Hosein Rafiemanesh

Foodborne diseases are a significant public health concern during mass gatherings, including the Arbaeen pilgrimage in Karbala, Iraq. This study aimed to investigate the prevalence and associated risk factors for foodborne disease among Iranian pilgrims attending the Arbaeen ceremony. A cross-sectional survey was conducted among 1,030 pilgrims via structured questionnaires. The questionnaire included sections on demographic information, potential risk factors, KAP scores (knowledge, attitudes, and practices) related to food safety, and symptoms and severity of foodborne disease. Logistic regression analysis was conducted to identify risk factors associated with moderate to severe foodborne disease. The prevalence of foodborne disease was 23.2%, with 9.4% of participants experiencing moderate disease and 6.7% experiencing severe disease. The most common symptoms included headache (42.5%), abdominal pain (27.0%), nausea (21.4%), and diarrhea (20.7%). Significant risk factors for foodborne disease included lower education levels (OR = 2.23), first-time travel (OR = 1.65), longer trip durations (OR = 4.33), and consumption of unpackaged water (OR = 5.23). Pilgrims with poor to moderate food safety practices were 2.10 times more likely to experience foodborne disease. The findings suggest that improvements in food and water safety, along with targeted education campaigns for vulnerable groups, could reduce foodborne illnesses during mass pilgrimages. Public health interventions should focus on enhancing food handling practices and ensuring safe drinking water access, particularly for first-time travelers, elderly individuals, and those with lower education levels.

Stenotrophomonas maltophilia (S. maltophilia) is an opportunistic pathogen that has been implicated in causing infections such as pneumonia, bacteremia, and skin and soft-tissue infections, particularly in patients with compromised immune systems. The worldwide emergence of antibiotic-resistant bacteria continues to rise. Antimicrobial photodynamic therapy (aPDT) has been investigated as a promising treatment for localized infections in response to the ever-growing problem of antimicrobial resistance. This research was designed to investigate the antibiotic resistance profile of S. maltophilia, confirm the effectiveness of aPDT with Rose Bengal against resistant isolates, and compare the expression of the smeDEF efflux pump gene before and after aPDT. A total of 139 S. maltophilia isolates were collected during 2023 to 2024 in this cross-sectional study. The isolates were identified using routine microbiological and biochemical methods and confirmed by molecular polymerase chain reaction (PCR) targeting the 23 S rRNA gene. Antibiotic susceptibility was determined using both Kirby-Bauer disk diffusion and E-test methods, following Clinical and Laboratory Standards Institute (CLSI) 2024 guidelines. aPDT was applied to S. maltophilia strains resistant to ≥ 2 antibiotic classes, using Rose Bengal at concentrations ranging from 1 to 100 µM, activated by green (530 nm) and blue (470 nm) diode lasers at fluences of 2 and 5 J/cm². The expression of the smeDEF gene was assessed using real-time PCR. Antibiotic susceptibility testing revealed resistance rates of 6.4% to levofloxacin, 4.3% to minocycline, and 3.6% to trimethoprim-sulfamethoxazole (TMP/SMX). Four S. maltophilia isolates showed resistance to ≥ 2 antibiotic classes. aPDT with Rose Bengal activated by blue and green diode laser light inhibited growth in all but one resistant isolate, which grew under green light at a dose of 2 j/cm². Real-time PCR analysis revealed a 1.4-fold downregulation of the smeDEF gene in the S. maltophilia isolate resistant to five antibiotic classes following aPDT treatment, compared to the control. The current research discloses the increasing pattern of antibiotic resistance in S. maltophilia isolates in Iran. Yet, TMP/SMX is counted as the first option for the treatment of S. maltophilia infections. Furthermore, our findings suggest that, aPDT is an effective therapeutic approach for treating antibiotic-resistant S. maltophilia isolates.

High-grade gliomas represent one of the most formidable challenges in neuro-oncology, characterized by rapid progression and poor prognosis despite aggressive multimodal interventions. The combination of Gamma Knife radiosurgery and bevacizumab has emerged as a promising therapeutic approach for extending survival in patients with recurrent high-grade gliomas. A systematic review and meta-analysis followed PRISMA guidelines, drawing on comprehensive searches of PubMed, Scopus, and Web of Science databases. Studies assessing the efficacy of Gamma Knife radiosurgery in conjunction with bevacizumab for recurrent high-grade gliomas were identified and subjected to rigorous quality assessment using the modified Newcastle-Ottawa Scale. Pooled hazard ratios (HRs) for progression-free survival and overall survival were calculated using a random-effects model to account for variability across studies. Six studies were included in the systematic review, among which four provided sufficient data for quantitative synthesis in the meta-analysis. The pooled analysis revealed that combined therapy significantly improved progression-free survival (HR: 0.712, CI: 0.467–0.956, p < 0.001) compared to monotherapy. However, the two groups had no significant difference in overall survival (HR: 1.069, CI: 0.395–1.742, p = 0.097). Sensitivity analyses confirmed the robustness of these findings. High heterogeneity was noted for overall survival (I² = 98.24%), warranting cautious interpretation. This meta-analysis suggests that while Gamma Knife combined with bevacizumab significantly prolongs progression-free survival in patients with recurrent high-grade glioma, it does not confer an overall survival advantage.

Oral complications following cancer treatment are a challenging issue for oncologists. Several studies have demonstrated the efficacy of biotics in the prevention and treatment of oral complications in thyroid and head and neck cancers. Following the PRISMA criteria, a systematic review and meta-analysis of included studies on efficacy, safety, dosage, and duration of treatment was performed. A total of 12 randomized controlled trials and a total of 885 individuals were included in this meta-analysis. Our analysis showed that biotics had a slight but insignificant effect on the incidence of oral mucositis (Risk ratio (RR) = 0.90, 95% CI [0.79, 1.03]), and a significant impact on reducing the severity of oral mucositis (RR = 0.62, 95% CI [0.48, 0.80]). Biotics also had a slight but insignificant effect in developing xerostomia in thyroid and Head and neck cancer (HNC) patients. Subgroup meta-analysis demonstrated that Bifidobacterium-containing products were more effective than other blends. Our findings demonstrated that biotics are effective and safe for HNC and thyroid patients suffering from oral complications.

Background: Drug use, especially injecting drug use, is associated with a higher risk of tuberculosis (TB). This study aimed to systematically review the prevalence of TB among people who use drugs (PWUD) in Iran. Methods: A systematic search was conducted in international and national databases. All studies that provided data on the prevalence of TB among PWUD based on screening tests and diagnosis from 1990 up to August 2019 were assessed. Meta-analysis was performed on the prevalence of active TB among people who inject drugs (PWID). Findings: Overall, nine studies were included. The studies were carried out from 1994 to 2012 in seven out of the 31 provinces of Iran. Seven studies provided data on the prevalence of TB diagnosis among 1087 PWID. The pooled prevalence of TB diagnosis was 10.1% (95% CI: 4.5, 15.8) in studies carried out in hospitals and 0.54% (95% CI: 0.04, 1.04) in other settings. Conclusion: The present review suggests an approximately 40 times higher prevalence of TB among PWID compared to the general population. However, most of the included studies were conducted on a subpopulation of drug users, and caution should be exercised when generalizing the findings.

Objective Gaming motivations are a central aspect of playing video games, and their importance to understanding both healthy and problematic gaming behavior has been increasingly elucidated. In this study, we aimed to translate the 18-item Gaming Motivation Scale (GAMS-18) to Persian and validate it in a population of Persian speaking gamers, specifically for the assessment of online gaming.Methods After translation from English to Persian, content validity of the questionnaire was assessed by a panel of experts and test–retest reliability was calculated in a sample of 70 students. Data from an online survey of 791 Iranian online gamers were used for the assessment of construct validity using confirmatory factor analysis.Results The item content validity index and the scale content validity index for clarity and relevance ranged from 0.80 to 1.00. Internal consistency reliability of the GAMS-18 was 0.90 and the test–retest reliability was 0.89. The test–retest reliability of the GAMS-18 was 0.89, and the internal consistency was 0.90. The GAMS factors had acceptable correlation with other motivational scale such as Player Experience of Need Satisfaction. Incorporating the proposed additional error paths improved the model fit to an acceptable level.Conclusion The Persian version of the GAMS can assess digital gaming behavior based on the six self-determination theory motivation types, and measures different aspects of motivation that other instruments. It is also demonstrated to have good reliability and validity and could be used in research on the motivations of online gamers in Persian-speaking populations.

Objective: It seems that the available data on performance of the Rapid Arterial oCclusion Evaluation (RACE) as a prehospital stroke scale for differentiating all AIS cases, not only large vessel occlusion (LVO), from the stroke mimics is lacking. As a result, we intend to evaluate the accuracy of the RACE criteria in diagnosing of AIS in patients transferred to the emergency department (ED). Method: The present study was a diagnostic accuracy cross-sectional study during 2021 in Iran. The study population consist of all suspected acute ischemic stroke (AIS) patients who transferred to the ED by emergency medical services (EMS). A 3-part checklist consisting of the basic and demographic information of the patients, items related to the RACE scale, and the final diagnosis of the patients based on interpretation of patients’ brain MRI was used for data collection. All data were entered in Stata 14 software. We used the ROC analysis to evaluate the diagnostic power of the test. Result: In this study, data from 805 patients with the mean age of 66.9 ± 13.9 years were studied of whom 57.5% were males. Of all the patients suspected of stroke who transferred to the ED, 562 (69.8%) had a definite final diagnosis of AIS. The sensitivity and specificity of the RACE scale for the recommended cut-off point (score ≥ 5) were 50.18% and 92.18%, respectively. According to the Youden J index, the best cut-off point for this tool for differentiating AIS cases was a score > 2, at which sensitivity and specificity were 74.73% and 87.65%, respectively. Conclusion: It seems that, the RACE scale is an accurate diagnostic tool to detect and screen AIS patients in ED, Of course, not at the previously suggested cut-off point (score ≥ 5), but at the score > 2.

Objective Gaming motivations are crucial aspects of healthy and problematic video gaming behavior. The aim of this study was to assess the psychometric properties of the widely used Motives for Online Gaming Questionnaire (MOGQ).Methods Test-retest reliability was evaluated in a sample of 66 university students. Data from 791 participants in an online survey of Iranian online gamers were examined to assess convergent validity and construct validity using confirmatory factor analysis. Internal consistency of MOGQ factors was assessed in both samples.Results The item content validity index (I-CVI) and the scale content validity index (S-CVI) were between 0.8 and 1.0 for clarity and relevancy. The test-retest reliability of the 27-item questionnaire was 0.85 and internal consistency was 0.94. After incorporating additional error paths, model fit improved to an acceptable level. The MOGQ factors had acceptable correlations with relevant motivational scales such as Gaming Motivation Scale and Player Experience of Need Satisfaction. Recreation motives had the highest average score in the sample and social ones had the lowest, and males scored higher than females across all motivation domains except escape.Conclusion The MOGQ is a suitable instrument for the assessment of online gaming motivations in the Iranian population.

Comorbid alcohol and illicit drug use disorder is relatively prevalent . We aimed to assess the prevalence, pattern, and associated factors of alcohol use disorder among treatment-seeking individua...