination. Moreover, the lowest awareness of risk factors was related to the history of IVF treatments and the application of talcum powder to the genital area.ConclusionThe study findings showed that women living in the western region of Iran have moderate awareness of ovarian cancer and insufficient knowledge of cancer warning signs; this suggests that it is necessary to train Iranian women to raise awareness of the signs and risk factors for ovarian cancer.

Socio-Economic Status and Clinical Breast Examination Screening Uptake: Findings from the First Cohort Study among Iranian Kurdish Women.

Clinical Breast Examination (CBE) is utilized as a screening modality in many low income countries without widespread mammography capability. The aim of the current study was to evaluate the impact of socio-economic status (SES) on CBE screening rates in Iranian Kurdish women. A cross-sectional study was conducted in the western region of Iran. A sample of 5,289 Iranian Kurdish women aged 35-65 years old was analyzed. Data were collected from July 2014 to September 2018. The Concentration Index-CI and Concentration Curve were used to estimate the socioeconomic inequalities in CBE rate. The analysis of data was done by STATA software (Version 14). 12.3% of the women had received CBE at least once. CBE rates in the 46-50 age group were higher than in other age groups (OR = 2.06; 95% CI = 1.56-2.71). Women with 6-9 years of education had higher odds ratio of receiving CBE (OR = 1.41; 95% CI = 1.02-1.94). Women living in rural areas were less likely to have received CBE compared to those living in urban areas (OR=0.54; 95% CI = 0.42-0.61). The overall concentration index for receipt of CBE was 0.188. In countries without widespread mammography programs, strategies for the promotion of CBE should focus on the lower SES population.

A new species of Calomyscus Thomas, 1905 (Calomyscidae: Rodentia) from western Iran

Eight extant species have been so far recognized for Calomyscus Thomas, 1905 which is distributed in the west of Asia. The only species which was reported from the Zagros Mountains in western and southern Iran was C. bailwardi. However, based on the integrative methods such as molecular, morphometric and karyological studies a new species is worth to be described other than C. bailwardi from the Zagros Mountains. In the present survey a new species which has been distributed in western regions of Iran was described as Calomyscus behzadi sp. nov. The new species constituted a monophyletic clade in phylogenetic tree which its relationships are unresolved. A new karyotype was reported for the new species as 2N=44 and FNa=48. The results of multivariate statistical analyses also separated the new species from C. bailwardi and other recognized species of the genus Calomyscus. Based on the size + shape data, C. behzadi sp. nov. has shorter nasal than C. bailwardi, group D and C. grandis and narrower than C. baluchi but wider than C. hotsoni and C. elburzensis. Moreover, according to the shape data, the new species has shorter m2 than C. elburzensis, C. bailwardi, C. hotsoni, C. grandis and group D and narrower than C. bailwardi, C. grandis and C. baluchi. The new species was described from regions which had been known already as distribution area of C. bailwardi.

Clustering of different atmospheric patterns leading to an increase in different types of atmospheric pollutants in the greater Tehran area during the last 17 years (2004-2020)

Introduction: Air pollution is one of the main problems of industrial and large cities like Tehran, due to its harmful effects, especially on human health. Materials and methods: Based on the intensity and continuity of the standard air pollution index during 2004-2020 for 112 cases in Tehran, the principal component analysis method was applied in T-mode and clustering of days for similar 500hPa geopotential height changes were provided. The synoptic patterns leading to these different pollution cases were obtained. Results: The study of the mentioned days shows the activity of five atmospheric patterns with the frequency of 47, 28, 12, 13, and 4%, respectively. Conclusion: The first pattern happens during the cold season, associated with the simultaneous placement of the atmospheric ridge along with Siberian high-pressure system. The second group, which occurs mostly in summer and during late spring, is controlled with the predominant ozone pollutant. The main activity of the third pattern occurrences in summer and late spring, which is associated with the presence of monsoon Indian low-pressure on the southeastern regions in Iran. The fourth pattern, which occurs mostly in spring and autumn, associates with the establishment of dynamic low pressure in the western regions of Iran and Iraq, as well as the establishment of the thermal low-pressure system in the central part of the country. The last group is a local pattern that occurs due to the passage of the gust front and the shear of the wind field dust rise in the Tehran.

New climatic zones in Iran: a comparative study of different empirical methods and clustering technique

Recently in agricultural and industrial sectors, researchers have started to classify the climate of a region using empirical methods and clustering. This study aims to compare four empirical approaches to climate classification (Thornthwaite and Mather, De Martonne, the Extended De Martonne, and the IRIMO (I.R. of Iran Meteorological Organization)) with Ward’s hierarchical agglomerative clustering applied to the climate of Iran. The dataset used in this study comprises maximum and minimum temperatures and precipitation data of 356 weather stations extracted from IRIMO’s databases. Thirty-five synoptic weather stations are selected among 356 stations. These stations are selected regarding the best uniform distribution, elevation, windward and leeward sides of the mountain ranges, and availability of a continuous 50-year data (1966–2015). Compared with the other three empirical reference methods of climate classification, the Thornthwaite and Mather method emphasizes the role of water bodies and air masses in determining the climate type of a region. Highlighting these two factors is identified as the main advantage of this method over the other three. This advantage is the most noticeable for the highlands/mountainous regions, in the vicinity of the Zagros Mountains, and in the western regions of Iran. As a case in point, while in the De Martonne and the Extended De Martonne methods, the Zagros storm cell is climatically classified similar to patchy areas in Caspian Sea coastal zone, this cell is correctly identified as a separate zone in the Thornthwaite and Mather method. The results also reveal that the clusters obtained from Ward’s algorithm are comparable to those of empirical climate classifications, particularly Thornthwaite and Mather method.

Cigarette Smoking and Its Financial Burden among Iranian Households: Evidence from Household Income and Expenditures Survey.

Background: The financial burden of cigarette smoking on households’ budget is not well documented in Iran. We aimed to identify the determinants of cigarette consumption and its financial burden among households in Iran. Study design: A cross-sectional study. Methods: A total of 39,864 Iranian’s households from 31 provinces were included in the analysis. Data on sociodemographic and socioeconomic characteristics (age, sex, household size, education level, employment status, income and wealth index), living area, number of cigarettes smoked and cigarette expenditures for households were extracted from the 2016 Household Income and Expenditures Survey (HIES). Tobit model was used to identify the determinants of cigarette smoking frequency and expenditures among Iranian households. Results: The average number of cigarettes smoked and cigarettes expenditures by all household members was 85.25 cigarettes and US$ 2.64 per month. Living in urban areas, wealth index of households, household income, household size and low educational attainment of household members were positively associated with frequency and expenditures of cigarette smoking. Results also indicated increasing patterns in the number of cigarettes smoked and cigarettes expenditures from east to west of the country. East Azerbaijan, Hamadan, Markazi and Chaharmahal va Bakhtiari provinces had higher cigarette smoking frequency and expenditures in Iran. Conclusions: Tobacco control interventions in Iran should focus more on households living in urban areas and low-educated households. As the frequency of cigarette smoking was higher in the western region of Iran, comprehensive tobacco control policies should be adopted in western provinces.

Epidemiology and trends of gastrointestinal cancer in Iran (2004-2008).

Gastrointestinal (GI) cancer is among the most common cancers in Iran. The main purpose of this study was to evaluate changes in the time trends of stomach, colon and rectum, and esophageal cancer during the past decade in Iran. In this cross-sectional study, the study population was all cases of GI cancers diagnosed in Iran between 2004 and 2008. Cancer incidence data for the years 2004-2008 were obtained from the cancer registry system of the Ministry of Health. All incidence rates were directly age standardized to the world standard population. Age-Satndardized incidence rate (ASR)per 105 persons was calculated using direct standardization and the world standard population. The crude rate was calculated in this study. Data were analyzed using SPSS (version 17) and Microsoft Office Excel 2007. During the 2004-2008 period, the ASR and crude rates of GI cancers, including esophagus, stomach, colon and rectum, among males were 5.05, 15.02, and 8.29 and 4.01, 11.81, and 6.4, respectively, and among females were 6.52, 7.055, and 7.75 and 4.40, 4.85, and 5.49, respectively. The most common cancers in women were colon and rectum, and stomach cancer had the highest incidence in males. In this study, most cases of stomach cancer were adenocarcinoma adenocarcinoma (Nos) in both women and men. The most common type of colorectal cancer was adenocarcinoma, which was greater in men than women. The most common type of esophageal cancer was squamous cell carcinoma in both sexes. The north and northwestern regions of Iran have the highest risk of GI cancer. According to this study, a significant increase was observed in the incidence of cancers in the north and western regions of Iran. Hence, screening and early detection programs are highly recommended in these high-risk areas.