Introduction: Despite definite recognition of major atherosclerotic risk factors, the relationship between the pattern of coronary artery disease and these risk factors is unknown.

Background: Measles is in elimination phase in Iran. Following occurrence of two cases of measles in two children under six years old with the history of measles immunization in one of the villages affiliated to Bahar District, west of Hamadan Province, northwest of Iran, this study was conducted to determine the immunity status of people living in the village affected by the measles outbreak in spring of 2018. Study design: A cross-sectional (descriptive-analytical) study. Methods: Overall, 272 populations of 0-40 yr old in the village affected by outbreak were enrolled. Multistage sampling was used for choosing participants. The data collection tool was a researcher-made checklist used to collect epidemiological data including demographic characteristics and vaccination status. Blood samples were taken from them and sent to the measles reference laboratory for IgG testing. The amount of optical density (OD) greater than 0.2 was considered as positive and less than 0.1 negative, respectively. Results: The mean age of the study population was 17.4 ±11.8 yr and the sex ratio was almost the same. Levels of antibodies against measles were positive in 63.24%, intermediate in 12.5% and negative in 24.26%. There was no significant difference between the immunity status of the subjects with gender (P=0.236) and age group (P=0.113). Pearson correlation results showed that in males there was a significant positive correlation between the age of the participants and the serum IgG level (r = 0.26, P=0.003). Conclusion: Measles immunity in communities is not sufficient to prevent outbreaks and small epidemics, and it is recommended that periodically, serological assessments carried out at community level and especially at high-risk groups.

Introduction: Influenza viruses are the major respiratory pathogens worldwide and high-risk groups such as healthcare workers may develop severe forms of the disease. The purpose of this study was to evaluate the cost-effectiveness of influenza vaccination for 4 target groups including pregnant women, elderly people (aged over 65 years), healthcare workers and school-age children in Iran. Methods: A cost-effectiveness analysis using a decision tree model over a one-year time horizon for the influenza vaccination versus no vaccination in Iran was carried out according to the prospective of the Ministry of Health. Epidemiological data were extracted from the relevant local databases and the literature. The medical and community care costs with sampling of the patients in all 4 groups were estimated. Results:

Background: Pain is a common complaint of the elderly and it is important to evaluate pain intensity carefully in aged people. There are different self-report scales for pain evaluation in elderly individuals, however, only a few studies have compared these scales. This study was conducted to compare 2 regular pain scales: FPS-R and NRS in the elderly population. Methods: In this cross sectional study, we evaluated 2 different pain assessment tools. A total of 120 bedridden patients, who were older than 65 years, and were admitted in governmental hospitals in Hamadan-Iran were studied during 3 months (May-July 2016). For evaluating pain, we used the FPS-R (faces pain scale-revised) and NRS (numerical rating scale). All participants' information were gathered in a checklist and analyzed using the SPSS 16 software. Results: All patients had some degree of pain that started from 1 month to over 6 months ago, among them, 115 (96%) had persistent pain. The mean pain intensity in the participants was similar with both scales. There was a strong correlation between the 2 scales when using the Pearson correlation method (r = 0.735, P < 0.001). The age group analysis showed a significant difference in different age subgroups, therefore, the 75 -85 year old age group had the highest and > 85 years old had the lowest pain intensity (7.07 vs. 5.36, respectively using NRS, PV = 0.014) Conclusions: Pain has a remarkable prevalence in bedridden patients in Hamadan. Both scales: the FPS-R and NRS scales had a strong correlation for measuring pain intensity in the elderly patient population, however, simplicity of the FPS-R scale for use with the older adults, makes it an appropriate pain scale in clinical practice. Future studies need to evaluate a suitable management pain for older adults.

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Background: This study aimed at evaluating the accuracy of the pediatric appendicitis scoring method in differentiating nonspecific abdominal pain (NSAP) from appendicitis. Methods: This cross-sectional study was conducted on 391 children who were hospitalized in the emergency ward due to acute abdominal pain suspected of appendicitis . Pediatric Appendicitis Score (PAS), C-reactive protein (CRP), and appendicitis pathology results of patients undergoing surgery were recorded. Results: The results showed that the no significant difference was found among patients in the three experimental groups (appendicitis, specific abdominal pain except appendicitis, and NSAP) with respect to temperature ( p = 0.212), but the other variables were significantly different. Findings showed that high CRP frequency, pain migration to right lower quadrant (RLQ), tenderness in right iliac fossa (RIF), anorexia, leukocytosis, high neutrophil, and mean tenderness in RLQ in the appendicitis group were higher than those in the other two groups ( p = 0.001). The PAS questionnaire can also be used as a reliable questionnaire with appropriate sensitivity (0.929) and specificity (0.993), and this questionnaire along with detailed clinical examinations could reduce the rate of negative appendectomy to less than 1%. Conclusions: This study showed high accuracy of PAS in diagnosing children with appendicitis and differentiating appendicitis from cases of NSAP and specific abdominal pain other than appendicitis. The PAS system could also significantly reduce cases of negative appendicitis. Although high CRP had an excellent ability to diagnose appendicitis, its accuracy was lower than PAS.

Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.