Background: Multiple sclerosis (MS) is an autoimmune disease associated with inflammation of the central nervous system in humans. This disease is the most common neurological disease, especially in young people. Various factors, including biological, genetic, and environmental factors, are effective on the prevalence of MS disease. This study intends to determine the relationship between geographical factors, and the prevalence of MS disease was performed. Methods: This ecological study was carried out on 2000 patients with diagnosis of MS during the years 2001–2014 in Isfahan province. All patients' data including age, sex, marital status, year, and location of patients were extracted from the files. Arc geographic information systems version 10.3 software was used for geographical maps, and for statistical analysis of data, SPSS.16 software ANOVA tests, independent t-test, and Kruskal–Wallis were used. Results: Based on recorded cases of MS, the highest and lowest cumulative incidence of diseases was related to the city of Isfahan (75.92 in one hundred thousand) and Aran Bidgol (1.16 in one hundred thousand), respectively. A significant relationship was observed between the incidence and height above sea level (P = 0.001), the average annual rainfall (P = 0.001), and land use (P = 0.001). With increase in the height above sea level and the average annual precipitation, the incidence of disease decreased. Conclusions: MS disease incidence is high in Isfahan province. The distribution of the disease is not the same in the cities of this province, and some cities have a higher incidence. Furthermore, the incidence of the disease is influenced by geographical factors such as height above sea level, average annual rainfall, and land use. Therefore, it is recommended that relevant authorities by the implementation of screening programs in high-risk areas take action to identify and treat patients in the early stages.

Background: Patients who experienced transient ischemic attack (TIA) are at high-risk for cardiovascular events. This study aims to evaluate diagnostic value of carotid artery intima-media thickness (CIMT) and ABCD2 score for predicting cardiovascular events in long-term follow-up after TIA. We prospectively included sixty patients with TIA who admitted to hospital from March 2016 to August 2016. Methods: Duplex ultrasonography of internal carotid arteries was performed. ABCD2 scores were evaluated for each patient. At a median follow-up of 20 months, patients were asked about new cardiovascular events. We used IBM SPSS software version 22.0 with Chi-squared, t-test, ANOVA, receiver operating characteristic, and area under the curve (AUC) analysis for our work. Results: Sensitivity and negative predictive value of the combined score (ABCD2+CIMT) was the highest (96.3% and 90.9%, respectively), and the specificity and positive predictive value of the CIMT were the highest (57.5% and 63.1%, respectively) to predict cardiovascular events in long-term. Conclusion: Compared to ABCD2 score, CIMT proved to be more accurate to predict cardiovascular events in long-term follow-ups (AUC = 0.736 vs. AUC = 0.640). However, adding CIMT value to ABCD2 score was even better (AUC = 0.750). Therefore, CIMT measurement in the ABCD2 score after TIA enables prediction of long-term cardiovascular events.

Background: Walnut green husk (WGH) extract has been known as potential preventive and therapeutic antioxidants and antimicrobials due to its high polyphenol content. In this study, preparation of spray dried WGH extract-loaded microcapsules by maltodextrin and its blending with two other natural biodegradable polymers, pectin, or alginate were investigated. Methods: In this study, encapsulation efficiency (EE), total phenol content (Folin–Ciocalteu reagent method), antioxidant (DPPH scavenging assay) and antimicrobial activities (agar well diffusion method) structural (SEM and FTIR studies), and release properties of WGH extract-loaded microcapsules were investigated. Results: High retention of phenolic content in microcapsules indicated the successful encapsulation of WGH extract. Addition of biopolymers to maltodextrin matrix has a positive effect on EE and other properties of microcapsules. The microcapsules prepared with mixture of maltodextrin and pectin had higher EE (79.35 ± 0.87%) and total phenolic (TP) content (56.83 ± 1.04 mg gallic acid equivalents [GAE]/100 g) in comparison to maltodextrin and alginate mixture (EE: 75.21 ± 0.24%, TP content: 54.33 ± 1.53 mg GAE/100 g) and maltodextrin only matrix (EE: 72.50 ± 1.00%, TP content: 50.67 ± 1.35 mg GAE/100 g). Extract-loaded microcapsules also showed nearly spherical structure, good antioxidant (with the percentage DPPH inhibition ranged from 75.17 ± 1.42% to 80.87 ± 2.29%), and antimicrobial properties (with mean inhibition diameter zone ranged from 7.76 ± 0.86 mm to 11.53 ± 0.45 mm). Fourier transform infrared analyses suggested the presence of extract on microcapsules. The in vitro extract release from microcapsules followed an anomalous non-Fickian diffusion mechanism with almost complete release. Conclusions: WGH extract microcapsules can be used as novel and economic bioactive phytochemical and therapeutic agents to prevent oxidation and microbial activity.

Background: Petrol is an integral ingredient in industrial world. According to the US Agency for Toxic Substances and Disease Registry, there are typically more than 150 chemicals in petrol, including small amounts of benzene, toluene, xylene, ethyl benzene, and trace amounts of some contaminants, such as lead. The aim of this study was to measure the possible deleterious effect of long-term exposure to petrol on blood parameters and liver function. Methods: This is a case–control study conducted on 160 participants. Among them, 80 participants worked in a gas station for at least 4 years and 80 participants appeared with no history of occupational exposure to petrol. Blood sample was taken at the time of admonition to the tardive office at each station at 10 AM to measure the association of number of total and differential leukocyte and liver functions. Results: Based on the results, significant reduction in total leukocyte numbers was found in exposed group compared to unexposed group (1347 ± 4.59, <0.001). However, there was a significant increase in neutrophil (75.9 ± 3.50 in exposed group compared with 58.9 ± 3.15 among unexposed group, P < 0.001). However, no significant difference was found in liver enzymes between both groups. Conclusions: Long-term exposure to petrol fumes has deleterious effect on white blood cells. A significant reduction in the number of total and differential lymphocyte seems to be attributed to the toxic effect of petrol ingredients.

Background: Screening is the most important action in the early diagnosis of breast cancer. This study investigates the impact of educational intervention based on the integrated behavioral model on breast cancer screening behavior in women in Karaj City, 2016. Methods: This semi-experimental study was conducted on 138 women who were attended to health centers in Mohammad Shahr city. The samples were selected using cluster sampling and were randomly divided into two groups, experimental and control group. Data gathering tool was a four-part questionnaire (demographic characteristics, knowledge, Champion's Health Belief Scale, subjective norms). Two 50-min sessions were held for educational intervention in the experimental group. Training was presented through lecture, questioning and answering and group discussion. The data were completed in three steps (before, immediately after and 2 months after the intervention) and were analyzed using SPSS 16 software. Results: The results showed that the mean score of all structures except the perceived benefits of mammography and mammography behavior have a significant difference in the intervention group than the control group in 2 months after intervention (P < 0.001). In all the studied structures, except the perceived benefits of mammography (P = 0.083) and mammographic behavior (P = 0.156), there was a significant difference between the two groups before and immediately after the intervention (P < 0.001). Conclusions: The finding of this study showed that the efficiency and effectiveness of an educational intervention based on health belief model along with subjective norms that emphasize the opinions of others about the behaviors of individuals also has a very dramatic effect on the promotion of breast cancer screening behaviors.

Background: Germinal matrix-intraventricular hemorrhage (IVH) is the most common brain hemorrhage in preterm neonates. The importance of this hemorrhage lies in its severe complications. There is no definite treatment for IVH in neonates; therefore, the prevention of IVH should be considered. Some studies have shown that Vitamin E can probably decrease the risk of IVH and the other study has not shown its efficacy. The aim of this study is to evaluate the effects of Vitamin E on incidence and severity of IVH in preterm neonates. Methods: This study is a randomized clinical trial conducted on 76 neonates with gestational age of ≤30 weeks in the Isfahan University of Medical Science. The neonates were divided into two groups. The group one was administered with 10 units of Vitamin E for 3 days and the second group with placebo. In the 4th and 7th days after birth, brain sonography was conducted to evaluate IVH. The presence of sepsis, incidence of necrotizing enterocolitis, and hypotension were examined. Results: In this study, 76 neonates with the mean age of 28.49 ± 1.46 weeks participated. The incidence of hemorrhage in the 4th day was 26.3% in cases and 42.1% in controls with no significant difference (P = 0.3). The findings of the second sonography reported the incidence of IVH in 17.1% of cases and 36.8% of control group. Conclusions: Based on findings of the current study, Vitamin E use did not significantly decrease IVH in neonates. Further studies with larger sample size are needed.

Introduction: High-cost sharing in physician care may result in worse health outcomes and financial burdens for individuals, and it reduces needed health-care utilization. Hence, this study examines the impact of cost sharing on utilization of Physician care. Methods: In the present study, multistage sampling (n = 1610) was done to collect general physician utilization and quality of life. Count data model was used to analyze the effect of cost sharing and other factor on the ratio of referring to the general physician. Negative binomial regression was employed to analyze the utilization model. Results: People who have high-cost sharing had used general physician services much less, so that ratio of incidence among them was 0.18 less than individuals with low-cost sharing (P < 0.05). Gender and age variables showed a significant effect on the demand for the general physician visit (P < 0.05). Conclusions: A low cost-sharing policy would remove the clinically and financial threat from the patient decision-making so as to provide them with access to needed care.