BackgroundSome genotypes of human papillomaviruses can infect the genital tract and they are important infectious agents which their oncogenicity is regardable. Thus the aim of this study was to determine the prevalence of various genital human papillomaviruses (HPV) among women being subjected to routine pap smear test in Bushehr city of Iran.ResultsBased on the collected data, 11(5.5%) samples were detected positive for HPV DNA and 189(94.5%) samples out of 200 samples were detected negative for HPV DNA. Meanwhile 4(2%) samples detected positive for HPV DNA by PCR were detected positive for HPV by pap smear test as well. On the other hand 5 samples which were detected positive for HPV by pap smear test didn't have HPV DNA after being tested by PCR method. Among the 11 positive samples 7 samples were identified as HPV-16, 3 samples were HPV-18 and one was HPV-53.ConclusionRegarding the prevalence of highly carcinogen genotypes of HPV in our study determination of genital HPV prevalence among the normal population of women of Bushehr city is recommended.

Background: The Acute Physiology and Chronic Health Evaluation (APACHE) II is still commonly used as an index of illness severity in patients admitted to intensive care unit (ICU) and has been validated for many research and clinical audit purposes. Aims and objectives: To investigate the diagnostic value of the APACHE II score for predicting mortality rate of critically ill patients. Design: This was a single-centre, retrospective study of 200 Iranian patients admitted in the medical-surgical adult ICU from June 2012 to May 2013. Methods: Demographic data, pre-existing comorbidities and variables required for calculating the APACHE II score were recorded. Receiver operating characteristic (ROC) curves were constructed, and the area under the ROC curves was calculated to assess the predictive value of the APACHE II score. Results: Of the 200 patients with a mean age of 55⋅27 ± 21⋅59 years enrolled in the study, 112 (54%) were admitted in the medical ICU and 88 (46%) in the surgical ICU. Finally, 116 patients (58%) died, and 84 patients (42%) survived. The overall actual and predicted ICU mortality were 58% and 25⋅16%, respectively. The mean APACHE II score was 16⋅31 in total patients, 17⋅78 in medical ICU and 14⋅45 in surgical ICU patients (P = 0⋅003). Overall, the APACHE II score had the highest prognostic value for predicting the mortality rate of critically ill patients with an area under the cure of 0⋅88, and with a cut-off value of 15, the APACHE II score predicted mortality of patients with a sensitivity of 85⋅3%, a specificity of 77⋅4%, a positive predictive value of 83⋅9% and a negative predictive value of 73⋅9%. Conclusion: This study shows that an APACHE II score of 15 provides the best diagnostic accuracy to predict mortality of critically ill patients. Our observed mortality rate was greater than the predicted death rate, in comparison to the other prestigious centres in the world. Therefore, it appears that we must improve our intensive care to reduce mortality. Relevance to clinical practice: There is a need to create a suitable scoring system to predict the mortality rate of critically ill patients in accordance with the advanced technological equipment and experienced physicians and nurses in that ICU.

Our findings revealed that metabolic markers are strongly associated with OA and the addition of each component of the MeS, significantly increases the risk of developing OA, therefore control of metabolic factors and appropriate screening must be considered in health policy making and prevention programs.

BackgroundAlthough Iran is reported to be an endemic country for hepatitis E virus (HEV), data on the prevalence of HEV infection among pregnant women are scarce and the epidemiology of HEV is unknown in most parts of the country. Therefore, this study was conducted to elucidate the prevalence, risk factors and genotypic pattern of HEV infection among pregnant women resident in the northern shores of Persian Gulf. This is the first report on the epidemiology of HEV infection among pregnant women in this territory.MethodsFrom October 2016 to May 2017, 1331 pregnant women participated in this study. The mean age ± SD of participants was 27.93±5.7 years with a range of 14–45 years. Serum samples of pregnant women were screened for the presence of anti-HEV total antibodies, anti-HEV IgG and anti-HEV IgM using commercially available ELISA kits (DIA.PRO, Milan, Italy). All anti-HEV IgG and anti-HEV IgM positive samples were tested for HEV RNA using two independent reverse transcriptase polymerase chain reaction (RT-PCR) assays, targeting ORF2 and ORF3 of HEV genome. In addition, 92 anti-HEV seronegative samples as well as 50 pooled seronegative samples were evaluated by two independent RT-PCR assays for validation of results.ResultsOf the 1331 pregnant women, 84 women (6.3%, 95% CI: 5.1%-7.7%) were positive for anti-HEV antibodies, of which 83 women had anti-HEV IgG, and 11 women (0.83%, 95% CI: 0.47%-1.47%) had anti-HEV IgM. The highest rate of HEV seroprevalence was observed among Afghan immigrants (68.0%), uneducated pregnant women (46.51%) and those residents in Bushehr city (8.75%). All anti-HEV IgG and/or IgM positive samples were found to be negative for HEV RNA. In addition, all of the evaluated anti-HEV seronegative samples were negative for HEV RNA. HEV seropositivity among pregnant women was statistically associated with age, ethnicity, place of residence, number of pregnancies, and level of education. So that, low education levels, Afghan, residence in Bushehr city, age group >34 years, and more parities were risk factors for exposure to HEV. In contrast, HEV seropositivity was not associated with stage of gestation, history of abortion, and time of sampling.ConclusionThe northern shores of Persian Gulf in Iran, with HEV seroprevalence of 6.3%, can be classified as an endemic geographical region for hepatitis E, and residents of Bushehr city, Afghan immigrants and uneducated women are the main at-risk populations in this territory.