Background: Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. Materials and Methods: This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. Results: Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean± standard deviation of 63±11.8 years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). Conclusions: Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.

COVID toes or chilblain-like skin lesions represent a widespread and specific skin presentation mostly in the feet that may be attributed to COVID-19 infection.They may last for several months. We conducted this study to investigate chilblainlike lesions in children during the COVID-19 pandemic, any predisposition, location, clinical course, and prognosis. We searched Google Scholar, Scopus, and Medline (PubMed) databases using the following keywords: "Coronavirus" OR "COVID-19" AND "Chilblains" OR "Pernio" OR "Perniosis" OR "Children" OR "Cutaneous" OR "skin." The inclusion criteria were: (a) Studies that described the specific vascular skin lesion. (b) Studies that included patients aged >1 month till 18 years. (c) Case reports, case series, retrospective or prospective cohort studies, case-control studies. A total of 28 articles were included. The total number of children with chiblain-like lesions (CLL) was 433. The mean age of children presenting CLL during the COVID-19 pandemic was estimated as 12.58 ± 2.15. Of note, 53.6% of them were male. The nasopharyngeal SARS-CoV-2 RT-PCR test and anti-SARS-CoV-2 antibodies were mostly negative for the virus. In conclusion, it is crucial to be familiar with various presentations of COVID-19 infection and their clinical significance to approach the earliest diagnosis, immediate treatment, estimate the prognosis, and finally isolate the patients to prevent spreading. Chilblainlike lesions as a possible cutaneous presentation of COVID-19 in children may last several months with the indolent course.

Breast cancer is the most common type of cancer diagnosed in women and is the main cause of cancer-related death in females. It accounted for 1.7 million cases of cancer and caused 521,900 deaths in 2012. Breast cancer alone comprises 25% of all cancers and 15% of cancer-related deaths in women (Torre et al., 2015).According to the global statistics, incidence of breast cancer increases by 2% annually worldwide (DeSantis et al., 2011). The prevalence of breast cancer is the highest among the Iranian women in the age range of 40 to 49 years and its prevalence in this age range reaches 120 in 100,000 population (Mousavi et al., 2007). Differences exist in the prevalence and morbidity and mortality of breast cancer among different countries. A reduction in morbidity and mortality related to breast cancer has been reported in the north, south and west of Europe (Autier et al., 2011) while the trend of breast cancer-related morbidity and mortality is increasing in Asia, Japan, Korea and China (Katanoda and Yako-Suketomo 2010). Such variability may be related to several factors, and many studies have AbstractBreast cancer is one of the most common causes of cancer mortality in Iran. Social determinants of health are among the key factors affecting the pathogenesis of diseases. This cross-sectional study aimed to determine the social determinants of breast cancer survival time with parametric and semi-parametric regression models. It was conducted on male and female patients diagnosed with breast cancer presenting to the Cancer Research Center of Shohada-ETajrish Hospital from 2006 to 2010. The Cox proportional hazard model and parametric models including the Weibull, log normal and log-logistic models were applied to determine the social determinants of survival time of breast cancer patients. The Akaike information criterion (AIC) was used to assess the best fit. Statistical analysis was performed with STATA (version 11) software. This study was performed on 797 breast cancer patients, aged 25-93 years with a mean age of 54.7 (±11.9) years. In both semi-parametric and parametric models, the three-year survival was related to level of education and municipal district of residence (P<0.05). The AIC suggested that log normal distribution was the best fit for the three-year survival time of breast cancer patients. Social determinants of health such as level of education and municipal district of residence affect the survival of breast cancer cases. Future studies must focus on the effect of childhood social class on the survival times of cancers, which have hitherto only been paid limited attention.

Background:Postpartum depression is considered as a major health complication of women after delivery. It is necessary to find an essential approach for the prevention of its serious consequences on mothers’ and infants’ health. The aim of this study was to investigate the effect of home visiting on postpartum depression.Methods:The first stage of study was the design of postpartum package. According to the package, a clinical trial was performed for 276 mothers who had delivered in affiliated hospitals of Shahid Beheshti University in 2013 and were divided into two groups, i.e., control group and intervention group. Intervention group received health care by home visiting, and control group had no intervention. Mothers were supposed to fill up Edinburgh Postnatal Depression Scale before and 60 days after delivery, and the results were compared. The data were analyzed by SPSS version 18 software and t-test, Chi-square, and logistic regression test.Results:The mean ages of participants were 27.03 ± 5.2 standard deviation (SD) in intervention group and 27.37 ± 5.4 SD in control group. Occurrence of depression was 7.6% in intervention group and 19% in control group, and there was a significant difference between two groups (P < 0.05). The logistic regression results indicate that groups (intervention and control) (P = 0.087, odds ratio [OR] =2.1); planned and unplanned pregnancy (P = 0.028, OR = 2.5) and the infant nutrition (P = 0.025, OR = 2.2) are significantly associated with the postpartum depression.Conclusions:Providing postpartum home visiting can influence postpartum depression in a positive way and could improve mothers’ and infants’ health.

Background:Cancer is the second most common cause of morbidity and mortality in children. This study aimed to epidemiologically and demographically assess common cancers in children in Iran.Materials and Methods:This cohort study was conducted on children registered in Mahak Hospital and Rehabilitation Complex (which is a non-governmental organizations (NGO)-related hospital for only malignant diseases). A total of 2232 questionnaires were filled out for cancer patients between 2007 and 2016. The factors including age, gender, race, family history, type of treatment, and type of cancer were entered into Cox regression model to examine their effect on mortality of children diagnosed with cancer.Results:The Cox regression model showed that age, race, type of cancer, family history of cancer, and type of treatment had a significant effect on mortality of children diagnosed with cancer (P < 0.05). The hazard ratio (HR) of mortality in 10–15 years old was higher than that of 1–5 years old (P = 0.03, HR = 1.3). The HR of mortality in patients with brain tumor (P < 0.01, HR = 2.24), sarcoma (P < 0.01, HR = 2.32), and neuroblastoma (P < 0.01, HR = 2.56) was twice the value in patients with leukemia. The HR of mortality in patients who had a family history of cancer was higher than that of patients without it (P < 0.01, HR = 1.33). Patients who had undergone chemotherapy along with surgery and radiotherapy (P = 0.02, HR = 0.68) and patients who received chemotherapy along with surgery (P = 0.01, HR = 0.67) had a lower HR of mortality compared to the chemotherapy group.Conclusion:Young age, multidisciplinary approach, and absence of family history were associated with lower hazard of death in children diagnosed with cancer; brain tumor, leukemia, and sarcoma had higher hazard of mortality compared to leukemia. Children with a family history of cancer should be under regular follow-up. Treatment should be multidisciplinary and comprehensive.

Introduction: Quality of services is considered as one of the main indexes of progress and success in any organization. The aim of this study was to evaluate the quality of services in some health centers in Tehran city. Materials and Methods: This was a cross-sectional study that assessed the rate of satisfaction among patients referred to randomly selected health centers in Tehran through a questionnaire of SERVQUAL. The method of data gathering was through interviews with patients. Data were analyzed using spss software version 17 and Chi-square and Fisher's exact test. Results: 100 patients were studied in total. There was a significant differences in all dimensions measured in the SERVQUAL questionnaire between expectations and reality other than access to a physician in the office all the time. The biggest difference between expectations and reality within the empathy (P = 0.001). Conclusions: There are significant differences between current situation and the ideal of health services in health centers in Tehran city. Also expect from service providers is not only medication but also kindness, empathy and compassion, confidence, respect, interest and the sense of responsibility are so effective to the satisfaction of clients.

Background: The birth of a child with a hearing disability is a stressful event in the family. Since consanguineous marriages are associated with the incidence of congenital hearing loss, it is expected that such parents will experience greater psychological problems. Objective: The current study investigated and compared anxiety, depression, and stress in parents of children with severe hearing loss who have undergone cochlear implantation with a focus on the relation between parents (consanguineous vs. non-consanguineous). Methods: This cross-sectional study was conducted on all 180 couples (360 individuals) who had become parents and attended Baqiyatallah hospital’s Cochlear Implant Center from 2007 to 2009. The participants included two groups of consanguineous (125 couples) and non-consanguineous (55 couples) parents. After providing consent to participate in this study, the participants completed the short form of the Depression and Anxiety and Stress Scale questionnaire (DASS-21). Data analysis was done using SPSS 17 and t test. Results: The participating parents had high levels of depression, anxiety, and stress. Depression and anxiety were significantly higher among the consanguineous parents (P=0.001 and P=0.005, respectively). However, stress levels were not significantly different between the 2 groups. Moreover, compared to the fathers, the mothers had higher levels of depression, anxiety, and stress (P<0.05). Conclusion: Based on these findings, it may be concluded that the birth of a child with hearing loss can be the source of psychological problems in parents, particularly in consanguineous parents. Furthermore, mothers are more psychologically vulnerable than fathers.

Factors affecting the time of survival after breast cancer (BC) diagnosis remain unknown. However, some of the prognostic factors have been identified. The aim of this study was to investigate the effects of biologic and socioeconomic factors on long-term survival of BC patients. This was a descriptive chart review and survey of all women with a confirmed diagnosis of BC registered in Shohada-e-Tajrish Cancer Research Center database from March 2004 to March 2015. The checklist of study consisted of biologic, demographic, reproductive, genetic, medical, and therapeutic information of patients. The minimum time of follow-up was 3 years and the maximum was 10 years. We then evaluated possible associations of these variables with BC survival using Cox and parametric regression models of survival analysis. The study population was 1276 BC patients. Their mean survival was 23 (range 1–120) months. Between the parametric models, Weibull regression model demonstrated the lowest Akaike information criterion and thus the best fit, and tumor size, number of lymph nodes, BC stage, educational level, and high-fat diet were significant in this model. Based on our findings, educational level, consumption of fat, and characteristics of tumor at the time of diagnosis (disease stage, tumor size, number of involved lymph nodes) are the most important prognostic factors affecting long-term survival of BC patients. We suggest that future studies assess the efficacy of possible interventions for these factors.