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Ashraf Saber, Maryam Omidi, Fereshteh Eidy, Mahdis Mehrabi Bardar, Rahman Panahi, Zahra Moghadasi, Shiva Pouraliroudbaneh, Ahmadreza Shamsabadi,
Volume 20, Issue 2 (9-2024)
Abstract

Background and Objectives: Violence against pregnant women is a clear violation of women's rights associated with many consequences and complications both for the mother and fetus. In this study, we aimed to determine factors affecting the severity of domestic violence against pregnant women.
Methods: This cross-sectional descriptive-analytical study was carried out between July 2020 and September 2021. The participants were 234 women with low-risk pregnancies (28-40 weeks) who were transferred to the maternity ward of Bentolhoda Hospital in Bojnurd City. Mothers were selected by the convenience sampling method. A two-part questionnaire was used in this study, which included demographic and midwifery information questionnaires and a domestic violence questionnaire created by Tabrizi in 2013. Subsequently, the data were analyzed using logistic regression.
Results: The prevalence rate of violence against pregnant women (experiencing at least one type of domestic violence from the husband) was 64.6%.  Among those who had experienced violence, 36.1% of the participants experienced low to very mild violence during pregnancy and 63.9% experienced moderate violence. However, severe violence was not experienced by any of the research units. Also, there was a significant relationship between babies' gender and the severity of violence (P=0.03). Pregnant women with male fetus (OR=3.14, CI95%:1.093–9.069) were 3.14 times more exposed to violence with moderate severity.
Conclusion:  In this study, most women suffered domestic violence with moderate severity. Among pregnant women with male fetuses, the severity of violence was even higher. Thus, it is necessary to pay a proper attention to the design and implementation of educational and support programs for these women to prevent domestic violence and reduce its adverse impacts.
 

Zahra Kordi, Mostafa Enayatrad, Abolfazl Emamian, Fatemeh Rahaei, Mansooreh Fateh, Mohammad Hassan Emamian,
Volume 20, Issue 3 (12-2024)
Abstract

Background and Objectives: Colorectal cancer is considered as one of the most common cancers in the world and Iran. Epidemiological studies are necessary to evaluate the trend of this disease in society. This study aimed to describe the incidence and trend of colorectal cancer in 13 years in Shahroud and Meyami districts, Iran.
Methods: The data were obtained from the population-based cancer registry system at Shahroud University of Medical Sciences, including patients in Shahroud and Meyami districts. The standardized incidence rate (ASR) was calculated based on age and gender, and the 13-year trend from 2010 to 2022 was calculated using joinpoint regression along with the percentage of annual changes.
Results: In general, 543 cases of colorectal cancer were recorded from 2010 to 2022, including 280 (51.6%) males and 263 (48.4%) females. The most recorded cases of this cancer were in 2021 with 54 cases. The Age-standardized mean incidence rate of colorectal cancer in this period was 17.6 per 100,000 people. The ASR of colorectal cancer in males and females was 18.4 (95%CI: 16.2 - 20.6) and 16.8 (95% CI: 14.8 - 18.9), respectively. The annual percent change of ASR during the study period was 2.33% (95% CI: 0.13 – 4.87), indicating an increasing trend.
Conclusion: In the Shahroud and Meyami districts, the incidence rate of colorectal cancer was 17.6 per 100,000 people and has increased relatively over the 13-year study period.

Ali Alami, Hassan Eshaghiyan Farimani, Farnaz Sharifi Mood,
Volume 20, Issue 3 (12-2024)
Abstract

Background and Objectives: Suicide is a major health concern worldwide, and there is a strong association between the presence of suicidal ideation and suicide attempt in the future. This study aimed to determine the epidemiological status of suicidal thoughts among university students and its correlation with some of their personal, family, and social factors.
Methods: An analytic cross-sectional study was conducted on 556 students of Gonabad University of Medical Sciences (GMU) who met the inclusion criteria and were selected by multi-stage sampling in 2023. To collect data, a checklist and the Beck Scale for Suicidal Ideation (BSSI) were used. The collected data were analyzed using independent t-tests, chi-square, Fisher's exact test, and logistic regression.
Results: The prevalence (95% confidence interval) of suicide ideation among students of GMU was estimated at 20.5% (17.2-23.8%), with 11.5% of the students having high-risk (High and very high risk) suicidal thoughts. The prevalence of suicidal ideation was significantly higher among female compared to male students (P=0.016). Moreover, single students had more suicidal thoughts compared to married ones (P=0.019). In contrast, there was no statistically significant association between suicidal ideation and age, native status, place of residence and faculty of study of students.
Conclusion: The prevalence of suicide ideation and high-risk suicide ideation among the students was found to be relatively high. Thus, attention to state of mental health of students, especially female and single students, as well as creating suitable conditions for living and studying for them is recommended.

Manoochehr Karami,
Volume 20, Issue 3 (12-2024)
Abstract

Artificial intelligence (AI) refers to the process in which computers, rather than human intelligence, perform tasks, such as early warning of an epidemic. This editorial aimed to describe the potential applications of digital health and the challenges faced by the health system of Iran concerning the application of artificial intelligence and innovative technology in public health surveillance and early warning of epidemics. The use of new technologies at national and subnational levels for early warning of public health threats requires a suitable platform within the context of disease surveillance systems. The Iran health system currently utilizes a syndromic approach and event-based surveillance to monitor acute respiratory infections. However, the structure of Iran's national communicable disease surveillance system has faced challenges due to the inability to share and exchange data at the level of primary health care data sources. Accordingly, application and integration of AI should be considered as Iran’s health priority to promote infrastructure and technology requirements, including compatibility, interoperability, and strategies for ethical and responsible use by public health authorities. Since pandemics and epidemics have not been limited to the previous ones, such as COVID-19, influenza, SARS, dengue fever, and similar threats, operations planning is required for the integration of artificial intelligence tools to prepare and respond to biological threats promptly by the Iranian Ministry of Health, stakeholders, and other parties.

Pardis Mohammadzadeh, Maryam Afraie, Elham Nouri, Mohammad Aziz Rasouli, Ghobad Moradi,
Volume 20, Issue 3 (12-2024)
Abstract

Background and Objectives: This study aimed to compare the health status of Iran with that of the Eastern Mediterranean Regional Countries in terms of various health indicators.
Methods: The data from 27 health indicators were collected in 2023 from WHO, EMRO, and the World Bank and then grouped into five categories: mortality and morbidity indicators, nutritional risk factor and non-communicable disease indicators, health financing indicators, maternal and immunization indicators, and health workforce indicators. This study used MEREC, a method that analyzes the effects of deleting criteria, to determine the weighting of the indicators. The countries were then ranked using the MARCOS method, one of the new multi-criteria decision-making methods.
Results: Qatar, Saudi Arabia, and the United Arab Emirates were in the best situation. Iran ranked 8th, 6th, 7th, 4th, and 13th in the first to fifth categories mentioned in the methods. Iran also ranked 10th among the countries in the region in the overall ranking of all these indicators.
Conclusion: Many researchers and policymakers evaluate the health status in Iran based on the introduced health indicators. Iran needs to intensify its efforts to strengthen its position in the Eastern Mediterranean region, considering its overall circumstances.

Marzieh Fattahi-Darghlou, Hamid Gheibipour, Neda Mahdavi, Fatemeh Shahbazi,
Volume 20, Issue 3 (12-2024)
Abstract

Background and Objectives: More than 12 types of cancer are caused by contact with environmental factors and occupational carcinogens. Therefore, this study aimed to evaluate the trend of mortality and disability-adjusted life years (DALYs) rates attributed to occupational carcinogens in Hamedan province, Iran, from 1990 to 2021.
Methods: In this ecological study, the Global Burden of Diseases database was used to collect the required data. The trend of changes in the mortality and disability-adjusted life years rates was examined using joinpoint regression analysis and the Join Point Regression software.
Results: The years of life lost (YLLs) due to premature death and disability attributed to occupational carcinogens in Hamadan Province increased from 10.31 per 1,000 population in 1990 to 23.33 per 1,000 population in 2021. The average annual percent change (AAPC) in DALYs was 3.79% for women and 2.57% for men. The all-cause mortality rate attributed to occupational carcinogens rose from 0.31 per 100,000 population in 1990 to 0.74 per 100,000 in 2021 (AAPC = 2.78%; 95% CI: 2.68% to 2.90%).
Conclusion: The trend of mortality and disability-adjusted life years due to occupational carcinogens in Hamadan province had an increasing trend overally. Periodic screenings for workers in high-risk occupations are essential to mitigate the burden of occupational cancers.

Iman Dianat, Mohammad Sadegh Masoumi, Homayoun Sadeghi Bazargani, Gholam Hossein Safari, Sepideh Harzand-Jadidi,
Volume 20, Issue 4 (3-2025)
Abstract

Background and Objectives: One of the most important steps in reducing traffic accidents is the accurate recording of the spatial information of these incidents using Geographic Information Systems (GIS).The present study was conducted with the aim of geographically analyzing high-risk areas for traffic accidents in Tabriz and determining the spatial distribution pattern of traffic incidents based on accident outcomes.
Methods: In this descriptive-analytical study, data on property damage, injury, and fatal traffic accidents in Tabriz during 2017 were collected from various sources, and accident locations were identified using geographic addresses and coordinates. To analyze the geographical distribution of high-risk accident zones, spatial analysis methods including Moran’s Index, Kernel Density Estimation, Geographically Weighted Regression (GWR), and correlation analysis were employed.
Results: In this study, the cumulative pattern of accidents in Tabriz was confirmed, such that district 8, northeast of District 3, central and southern regions of District 1, and the entrance to District 5 of Tabriz city had dense accident distribution patterns. The religious, commercial, and service land-use layers had the highest correlation with accident density. High-traffic axes had fewer accidents; the highest was related to areas with low traffic volume. Autumn and winter have the most damage accidents, and the highest number of accidents leading to death was assigned to the spring season.
Conclusion: Given the concentration of traffic accidents in high-risk areas of Tabriz—particularly in District 8 and the eastern entrances—it is recommended that traffic infrastructure be improved, traffic regulations be strengthened, and monitoring be enhanced through intelligent systems to reduce accidents. Additionally, conducting public awareness campaigns can also be effective in decreasing traffic incidents.

Saeed Dastgiri, Leyli Mohammad Khanli, Ehsan Farifteh, Elham Davtalab Esmaeili,
Volume 20, Issue 4 (3-2025)
Abstract

Biological evolution leads to changes and extension in biological units’ pool of the population, which is called “gene.” This definition of evolution has comprehensively become more complex today, which includes behavior and cultural units called “meme”, and electronic or digital units called “teme in addition to the biological units. The spread of all three units (gene, meme, and teme) follows a specific evolutionary algorithm inspired by Darwinian principles regarding reproduction and selection of the best adaptation.
The propagation pattern of genes is based on the genetics laws, whereas the epidemiological pattern for meme and teme usually follows viral models. The success of a meme lies in its ability to spread across an entire population like an epidemic to ultimately become a stable and endemic component of that culture.
In conclusion, further research would be essential for the comparison of cultural and behavioral evolutionary algorithms with biological evolution and modeling the development and evolution of meme and teme in order to discover their advantages and disadvantages in human populations.

Zahra Saboohi,
Volume 21, Issue 1 (6-2025)
Abstract

Electronic health records, as a new tool in monitoring and controlling epidemic diseases in Iranian schools, can help reduce the spread of diseases. This article examines the role of this system in preventing epidemics and increasing coordination between educational and health institutions.
Niloufar Bahrampour, Seyed Vahid Ahmadi Tabatabaei, Maryam Faraji, Aliakbar Haghdoost,
Volume 21, Issue 1 (6-2025)
Abstract

ackground and Objectives: Waste refers to solid, liquid, and gaseous materials (excluding sewage) generated from human activities and considered discardable by the producer. The production of household waste also rises with the increase in population. Therefore, evaluating the effects of household waste management on health is a critical issue. Effective interventions can be implemented to mitigate its impacts by identifying the problems and risks associated with this type of waste.
Methods: This study is a scoping review aimed at health impact assessment of household waste management. In this study, PubMed, Scopus, and Web of Science electronic databases were searched in English between 2014 and 2024, and the results were entered into Endnote software and screened.
Results: From the initial search of 3,504 studies, 109 full-text articles were ultimately included in the review. The results indicated that most of the research was conducted in developing countries. The primary data collection tools were laboratory samples, and most of the studies were quantitative. Most of these studies have focused on the effects of household waste management on physical health, while the least explored dimension was spiritual health.
Conclusion: This study shows that household waste management, in addition to its effects on physical health and environmental pollution, can affect mental, social, and spiritual health. Therefore, by identifying these effects, we should seek solutions for better household waste management to minimize negative health effects.

Aliasghar Fakhri-Demeshghieh, Hesameddin Akbarein, Rouzbeh Bashar, Mohammad Reza Shirzadi, Zahra Boluki, Narges Ghasemzadeh,
Volume 21, Issue 1 (6-2025)
Abstract

Background and Objectives: Rabies is a public health threat worldwide. This study aimed to determine the amount and trend of the costs of anti-rabies serum and rabies vaccine in Iran between 2015 and 2022.
Methods: Using national data from March 2015 to March 2022, the cost of anti-rabies serum, human rabies vaccine, and the total cost of both were determined. The annual trend of the serum, vaccine, and total cost was determined using Joinpoint regression with a maximum of one.
Results: The highest rabies serum and vaccine costs were observed in 2021 and 2020 (58.3 and 6.874 US million dollars), respectively. Average Annual Percent Change was statistically significant (p<0.001) and indicated an increasing trend in the costs of anti-rabies serum. The trend in vaccine costs between 2015 and 2020 was increasing, and the annual percent change between 2015 and 2020 (p˂0.001) and 2021 (p˂0.001) were statistically significant. The average annual percentage change was statistically significant for the total costs of anti-rabies serum and rabies vaccine (p˂0.001) and indicated an increasing trend in Iran.
Conclusion: The lowest rabies vaccine costs were observed in 2021, which might be due to the COVID-19 pandemic. To reduce rabies losses, the domestic production of anti-rabies serum, implementing rabies control measures in unowned dogs, and increasing public awareness about animal bites, particularly dog bites, are recommended.

Haniyeh Salehi Sarbijan, Tanya Dehesh, Firuzeh Mirzaei, Armita Shahesmaeilinejad,
Volume 21, Issue 2 (9-2025)
Abstract

Background and Objectives: Declining fertility rates have become a significant demographic challenge in Iran. This study aimed to evaluate the extent of desire for childbearing and its associated factors among women in Jiroft, Iran, in 2022.
Methods: This cross-sectional study included 600 married women under 49 years of age who attended comprehensive health centers in Jiroft. Data were collected using a questionnaire that covered demographic information and questions related to the study objectives. Statistical analysis, such as frequency, percentage, and logistic regression, was performed using SPSS version 20 software.
Results: The current desire for childbearing was found to be 32.7%, while the future desire was 59.7%. The primary reasons cited for desiring children were the wish to be a mother (94.4%) and the love for children (93.9%). Conversely, the main reasons for not desiring children included concerns about securing the future of children (57.2%) and the increased economic burden of having another child (50%). Factors significantly associated with the desire for childbearing were the number of children (one child vs. no child: OR=5.23,95% CI: 2.03–13.49; two children vs. no child: OR=2.21,95% CI: 0.98–5.001), the subscale “Child as a Pillar of Life” (OR=1.02,95% CI: 1.008–1.04), the subscale “Postponing Childbearing to the Future” (OR=1.06,95% CI: 1.05–1.08), and the subscale “Childbearing Requires Prerequisites” (OR=1.01,95% CI: 1.002–1.03).
Conclusion: Overall, one-third of the women who participated in this study currently desired childbearing, and nearly two-thirds expressed a desire for it in the future. A positive attitude towards childbearing emerged as the most essential factor associated with this desire.

Marzieh Gharanjiki, Abdolhalim Rajabi, Taghi Amiriani, Gholamreza Roshandel, Mohammadali Vakili,
Volume 21, Issue 2 (9-2025)
Abstract

Background and Objectives: Colorectal cancer is the most common gastrointestinal malignancy worldwide, and its incidence is increasing in Iran. Competing risk analysis offers a refined approach to identify factors influencing Colorectal cancer-specific mortality. Therefore, This study was designed and conducted to determine the survival of patients with colorectal cancer and its associated factors.
Methods: The study was a historical cohort. Data of patients diagnosed with colorectal cancer between 2013 and 2019 at Golestan University of Medical Sciences were collected, and patients were followed up until May 4, 2024. Patient survival was estimated, and the cumulative incidence function, as well as competing risk models of cause-specific hazards and subdistribution hazards, were applied for competing risk analysis. Model adequacy was assessed using the Akaike Information Criterion. Analyses were performed in STATA version 17 (α = 0.05).
Results: Of the 811 patients, 366 (45.13%) were women and the rest were men. The mean age and standard deviation were calculated as 58.54 ± 13.87 years. In the multivariable analysis of factors associated with colorectal cancer mortality in the presence of competing risks, variables including gender, age, literacy, ethnicity, and metastasis were statistically significant in both models. Findings indicated that the cause-specific hazard model provided a better fit for analyzing survival outcomes in colorectal cancer.
Conclusion: Competing risk analysis based on cause-specific hazards is recommended in the multivariable analysis of factors associated with colorectal cancer mortality, particularly in the presence of competing risks of death from other causes.

Ebrahim Ghaderi, Ghobad Moradi, Mostafa Salehi-Vaziri, Manoochehr Karami, Ehsan Mostafavi,
Volume 21, Issue 3 (12-2025)
Abstract

Background and Objectives: Over the past century, multiple pandemics have caused the deaths of millions and inflicted serious harm upon the global economy, and humanity is still concerned about the emergence of future pandemics. This paper aims to provide an overview of the upcoming challenges in public health by reviewing previous pandemics and threats, examining past experiences, and analyzing current conditions.
Methods: In this non-systematic review, the Google Scholar search engine was searched using suitable keywords, and studies relevant to the subject were selected.
Results: With increasing population and closer human interactions, the risk of outbreaks of infectious diseases is felt more than in the past. The existence of thousands of pathogens in wildlife, along with the impacts of climate change, globalization, lifestyle, hunting, and environmental destruction, raises the probability of human exposure to these agents. If these encounters lead to genetic changes in pathogens and create new species, the risk of emerging and transmissible diseases to humans will increase. In addition to natural factors, human-related factors including bioterrorism and drug resistance (while not considered direct human actions, they result from human misconduct) must also be considered.
Conclusion: Among various pathogenic microorganisms, viruses are highlighted as the principal agents of future pandemics due to their ability for rapid mutation, persistence in wildlife reservoirs, and the lack of effective preventive and therapeutic tools. What is crucial for countries is to utilize the lessons learned from previous pandemics to increase preparedness through strengthening health systems, employing the one health strategy, and mobilizing all capacities for future pandemics.

Abouzar Raeisvandi, Ladan Mohammadizadeh, Mahsasadat Darb Emamiye, Sakineh Rezaeipoor Kopte, Mahsa Moghanni Yazdi, Elahe Jafari, Marziyeh Amjadi, Zahra Hosseinkhani,
Volume 21, Issue 3 (12-2025)
Abstract

Background and Objectives: Suicidal thoughts and depression during adolescence present significant challenges that have major negative consequences for public health. The current study aimed to assess the effectiveness of a cognitive-behavioral therapy-based strategic program for preventing suicide and depression in adolescents.
Methods: This randomized controlled trial was conducted in the winter of 2025 on 36 adolescents with suicidal thoughts and depression in Qazvin province, Iran. Participants were randomly assigned to either an intervention or a control group. The intervention group received cognitive-behavioral therapy for 6 weeks, while the control group received the standard treatment protocol designed by the Ministry of Health for 4 weeks. Comparisons between groups were made before, immediately after, and three months following the intervention. The Beck Scale for Suicidal Ideation and the Beck Depression Inventory-II were used to assess suicidal thoughts and depression.
Results: The mean difference in suicidal ideation and depression scores (with 95% confidence intervals) in the intervention group compared to the control group was 2.96 (1.19, 4.74) and 5.84 (0.86, 10.81), respectively, immediately after the intervention, and 6.06 (4.51, 7.61) and 11.62 (7.24, 15.99), respectively, at the three-month follow-up. Cognitive therapy had a significant effect only on reducing depression (p = 0.022). Furthermore, the pattern of change in suicidal thoughts over time differed significantly between the two groups (p = 0.021).
Conclusion: The cognitive-based strategic program significantly reduced depression levels among adolescents. These findings highlight the importance of incorporating cognitive therapy into depression treatment programs in health and medical centers. Additionally, intervention programs aiming to reduce suicidal thoughts should be designed with consideration of changing patterns of suicidal ideation over time.

Fatemeh-Sadat Hosseini, Farzad Younesian, Masud Yunesian,
Volume 21, Issue 3 (12-2025)
Abstract

Background and Objectives: Infertility, as one of the most critical public health and reproductive issues globally, has extensive impacts on the physical, psychological, and social well-being of couples. Previous studies have shown that socioeconomic components, alongside biological variables, influence the occurrence and aggravation of infertility. We aimed to evaluate the relationship between some socioeconomic variables and prevalence of infertility at the province level.
Methods: This ecological study examined the relationship between infertility (dependent variable) and key socioeconomic indicators (independent variables) at the provincial level in Iran. Primary and secondary infertility defined using lifetime clinical, current clinical, and epidemiological definitions served as dependent variables. Statistical analysis employed univariate and multiple linear regression using the stepwise method, with a significance level of 0.05.
Results: Although numerous variables showed significant associations with infertility in simple regression models, only illiteracy and unemployment rates in the multiple regression model retained significant relationships with infertility. Furthermore, unemployment retained its significance only in epidemiological definition of primary infertility at the multiple model. Other variables lost their significance.
Conclusion: Provincial illiteracy rates emerged as the strongest predictor of infertility prevalence. Illiteracy is directly associated with infertility and also represents an important indicator of broader socioeconomic conditions. However, due to its ecological design, this study cannot distinguish between these two pathways.

Mahboobeh Naroui, Parya Jangipour Afshar, Aliakbar Haghdoost,
Volume 21, Issue 3 (12-2025)
Abstract

Background and Objectives: This study was conducted to determine the rate and examine factors associated with the migration of patients from Iranshahr to other regions of Iran for hospital care during 2023–2024.
Methods: This cross-sectional study employed an indirect approach. First, patients registered in the SIB system were asked about the size of their close family network. If the patient or their first-degree relatives had traveled outside Iranshahr to receive medical services, they were interviewed. Ultimately, 159 individuals were included. Factors and challenges associated with patient migration were scored on a scale from 0 to 20.
Results: The proportion of individuals who migrated from Iranshahr for hospital services in the past year was 5.9% (95% CI: 5.0, 6.7), equivalent to 6,785 people. The leading factor for migration was the type of illness, with a score of 19.1 (95% CI: 18.5, 19.5). Most patients traveled for gastrointestinal, cancer, and cardiac diseases, with referrals mainly to Kerman and Yazd provinces. Satisfaction with services received, with a score of 17.1 (95% CI: 16, 17.5), was the main reason for repeat referrals. The principal challenges were transportation costs (score 16.6) and accommodation costs (score 16.3).
Conclusion: Poor quality, limited effectiveness, and lack of diagnostic infrastructure were the main drivers of patient migration. To promote access and social equity, strengthening the healthcare infrastructure in this region must be prioritized.

Fatemeh Sedghi, Sahar Mohammadnabizadeh, Fereshteh Najafi, Maryam Mohammadi,
Volume 21, Issue 4 (3-2026)
Abstract

Background and Objectives: Anemia is a major public health concern among pregnant women and is associated with adverse outcomes such as preterm birth, low birth weight, and increased maternal mortality. This study aimed to investigate factors associated with anemia among pregnant women attending comprehensive health service centers in Sarakhs, Northeast Iran.
Methods: In this cross-sectional analytical study, data from 904 pregnant women registered in the Sina system in 2023 were analyzed. Demographic, clinical, and laboratory data were extracted. Anemia was defined as a hemoglobin level below 11 g/dL, and logistic regression analysis was used to assess associations between potential predictors and anemia.
Results: The mean age of participants was 27.2 ± 6.8 years. The prevalence of anemia among pregnant women in Sarakhs was 17.7% (95% CI: 15.2%–20.5%). In multivariable analysis, rural residence was associated with lower odds of anemia (OR = 0.58, P = 0.01), as was non-Sistani ethnicity compared with Sistani ethnicity (OR = 0.44, P = 0.003). A history of low birth weight (<2500 g) significantly increased the odds of anemia (OR = 7.14, P < 0.001). Compared with underweight mothers (BMI <18), those with normal weight, overweight, and obesity had 58%, 71%, and 78% lower odds of anemia, respectively (OR = 0.42, 0.29, and 0.22). Absence of kidney disease (OR = 0.22, P = 0.03) and iron supplementation before pregnancy (OR = 0.50, P = 0.05) were also protective. No other variables showed significant associations with anemia.
Conclusion: These findings highlight the importance of ethnic and geographic factors in the prevention of anemia in pregnancy and underscore the need for targeted interventions, including thalassemia screening and strengthening preconception and antenatal iron supplementation programs, to reduce anemia and improve maternal and child health outcomes.

Rasoul Gholamiveis, Fatemeh Heydarpour, Mehdi Moradinazar,
Volume 21, Issue 4 (3-2026)
Abstract

Background and Objectives: Prostate cancer is one of the most common cancers among Iranian men and has shown a marked increase in both incidence and mortality over recent decades. This study aimed to analyze temporal trends in prostate cancer incidence and mortality in Iran using an Age–Period–Cohort (APC) analytical framework.
Methods: Data were extracted from the Global Burden of Disease Study 2021 for Iranian males aged 45 years and older during 1992–2021. Data were stratified into eight 5-year age groups and six 5-year time periods. APC analysis was conducted using the second-order difference method, and Joinpoint regression was employed to assess temporal trends in risk factors.
Results: In 2021, the age-standardized incidence rate reached 30.05 per 100,000 population, and the mortality rate reached 10.66 per 100,000 representing increases of 105.96% and 14.99%, respectively, compared to 1992. Age effects were positively associated with both incidence and mortality. The period effect peaked during 2002–2006. Cohort analysis revealed that younger birth cohorts exhibited a slower acceleration in incidence rates. Among risk factors, the disease burden attributable to smoking increased by 17.1%, while the protective effects of low calcium intake and low milk consumption diminished over time.
Conclusion: Rising incidence and mortality are shaped by age, period, and cohort effects. The relative decline in younger cohorts underscores the need for targeted prostate cancer screening programs. Strengthening public health education policies and improving access to diagnostic services can reduce the disease burden.

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Volume 1111, Issue 0 (9-2021)
Abstract



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