Men's Health Journal

Introduction: Mouse spermatogonial stem cells (SSCs) can be cryopreserved for long periods while preserving their spermatogenic ability. Although cryopreservation has been found to increase reactive oxygen species (ROS) formation that damages cellular structures. In the present study, we added vitamin E to the basic freezing medium in order to evaluate its effect on the efficiency of spermatogonial stem cells.

Methods: SSCs isolated from testes of 6 days old male mice by enzymatic digestion. Vitamin E 100, 200, 400 µg/mL was added to the basic freezing medium. The cell viability was evaluated by MTT assay. After thawing, SSCs were cultured for 1 month and the expression pattern of specific genes of SSCs measured by real-time PCR technique.

Results: The survival rate of the freeze cells in the presence of vitamin E was significantly higher than the control group (p<0.05). The number of colonies and their diameter measured after one month were significantly higher in the vitamin E groups than in the control group (p≤0.05).

Conclusion: Adding vitamin E to the basic freezing medium thus can be helpful in increasing the quality and viability of SSCs after cryopreservation.

Background: Varicocele means dilation and torsion of spermatic veins. About 15%-40% of infertile men suffer from Varicocele. It seems that 70% of secondary infertility in men occurs due to Varicocele. Varicocele is the most common surgical cause for male infertility. Varicocelectomy is considered as the best treatment method for patients with Varicocele that increases 30%-50% of the postoperative fertility rate. The purpose of this study was to investigate the effect of Varicocelectomy on inhibin B and use this marker to predict infertility in men.

Methods: In this study, all infertile patients in any age that were candidate for Varicocelectomy and hospitalized in Imam Hospital in Urmia were included. Exclusion criteria were defined as orchitis, trauma, diabetes, radiotherapy, chemotherapy and coitus complications. Sperm analysis (SA) was conducted three times for patients and then serum levels of FSH, LH, T, inhibin B, SA were measured before surgery and also six months after surgery. Furthermore, during the hospitalization and infertility period, testes were examined before surgery in terms of consistency and size.

Results: The mean ± SEM (standard error median) age of 40 patients was 28.4±5.14 (range: 18-40) years old. Mean size of the testes and mean sperm density and serum levels of LH.FSH remained the same. However, mean sperm motility, serum levels of T and inhibin B were statistically significant after the Varicocelectomy (p-value=0.005). A significant relationship was found between serum levels of inhibin B and infertility; however, there was no significant relationship between sperm count and serum levels of LH, FSH and T. Varicocelectomy can improve sperm motility and increase Inhibin B in patients and so improves spermatogenesis parameters and it may be one of the causes of fertility in patients.

Conclusion: The results of this study indicate that sperm motility and increase in inhibin B after Varicocelectomy can improve spermatogenesis parameters. Serum levels of FSH, T, LH and sperm morphology and also grade of Varicocele, patient age, and testis size have no effect on spermatogenesis and fertility after Varicocelectomy.

Introduction: Uterine septum is one of the most common congenital abnormalities in women that leads to numerous gynecological problems and adverse obstetrics outcomes. This study aimed to evaluate the effects of Hysteroscopic Resection on pregnancy outcomes in women undergone the surgery.

Methods: In this quasi-experimental study, 90 women were included from April 2016 to June 2018 from patients attending to Rasoul Akram hospital of Tehran. The inclusion criteria included: the age lower than 35 years old, primary infertility, idiopathic recurrent spontaneous abortion, BMI between 19 and 30, and having informed consen. Septum was resected by scissor upward and lateral. After 10 months of follow-up in average, we assessed rate of live births, abortions, birth weight and presentation.

Results: 82 individuals were assessed for occurrence of conception (response rate=91%).  The mean age of patients was 30.01 ± 6.76 years and the mean BMI was 26.25 ± 4.88. Out of 82 patients, 36 patients were pregnant, of whom 16 (44.4%) had abortions. 5 (14.9%) of the pregnancies ended with preterm birth, and 6 (17%) ended with stillbirth.

Conclusion: The present study showed that the infertile patients with uterine septum and with no other causes of infertility were more likely to be pregnant compared to other patients with idiopathic infertility. Our study showed that post-operation fertility following Hysteroscopic Resection was lower than that in previous reports. According to the findings of this study, scissors may be safe, effective and cost-effective method for removing uterine septa.

Introduction: Bladder cancer is the ninth common cause of cancers in both sexes worldwide. Nevertheless, little is known about the descriptive and analytic epidemiology of bladder cancer in Iran. The present study aimed to describe the nationwide distribution of death due to bladder cancer in Iran.

Methods: This cross-sectional study used data of bladder cancer cases who were registered in the national cancer-registry system by the Ministry of Health and Medical Education during 2001-2007. Age-standardized mortality rates due to bladder cancer were presented according to nine geographic poles across the country.

Results: The overall mortality rate of bladder cancer (per 100,000 population) was 2.26 in men and 1.36 in women; while the rates were constantly higher for men across all age groups.  The highest and lowest age-standardized mortality rates in provinces (per 100,000 population) belonged to Mazandaran (6.126) and Tehran (1.112), respectively.

Conclusion: Death from bladder cancer seems to increase by age in Iran, mainly among men. This association might be partially due to increased life expectancy, altered high-risk lifestyle behaviors and/or improvement in cancer registration system. Information on the distribution of mortality due to bladder cancer could be useful for local prevention strategies, where specific profile of communities and patients is taken into account.

Introduction: Patients with acute renal colic need to choose between undergoing medical treatments and receiving interventions. The Aim of this study is to evaluate the outcomes of patients who are discharged from emergency departments with ureteral stones lesser than 6 millimeters. In doing so, the effect of diagnostic treatment approaches on clinical outcomes and referral rate is to be assessed.

Patients and Methods: This study was performed on patients with ureteral stones referred to emergency department of Shohadaye Tajrish Hospital between May2015 to June 2018. A checklist was filled out for each patient and it included their complete medical history, physical examination results and paraclinical data. Patients were then studied for 4 weeks to determine referral times to hospital and clinical outcomes.

Results: 105 patients include 81 men (77.14%) with average age of 37.1±12.4 years were studied. The mean stone diameter was 4.2±2.1 mm.  Most of ureteral stones were seen in the right-hand side (60 percent). 71 patients (67.6%) did not have any history of nephrolithiasis and 73 (69.5%) did not have positive family history for nephrolithiasis. Ureteral stones were still observed in 42 patients (40%) after two weeks of studies and only one patient (1.1%) had stone in Ultrasound Imaging after 4 weeks of observations.

Conclusion: Most Patients (95%) with stones smaller than 6 mm responded to Medical Expulsive Therapy (MET) after 4 weeks and passed spontaneously ureteral calculi.

Abstract

Background: Aortic aneurysm is one of the most common cardiovascular diseases that can lead to numerous challenges for patients. The mortality rate of ruptured Thoracic Aortic Aneurysm (TAA) is observed to be high. In order to reduce this high rate, appropriate methods to diagnose TAA as well as its useful and aggravating factors are to be developed and/or identified. The objective of this study is the evaluation of the thoracic aortic aneurysm and dissection, in Mazandaran Heart Center.

Method: This cross-sectional study with a census design was performed on all patients with thoracic aortic aneurysm and dissection who have undergone aneurysm surgery, from December 2010 to January 2019. Patients’ information was extracted from their medical records archive. SPSS 16.0 was used for statistical analysis.

Result: From 53 patients with a thoracic aortic aneurysm, 77.4% were male. The mean age of patients was 59.70±12.07 years. 21 (39.6%) patients were more than or equal to 60 years old, while the remaining 32 (60.4%) were less than 60 years of age. The overall mortality rate was 11.3%. The mean aortic diameter of the patients was 5.42 cm. All patients had type A dissection. In other words, type B was not seen.

Conclusion: Given the high prevalence and high mortality rate of thoracic aortic aneurysm, early screening can be beneficial and can increase the survival rate of patients. Laboratory and pathologic findings, along with clinical findings, can be very beneficial in early diagnosis.

Background and aim: To find if intra-operative local injection of Mitomycin-C after internal Urethrotomy in patients with urethral stricture can improve the outcome of surgery.

Materials and Methods: Seventy patients were allocated in two groups randomly and data were analyzed. The case group (n=35) was treated by internal Urethrotomy with intra-operative local injection of Mitomycin-C. The control group (n=35) was underwent standard internal Urethrotomy. The patients were followed after removing catheter and for 6 months after surgery by USS PROM questionnaire and uroflowmetry.

Results: A significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.006) and urine flow pattern (p-value=0.025) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, six months after surgery. In the case group, in the six months after operation, only 2.9% of patients had Q-max less than 15 and no one had obstructive pattern, while in the control group, 25.7% of patients had Q- max less than 15 and 17.1% had obstructive pattern. However, the patient's satisfaction history did not show any significant difference in post-internal Urethrotomy voiding status in the local injection of Mitomycin-C group and control group, either immediately after removal of the urethral catheter (p-value=1) and six months after surgery (p-value=0.198). Also, no significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.771) and urine flow pattern (p-value=1) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, immediately after removal of the urethral catheter.

Conclusions: Intra-operative local injection of Mitomycin-C after internal Urethrotomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Lower recurrence rate of urethral stricture is the main effect of local Mitomycin-C application that is more prominent after six months follow up.

Background: Depression is amongst the most significant causes responsible for loss of life, worldwide. It also increases the likelihood of accidents which may lead to unpleasant outcomes.

Aim: This paper was aimed to measure the prevalence and related factors of depression amongst taxi drivers in Tehran city, from 2017 to 2018.

Methods: This cross-sectional study was conducted on 350 taxi drivers. Cluster sampling was applied. Standard questionnaires, including Beck-21 items questionnaire, to measure depression, and job satisfaction questionnaire (JDI), were applied. Statistical analyses were performed using SPSS version 24 using Odds Ratios (OR) by logistic regression models. Significant level was considered 5% at all analyses.

Results: The prevalence of depression was 43.3% and mean (SD) of job satisfaction score was 188.1 (54), with a median and interquartile range (70±193) for the highest and lowest level of job satisfaction were 350 and 60, respectively. The odds of having depression were 2.2 times higher in drivers with low job satisfaction (OR=2.2; 95%CI:1.3,3.8), 6.2 times higher in drivers who reported bad/very bad economic status (OR=6.2; 95%CI:2.1,18.3), and 1.8 times higher in cigarette smokers ‎(OR=1.8; 95%CI:1.0,3.4). The odds also increased by 2.6 times in drivers who reported average self-rated health (OR=2.6; 95%CI: 1.5, 4.5), and by 10.1 times in drivers who reported bad self-rated health ‎ (OR=6.2; 95%CI: 1.5, 65.0). Furthermore, having a history of depression amongst first degree family members, increased the odds by 2.6 times‎ (OR=2.6; 95%CI: 1.5, 4.5).  ‎  ‎

Conclusion: We found that 43% of taxi drivers in Tehran city suffer from varying degrees of depression. It seemed that cigarette smoking, family history of depression, job dissatisfaction, and poorer economic status were important contributors of depression in our investigation.

Introduction: While the Mental health of Medical practitioners has drawn much attention worldwide in recent years, it has been neglected in Iran. This research aims to provide a quick insight into the mental health of the medical practitioner.

Methods: Samples were 208 medical practitioners with different scientific ranks and various specialties in an educational hospital in Tehran. The General health questionnaire (GHQ-12) was used as research too.

Results: The Data collected by standard GHQ-12 questionnaire and demographic survey were analysed with a cut-off point of 3 for classifying GHQ status among medical practitioners and3.5 (average point of Iranian adults according to Ebadi et al. 2006) for comparing medical practitioners with the general population. Data analysis revealed that 51.4\% of medical practitioners fell below the average point of Iranian society in terms of mental health. Other criteria were gender, marital status, scientific rank, work experience, and specialty. There was no significant difference between males and females (Z=-1.662, p<0.096) and between single and married ones (Z=0.604, p<0.546). A significant difference existed between medical practitioners with different scientific ranks (assistant, assistant professor, associate professor, and professor) (Z=7.614, p<0.022). There was also a significant positive relationship between work experience and mental health (r=0.240, p<0.001) and between age and mental health (r=0.201, p<0.004). A comparison of surgical groups with the non-surgical group confirmed the absence of significant difference (Z=-1.252, p<0.210), with both groups suffering from equally poor mental health. The average mental health of internists and pathologists was significantly lower than general surgeons and physiologists.

Conclusion: The results denote that medical practitioners are exposed to stressful events arising from their profession. It is recommended that their occupational conditions be carefully examined, and mental health promotion programs are designed and implemented.

Introduction: This paper aims to determine the effectiveness and sensitivity of peak expiratory flow in early diagnosis of chronic obstructive pulmonary disease (COPD). In view of high cost and unavailability of spirometry and the ever-increasing prevalence of COPD as a result of cigarette smoking, this study can do much to lighten the economic burden in national health system. Materials and Methods: We examined 250 patients taking spirometry test in Shohadaye Tajrish Hospital during 2008, chosen by simple random sampling method. COPD was defined as FEV/FVC<70% according to existing resources. PEF values smaller than 80% were considered as abnormal based on ATS criteria. We assessed PEF sensitivity in comparison with FEV1/FVC. Results: COPD prevalence among spirometry tests was 21.2%. Out of the patients, 76.27% were male and 92.9% were older than 40. PEF sensitivity was 74% and its specificity was 97.5%.  Discussion: The higher COPD prevalence among men may be explained by higher cigarette smoking rate among men than in women in our country. Moreover, COPD occurrence risk increases with age. Conclusion: The positive predictive value of PEF compared with EFV1/FVC reveals that this test is an appropriate diagnostic tool which can diagnose COPD earlier than EFV1/FVC.

Introduction: Nitrite test is a simple, inexpensive method for diagnosing urinary tract infections. This paper evaluates the efficiency of nitrite test in the diagnosis of urinary infections. In doing so, we analyzed patients in Khatam-ul-Anbia Hospital of Zahedan City and determined the sensitivity and specificity of this test. Material and Methods: This is a cross-sectional study involving 200 randomly selected patients with urinary infection symptoms in Khatam-ul-Anbia Hospital. Urine samples were tested for the presence of nitrite and urine culture was performed. Results: We selected 200 patients, out of which 100 had negative nitrite test and 100 had positive nitrite test. Out of 100 patients with negative nitrite test, only 4 had positive urine culture. Out of 100 patients with positive nitrite test, 98 had positive urine culture with colony count of more than 10⁵ CFU/ml (sensitivity: 98%, specificity: 96.9%). Conclusion: As an inexpensive and easy method, nitrite test is a valuable test which can obviate the need for urine culture before treatment.

Introduction: Pituitary adenomas are commonly benign, slow-growing tumors that arise from cells in the pituitary gland and consist of a common type of intracranial space-occupying lesions. Based on the functionality and size of the adenoma, both medical and surgical approaches have been described. In this study, the authors aim to determine the effects of contributing factors of patients with pituitary adenoma undergoing trans-sphenoidal endoscopic surgery to their postoperative clinical status. Material and Methods: From March 2015 to November 2016, 100 patients diagnosed with pituitary adenoma confirmed by Magnetic Resonance Imaging (MRI) underwent a trans-sphenoidal endoscopic approach in the department of Neurosurgery of Shohada Tajrish Hospital. Demographic data, as well as pre-defined relevant contributing factors regarding clinical status, were recorded. All patients underwent neuroimaging and neurological examination before surgery and were followed in the postoperative period by repeated neurological examination, imaging surveys, and histopathological studies. Statistical analysis was performed using SPSS program version 23. Results: This study consisted of 59 males and 41 females with a mean age of 45.2 (24-63 years). Visual field defect (48\%) was the most frequent finding, while asymptomatic status (36\%) was the second major clinical finding in the patients. Neuroimaging survey revealed small tumor size and low extension type in 39 and 40 patients, respectively. Following the trans-sphenoid surgical approach, intact adrenal, gonadal, and thyroid function was found in 92\%, 92\%, and 89\% of the postoperative phase cases. In the postoperative period, visual field defects, need for re-operation, diabetes insipidus (DI), focal neurological deficits (FND), diplopia, post-operative hemorrhagic event, cerebrospinal fluid (CSF) leak and meningitis were observed in 15\%, 6\%, 5\%, 4\%, 3\%, 3\%, 2\% and 1\% respectively. Moreover, three patients expired in the postoperative period. Our statistical analysis identified the presence of headache (P-value 0.039), functional pituitary adenoma(P-value 0.031), abnormal adrenal gland function(P-value 0.028), abnormal thyroid function (P-value 0.003), and abnormal growth hormone (GH) levels (P-value 0.008) as the major relevant contributing factors in determining the clinical status such as radiological imaging studies of the pituitary region, and hormonal profiles of these groups of patients. Conclusion: In general, the current study revealed that headache, as well as the presence of functional pituitary adenoma and abnormal adrenal, thyroid, and growth hormone levels, are among the major contributing factors in the determination of the postoperative clinical status of patients diagnosed with pituitary adenomas underwent trans-sphenoid surgery.

Background: Among cement dust, quartz particles are the most harmful and cause pulmonary fibrosis, which is pathologically among the severe and malignant pneumoconioses. Therefore, by measuring the dust and examining the status of lung functions among workers, we can assess the effects of inhaling cement dust. We aimed to assess the effect of cement dust on pulmonary functions among cement workers during 1999-2000 in Khash, Sistan and Baluchestan Province, Iran. Material and Methods: The total and inhalation dust of the working environment of different units in this industry was measured by individual sampling pump and silicon by weight method and after correcting the volumes, mg/m³ of dust was calculated.  Results: The total dust in different environments was 6.8-95 mg/m³ and the inhaled dust was 2.5-23 mg/m³. Due to the percentage of free silica associated with dust, these values are several times the standard values in the workplace.  The mean values of respiratory functions (FEV1, FVC, VC) in all cases were lower (P-value<0.005) than the mean values in the control group. The difference in the mean FEF25-75 values between the two groups was not significant (P-value>0.5). Although in the case group (all types of workers) the percentage of people with cough was more than the control group, the difference was not statistically significant (P<0.05). With respect to having sputum in the morning and during the day and night and the type of sputum (green and thick, thin, and no sputum), the case group experienced higher rates of sputum and respiratory symptoms. Conclusion: The working environments of cement factories, contrary to what is stated in the toxicology textbooks, requires more attention of health experts and industry managers. Examinations and periodic dust control measures and hiring an occupational health expert is necessary to maintain the health of workers in these environments.

Background: High risk behaviors such as substance use are among the human factors that can play an important role in fatal road accidents and deaths. Objective: To determine the status of alcohol consumption based on vitreous fluid exam in cadavers sent to Tehran Legal Medicine Organization. Materials and Methods: In this descriptive analytical cross-sectional study, all fatalities sent to the Tehran Legal Medicine Organization during 2018 were studied. A vitreous sample was used to measure the amount of alcohol. Results: Out of 676 cadavers (85% male; mean age 40.6±6.45), the toxicology results for alcohol was positive in 6.51% (91% male; mean age 37.10±15.7). There was a significant difference between the two sexes (P < 0.00) and the educational level (P1< 0.00). Most fatal accidents occurred in positive toxicology cases between 10-12 pm and on Fridays followed by Thursdays. Conclusion: The policy of non-consumption of alcohol based on Islamic teachings in Iran has played an important role in significantly reducing fatal accidents caused by alcohol.

Introduction: Transsexualism is a gender disorder in which the patient's physical gender is in conflict with his / her mental gender and emotionally and psychologically feels that he / she belongs to the opposite sex. There are several ways to correct this disorder and improve a person's physical and mental health. Gender reassignment surgery is one of the treatment methods commonly performed for this purpose. Materials and Methods: This cross-sectional study was performed in 2019 in patients referred to the psychiatric ward of the Forensic Medicine Organization, Dr. Mir Jalali Surgery Center and the Welfare Organization. The sample size was 30 people according to the facilities of the research team, which was selected by census sampling method. After completing the informed consent to participate in this research project, all subjects completed the GHQ-28 mental health questionnaire and the researcher-made information form. Subsequently, the results were statistically analysed under SPSS21 statistical software.Results: Amongst the 30 participants (Male to Female /Female to Male = 14/16), the mean age was 27.06 ± 2.40 years, the mean time after surgery was 30.17 ± 3.18 month and the mean age of sexual identity change was 10.45 ± 3.91 year, respectively. Illicit drugs were used by 20% of these people, all of whom were amphetamines. The majority of the samples were dissatisfied with family and community support. Also, no difference was reported in the quantity and quality of intercourse before versus after surgery. The results of GHQ-28 mental health questionnaire showed that all items were lower than the community average. There was no significant difference in mental health between the two groups. Conclusion: Financial and spiritual support of family and society is very effective on Gender reassignment surgery results, especial sexual function. It seems that despite the significant advancements made in the field of sex reassignment, such operations and the resultant change in individuals’ gender have not met their needs.

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Introduction: Andropause is a syndrome with a slow progression that is associated with androgen deficiency in older men. This study aimed to collect all scientific data about the factors that cause the occurrence of andropause in Iranian men as well as the aspects of life which can be affected by this disorder. Materials and Methods: Searching was conducted in international databases including MedLine, Scopus, Web of Science, ProQuest, and national database (SID) from inception until December 2019. Retrieved studies were reviewed by two researchers independently and selected studies were summarized in a table. Results: Finally, 21 related studies were included and summarized information showed that andropause can be negatively affected by age, lower testosterone levels, smoking, lower economic status, lower educational level, and poor employment status. Some studies have also implied that there is a significant correlation between andropause and quality of life, sleep quality, depression, anxiety, marital dissatisfaction, urinary incontinence, coronary heart disease, and metabolic syndrome. Conclusion: According to the collected data in this present study, Iranian studies have covered a wide variety of complications and related factors in the field of andropause but, we still lake some studies about other aspects of andropause such as musculoskeletal impairment, erectile dysfunction, memory and cognitive disorders, skin and hair disorders, decreased libido, and other mood disorders.

Introduction: Multiple sclerosis (MS) is one of the most common neurological disabling diseases in human societies with no complete cure. IFN-β has been proven to be an important advance in the MS treatment, but early identification of treatment failure is its major concern. Some researches revealed that MxA is an appropriate biomarker for predicting response to IFN-β, so we performed this study to evaluate the relationship between MxA level and response to INF- β treatment.Methods: International and internal databases were searched using “MxA”, “Myxovirus resistance protein A”, “IFN-β”, “interferon Beta”, “multiple sclerosis” and “MS keywords until October 2019. Inclusion criteria were original studies considering the MxA assays in MS patients under IFN-β therapy. Some reported cut-offs from partially the same settings (7 studies) were pooled using the weighted average. Finally, the overall statements of the included studies were compared and discussed to obtain a comprehensive conclusion about the clinical value of MxA assays in patient monitoring and designing their treatment plan. Results: A total of 456 articles were identified. The Screening was led to exclusion of 427 articles. Finally, 28 original studies met the inclusion criteria for this systematic review. Almost all studies have concluded that the MxA is significantly correlated with response to IFN-β therapy and also MxA expression is under the direct effect of Neutralizing antibody (NAb) against IFN-β. Reported cut-offs for MxA ranged from 3.3 to 6.3 NR and the weighted average of them was estimated to be 4.1 NR. Conclusion: It could be suggested that in patients under IFN-β therapy with an active disease which doesn’t fulfill the criteria for the breakthrough disease, MxA level can help to determine whether to continue the drug and follow up a patient or change the treatment regimen.

Introduction: Human Papilloma Virus (HPV) has many different epidemiological, social and political aspects. The aim of this study was to determine the research priorities according to the necessary aspects of HPV in Iran. Methods: The national and international databases were searched to obtain the published articles regarding HPV in Iran. All Epidemiologic studies were included in this review to assess research priorities. Results: Of 148 studies involving 14,661 participants, the most studies were conducted in Tehran (44.75%) province. Measuring prevalence of HPV (n=63, 42.5%), diagnosis of HPV by molecular techniques (n=52, 35.1%), Knowledge, Attitude and Practice studies (KAP) (n=13, 8.7%), vaccine efficacy (n=8, 5.4%), cost and cost effectiveness analysis (n=4, 2.7%), co-infection of HPV and sexually transmitted diseases (n=5, 3.3%) were the frequent aims of the included studies. Sixty percent (n=57) of the studies were conducted in clinical patients including patients with cervical cancer (n=30, 52.6%), patients with prostate cancer/Benign Prostate Hyperplasia (n=6, 10.5%), and patients with Esophageal carcinoma (n=5, 8.7%).  Conclusion: According to our results, the high-risk groups such as female sex workers, injecting drug users and prisoners are in priority for research in the field of HPV. Despite ample epidemiologic studies on prevalence and association of HPV with specific cancers, evidence towards effectiveness and cost-benefits of HPV vaccination is required to prevent the infection and its complicated clinical consequences.

Background and Method: Recurrent Pregnancy Loss (RPL) is defined as the occurrence of two or more consecutive miscarriages within the first 20 weeks of pregnancy. The key challenge remains to be what it is that has to be done with couples experiencing RPL. Infections, endocrine disturbances, a suboptimal uterine environment, advanced maternal age, and genetic influences are some of the factors which may increase the chances of RPL occurrence. Despite all medical and research efforts, approximately 40 percent of RPL cases are categorized as unexplained. This is while amongst all the various factors which may lead to such condition, fathers’ genetic influences have often been ignored in the past. In fact, parental chromosomal anomalies, gene mutations such as the microdeletion of chromosome Y, and/or some polymorphism of HLA-G have shown to contribute and lead to miscarriage.

Result: Furthermore, high levels of Reactive Oxygen Species (ROS) can cause DNA damage in spermatozoa. Meantime, sperm DNA damage has been closely linked with indicators such as fertilization, embryo quality, implantation, spontaneous abortion, congenital malformations, and childhood diseases. Sperm Chromatin Structure Assay (SCSA) is a test to measure DNA fragmentation. Moreover, the other SCSA parameter that needs to be considered is high DNA stainability (HDS). It is worth mentioning that HDS is associated with frequency of aneuploidy in spermatozoa. In addition, high HDS can be associated with an increased risk of early abortion in IVF and ICSI cycles.

Conclusion: Additionally, increasing paternal age and varicocele can increase the risk of miscarriage. Advanced Paternal Age (APA) can also increase the relative risk of offspring neurocognitive defects. In saying that, the microsurgical varicocelectomy effectively increases the odds of natural pregnancy, the rate of high-quality embryos, and the success rate of in vitro fertilization.

Introduction: The present study aimed to compare the national health indicators and the effectiveness of primary preventive interventions on traffic accidents in Iran during the last decade (2009-2019). Methods: All published original articles on the primary preventive intervention and health indicators of traffic accidents in Iran were extracted. The inclusion criteria included epidemiologic studies on Iranian male population during 2009-2019. Data were screened and extracted by two independent evaluators and the quality of studies was checked using the STROBE checklist. The exclusion criteria included those articles aimed at presenting results of second or third levels prevention (including injury management, pre-hospital emergency management, economic analyses, case reports, and traffic accidents from non-human perspectives).  Accident-related mortality rates, proportionate mortality from traffic accidents per 1000 vehicles, and per 1000 accidents were estimated.  Results: A total of 65 original articles were included of which 13 were presented health indicators. The crude mortality rate varied from 57.1 in Sistan-Balooshestan province to 73 (per 100,000 population ) in Fars province.  The age-standardized mortality rate among male pedestrians (per 100,000 population) varied from 10.6-33.4 in Gilan and Mazandaran, 42 in Fars, 50.9 in Lorestan provinces. During the last 10 years, the mortality rate decreased from 38 to 12 cases per 1000 vehicles and increased from 51 to 56 cases per 100 accidents. Studies on the effectiveness of primary level prevention have addressed regulations on controlling blood alcohol level and international projection models.  Conclusions: The type of health indicators related to traffic accidents seems to vary greatly among studies. Investigation on the effectiveness of primary preventive interventions on traffic caccidents are proposed frequently by WHO. Nevertheless, short-term and long-term effectiveness of many interventions including educational packages, regulations and specific laws have not been assessed in Iran.

Introduction: Intestinal parasites of humans are important health problems of most communities, especially those situated in tropical and subtropical areas. This review study was done on the population of Mazandaran Province, northern Iran, during 1991-2013, to gain a better understanding of the distribution of intestinal protozoan parasite, Giardia Lambelia, in this province by providing a geographic map. Material and Method: This review was performed by collecting the data through international search engines such PubMed, ScienceDirect, Google Scholar, SID, Magiran and postdoctoral theses. Data were classified and analysed by SPSS software. Then Data applied to the map by ArcGIS software. Results: According to our study, the maximum level of infection with Giardia Lamblia between male patients was seen in Tonekabon in 1982 and the Prevalence of this intestinal parasite in the western regions of the province was more than other regions. The prevalence of Giardia decreased After 23 years.  Discussion: The prevalence of intestinal protozoan parasite, Giardia Lambelia, among people of Mazandaran Province is still very high which necessitates performing special control measures.

The papillomavirus family is known to be responsible for a quarter of virus-related cancers worldwide. High-risk types are the causative agents of anogenital, cervical and various cancers of the mouth, throat, intestines, vagina, penis and anus. Cervical cancer and various other malignancies induced by papillomaviruses are a global health problem, and the growing prevalence of these diseases indicates the need to increase awareness of this viral family. In this review, published articles during 2001-2020 were searched using keywords such as Papillomavirus, Cervical Cancer and Papilloma Vaccine. Our review represents the results of the association of high-risk HPV serotypes with many malignancies in human. Furthermore, issues such as HPV vaccination, cervical cancer screening, and other preventive programs worldwide are discussed.

Background: Approximately 40-50% of infertilities is related to males. Abnormal sperm chromatin structure is suggested as a significant cause of infertility. Protamines constitute a significant component of the sperm chromatin, and they play a vital role in the proper packaging of chromatin. Numerous studies have shown that protamine deficiency in sperm is associated with low sperm quality and infertility. Given the importance of protamine infertility, the purpose of this article is to investigate the content of protamine and its biological importance in male fertility. Materials and Methods: In this study, data and information collected on English-language articles from PubMed and MEDLINE databases. For Persian articles, Persian-language databases, including SID Scientific Database, IranMedex Medical Articles Database, IranDoc (Iran Scientific Information and Documents Research Institute), Magiran Publication Information and MedLib investigated. Results: Based on previous studies about protamine and its role in spermatogenesis, any disruption in protamine genes, including PRM1 and PMR2, can disrupt histone/protamine ratio, leading to abnormal spermatozoa. Conclusion: Most the previous studies approved any mutation in protamine genes correlates with infertility in men. These results can be a potential subject for future researches into infertility treatment in men.

Introduction: Population aging is becoming a global challenge for developing countries. The aim of the present paper is to review the current literature on geriatric health and to propose possible research areas. Methods: By reviewing scientific databases, all published papers in geriatric health within the last 5 years (until 31 December, 2019) were extracted. Inclusion criteria were being about elderly health conducted on Iranian elderly population and published no longer than 5 years ago. Unrelated, foreign studies and qualitative, trend analysis, and case series were excluded. The keywords were classified into 5 macro domain of General, Biological, psychological, Social and Spiritual domains. Results: Until 31 December, 2019, 713 related studies were finally retrieved. 56.8% of keywords belonged to the Biological macro domain. Among which, neurologic disorders had the highest proportion of studies (n=108, 15.1%). The most prevalent subdomain was the “Sociological” (P=15.4%) and the most prevalent keyword was “Quality of life”. The lowest proportion of studies was belonged to Hematology and Otolaryngology (0.4% each). Among the top institutions in terms of publication output are University of Social welfare and Rehabilitation Sciences (11%), Shahid Beheshti University of Medical Sciences (9.7%), and Iran University of Medical Sciences (9%).   Conclusion: Most of the literature concerning elderly`s health in Iran has focused on biologic aspect of health. There seems to be an urgent need to develop a research roadmap to cover all aspects of research among elderlies. Various prepositions to develop and promote context-based and innovative strategies are also provided.