Zaher Khazaei

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition posing significant emotional and practical challenges for families, particularly during the diagnostic process. Limited research has explored how parents in non-Western contexts interpret and emotionally navigate this experience. This study investigated Iranian parents’ beliefs, meaning-making processes, and emotional trajectories during and after the ASD diagnostic journey, aiming to identify culturally shaped patterns and implications for family-centered care. Methods: In 2024, a qualitative study was conducted in Yazd, Iran, using conventional content analysis guided by Graneheim and Lundman’s framework. Twelve parents of children with ASD (aged ≤ 6 years) were recruited via purposive sampling with maximum variation from “Tolou-e-Mehr” and “Baqa” Autism Centers, the only Welfare Organization-supervised diagnostic and rehabilitation centers in Yazd at the time. In-depth, semi-structured, face-to-face interviews with individual participants were conducted until data saturation was reached. Data were analyzed using MAXQDA version 18, and rigor was ensured through Lincoln and Guba’s trustworthiness criteria. The findings were reported in accordance with the 32-item COREQ checklist. Results: Three categories and one overarching theme emerged from the analysis. The overarching theme, “The Parental Journey Through Autism Diagnosis Amid Uncertainty and Progressive Adaptation , ” captures parents’ evolving experiences across the diagnostic pathway. The three categories included: (1) Diagnostic Process Challenges; (2) Emotional Trajectory of Parents During Diagnosis; and (3) The phases of Parental Response, from initial symptom recognition through post-diagnostic adaptation. A key contribution of this study is the identification of a culturally grounded predominant trajectory encompassing seven key phases of Parental Responses across and beyond the autism diagnostic journey: symptom recognition, denial and shock, anger and frustration, bargaining and resistance to medical advice and treatment, emotional distress/depression, social isolation, and acceptance/adaptation. Granular participant-level analysis revealed that while parents demonstrated an overarching chronological progression toward adaptation without backwards regression, individual trajectories were dynamic and flexible, with parents selectively navigating or bypassing intermediate phases. This trajectory incorporates culturally specific elements, including resistance to medical recommendations through religious practices and stigma-related isolation that extends to broader family networks. Parents also reported diagnostic delays, inconsistent assessments, and fragmented service pathways that intensified emotional burden. Conclusions: It seems this study provides novel insight into the culturally shaped emotional processes Iranian parents undergo during ASD diagnosis and beyond, highlighting how systemic challenges intersect with personal coping responses. Findings underscore the need for timely diagnosis, coordinated family-centered services, and culturally sensitive psychosocial support to help parents navigate their dynamic diagnostic pathways. Trial registration: Not applicable.

Objective: This ecological study examines epidemiological trends in tuberculosis, multidrug-resistant TB, extensively drug-resistant TB, and latent TB infection across Iran and its provinces from 1990 to 2021, and explores their association with the Human Development Index. Methods: Data from the Global Burden of Disease 2021 study, were used to assess the incidence, mortality, and prevalence of tuberculosis, multidrug-resistant tuberculosis, extensively drug-resistant tuberculosis, and latent tuberculosis infection at both national and provincial levels in Iran. The association between tuberculosis indicators and the Human Development Index was evaluated using bivariate correlation analysis, with P < 0.05 considered statistically significant. Geographic maps illustrating the spatial distribution of the disease across provinces were generated using Arc-GIS 10.8.2 software. All statistical analyses were performed using Stata version 12 (Stata Corp, College Station, TX, USA). Results: The age-standardized incidence rate (ASIR) of tuberculosis decreased from 22.60 cases per 100,000 population (95% CI: 20.09–25.41) in 1990 to 13.51 cases (95% CI: 11.98–15.15) in 2021. The average annual percent change was: − 0.40 (95% CI: − 0.43 to − 0.37). In 2021, the age-standardized mortality rate was 1.09 cases per 100,000 (95% CI: 0.92–1.30), with an average annual percent change: − 0.73; (95% CI: − 0.80 to − 0.57). Sistan and Baluchistan (32.21 per 100,000) and Golestan (24.46 per 100,000) reported the highest incidence rates, whereas Chahar Mahaal and Bakhtiari (3.08 per 100,000) and Isfahan (6.71 per 100,000) reported the lowest. A significant inverse correlation was observed between the Human Development Index and tuberculosis indicators ( P < 0.05). The prevalence of multidrug-resistant tuberculosis was 1.7%, and the prevalence of latent tuberculosis infection was 25,027 cases per 100,000 population. Conclusion: Substantial progress has been made in reducing the tuberculosis burden in Iran. Nevertheless, marked regional disparities and persistent challenges related to multidrug-resistant tuberculosis and latent TB infection highlight the need for targeted interventions, including enhanced screening, improved diagnostic capacity, and expanded preventive treatment strategies.

Background: Thyroid cancer is the most common malignancy of the endocrine system. Given the differences in its frequency pattern across various parts of the world, understanding the frequency pattern of this cancer in Iran, as well as the burden of this disease, can play a key role in prevention and screening ...

Supplementary Table from Opium Use and the Risk of Liver Cancer: A Case–Control Study

Limited evidence is available to acknowledge the association between opium use and liver cancer. In a case–control study, we recruited 117 cases of primary liver cancer (PLC) and 234 age and sex-matched neighborhood controls from 2016 to 2018. We calculated odds ratios (OR) for opium use and 95% confidence intervals (95% CI), using conditional logistic regressions. Compared with non-users the adjusted OR (AOR, 95% CI) for opium use was 6.5 (95% CI, 2.87–13.44). Compared with people who had no history of use, a strong dose–response effect of opium use was observed by amount of use (AOR, 10.70; 95% CI, 3.92–28.70). Cumulative use of opium also indicated that using over 30 gr-year could increase the PLC risk dramatically (AOR, 11.0; 95% CI, 3.83–31.58). Those who used opium for more than 21 years were highly at risk of PLC (AOR, 11.66; 95% CI, 4.43–30.67). The observed associations were significant even among never tobacco smokers (including cigarette and water-pipe smoking).Prevention Relevance:The results of this study indicate that opium use dramatically increased the risk of liver cancer. Because opioids are increasing for medical and non-medical use globally; accordingly, severe health consequences such as liver cancer have to be investigated widely.

Limited evidence is available to acknowledge the association between opium use and liver cancer. In a case–control study, we recruited 117 cases of primary liver cancer (PLC) and 234 age and sex-matched neighborhood controls from 2016 to 2018. We calculated odds ratios (OR) for opium use and 95% confidence intervals (95% CI), using conditional logistic regressions. Compared with non-users the adjusted OR (AOR, 95% CI) for opium use was 6.5 (95% CI, 2.87–13.44). Compared with people who had no history of use, a strong dose–response effect of opium use was observed by amount of use (AOR, 10.70; 95% CI, 3.92–28.70). Cumulative use of opium also indicated that using over 30 gr-year could increase the PLC risk dramatically (AOR, 11.0; 95% CI, 3.83–31.58). Those who used opium for more than 21 years were highly at risk of PLC (AOR, 11.66; 95% CI, 4.43–30.67). The observed associations were significant even among never tobacco smokers (including cigarette and water-pipe smoking).Prevention Relevance:The results of this study indicate that opium use dramatically increased the risk of liver cancer. Because opioids are increasing for medical and non-medical use globally; accordingly, severe health consequences such as liver cancer have to be investigated widely.

Supplementary Table from Opium Use and the Risk of Liver Cancer: A Case–Control Study

Supplementary Table from Opium Use and the Risk of Liver Cancer: A Case–Control Study

Limited evidence is available to acknowledge the association between opium use and liver cancer. In a case–control study, we recruited 117 cases of primary liver cancer (PLC) and 234 age and sex-matched neighborhood controls from 2016 to 2018. We calculated odds ratios (OR) for opium use and 95% confidence intervals (95% CI), using conditional logistic regressions. Compared with non-users the adjusted OR (AOR, 95% CI) for opium use was 6.5 (95% CI, 2.87–13.44). Compared with people who had no history of use, a strong dose–response effect of opium use was observed by amount of use (AOR, 10.70; 95% CI, 3.92–28.70). Cumulative use of opium also indicated that using over 30 gr-year could increase the PLC risk dramatically (AOR, 11.0; 95% CI, 3.83–31.58). Those who used opium for more than 21 years were highly at risk of PLC (AOR, 11.66; 95% CI, 4.43–30.67). The observed associations were significant even among never tobacco smokers (including cigarette and water-pipe smoking). Prevention Relevance: The results of this study indicate that opium use dramatically increased the risk of liver cancer. Because opioids are increasing for medical and non-medical use globally; accordingly, severe health consequences such as liver cancer have to be investigated widely.

Introduction: COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov2). It is a potentially deadly disease with grave consequences for public and global health. This study compared laboratory indices in recovered and fatal COVID-19 cases. Methods: In this descriptive-analytical cross-sectional study, sampling was conducted using the total count method, and ...