Objective: Human papillomavirus (HPV) vaccination is currently not included in the national vaccination program in Iran. Regional data on the distribution of HPV types in women are important as they can predict the impact of currently available vaccines and help health policy makers to consider all the possibilities with regard to HPV vaccination. Methods: A total of 1,218 Iranian women with normal cervical cytology were included in this study. The presence of the HPV genome was investigated in all specimens by PCR assay, and all HPV-positive samples were genotyped. Results: Totally, HPV was detected in 88 samples (7.2%). According to different geographical regions, the HPV prevalence varied: the highest HPV prevalence was observed in the North (11.7%) and the lowest in the Center (4.5%) of Iran, and this difference reached a statistically significant level (p < 0.05). In this study, the most frequent HPV types were HPV 16, 18, 66, and 11, representing 63.8% of all HPV infections. Conclusion: Based on this study, it is estimated that HPV vaccines could have a great impact on the prevention of cervical cancer in Iran. This study highlights the necessity of introducing educational programs in high schools, robust screening programs, and vaccination in Iran.

Distinct human papillomavirus (HPV) 18 variants are thought to differ in oncogenic potential and geographic distribution. As such, understanding the regional variants of HPV 18 would be of great importance for evolutionary, epidemiological, and biological analysis. In this regard, the sequence variations of E6 gene were investigated to characterize more common variants of HPV 18 in normal cells, premalignant, and malignant samples collected from the cervix. In total, 99 samples of HPV 18 were analyzed by polymerase chain reaction and sequencing. In overall, lineages A was identified in all study subjects, among which sublineage A4 was dominant although the difference observed was not statistically significant with regard to different stages of disease. Sublineage A4 comprised 90.9% of samples and the remaining were belonged to sublineages A1, A2, A3, and A5 at the frequency of 6.1%, 1%, 1%, and 1%, respectively. In conclusion, our findings clearly highlight the sublineage A4 of HPV 18 as the most dominant variant in Iran.

In Iran, human papillomavirus (HPV) vaccination is not currently included in the national vaccination program and there are no comprehensive approaches to cervical screening program. Regional data on distribution of HPV types in women is important to predict the impact of current HPV vaccines. Although several studies on distribution of HPV types in cervical precancer and cancer have been conducted in Iran, in most of them HPV positive samples were subjected to specific-primer genotyping (mainly 16 and 18), and leaving the other HPV genotypes almost undetermined. Therefore, the present study aimed to investigate the distribution of HPV types in cervical neoplasia from West and Northwest of Iran. A total of 112 women with atypia, cervical intraepithelial neoplasia, and invasive cervical cancer were included. A PCR assay was performed in all samples to detect the presence of the HPV genome using the GP5+/6+ L1 consensus primer set. All HPV positive samples were subjected for sequencing. In overall, HPV prevalence was 20% in atypica, 44.5% in cervical intraepithelial neoplasia I, 92.3% in cervical intraepithelial neoplasia II-III, and 98.2% in invasive cervical cancer. The most frequent HPV type was HPV 16 (79.2%), which was followed by HPV types 18, 6, and 33 at the frequencies of 6.5%, 5.1%, and 2.7%, respectively. The least HPV types were found to be 31, 45, 53, 58, and 66. In conclusion, this study shows that the current HPV vaccines could have great impact to reduce the burden of cervical cancer in Iran. K E Y W O R D Scervical cancer, cervical intraepithelial neoplasia, human papillomaviruse, types

Background Infertility is a global problem that refers to the absence of pregnancy after 12 months of intercourse without using contraception. Assisted reproductive techniques (ART) are a treatment technique for infertile patients. Poor ovarian response to stimulation (POR) is one of the challenges in the field of ART. POR refers to people in whom, despite appropriate ovarian stimulation, the number of oocytes retrieved is less than expected. Several ovarian stimulation protocols are applied in POR patients, but the best protocol is not defined. One of the protocols used in POR patients is the "double stimulation in the same ovarian cycle" (DuoStim) protocol. During the DuoStim protocol, both follicular and luteal phases of an ovarian cycle are stimulated. It allows us to retrieve oocytes twice in one ovarian cycle. In the current study, ovarian stimulation in follicular and luteal phases in an ovarian cycle in patients with the poor ovarian response is compared. Results Twenty-six infertile patients with poor ovarian enrolled. They had a mean ± standard deviation age of 36.3 ± 3.15 years. The duration of follicular phase stimulation (FPS) was shorter than luteal phase stimulation (LPS) (pvalue = 0.003). The total dose of gonadotropin was significantly lower in FPS than in LPS (pvalue = 0.013). Significantly fewer total oocytes were retrieved after FPS than after LPS (pvalue = 0.001). Conclusion This study supports the putative benefits of LPS in infertile women with POR. Utilizing the DuoStim strategy in people with poor ovarian response caused more oocytes to be retrieved. Trial registration: irct.ir identifier: IRCT20221001056068N1, 11/22/2022, https://www.irct.ir/trial/66187.

Antegren (Natalizumab) is a humanized monoclonal antibody directed against alpha 4-integrin. This antibody binds to the alpha 4 subunit of alpha 4 beta 1-integrin (VLA-4) and alpha 4 beta 7-integrin on leukocytes and blocks the interaction of these integrins with their ligands (VCAM and MadCAM). Disruption of these cell adhesion molecule interactions inhibits the migration of leukocytes through the blood-brain barrier and the trafficking of leukocytes through the extracellular matrix. In clinical studies, short-term treatment of patients with multiple sclerosis (MS) with antegren resulted in a clear reduction of the number of new active brain lesions on magnetic resonance imaging (MRI). Antegren was safe and well tolerated. Two large phase III studies will help to determine the long-term effect of antegren on MRI and clinical outcome in relapsing-remitting MS patients.