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Background Islamic Republic of Iran has been the target of massive sanctions since 1979, which got intensified in 2005, 2012, and also in 2015 following JCPOA cancellation. Long-term economic sanctions have impacted Iran’s health system. The aim of this study is to examine the impact of sanctions on health system in Iran, and Iranian people’s health. Methods A scoping review was performed. PubMed/Medline, Embase, Web of Science, Scopus, and Scientific Information Database were searched from 2012 using the sanction, health and Iran keywords to find the studies that examined the impacts of sanctions on health in Iran. After screening, only original studies, namely studies which collected data through experiments, surveys, observation, interviews, or review of the literature were included, and letters to the editors and secondary reports were excluded. Final listings of articles were supplemented with hand searches of reference listings to ensure completeness. Data on study characteristics and the impacts of sanctions on health were extracted and summarized. Result The preliminary search has identified 273 documents among which 11 articles had the eligibility criteria to be included. They showed remarkable effects of sanctions on access to medicines for the treatment of cancers, non-communicable diseases, asthma, epilepsy, addiction, and hemophilia. Conclusion While there is a scarcity of evidence in quantifying the sanction’s impact and also the potential impact on different dimensions of people’s health, it seems that innocent people suffered from the economic downturn caused by sanction. The exact impact of sanctions on different health related areas could be the subject of further studies. Furthermore, more vigorous monitoring and evaluation systems are needed to investigate the effects of sanctions on health outcomes and system to be sure that they do not violate people’s fundamental human right to health.

ObjectivesThis review aimed to analyse the impacts of international economic sanctions on the overall health status of Iranians and the health system performance of Iran, in addition to identifying effective strategies for making the health system resilient to sanctions.Study designA scoping review.MethodsThree databases and grey literature were reviewed, and additional papers were identified in the lists of references. Two authors reviewed papers to check duplications and screen through inclusion/exclusion criteria. Furthermore, a narrative approach was employed to synthesise the findings.ResultsGiven overall health impacts, economic sanctions are believed to have adverse effects on Iranian's health and cause significant financial hardships in accessing healthcare services. These hardships mostly affect those in marginalised and vulnerable groups. Economic sanctions degrade Iran's health system by negatively impacting health services' availability. The detrimental effects of sanctions on economic and social circumstances were also documented. Economic sanctions could also adversely affect health research and education. Most strategies identified for health system resilience to sanctions are related to the health system governance.ConclusionsEven if essential medicines and supplies are exempted from the sanction regime, the impact of economic sanctions on public health is unavoidable. The quantification of the effect economic sanctions on different health‐related areas needs by further research. The measures identified for dealing with sanction can be considered in other countries but more work is needed to explore how health of people can be resilient against negative consequences of sanctions.

Introduction: Tuberculosis (TB) and its diagnosis are of great importance in the middleeast, according to the increasing burden of this disease and the large number of unreported cases. Less than 20% of all TB cases only have extra-pulmonary manifestations and breast TB is a rare form of extra-pulmonary TB. It includes about 1% of all breast lesions. Case Presentation: This study presents an 83 year-old breast TB female case with the complaints of fatigue, lethargy, and fever. In the physical examination, the patient had a discharging abscess in upper outer quadrant of her right breast associated with edema and erythema, accompanied with multiple axillary and supraclavicular adenopathies. Imaging showed multiple cervical, axillary, and abdominal adenopathies. Clinical manifestations were highly suggestive of inflammatory breast carcinoma. Further investigations, including lymph node biopsy and Polymerase Chain Reaction (PCR) helped with the diagnosis of TB in the patient. The patient was treated with quadruple therapy of TB. Conclusion: Because of its nonspecific clinical features, TB mastitis is often being misdiagnosed and underreported. Early diagnosis of breast TB could reduce patients' morbidity and also facilitate an effective treatment of patients with inflammatory breast lesions. TB should be the first differential diagnosis of granulomatous mastitis.