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Introduction Dyslipidemia may be defined as increased levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), or a decreased serum high-density lipoprotein cholesterol (HDL-C) concentration. Dyslipidemia is an established risk factor for cardiovascular disease (CVD). We aimed to investigate the association of dyslipidemia and CVD events among a population sample from Mashhad, in northeastern Iran. Material and methods This prospective cohort study comprised a population of 8698 men and women aged 35–65 years who were recruited from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. Socioeconomic and demographic status, anthropometric parameters, laboratory evaluations, lifestyle factors, and medical history were gathered through a comprehensive questionnaire and laboratory and clinical assessment for all participants. Cox regression model and 95% confidence interval (CI) were used to evaluate the association of dyslipidemia and its components with CVD incidence. Results After 6 years of follow-up, 233 cases of CVD (including 119 cases of unstable angina [US], 74 cases of stable angina [SA], and 40 cases of myocardial infarction [MI]) were identified in the study population. Unadjusted baseline serum LDL-C, TC, and TG levels were positively associated with the risk of total CVD events among the entire population (HR: 1.54, 95% CI: 1.19–2; P -value< 0.01; HR: 1.53; 95% CI: 1.18–1.98; P  < 0.01; HR: 1.57; 95% CI: 1.27–2.03; P < 0.01, respectively). However, after adjusting for confounding factors (age, body mass index [BMI], family history of CVD, smoking status [non-smoker, ex-smoker and current smoker], lipid lowering drug treatment, anti-hypertensive drug treatment, hypertension, healthy eating index [HEI], total energy intake, and presence of diabetes mellitus), a significant direct association only remained between TC and MI risk in men (HR: 2.71; 95%CI: 1.12–6.57; P -value< 0.05). Conclusion In the present study, TC baseline level was significantly associated with the risk of MI among men.

BackgroundLongitudinal studies provide insights into the outcomes of medical training curriculum. However, few educational cohort studies have been conducted in Iran. This study aims first to evaluate the impact of the current curriculum on medical students' medium- and long-term academic and career outcomes and, second, to identify medical students' characteristics and how they change through the doctor of medicine programme.Methods and analysisThis protocol outlines a multi-phase, prospective cohort study that will take place in Mashhad, Iran. The study will implement the Kirkpatrick model, investigating medical students' knowledge, skills, behaviour and professionalism development over 10 years. Approximately 1000 medical students will be recruited through peer invitations and social networks. Data will be collected through baseline and follow-up questionnaires, academic performance records and comprehensive test scores throughout the Doctor of Medicine (MD) programme.The data from the questionnaires will be reported using a Likert scale. Quantitative data will be described using means and SD, while qualitative variables will be presented as frequencies and percentages. We will evaluate the relationship between quantitative variables using correlation coefficients and the relationship between qualitative variables via the χ2 or Fisher exact test. All tests will be two-sided, with a significance level set as p<0.05.Ethics and disseminationAll participants will complete written informed consent before data collection. All students can withdraw from the study at any time with no consequences. Results of this study will be presented at relevant conferences and will be submitted for publication in peer-reviewed journals. This study was approved by the Ethics Committee of Mashhad University of Medical Sciences.Study registration numberIR.MUMS.REC.1400.311.

Chronic shortened sleep can increase several cardiovascular risk factors, including depression, anxiety, metabolic syndrome, diabetes and hypertension. In the current study, we aimed to investigate the relationship between sleep patterns and the incidence of coronary heart disease (CHD). A total of 9704 healthy participants were recruited for the MASHAD cohort study. Within 6 years of follow-up, participants were categorized into four groups based on their number of hours of nightly sleep. Cox’s proportional hazard model was used to assess relative risks (RRs) and 95% confidence intervals (CIs). During the study, 235 heart problems, including myocardial infarction, stable angina and unstable angina, were confirmed. There were significant differences between men and women who had short and long nightly sleep (p < 0.05). The incidence of CHD was significantly higher in participants with very short night sleep durations than in those with longer hours of night sleep. The subjects with very short nightly sleep were more susceptible to unstable angina (RR: 2.614 (CI 1.354–5.047)) (p < 0.05). We found that shortened nightly sleep was associated with an increased incidence of coronary heart disease in an Iranian population. These findings suggest that sleep disorders, especially shortened night sleep, can be a risk factor for CHD.

Background: Sexually transmitted infections (STIs) are one of the world’s most severe health challenges. The existence of STIs such as human papillomavirus (HPV) might cause cervical cell changes leading to cervical cancer. Objective: This study aims to assess the association of STIs with cervical cytological abnormalities and genital warts among women in northeastern Iran. Materials and Methods: This cross-sectional study was carried out on 190 women referred to the central laboratory of Academic Center for Education, Culture, and Research, Mashhad, Iran from March to July 2022. The presence of genital infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Herpes simplex viruses (1 and 2) were assessed using the real-time polymerase chain reaction method. HPV genital infection was detected based on the principles of reverse hybridization, and cellular changes in the cervix were examined by the liquid-based cytology technique. Results: The mean age of participants was 35.33 ± 8.9 yr. 34 different HPV genotypes were detected in all HPV-positive cases, and the most common genotype was low-risk HPV6. No significant association was found between STIs and cervical cytology abnormalities. The prevalence rates of sexually transmitted pathogens among HPV-positive and HPV-negative individuals were 10.9 and 1.6%, respectively. The frequency of genital warts was significantly higher in cases with multiple infections of high- and low-risk HPV genotypes. Conclusion: High percentages of the participants with non-HPV STIs and HPV infection had normal cervical cytology. It is advised to use STIs and HPV diagnostic tests along with cytology examinations for cervical cancer screening. Key words: Sexually transmitted infections, Human papillomavirus, Cervical cancer, Genital wart, Genotypes.

Background: Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some provinces of northeastern Iran. We aimed to investigate clinical and laboratory findings of VL among children who admitted to the pediatric ward in a referral hospital in Mashhad, northeastern Iran. Methods: A retrospective study, between 1997 and 2017, was performed on the data sheet registered for children with confirmed VL at the referral Emam Reza Hospital in Mashhad. Hematological and biochemical profiles of the patients were analyzed. Results: Thirty-five children with VL, confirmed by the presence of amastigotes of Leishmania in Giemsa stained smears of the bone marrow, had been recorded through 20 yr. The mean age of patients was 3.7±4 yr. The majority of the patients suffered from hepatosplenomegaly (100%, n=35/35), followed by prolonged fever and pallor (91%, n=32/35), weight loss (85%, n=30/35). The main laboratory findings were anemia (94.1%), leukopenia (52.9%) and thrombocytopenia (70.5%). Almost one-third (37.1%; 13/35) of VL patients inhabited in rural areas of the Bojnoord district as a known VL endemic focus in northeastern Iran. Conclusion: Our preliminary data showed that the origin of VL is still in some districts other than Mashhad, where VL just will be diagnosed.

Background and Aims Socio‐economic status (SES) has been shown to be associated with cardiovascular disease. We aimed to investigate the relationship between SES and traditional risk factors for cardiovascular diseases in 35 to 65 adults of the MASHAD cohort study drawn from the second biggest city in Iran, Mashhad with a population of almost 3 million. Methods In this cross‐sectional study, subjects were divided into three categories of SES status based on their education level, employment status, and monthly income using latent class analysis (LCA). The three SES of low, medium, and high classes were compared in terms of cardiovascular disease risk factors including diabetes mellitus, metabolic syndrome, obesity, dyslipidemia, and hypertension. p value less than 0.05 was considered as significant. Results A total number of 9704 participants were included in the study. According to goodness‐of‐fit measures and entropy the three‐class model is the most optimal and suitable model here. Participants with a low SES had significantly lower means of age, physical activity level, waist circumference, systolic blood pressure and LDL‐C, and higher means of weight, and hip circumferences. Also, the prevalence of smoking, hypertension and metabolic syndrome were lower in low SES group than the two other groups. Logistic regression showed that the odds of obesity in the high SES class was 1.3‐fold higher than for the middle SES class. Moreover, the chance of metabolic syndrome and hypertension in the low SES class was respectively 0.81 and 0.83 of the middle SES class. Conclusion Lower socio‐economic was associated with metabolic syndrome and hypertension and obesity was associated with higher SES; it may therefore be necessary to develop more specific and personalized preventive policies for populations in each socio‐economic class. Summary The odds of obesity in the high socio‐economic status (SES) class was 1.3‐fold higher than for the middle SES class. The odds of metabolic syndrome and hypertension in the low SES class was respectively 0.81 and 0.83 of the middle SES class.

The province of Khorasan-Razavi in the North East of Iran is an endemic area for anthroponotic cutaneous leishmaniasis (ACL caused mainly by ) and zoonotic cutaneous leishmaniasis (ZCL caused mainly by ). Based on clinical signs, some cities were considered as ACL foci while others were considered to be endemic for ZCL. This paper reviews studies performed on patients diagnosed with cutaneous leishmaniasis (CL) via the use of direct slide examination, ELISA, electrophoresis isoenzyme, RAPD PCR and PCR in Mashhad; the study also includes cases of CL in other cities of the Khorasan-Razavi province where only PCR used as a diagnostic tool. The data show that both and caused CL in most of the cities investigated. Our review shows that was found in areas where ACL is prevalent and was observed in areas with high incidence of ZCL. This distribution represents a major change in the epidemiological pattern of Leishmania in the Khorasan-Razavi province.

: Heat shock protein 27 (HSP27) is an intracellular chaperone constitutively expressed in many cell types including cardio myocytes and endothelial cells. Circulating levels of HSP27 and anti-HSP27 antibody are higher in patients with CVD. Anti-HSP27 antibody concentrations were also reported to be increased in atherogenesis. We aimed to evaluate serum anti-HSP27 antibody titers in individuals with, or without, MetS in the MASHAD study cohort with large sample size in 6,568 subjects. : Participants with MetS were identified from MASHAD cohort (n=3358) using the IDF criteria, and the control group were those individuals who did not meet these criteria (n=3210). In-house enzyme-linked immune sorbent assay (ELISA) method was used for measuring Anti-HSP27 antibody levels. The two groups were matched for age, sex and smoking habit. : As expected, there were significant differences in height (p= 0.004), waist and hip circumference, weight, BMI, systolic and diastolic blood pressure, TGs, TC, HDL-C, Hs-CRP, glucose, with the presence of diabetes mellitus, hypertension, hyperlipidemia (p<0.001) between the two groups. Serum HSP27 antibody titers did not show significant difference between the groups with and without metabolic syndrome (p= 0.740). : In conclusion, our results revealed serum anti-HSP27 antibody titers were not statistically different between individuals with and without MetS. However, it is possible that drug treatment may affect antibody titers and confound our findings in this population sample..

Metabolic syndrome (MetS) is a risk factor for type 2 diabetes mellitus and cardiovascular disease. Obesity is a component of the metabolic syndrome. Several genetic variants are reported to be associated with obesity and hypo adiponectinemia, including ars1800796 polymorphism of the interleukin-6 (IL-6) gene. Since obesity is associated with inflammatory factors, the aim of this study was to investigate the association between this polymorphism and MetS and its related features. Obese patients with body mass index (BMI) ≥ 30 (n = 182) were recruited into this study and divided into two groups; 110 patients with MetS, based on the International Diabetes Federation (IDF) criteria, and 72 subjects without MetS. The anthropometric and biochemical data for the groups were compared. Genotyping was carried out using RT-PCR. The association of the genetic polymorphism with MetS and its components were assessed using univariate and multivariate analyzes. There was an association between the presence of the rs1800796polymorphism of the IL-6 gene, with BMI (P = 0.031), high-density lipoprotein (HDL) (P = 0.010) and low-density lipoprotein (LDL) (P = 0.037), while this genetic variant did not show any significant association with the presence of MetS as defined by the IDF. We demonstrate an association between the rs1800796 genetic variant of the IL-6 gene with components of MetS including BMI, and HDL-cholesterol, but not the MetS itself. Therefore, supporting further studies are warranted to investigate this point in a larger population.