Background The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. Methods This retrospective study, carried out over a three-year follow-up period (2014–2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. Results From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. Conclusion The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.

BACKGROUND: Cutaneous Leishmaniasis (CL) isn’t a deadly disease, but it has always been taken into consideration due to the long-term involvement of patients with skin. Various factors can play an intervening role in increasing the rate of disease. The present study aimed to evaluate the prevalence and associated factors of disease from 2011-2017 and provide appropriate control strategies for reducing its incidence in Neyshabur county. METHODS: All patients with CL, who had medical records in the health centres of Neyshabur from 2011 to 2017, were examined for conducting this analytical-descriptive study. Data were analyzed by descriptive statistics and chi-square test at a significant level of 0.95 using SPSS V22. RESULTS: Findings indicated that the highest annual incidence was in 2016 (229 patients), and the least incidence was in 2014 (100 patients). The majority of patients were under 10 years of age and 51.7% of patients were male. About 59.5% of patients were living in cities and 35% of them were living in North of Neyshabur city. Hands were the most affected part of the body (56.0%) followed by trunk (1.3%). Most patients (69.9%) were treated with topical regimens. CONCLUSION: This study showed that CL was hypo-endemic in Neyshabur. Also, the disease was more prevalent in urban areas. Therefore, appropriate health measures to improve environmental conditions, public health educations, and the public awareness of the positive impact of early diagnosis of disease in the success of treatment (especially for inhabitance suburbanite) are essential.

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Background:The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff's perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff's perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering. Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre-and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff's opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS.

Background: Generally, the incidence rate of colorectal cancer (CRC) is increasing among young patients (aged <49 years), while the reasons for the rising incidence are unclear. Indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent manner. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and pathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. Methods: This retrospective study was carried out over a three-year follow-up period (2014-2017) and included 562 CRC patients in three Mashhad City hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and familial features together with information on the presence of genetic mismatch repair-deficiency in relation to final patient status (surviving versus deceased cases). Analyses using R studio software were performed on early-onset CRC (n=222) and late-onset CRC (n=340) groups produced by division at the age of 50 years. Results: From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC compared to men (56% vs. 44 %) , while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, while it was 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal, and proximal), the frequencies were 61%, 28% and 11%, respectively, but the variation did not reach statically significance. There was a dramatic difference with regard to the history of CRC in second-degree relatives (SDR) and that of the combination of first-degree relatives and SDR (p=0.001 and p=0.03, respectively). Expression of the MLH1 and PMS2 genes were significantly different between survivors and deceased, however this finding was not observed with regard to the MSH6 and the MSH2 genes. Conclusion: The variation of demographic, pathological and genetic characteristics of CRC between early-onset and late-onset cancers of this kind emphasizes the need for a well-defined algorithm to identify high-risk patients.