Background: The extent of infection by coronavirus disease 2019 has not been well known. In this study we aimed to determine seropositivity of COVID-19 virus infection in population of a highly affected area in north of Iran. Methods:In a population-based cluster random sampling design through phone call invitation, a total of 196 household including 551 subjects agreed to participate in this study. Each participant were taken 50ml blood sample at health care center. Rapid test kits were used to detect antibody against COVID-19. Crude, population-weight adjusted and test performance adjusted prevalence of antibody seropositivity to SARS-CoV-2 were reported. Results:The prevalence of antibody seropositivity was 22% (95%CI: 19-26%). The population weight adjusted estimate was 21% (95%CI: 14-29%) and test performance adjusted prevalence was 33% (95%CI: 28-39%). Based on these estimates the range of infected people in this province would be between 518000 and 777000. Conclusion:The population seropositivity prevalence of COVID-19 virus infection indicated that the asymptomatic infection is much higher than the number of confirmed cases of COVID-19. This estimate can be used to better detect infection fatality rate and decide for public policy guidelines.

We determined the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an affected area in northern Iran in April 2020. Antibodies to SARS-CoV-2 were detected in 528 persons by using rapid tests. Adjusted prevalence of SARS-CoV-2 seropositivity was 22.2% (95% CI 16.4%-28.5%).

Background: Addiction is a primary, chronic disease of brain reward, motivation, memory and the related circuitry. Objectives: The purpose of the study was the measurement of effective components in addiction relapse, in Rasht city of Guilan province, Iran. Patients and Methods: This study was done in 2014 that has been performed by using the factor analysis method. In the qualitative stage the process owners were 45 experts, and in the factor analysis stage they were 1850 people who were under treatment at addiction treatment centers. The data collection tool was a Researcher-Made Questionnaire whose content validity was determined through expert panel, and its construct validity was determined through exploratory factor analysis by principal component analysis method with varimax rotation using SPSS16 software. Results: In exploratory component analysis, 4 main components were identified; Individual factors with 6 variables, 25.72% variance, and 17.81 eigenvalue as the most important factor, and Economic factors with 5 variables and 7.64% variance as the less important factor, clarified the Addiction Relapse changes; however, in the fitted model which is the most completely saturated model, 4 factors of Individual factors with ß = 0.48, family factors with ß = 0.23, occupational factors with ß = 0.2, economic factors with ß = 0.12 had the highest predictive power in the order of importance. Conclusions: According to the findings, individual, familial, social, cultural, and economic factors were the most important in relation to the addiction relapse.

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a populationbased cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results: A total of 19,936 cases of malignancy (mean age 55.4±18.0 years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: 64.0±11.5 years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per 10 5 men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per 10 5 men and women which decreased to 6.9 and 4.1 per 10 5 in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

Background: Despite advances in clinical research, the long-term effects of COVID-19 on patients are not clear. Many studies revealed persistent long-term signs and symptoms after recovery that continue for more than months after infection with SARS-CoV-2 and are not explained by an alternative diagnosis. Methods: In a prospective cohort study,259 hospitalized patients between 18 to 59 years, who were diagnosed with COVID-19 infection by molecular RT-PCR were interviewed. Demographic characteristics, comorbidities, and complaints were studied by telephone interviews. Any patient-reported symptoms that continued or developed from 4 weeks up to 12 weeks after the onset of the COVID-19 were recorded only if they did not exist prior to infection. The 12-Item General Health Questionnaire was used for screening and assessing mental symptoms and psychosocial well-being. Analyses were done using Excel and STATA SE software v13.1. Results: The mean age of participants was 43.8 ± 9.9 years, the mean length of hospital stay was 4.4 ± 4 days, and 58.3% were women. About 37% had at least one underlying disease, The most common comorbidities were diabetes mellitus in 38.1%, hypertension in 32%, and hypothyroidism in 13.4%. 92.5 % showed ongoing symptoms that the most prevalent complications were hair loss (61.4%), fatigue (54.1%), shortness of breath (40.2%), altered smell (34.4%), aggression (34.4%), memory impairment (29 %), and depression (25.1%), respectively. The mean total score based on GHQ-12 was 1.53 ± 2.66 in the range of 0 and 12. In terms of factors affecting patients' complaints, there were significant differences between gender and underlying disease (ρ <0.0001 and ρ = 0.005, respectively). Conclusion: This study shows a high rate of long COVID conditions in patients which should be considered by physicians, policymakers, and managers.

Background: Hepatitis C is a major cause of liver failure and liver transplantation. The known risk factors of this disease include blood transfusion, injection drug use, high risk sexual behaviors, tattoos, and use of shared blades and syringes. Due to the higher risk of viral hepatitis among people in prison, this study was done to find the seroprevalence of hepatitis C virus (HCV) and associated risk factors in Lakan Prison in Rasht. Methods: Prisoners in Lakan Prison underwent a cross-sectional study in 2018. A questionnaire containing demographic information and risk factors was distributed to the inmates and they were asked complete them. High-risk individuals were selected and a blood sample was taken and tested. Data were collected and analyzed by SPSS18 software. Results: Out of 2215 prisoners, 1238 people had at least one risk factor, of whom 408 individuals were selected by random sampling. One hundred inmates were positive for anti-HCV antibody, yielding a prevalence of 24.5% (95% CI: 20.4%–28.7%) of whom 42.6% were people who injected drugs and 4 cases were found positive for the hepatitis B surface antigen, yielding a 1% prevalence (95% CI, 0.2%–2%.). A history of injecting drug use (OR 4.28, 95% CI: 2.55–7.17), and previous history of imprisonment (OR 2.94, 95% CI: 1.34–6.53) had association with HCV infection. Conclusion: The present study shows that hepatitis C is prevalent in prisons and preventive and screening programs should be implemented with necessary training for inmates.

Introduction: The COVID-19 has been associated with many problems for the general public and especially health care workers (HCWs). This study conducted to provide predictors of COVID-19 outcomes on HCWs in Rasht, Iran.Methods: In a retrospective cross-sectional study, 381 HCWs with positive RT-PCR or high-resolution lungs computed tomography for COVID-19 from February 21 to April 19, 2020 evaluated. The prevalence, demographic, clinical, laboratory, and radiological presentations and outcomes and their correlation were studied.Results: The prevalence of COVID-19 in HCWs was 5.62%, and the total mortality rate was 0.2%. The mortality rates were different between genders (P=0.002) and in general ward compared to intensive care unit (P=0.001). In the multivariate analysis, age (OR:1.12, 95%CI 1.02–1.23, P=0.014), diabetes mellitus (DM) (OR:10.73, 95%CI 1.91–60.3, P=0.007), blood group B (OR:19.2, 95%CI 1.8–199.984, P=0.013), the presence of peribronchovascular involvement (OR:1.1, 95% CI OR:1.02–1.2, P=0.019), dyspnea on admission (OR:1.05, 95%CI 1.01–1.09, P=0.013), higher neutrophil count (OR:1.09, 95%CI 1.04–1.14, P<0.001), higher level of alkaline phosphatase (OR:1, 95%CI 1.001–1.002, P=0.001), and longer prothrombin time (OR:1.027, 95%CI 1.008–1.046, P=0.005) increase the risk of mortality. The cutoff of 90% for oxygen saturation on admission (sensitivity=91.9%, specificity=88.9%) and 1004 for absolute lymphocyte count (sensitivity=81.8%, specificity=66.6%) were estimated as predictors of mortality.Conclusions: Old age, male sex, underlying disease of DM and hypertension, O2 saturation less than 90%, and absolute lymphocyte count less than 1004/mL in HCWs are prone to adverse outcomes such as the need for mechanical ventilation or death.

Despite advances in clinical research, the long-term effects of COVID-19 on patients are not clear. Many studies revealed persistent long-term signs and symptoms. In a survey study, 259 hospitalized confirmed COVID-19 patients between 18 and 59 years were interviewed. Demographic characteristics and complaints were studied through telephone interviews. Any patient-reported symptoms that continued or developed from 4 weeks up to 12 weeks after the onset of the disease were recorded only if they did not exist prior to infection. The 12-Item General Health Questionnaire was used for screening and assessing mental symptoms and psychosocial well-being. The mean age of participants was 43.8 ± 9.9 years. About 37% had at least one underlying disease. 92.5% showed ongoing symptoms that the most prevalent complications were hair loss (61.4%), fatigue (54.1%), shortness of breath (40.2%), altered smell (34.4%), and aggression (34.4%), respectively. In terms of factors affecting patients' complaints, there were significant differences between age, sex, and underlying disease with long-remaining complications. This study shows a high rate of long COVID-19 conditions that should be considered by physicians, policymakers, and managers.