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Toxocariasis is human infection caused by larval stage of Toxocara helminthes. The adult Toxocara helminthes live in intestine of dog and cat, but if the human accidentally ingests the egg, the larva is released into the intestine and then penetrating to mucosal capillaries and by blood stream migrates to various organs. Considering to the larva of parasite cannot be adult in human body and finally is destroyed, but its placement in the organs leads to irritation and inflammation of the tissue and appearance of signs and symptoms. The parasite   affects liver, lung and central nervous system more than other organs. The most obvious symptoms of this disease are irregular fever, liver enlargement and sever eosinophilia. Other symptoms depend on the final location of the parasite, for example, respiratory symptoms (similar to asthma) will occur at the time of parasite settling in the lung and nervous disorder when the parasite is deployed in the nervous system (1). Sever clinical symptoms due to the disease is more common in 2 to 7 years old children, because of contacting with polluted playground soil or stray dog and cat, that the chance of them getting disease is increased (2). In developing countries including Iran, the diagnosis of the disease is done by collecting signs and symptoms, evaluating risk factor and laboratory results. Laboratory results which is considered on this disease containing eosinophilia, hypergammaglobulinemia and increasing of isohemagglutinin A and B. The serological test by ELISA technique was used for diagnosis of anti-parasite antibody in European countries and USA, the sensitivity and specificity of this test was 78 and 98%, respectively. There is no definitive guideline to the treatment of the disease but the most common treatment plan is 400 mg albendazole and 100 to 200 mg mebendazole, twice a day for 5 days (1). In recent years the number of dogs and cats in the human environment has been increased in our country and consequently the rate of soil contamination to eggs of Toxocara has been increased. The consequence of this phenomenon is an increasing chance of human contact the egg of this parasite and onset of toxocariasis. The studies in Iran is reported the rate of soil contamination to this parasite is minimum 3.9% (Urmia) to maximum 63.3% (Khoramabad), while the rate of contamination in soil of Arak parks is 26.6% (3-5). In addition, the results of serological study showed that the prevalence of toxocariasis in 5 to 15 years old asthmatic patients was 1.8%, in Arak (6). But the results of a review study showed that the prevalence of toxocariasis in general population of Iran was 15.8% and this rate is increasing (7). Changes in Ecosystem and abundance of garbage in Iranian cities have led to overabundance of dogs and cats in human environment. On the other hand, accepting some of cultural western lifestyle such as keeping pets, apart from their social and legal responsibility has been caused increasing risk of infectious disease transmitted by animals such as toxocariasis.  Due to the relatively high prevalence of Toxocara infection among dogs and cats in Iran, the need to pay attention to the disease caused by this parasite is felt as a potential medical and health hazard in the country. In this condition, holding workshops for remembering of symptoms, diagnosis method, treatment and prevention of the disease for clinician associate with infected patients, would has an important role for quick diagnosis and remedy of the patients and would reduce the corporal and psychological load of them. Also, performing the research studies would help to know current epidemiological situation and changes that have taken place in various parts of Iran. In the other side, encouraging scholars for isolation, purification and examine excretory-secretory antigens of this parasite that used for producing the serological diagnostic kits could increase accuracy and reduce cost of diagnosis test of disease and finally improve the level of health in community.

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Abnormal and uncontrolled growth of the cells can lead to cancer. In advanced countries, cancer is the second leading cause of death, and in our country, it is the third cause of death (after cardiovascular diseases and driving accidents). According to a report published by the Institute of Health and Evaluation (2015), for evaluating 32 cancers in 195 countries between 2005 and 2015, the prevalence of cancer has increased by 33% (1). Radiotherapy is one of the most common cancer treatments that can be used alone or in combination with other therapies such as surgery, chemotherapy or hormone therapy. Approximately 52% of patients with cancer have to be treated by Radiotherapy with a 50% contribution to treatment (2). Radiation therapy uses gamma rays or x-rays or accelerated particles to destroy tumor cells (3). In the past, radiotherapy was done in a two-dimensional fashion, using rectangular fields based on conventional imaging that has now been replaced with 3D conformal radiotherapy. In Three‐dimensional treatment, based on CT or other imaging methods, the treatment volumes such as: GTV (Gross Tumor Volume), target with microscopic spread of tumor that is CTV (Clinical Tumor Volume), ITV (Internal Target Volume), PTV (Planning Target Volume) and also related organs at risk are defined with high accuracy for treatment planning (4). In recent years, with the advancement of computer sciences in treatment planning systems, as well as accelerator equipment for delivering the dose to the patient, treatment can be applied as Intensity Modulated Radiation Therapy (IMRT). In IMRT, each radiation field consists of a beamlets and produces different intensities. This treatment is especially useful for curved areas and when the organs at risk are in the vicinity of the tumor. IMRT can be delivered using linear accelerators with static or Dynamic MLCs, Intensity Modulated Arc Therapy (IMAT), Volumetric Arc Modulated Therapy (VMAT) or tomotherapy (5). In determination of treatment volumes, the selection of appropriate margin is very important, because small margin may cause loos of the tumor and great margin can damage healthy tissues. The use of IGRT (Image Guide Radiotherapy) reduces these errors and increases the accuracy of treatment. Todays, in developed countries, SRT (Stereotactic Radiation Therapy) is used to destroy the non-surgical tumors, such as some of the brain tumors. In SRS, the prescribed dose is delivered to the tumor up to five sessions. In this method using imobilization devices is important, which usually involve the use of the relevant frames (6). In this regard, Cyber knife is actually a stereotactic system in which the x-ray source is mounted on a robot and can rotates in different angles. This treatment is based on three-dimentional imaging, so the tumor can be identified precisely with the guide of imaging. Cybernayev can be used to treat small tumors with high precision (7). In addition to treatment with X-rays, ions such as proton can be used to kill cancer cells. One of the important features of treatment with proton is the deliver of the absorbed dose of the particles into the tissue. The absorbed dose curve of this beam in the tissue has a peak at a specified depth, depends on the energy used, called the Bragg peak which can give the highest dose of radiation in the tumor site (8). There have been many advances in radiotherapy in Iran in recent years, but there is still lack of some advanced treatment equipment. On the other hand, with the regard of the significant cancer rate in the country, it is necessary to have proper information about the incidence of cancer at first. It should be noted that the use of registration systems based on just laboratory information (pathology) leads to a low number of cancer statistic, which this way is recorded in Iran. However, the cancer registry system in developed countries is based on clinical information and mortality in addition to collecting laboratory information. Another factor causing errors in the cancer record statistics is the population coverage of cancer registries; for example, population coverage in the United States is 99%, Australia and New Zealand is 86%, and the European ::union:: is 57%, while coverage in South and central America is only 21% and in the African and Asian countries is 11 % and 8 %., respectively (1). Therefore, at first, it seems necessary to register the cancer properly in our country and then, based on the needs assessment for the different regions, establish and equipe radiotherapy centers.

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Cancer is a multifactorial Disorder caused by variations in multiple genes coupled with environmental risk factors. The genes involved in the carcinogenesis can be classified into several groups, including proto-oncogenes, tumor suppressor genes, genes involved in genome stability and cell migration. The accumulations of genetic changes lead to tumor mass and formation of new blood vessels to grow. The tumor is not a collection of single cells and has bilateral interactions with its environments. The tumor microenvironment (TME) has a similar function to stem cells niches that affect tumor progression and metastasis. The study of this environment is effective in diagnosis and treatment of cancer and provides valuable and new information for controlling tumor malignancy and risk assessment (1). This paper focuses on TME components and the molecular targets for cancer treatment. Investigating of TME by cellular and molecular profiles indicated that there are different types of cells in this environment that promote neoplastic changes and metastasis and protect the tumor from the immune system and lead to resistance to treatment (2). Among the different types of cells present in the TME, including parenchymal tumor, fibroblasts, epithelial and inflammatory cells, extracellular matrix and signaling molecules, blood and lymph vessels, the highest number of cells are fibroblasts. In the early stages of carcinogenesis, normal fibroblasts prevent tumor growth. The genetic changes of these cells, with the help of inflammatory agents, release the growth factors that directly inhibit tumor-stimulating cells or indirectly inhibit apoptosis by stimulating growth and inducing angiogenesis. Therefore, a complex system of interactions is created by the involvement of a variety of cellular factors and molecular signals (3,4). Within the TME infrastructure, there are interactions of tumor cells with extracellular matrix (ECM), tumor-associated macrophages (TAMs), cancer-associated fibroblasts (CAFs), mesenchymal stem cells (MSCs) and endothelial cells (EC). These communications have been established with the help of chemokines, growth factors, matrix metalloprotezes (MMPs) and ECM proteins, that lead to migration, invasion to distant organs and metastasis (5). TME restores tissue and induces metabolic changes in the tumor by making changes in the stromal and immune cells. This remodeling in a TME is similar to around of scar surrounded by different cells (6). Based on tissue type’s cancers, more than 40% of the CAFs can be derived from bone marrow progenitors that are recruited to the growing TME. Although CAFs may also be derived of epithelial cancer cells or stained fibroblasts that differentiate into myofibroblasts. In epithelial tumors, fibroblasts, mainly through the secretion of growth factors and chemokines, led to an altered ECM, and increase signals of proliferation and metastasis, and ultimately lead to tumor progression (7). The ECM also accumulated a scaffold of inflammatory and immune cells, lymph and nerve arteries. In general, in the metastatic phenomenon, the invasive tumors should be able to move, to break up the extracellular matrix of the tissue, to form new blood vessels, to survive in the blood and to stabilize in a new tissue environment. In studies that have been conducted to understand how these capabilities are achieved in cancer cells, TME has been identified as critical to the development of this phenomenon. TME stabilizes invasion of tumor to distant organs via signals to stromal or non-malignant cells and activation of transcription of genes (8,9). Also, angiogenesis precursor cells that are recruited to TME under hypoxic conditions are associated with metastasis. Some studies have shown that miRNA molecules are the main regulator of this activity, leading to changes in fibroblasts in the TME. MiR-21, miR-31, miR-214 and miR-155 play an important role in differentiation of normal fibroblasts to CAF (10). Although miRNAs in TME have not yet been fully identified, some studies indicated that miRNAs produced by TME cells and specially CAFs affect on tumor growth (11). Musumeci and colleagues showed the role of miRNAs in TME in prostate cancer. Their study found that expression of miR-15a and miR-16 down-regulated in fibroblasts of TME in prostate cancer. MiRNAs target oncogenes such as Bcl-2 and WNT pathway components (12). Several strategies have been proposed to remodel TME components in cancer treatment (2). Blocking the recruitment and activation of stromal cells in TME is one of these molecular approaches. Based on this strategy, Avastin has been designed to treat clone and glioblastoma cancer. Some drugs also block the interaction between the TME cells with the tumor and angiogenesis, ECM and inflammatory compounds in TME. Siltuximab is a human anti-IL-6 antibody that inhibits the pathway of IL-6 / STAT3 in cancer cells and its therapeutic effects have been reported in xenografet models. The effect of this drug in the Phase II clinical trials in platinuim-resistant ovarian cancer is under survey. More accurate identification of gene networks and cell pathways will help us improve our understanding of the pathogenesis of cancer and the advancement of therapeutic approaches. Therefore, in addition to controlling the signaling pathway inside the tumor, it is also necessary to identify the TME. Although, despite the recognition of the importance of TME in carcinogenesis, due to the multiplicity of involved cells, the origin of molecular mutations in its components is still not fully detected and requires extensive research in this area.

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In December 2019, a new type of coronavirus called COVID-19 was identified as an unknown cause of pneumonia in Wuhan, China. The pandemic virus was transmitted to humans from a type of seafood that could spread significantly among humans in a short time. Clinical signs of coronaviruses include fever, severe sweating, cough, pneumonia, and a weakened immune system, with acute cases leading to death. One of the most important coronavirus receptors in the host cell is the angiotensin 2 converting enzyme. It is noteworthy that the patient’s recovery process increases during the inhibition of angiotensin 2 converter enzyme. Therefore, the administration of drugs that inhibit this enzyme can be effective in recovering a patient with coronavirus. Flavonoids are one the inhibitors of the angiotensin-converting enzyme, which is abundant in fruits and vegetables. Fistula, a type of flavonoid known in nature as an antioxidant and anti-inflammatory agent in the treatment of many, can be effective in the treatment of coronavirus by inhibiting the enzyme converter angiotensin 2.

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Lack of preparation for fires can lead to irreversible damage. Therefore, fire prevention is crucial in effectively managing this risk. It is essential to implement measures to address fire incidents. Fire safety in hospital is particularly critical due to factors like the presence of disabled individuals who may not be familiar with emergency exit points, as well as the specialized medical equipment present. Fires in hospitals can result in extensive harm, including injuries to staff and patients, a loss of trust in local authorities, and the subsequent failure to deliver adequate healthcare services. Adhering to fire safety principles and fundamentals can help mitigate the impact of fires in all locations, especially medical facilities.