Background: Thalassemia major (TM) is a severe disease and the most common anemia worldwide. The survival time of the disease and its risk factors are of importance for physicians. The present study was conducted to apply the semi-parametric Cox PH model and use parametric proportional hazards (PH) and accelerated failure time (AFT) models to identify the risk factors related to survival of TM patients. Methods: The data of this historical cohort study (296 patients with TM) were collected during 1994 and 2013 in Zafar Clinic in Tehran. Gompertz PH and Weibull AFT models were used for survival analysis (SA) of these patients. Data analysis was performed using R3.2.2 software. Results: 153 (51.7%) of patients were female; the mean (±SD) age of the patients was 29.11 (±0.47) years. One-year survival rate for males and females was 0.963±0.007 and 0.973±0.013, respectively; and 3-year survival rate for males and females was 0.711±0.057 and 0.733±0.114, respectively. In the Gompertz model, birthplace and age at onset of the disease were significant factors (p= 0.035, and p= 0.005) in survival time. Also, in the Weibull model, birth place and age at onset of the disease were significant factors (p= 0.013, and p= 0.008) in survival time. The Akaike Information Criterion (AIC) for Weibull model was 158.51, which was lower than other parametric models. Conclusion: According to the results, the Weibull AFT model was found to be a better model for identifying the risk factors related to survival of patients with TM disease. Informing parents, especially mothers and paying attention to blood screening for early diagnosis may increase the survival rate of patients.

Purpose Bisphosphonates (BPs) have a powerful effect on reducing bone resorption and improving the survival of patients with breast cancer. We aimed to investigate the impact of BP treatment on the prevention of recurrence, metastasis, and death of breast cancer survivors in the perimenopausal period. Methods The search strategy aimed to identify both published and unpublished studies in PubMed, Web of Science, Scopus, Embase, ProQuest, and Google Scholar in March 2021. Two independent reviewers assessed quantitative papers selected for retrieval for methodological validity before being included in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Statistical meta-analysis was performed using Review Manager (RevMan) 5.4 statistical software when the data were homogenous. Meta-analysis was performed by calculating the effect size (hazard ratio; HR) and 95% confidence intervals (CIs). Results Twenty-one studies were eligible for this systematic review and meta-analysis. The overall The HRs for disease-free survival (DFS) and overall survival (OS) in women who received BPs were 0.89 (95% CI, 0.83–0.97; p = 0.005), and 0.75 (95% CI, 0.63–0.89; p = 0.001), respectively. The results showed that BPs had a significant effect on the prevention of locoregional (HR, 0.64; 95% CI, 0.42–0.97; p = 0.04), bone (95% CI, 0.74–0.95; p ≤ 0.001), and distant metastases (HR, 0.77; 95% CI, 0.62–0.94; p = 0.01). In the subgroup analysis based on study design, the only insignificant HR in the included randomized controlled trials (RCTs) was that of locoregional metastasis. Conclusion Although BPs have a promising effect on DFS, OS, and bone metastasis of perimenopausal women survivors of breast cancer, more RCTs are needed to evaluate their effect on other survivors’ outcomes.

Background: Congenital malformations are one of the most important and common types of anomalies in infants, which are one of the main causes of disability and mortality in children. Objectives: This study aimed to investigate the risk factors affecting the incidence of congenital malformations, as well as the number of different infant anomalies recorded in neonatal health data in Khoy, Iran, during 2017. Methods: In this study, all neonates born in the maternity wards of hospitals in Khoy, Iran, during 2017 were evaluated in terms of gender, weight, and parental consanguinity. Hurdle and Zero-inflation approaches were utilized for the double Poisson model. Moreover, the data were collected using some checklists, and the analyses were performed in R-3-6-1 software. Result: According to the results of the present study, the Hurdle approach was better than Zero-inflation. The birth weight and parental consanguinity affected the incidence of congenital malformations in infants. Conclusion: Given that a significant proportion of infants are born without any congenital malformations, it is important to use count regression models based on excess zero approaches to assess congenital malformations. It is also necessary to take steps to reduce consanguineous marriages and the number of infants with low-birth-weight to prevent congenital malformations.

Background: Congenital malformations are one of the most important and common types of anomalies in infants, and they are considered as the leading causes of disability and mortality in children. These malformations impose enormous costs on families and organizations involved in the treatment, maintenance, and education of patients. Objectives: This study aimed to investigate the risk factors affecting the incidence of congenital anomalies in infants born in Iran. Methods: In this retrospective descriptive-analytical study, we registered various information of all newborns examined and their mothers, including gender, family relationship of parents, type of delivery, types of congenital malformations, anomalies of the hands and feet, and anomalies of the nervous and reproductive systems in the maternity wards of hospitals in Iran. Data were gathered using a checklist. The relationships between different factors were assessed by chi-square test, and the factors influencing congenital malformations were investigated by logistic regression using SPSS-26 software. The significance level of all tests was 0.05. Results: According to the results, 7.5% of newborns had congenital malformations. Eclampsia and diabetes mellitus increased the risk of congenital malformations by 15 and 11%, respectively. The risk of congenital malformations in rural areas was 12% higher than in urban areas. Factors such as consanguineous marriages, history of abortion, and gender also affected the risk of congenital malformations. Conclusions: Necessary measures and plans in the field of premarital counseling, regular pre-pregnancy and post-pregnancy tests and controls, especially in rural and deprived areas, are essential and effective in reducing the incidence of congenital malformations.