OBJECTIVES: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. PATIENTS AND METHODS: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. RESULTS AND LIMITATIONS: In total 187 patients were identified-orthotopic neobladder (ONB) (N = 75), ileal conduit (IC) (N = 57), and cutaneous ureterostomy (CU) (N = 55)-and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning (p = 0.003, 0.011, 0.045) as well as better body image (p < 0.001), lower short- and long-term financial burden (p = 0.034 and <0.001, respectively), marginally lower complication rate (p = 0.049), and better 5-year overall survival (p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. CONCLUSIONS: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.

• MeSH
• cystektomie * metody   MeSH
• diverze moči * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádory močového měchýře * chirurgie   MeSH
• osobní újma zaviněná nemocí * MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Írán MeSH

As an important source of human food, milk can be a carrier of human pathogenic bacteria, including tuberculous and nontuberculous mycobacteria (NTM), in its raw and unpasteurized state. In this research, 175 raw milk samples and 175 traditional cheese samples were collected from traditional dairy stores in 22 regions of Tehran in a 9- month period from August 2019 to May 2020. Samples were prepared and transferred to a specialized laboratory, where they were inoculated in Lowenstein-Jensen (LJ) medium containing glycerol or sodium pyruvate, as well as Herrold's egg-yolk with and without Mycobactin J. to determine the sample's identity of samples. The recommended 16S rRNA (1436 bp) and hsp65 (644 bp) gene fragments from the positive isolates identified in Ziehl-Neelsen (Z-N) staining were amplified and sequenced using PCR and compared with the sequences of the gene fragments of reference strains available in the global GenBank database. No mycobacterial species were isolated from traditional cheese samples in microbial culture. In case of raw milk samples, a total of four bacteria were collected, all of which were found in the genetic differential testing to be NTM, including n = 1 Mycobacterium heraklionense, n = 2 Mycolicibacterium fortuitum, and n = 1 Mycobacterium thermoresistibile. The analysis of the results obtained by isolate sequencing using the 16S rRNA gene showed higher discriminatory power and percentage similarities in the identification of the isolates than the hsp65 gene.

• MeSH
• atypické mykobakteriální infekce * mikrobiologie   MeSH
• lidé MeSH
• mléko mikrobiologie   MeSH
• netuberkulózní mykobakterie genetika   MeSH
• RNA ribozomální 16S genetika   MeSH
• sýr * mikrobiologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH

OBJECTIVE: Given Iran's recent shift towards pronatalist population policies, concerns have arisen regarding the potential increase in abortion rates. This review study examines the trends of (medical), intentional (illegal), and spontaneous abortions in Iran over the past two decades, as well as the factors that have contributed to these trends. METHODS: This paper reviewed research articles published between 2005 and 2022 on abortion in Iran. The study employed the PRISMA checklist for systematic reviews. Articles were searched from international (Google Scholar, PubMed, Science Direct, and Web of Science) and national databases (Magiran, Medlib, SID). Once the eligibility criteria were applied, 42 records were included from the initial 349 records. RESULTS: Abortion is influenced by a variety of socioeconomic and cultural factors and the availability of family planning services. Factors that contribute to unintended pregnancy include attitudes toward abortion, knowledge about reproductive health, access to reproductive health services, and fertility desires, among others. In addition to health and medical factors, consanguineous marriage plays an important role in spontaneous and therapeutic abortion. A higher number of illegal abortions were reported by women from more privileged socioeconomic classes. In comparison, a higher number of medical and spontaneous abortions were reported by women from less privileged socioeconomic classes. CONCLUSION: Iranian policymakers are concerned about the declining fertility rate and have turned to pronatalist policies. From a demographic standpoint, this seems to be a reasonable approach. However, the new population policies, particularly, the Family Protection and Young Population Law, along with creating limitations in access to reproductive health services and prenatal screening tests as well as stricter abortion law could potentially lead to an increase in various types of abortions and their associated consequences.

• MeSH
• indukovaný potrat * statistika a číselné údaje   zákonodárství a právo   trendy   MeSH
• lidé MeSH
• potrat nezákonný statistika a číselné údaje   MeSH
• samovolný potrat epidemiologie   MeSH
• socioekonomické faktory MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH
• Geografické názvy
• Írán MeSH

This study investigated the therapeutic potential of probiotic bifidobacteria, isolated from Iranian fermented dairy products, in a hyperlipidemic animal model. Bifidobacterium strains were extracted from traditional dairy samples and screened using physiological and phenotypic examinations, 16S rRNA analysis, and probiotic properties such as tolerance to gastrointestinal juice, antimicrobial activity, and antibiotic susceptibility. The ability of the screened bifidobacteria to reduce serum and liver lipids in vivo was tested using male Wistar rats. Six strains of bifidobacteria were isolated from traditional Iranian fermented dairy. These strains showed promising in vitro activity in lowering triglyceride and cholesterol, tolerance to simulated gastrointestinal juice, the ability to adhere to Caco-2 cells, acceptable antibiotic susceptibility, and a broad spectrum of antibacterial activity. The diet supplemented with isolated bifidobacteria significantly reduced serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), liver tissue lipid levels, and hepatic enzymes in animals when compared to a high-fat diet without strains (p < 0.01). Additionally, the potential probiotic-supplemented diet significantly increased bile acid excretion in the feces and upregulated hepatic CYP7A1 expression levels (p < 0.05), while NPC1L1, ACAT2, and MTP gene expressions in small intestinal cells were downregulated (p < 0.05). Bifidobacteria isolated from Iranian traditional dairy showed potential for use in the production of fermented foods that have hypolipemic activity in the host.

• MeSH
• antibakteriální látky farmakologie   MeSH
• Bifidobacterium * genetika   izolace a purifikace   metabolismus   MeSH
• Caco-2 buňky MeSH
• cholesterol-7-alfa-hydroxylasa genetika   metabolismus   MeSH
• cholesterol krev   metabolismus   MeSH
• feces mikrobiologie   MeSH
• hyperlipidemie * MeSH
• játra metabolismus   MeSH
• krysa rodu rattus MeSH
• lidé MeSH
• mléčné výrobky mikrobiologie   MeSH
• modely nemocí na zvířatech MeSH
• potkani Wistar * MeSH
• probiotika * aplikace a dávkování   farmakologie   MeSH
• RNA ribozomální 16S genetika   MeSH
• triglyceridy krev   metabolismus   MeSH
• žlučové kyseliny a soli metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH

OBJECTIVE: Access to family planning services is a human right that plays an essential role in society's health, particularly women's health. The COVID-19 pandemic has affected all aspects of human life including access to family planning services. Accordingly, the main goal of this study was to explore the experiences of women and service providers from the main challenges and obstacles of access to family planning services and abortion services in Bangladesh, Iran, and the Netherlands during the COVID-19 pandemic. METHODS: In this qualitative study, the data were collected through online, telephone, or in-person semi-structured interviews with key informants. Participants selected by purposive sampling method. The participants included women aged 15 to 49 (n = 63) and service providers (n = 54) in the 3 abovementioned countries. These individuals were included from October 2020 until December 2020. Conventional thematic analysis was employed to analyze the collected data. RESULTS: The main extracted themes were challenges (reduction of referral; disruption of access to services; insufficient knowledge; worries among staff; rising prices; and unavailability of some contraceptives), measures (time extension and visit scheduling; telephone, online, and door to door services; and support of the media) and recommendations (health facility improvements; free, online, and closer services; and ongoing trainings and awareness campaigns). CONCLUSION: The COVID-19 pandemic has affected family planning and reproductive health services in different ways and has uncovered existing inequalities in access to these services. However, in Iran, the reported challenges were also rooted in new population policies that have further limited access to family planning and abortion services.

• MeSH
• COVID-19 * epidemiologie   MeSH
• indukovaný potrat * MeSH
• lidé MeSH
• pandemie MeSH
• služby plánování rodičovství metody   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Bangladéš MeSH
• Írán MeSH
• Nizozemsko MeSH

Iran has witnessed three major reversals of population policies since their inception in the 1960s. In response to a rapid decline in fertility to very low levels, the latest policy shift has led to the development of legislation that aims to encourage marriage and fertility, particularly the "Youthful Population and Protection of the Family" law approved in 2021. This study reviews the changes in population policy and their interrelations with fertility trends, focusing mainly on the shift towards pronatalist policies since 2005, and accompanying restriction of reproductive health and family planning services. Combining international and national sources, we position the new pronatalist drive in the country within the broader trend of government attempts to reverse fertility decline and promote conservative family values. Our study has three main aims. (1) We provide an overview of fertility trends, policy discourses and policy shifts in the context of the changes in the societal and political structures of Iran during the last half a century. (2) We highlight and discuss the most problematic features of the new Family Law, especially the legislation pertaining to maternal and reproductive health, access to abortion and contraception, and incentives supporting earlier marriage and higher fertility. (3) We discuss the likely consequences of the new legislation for maternal and child health and sexual and reproductive rights, for women in general, and the country's socio-economic disparities. As well as violating reproductive rights, the new policy is unlikely to achieve its aim of initiating a sustained rise in fertility in Iran.

• MeSH
• dítě MeSH
• fertilita * MeSH
• lidé MeSH
• reprodukční práva * MeSH
• služby plánování rodičovství MeSH
• těhotenství MeSH
• veřejná politika MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Írán MeSH

Klebsiella pneumoniae is an important cause of nosocomial infections and displays increasing resistance to fluoroquinolones (FQ). This study surveyed the mechanisms of FQ resistance and molecular typing of K. pneumoniae isolates from intensive care units patients in Tehran, Iran. A total of 48 ciprofloxacin (CIP) resistant K. pneumoniae isolates from urine samples were included in this study. Broth microdilution assays revealed high-level CIP resistance (MIC > 32 μg/mL) in 31.25% of the isolates. Plasmid-mediated quinolone resistance genes were detected in 41 (85.4%) isolates. Among which, qnrS (41.67%) was the most prevalent followed by qnrD (35.42%), qnrB (27.1%), qnrA (25%), qepA (22.9%), aac(6')-Ib-cr (20.83%), and qnrC (6.25%). Target site mutations (gyrA and parC) were assessed using PCR and sequencing on all isolates. A single mutation in gyrA (S83I) was found in 13 (27.1%) isolates and two isolates harbored six simultaneous mutations. Fourteen isolates (29.2%) had mutations in parC and S129A and A141V mutations were the most prevalent. Real time PCR showed an increase in the expression level of acrB and oqxB efflux genes in 68.75 and 29.16% isolates, respectively. Enterobacterial repetitive intergenic consensus (ERIC)-PCR revealed 14 genotypes and 11 of them were classified by multilocus sequence typing (MLST) into 11 different sequence types belonging to seven clonal complexes and two singletons, most of them have not been reported in Iran yet. We are concerned about the spread of these clones throughout our country. Most FQ resistance mechanisms were detected among our isolates. However, target site mutation had the greatest effect on CIP resistance among our isolates.

• MeSH
• antibakteriální látky farmakologie   MeSH
• bakteriální léková rezistence genetika   MeSH
• ciprofloxacin * farmakologie   MeSH
• DNA gyráza genetika   MeSH
• fluorochinolony * farmakologie   MeSH
• Klebsiella pneumoniae genetika   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• molekulární epidemiologie MeSH
• multilokusová sekvenční typizace MeSH
• plazmidy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH

Increasing the physical activity and sport participation rates of people with disabilities has been one of the most important targets of sport policy both at national and international levels. The purpose of the current investigation was to assess participation in sports or physical activities among Iranian veterans with extremity musculoskeletal disorders. Data were obtained from health needs assessment studies conducted among Iranian veterans with musculoskeletal disorders in a 12-year period between 2005 and 2017. The collected Information on sport or physical activity participation was analyzed using χ2 test, independent t-test, partial correlation coefficient and binary logistic regression (p < 0.05). Studies on 2644 veterans with extremity musculoskeletal disorders indicated that 37.6% (n = 994) of them participated in at least one type of sport or physical activity. The highest percentage of sport participation was 65% in bilateral upper limb amputees. Results from logistic regression analysis indicated that the chance of sport participation decreased with ageing while it increased with "Disability Percentage" assigned by the medical commission of the Veterans and Martyrs Affairs Foundation which is responsible for determining the disability rate of the veterans in Iran. It was observed that veterans with a higher "Disability Percentage" had a higher duration and frequency of sport or physical activity participation. The most popular sports among the subjects were track and field (20.1%, n = 192) and swimming (15.6%, n = 149). Generally, more than a third of the subjects participated in sports or physical activities in total and sport or physical activity participation was greater in the high-level lower extremity amputation group.

• MeSH
• amputovaní MeSH
• dospělí MeSH
• lidé MeSH
• muskuloskeletální nemoci MeSH
• odhad potřeb MeSH
• para sportovci MeSH
• pohybová aktivita * MeSH
• sporty pro handicapované * MeSH
• veteráni váleční MeSH
• zapojení do společnosti MeSH
• zpráva o sobě MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Geografické názvy
• Írán MeSH

It is estimated that nearly one-third of the world's human population is infected with Toxoplasma gondii (Nicolle et Manceaux, 1908). Human infection is commonly asymptomatic, multifaceted, and can manifest in severe pathological forms in congenital toxoplasmosis and immunocompromised individuals. This study attempted to recognise the seroprevalence of T. gondii infection in Iranian residents referred to medical laboratories for toxoplasmosis tests throughout the country. This retrospective cross-sectional study was conducted from 2015 to 2019 on individuals referred to diagnostic laboratories in 26 provinces, and these laboratories sent their samples to the referral centres. Accordingly, data associated with serodiagnosis of toxoplasmosis, age, sex, anti-T. gondii IgG, and IgM status in Iranian residents were collected from two referral diagnostic laboratories. All individuals were evaluated using the antibody immunocapture-chemiluminescence assay (CLIA) method with the Immulite®2000s XPi system. In this study, the first large-scale assay of T. gondii infection in Iran, an overall seroprevalence of 30.4% was among 35,047 patients examined. The highest IgM seropositivity rate was in the 10-20 years old patients. In addition, this study showed a very different prevalence of T. gondii across the country, highest in the humid areas, such as the Caspian Sea basin in the North, and the North West with seroprevalence of 48.6%.

• MeSH
• dítě MeSH
• dospělí MeSH
• imunoglobulin G MeSH
• imunoglobulin M MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• protilátky protozoální MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• séroepidemiologické studie MeSH
• Toxoplasma * MeSH
• toxoplazmóza * epidemiologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH

BACKGROUND: Early marriage occurs in some regions of the world. Given that early marriage can have many negative consequences for girls by affecting their physical, mental, and social health, the purpose of this study was to investigate the reasons for early marriage from the perspective of women who had experienced it in Zahedan, Iran. METHODS: This qualitative research was conducted based on the qualitative content analysis method in 2020-2021. The target population included women aged 18-35 living in Zahedan who were married under the age of 18 years. Purposeful sampling was used to select the participants. In order to collect data, in-depth interviews were performed to decipher the reasons for early marriage from these women's perspectives. A total of 36 interviews were conducted from October to December 2020 until reaching theoretical saturation. Conventional content analysis was used to analyze the data and extract the relevant concepts and categories. RESULTS: The analysis of the interviews in this study revealed three main categories:(1) "early marriage as a transcendental coercion" ( early marriage as a cultural heritage and early marriage as a control tool, girls' weaknesses and inability to resist, dominant attitudes toward gender and gender restrictions), (2) "early marriage as a solution or a kind of problem solving" (escape from undesirable family environment, escape from financial poverty, and strategic escape from an unpleasant situation), and (3) "early marriage as a voluntary act" (real agency and imaginary agency). To substantiate these findings, we presented excerpts from the interviews conducted with the participants. CONCLUSION: The results of this study suggest a multidimensional picture of early marriage. It seems that improving cultural conditions and empowering families and girls in various areas, including marriage, can reduce the rate of early marriage and/or at least mitigate its undesirable consequences.

• MeSH
• chudoba * MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• řešení problému * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH