Background: To evaluate any change in tear indices and confocal microscopic findings after corneal collagen crosslinking (CXL) in patients with progressive keratoconus. Methods: Thirty-two consecutive eyes from 23 patients having progressive keratoconus were enrolled in this prospective, interventional cohort study. The standard crosslinking surgery was performed for all patients. Visual, refractive, and topographic evaluations were done before and at 6 months after surgery. Tear function tests and confocal microscopic examination were performed before and at 1 month and 6 months after the procedure. Results: There was no significant change in Schirmer-1 test results and tear osmolarity at 1 month and 6 months after CXL. Using confocal microscopy, all eyes showed reduced or absent subepithelial nerve plexus. Differences in basal epithelial cell density, epithelial mean cell area, and keratocyte density in anterior and middle stroma and endothelial cell pleomorphism were all significant at 1 month and 6 months after CXL (P < 0.05). No significant change was noted in endothelial cell count and their polymegathism at 6 months follow-up. Significant improvement was noted in uncorrected visual acuity, best corrected visual acuity, flattest corneal meridian (K₂ ), and maximum keratometry in Pentacam (K_max ) after 6 months of the procedure.  Conclusions : While CXL would have no effect on tear indices and endothelial cell count, it can cause a significant reduction in subepithelial nerve plexus and significant alterations in epithelial cell density in the anterior and middle stroma.

Background: Musculoskeletal disorders (MSDs) are known to cause occupational injuries. This study aimed to collate the existed relevant data and develop a general feature of MSDs problem among Iranian workforce. Methods: In this study, we used the raw data related to 8004 employees from 20 Iranian industrial settings distributed throughout the country. In all studies, participants were selected based on simple random sampling method, and the data were collected using demographic characteristics and Nordic MSDs questionnaires. Results: The most prevalent MSDs symptoms were reported in the lower back (48.9%), shoulders (45.9%), neck (44.2%), upper back (43.8%), and knees (43.8%). Prevalence rates of MSDs at least in one body region were found to be the highest (90.3%) among health-care workers. Prevalence rates of MSDs symptoms in all body regions were higher among workers with dynamic activities as compared to those of workers with static activities. Conclusions: MSDs symptoms were common among the study population. Health-care provider and workers with dynamic activities had the highest rate of MSDs. These results merit attention in planning and implementing ergonomics interventional program in Iranian industrial settings.

Background: About two million people annually travel to Kingdom of Saudi Arabia to perform Hajj. The pilgrims may be at risk of exposure to communicable diseases in this mass gathering and their vaccination against contagious diseases can prevent many morbidities and mortalities. The aim of our study was to review the papers which evaluated effectiveness and compliance of the vaccines applied in Hajj. Methods: We used PubMed and Scopus to search international medical databases. The key words were as follows: Hajj, Haj, vaccine, vaccination, and immunization. The time interval of the search was from the beginning of 2010 to May 23, 2016. One hundred and thirty papers were extracted, and their contents were subsequently reviewed after title and abstract screenings. The original articles were included in the study and non-English articles were excluded from the study. Results: Considering the extracted papers, almost all pilgrims were vaccinated against meningococcal diseases. Using of influenza and pneumococcal vaccine rates were different among the pilgrims. The other vaccines have been taking according to specific conditions. Conclusions: The findings regarding influenza vaccine effectiveness are contradictory. A few studies confirmed the flu vaccine effectiveness while some others rejected its usefulness. Meningococcal immunization is an effective preventive tool with high compliance for Hajj pilgrims. Further investigations are recommended for the other vaccines.

Background: In this study, the nature of food commercials in children's television (TV) was monitored and analyzed; simultaneously, the relationship between recalling TV food commercials and children's interest in them and in the consumption of the same food products was evaluated. Methods: A total of 108 h children's programs broadcast on two channels (Two and Amouzesh) of Islamic Republic of Iran Broadcasting (IRIB) media organization were monitored (May 6-12, 2015). Simultaneously, a cross-sectional study using 403 primary schoolchildren (201 boys) in four schools of Shirvan, Northeast of Iran, was executed. The children were prompted to recall all TV commercials broadcast on IRIB. Meanwhile, they were directed to define in the list of recalled TV food commercials those were interested in and the commercials (food products) they actually were willing to consume. Results: Regarding the frequency and duration of broadcasting, food commercials ranked fifth and sixth, respectively. Fruit leather and plum paste were the most frequently broadcast food commercials. "High quality" (19%), "good taste" (15%), "novelty," and "message on nutritional composition" (13%) were the most frequent messages used in promoting the sale of food products, respectively. In addition, focus on "high quality/precision in the preparation of the food products" was the most frequently used appeals in TV commercials. There was a significant relationship between recalling TV food commercials and the interest in five out of eight of the commercials (62.5%) (P < 0.05). The relationship between recalling TV food commercials and the interest in the consumption of the same food product ("Tomato paste B") was statistically significant for 12.5% of the commercials (P < 0.05). Conclusions: TV food commercials do not encourage healthy eating. The current study provides convincing evidence for policy-makers and researchers to pay more attention to this area.

Background: A report of the activities of countries worldwide for six main policies to control tobacco use is published once every 2 years by the World Health Organization (WHO). Our objective was to perform a quantitative analysis for it in countries and regions to make a simple view of its programs. Methods: This was a cross-sectional study by filling out a validated checklist from the 2015 WHO Report (MPOWER). All ten MPOWER measures got scores and were entered independently by two individuals and a third party compared the values. Results: Fifteen countries, which acquired the highest scores (85% of total 37), included Panama and Turkey with 35, Brazil and Uruguay with 34, Ireland, United Kingdom, Iran, Brunei, Argentina, and Costa Rica with 33, and Australia, Nepal, Thailand, Canada, and Mauritius with 32 points. Conclusions: Comparison of scores of different countries in this respect can be beneficial since it creates a challenge for the health policymakers to find weakness of the tobacco control programs to work on it.

Vitamin D is a prohormone nutrient, which is involved in skeletal and extra-skeletal functions. Iron is another essential nutrient that is necessary for the production of red blood cells and oxygen transport. This element plays important roles in enzymatic systems including those required for Vitamin D activation. To the best of our knowledge, there is no exclusive review on the relationship between iron deficiency anemia (IDA), as the most prevalent type of anemia, and Vitamin D deficiency and the effect of recovery from iron deficiency on Vitamin D status. The aim of this study was to conduct a systematic search of observational and clinical trials in this field. The databases of PubMed, ProQuest, Cochrane Library, ISI Web of Knowledge, and SCOPUS were searched comprehensively. English-language human studies conducted on iron deficient patients or interventions on the effect of iron therapy on Vitamin D were extracted (n = 10). Our initial search yielded 938 articles. A total of 23 papers met the inclusion criteria. Thirteen studies were excluded because they were not relevant or not defining anemia types. The final analysis was performed on ten articles (3 cross-sectional and 7 interventional studies). Observational data indicated a positive relationship between iron status and Vitamin D, while trials did not support the effectiveness of iron supplementation on improving Vitamin D status. The mechanism underlying this association may involve the reduction of the activation of hydroxylases that yield calcitriol. Future randomized controlled trials with large sample sizes and proper designs are needed to highlight underlying mechanisms.

Background: Decision-making about patients with critical condition transfer from Intensive Care Unit to the general wards be delegated to their families. The aim of the study was explaining the experiences of family caregiver's about care of chronic critically ill patient. Methods: This study was conducted with a qualitative content analysis using unstructured interview. Participants were selected purposively from May 2014 to May 2015 and data collection continued until data saturation. Analysis was based on conventional content analysis. Results: Participants' experiences classified into three main categories as following: nonprofessional care, enhancing factors of care, and inhibiting factors of care. Conclusions: Finding of the current study showed different aspects of care. Care of chronic critically ill patients is a long-term process that affected by different factors. It seems that the exploration of caregivers needs and planning supportive interventions based on their needs improve the quality of care.