Comparison of bolus administration and short-term infusion versus long-term infusion of doxorubicin in terms of cardiotoxicity and efficacy.

Cardiotoxicity caused by anthracyclines chemotherapy is one of the leading causes of mortality and morbidity in cancer survivors. Continuous infusion (CI) instead of bolus (BOL) injection is one of the methods that seem to be effective in reducing doxorubicin (DOX) cardiotoxicity. Due to the variety of results, we decided to compare these two approaches regarding toxicity and efficacy and report the final results for different cancers. We included 21 studies (four preclinical and seventeen clinical trials) up to May 15, 2023. In children with acute lymphoblastic leukemia (ALL) and adults with chronic lymphoblastic leukemia (CLL) and gastric cancer, results were in favor of BOL injection, without increase in cardiotoxicity. On the other hand, CI showed to be better option in patients with small-cell lung cancer (SCLC) and breast cancer. Various results were also observed in adult patients with sarcoma. Overall, it can be concluded that the benefits of CI, especially in adults, outweigh its disadvantages. However, due to the variety of results and heterogeneity of studies, further clinical trials with a larger sample size and a longer duration of follow-up are needed to make a more accurate comparison between CI and BOL injection.

The evaluation of atorvastatin as an adjunct to fluconazole for the anti-fungal prophylaxis in acute myeloid leukemia: a multicenter, triple-blinded, randomized clinical trial.

The development of invasive fungal infections (IFIs) is a serious complication in acute myeloid leukemia (AML) patients who undergo an induction to remission chemotherapy. Given the increased mortality in AML patients with IFI despite prophylaxis, we need to address this problem. Statins have traditionally been employed in clinical settings as agents for reducing lipid levels. Nonetheless, recent investigations have brought to light their antifungal properties in animals, as well as in vitro studies. The objective of this study was to assess the effectiveness of atorvastatin when added to the routine IFI prophylaxis regimen in patients diagnosed with AML. A randomized, multicenter, triple-blind study was conducted on 76 AML patients aged 18-70, who received either placebo or atorvastatin in addition to fluconazole. Patients were followed for 30 days in case of developing IFIs, patient survival, and atorvastatin- related adverse drug reactions. Data were analyzed with SPSS version 26.0. A level of significance of 0.05 was utilized as the threshold for all statistical tests. The data were analyzed by adjusting for the effect of age, regarding that there was a significant difference between the two groups, and showed that atorvastatin reduced the development of both probable and proven IFI (based on EORTC/MSGERC criteria) compared to placebo. IFI-free survival was also significantly better in the atorvastatin group. The incidence of developing aspergillosis did not differ between the two groups. No serious adverse events related to atorvastatin were observed. The present investigation has substantiated the antecedent in vitro and animal research on the fungicidal impact of statins and has suggested the need for additional research involving larger sample sizes and an extended duration of follow-up. Trial registration: This study was registered on the Iranian registry of clinical trials as IRCT20210503051166N1 (Date of confirmation 2021.05.03).

Determine the factors that affected COVID-19 prevention behaviors based on constructs of social cognition theory.

BACKGROUND: COVID-19 is a universal challenge and novel disease is one of the core public health concerns. This study aimed to determine the factors that affected COVID-19 prevention behaviors (CPB) based on constructs of Social Cognition Theory (SCT). METHODS: This cross-sectional study was conducted on 426 participants referred to health centers of Arak from October 2021 to February 2022, and they were selected through a multi-stage random sampling method. Data were collected via a self-administered questionnaire which includes socio-demographic data (6 items), COVID-19 prevention behaviors (12 items), and SCT constructs related to COVID-19 (32 items). SPSS Ver-16 statistical software was used to analyze the data with one-way ANOVA, independent samples t-test, and multiple linear regressions. The significance level of α = 0.05 was considered for all tests. RESULTS: The mean age was 37.8 years (SD = 12.2) and ranged from 17 to 81. According to the results, 51.2% had higher education and 52.6% of the participants were female. The mean (SD) of COVID-19 preventive behaviors was 43 (SD = 7.8) out of 60. There was statistical association between CPB and three constructs of SCT. Multiple regression showed that the outcomes expectations (ß = 0.11, p < 0.001), self-regulation (ß = 0.41, p < 0.001), and self-efficacy (ß = 0.30, p < 0.001), age, gender, and history of COVID 19infection were associated with CPB and those described 61% of the variance of CPB. CONCLUSION: Rendering to the result of this study constructs of SCT is the key predictor of participants' CPB. Hence, based on these predictors, effective interventions and healthy messages could be designed based on this predictor-outcomes expectations, self-regulation, social support, and self-efficacy which can be beneficial to improve healthy behavior.

Effect of an educational intervention based on the theory of planned behavior on improving medication adherence in patients with multiple sclerosis treated with injectable disease-modifying drugs: randomized controlled trial.

BACKGROUND: Adherence to prescribed treatment in chronic diseases, as occurs in multiple sclerosis (MS), is a critical factor for a successful therapeutic response. This study aimed to investigate the effect of educational program based on Theory of Planned Behavior (TPB) on treatment adherence in patients with multiple sclerosis (MS) receiving injectable immunomodulatory drugs. METHODS: The present study is an educational randomized controlled trial research that was conducted on 100 patients with MS who had gone to MS clinic in Tehran city (Iran). The samples were randomly assigned to the intervention (N = 50) and control groups (N = 50). Data collection instrument was a researcher-made questionnaire based on TPB. Then, educational program was performed for the intervention group through four educational sessions. After three months, data collection was repeated for the two groups and data were analyzed. RESULTS: The knowledge and performance of the intervention group on treatment adherence drugs increased from 56.25 ± 20.3 to 78.31 ± 15.57 and 56.22 ± 5.76 to 71.62 ± 12.01 after the education respectively (p < 0.001). The mean of construct of TPB in the intervention group also increased after the intervention (p < 0.05). CONCLUSION: Applying the TPB model proved is very effective in developing an educational program for patients with MS, to enhance treatment adherence drugs. Besides such programs, follow-up education for controlling and monitoring are highly recommended. TRIAL REGISTRATION: This trial has been registered at Iranian Registry of Clinical Trials, IRCT20210808052109N1. Prospectively registered at 12-Aug-2021, (12/8/2021) available at: URL: https://en.irct.ir/trial/57994.

Effects of online social media on improving mothers' behaviors towards preventing their children's otitis media based on the PRECED model: a randomized educational intervention trial.

BACKGROUND: Otitis media is one of the most common diseases in children, especially those under 2 years of age. This study aimed to investigate the effect of educational intervention based on the PRECEDE model on mothers' preventive behaviors of middle ear infections in infants. METHODS: This study was conducted as an educational randomized controlled trial on 88 mothers with infants referred to health centers in Arak, Iran. Sampling from September 2021 to February 2022 selected trough stratified random sampling who were assigned to two groups of experimental = 44 and control = 44. The data collection tool was a reliable and valid questionnaire that included demographic information, constructs of PRECEDE model regarding otitis media, and preventive behaviors. The experimental group received 4 training sessions (each session 60 min) through WhatsApp social network. Information was collected through an online questionnaire before and 3 months after the educational intervention from both groups. Data analysis was also performed with SPSS version 23. RESULTS: Before the educational intervention there was no significant difference between the experimental and control groups in the otitis media preventive behaviors and structures of PRECEDE model (p > 0.05). After the educational intervention, in the experimental group the average score of knowledge from 0.49 to 0.81, attitude from 4.01 to 4.58, enabling factors from 0.72 to 0.85, reinforcing factors from 3.31 to 3.91 and behavior from 3.25 to 3.66 increased significantly (p < 0.001). CONCLUSIONS: PRECEDE-based education with controlling, monitoring and follow-up during the program was effective in promoting the preventive behaviors of otitis media. Therefore, due to the side effects of otitis media, especially in vulnerable periods such as childhood, it is recommended that trainings based on this model be carried out in other health care centers and clinics in order to maintain children health. TRIAL REGISTRATION: This trial has been registered at the Iranian Registry of Clinical Trials, IRCT20210202050228N1. Prospectively registered at 2021-May-21, (2021/05/21) available at: URL: https://en.irct.ir/trial/54073 .

The effect of concomitant use of Colony-Stimulating factors on bleomycin pulmonary toxicity - A systematic review and meta-analysis.

BACKGROUND: Changes in the incidence of bleomycin pulmonary toxicity (BPT) as a result of adding colony-stimulating factors (CSF) to bleomycin regimens has been investigated in numerous studies. We performed a systematic review and meta-analysis to assess the outcomes of these studies. METHODS: A systematic search was performed using Pubmed, Scopus, Web of Science, and Embase on April 2021. Studies evaluating the incidence of BPT in patients receiving bleomycin with and without CSF were included. In addition, meta-analysis was performed by pooling odds ratios using R. RESULTS: Out of 340 obtained records, our qualitative and quantitative analysis included 3234 and 1956 patients from 22 and 14 studies, respectively. The quantitative synthesis showed that addition of CSF significantly increased the risk of BPT incidence (OR = 1.82, 95 % CI: 1.37-2.40, p < 0.0001; I2 = 10.7 %). Subgroup analysis did not show any association between continent, bleomycin dose, cancer type, type of study, and pulmonary function test with BPT incidence. CONCLUSION: This systematic review and meta-analysis showed that co-administration of CSF with bleomycin increases the incidence of BPT. The physicians need to consider this finding while deciding the best strategy for this cohort of patients.

The Effectiveness of Tailored Interactive Multimedia Software based on the Trans-Theoretical Model for the Promotion of Physical Activity Behaviours.

Background: Although physical activity (PA) is essential, it is difficult to motivate people to take part in PA, especially the ones with high blood pressure (hypertension). One of the most commonly applied theoretical frameworks to change health behaviours is the Trans-Theoretical Model (TTM). The aim of this study was to examine the effectiveness of tailored, interactive multimedia software based on TTM for the promotion of PA behaviours among Iranian adults. Methods: This interventional study selected 120 healthy individuals aged 30 years old-50 years old from health centres in Delijan, Iran using multi-stage sampling. The participants were in the pre-contemplation and contemplation stages of PA behaviour. For the intervention, an active multimedia training (active life) based on TTM, like six training sessions of approximately 30 min (once a week) plus aerobic exercise videos were designed and provided to the intervention group. Data was collected using a valid and reliable questionnaire before and 6 months after the intervention and analysed using statistical tests. Results: The mean age of the participants was 38.20 (SD = 7.11) years old. Six months after the intervention, 61.7% of the individuals in the intervention group and 3.3% in the control group progressed to the action stage, which was significant only in the intervention group (P < 0.001). There was a significant increase in PA in both groups, yet this increase was significantly higher in the intervention group (36.02 [SD = 31.22] to 146.16 [SD = 90.43]; P < 0.001) compared to the control group (33.41 [SD = 28.33] to 54.41 [SD = 44.02; P < 0.001). Conclusion: The results obtained indicated that the implementation of educational intervention using multimedia designed based on TTM could be used as one of the effective strategies to promote PA to prevent hypertension in adults.

Clinical characteristics of 200 COVID-19 patients in Mashhad, Iran, February and March 2020.

Introduction: Coronavirus disease 2019 (COVID-19) is a pulmonary involvement which was reported for the first time in December 2019 in the city of Wuhan, Hubei province, China. The aim of the study was to describe the demographic, clinical, laboratory, and radiological characteristics of 204 definitive laboratory-confirmed COVID-19 patients hospitalized in Mashhad, Khorasan Razavi province, Iran. Patients and Methods: This study was performed on 204 laboratory-confirmed COVID-19 patients. A set of laboratory tests combined with various patient information and results from lung high-resolution computed tomography (HRCT) were gathered in a checklist and analyzed to give us a better view of patients who are hospitalized due to the complications caused by this disease. Results: The average age of our patients was 58.83 ± 15.93 years. There were 122 (59.8%) male and 82 (40.2%) female patients, and almost all of our patients had at least one underlying disease. Nine (4.4%) of our patients reported having gone for a trip to COVID-19-epidemic areas in the last 2 weeks. The most common signs shared among all our patients were cough, fever, and decreased O2 saturation; the average respiratory rate was 25.50 ± 6.74/min, average axillary body temperature was 37.69°C ± 0.69°C, and average O2 saturation was 88.34% ± 7.34%. Conclusion: Based on our results, the most common signs of this disease are fever, cough, and shortness of breath, similar to seasonal influenza. Our data on disease severity showed that 33 (16.2%) patients had moderate disease, 139 (68.1%) had severe disease, and 28 (13.7%) were critical; 22 (10.8%) of our hospitalized patients died due to the complications of this disease.

Spatial Cluster Analysis of Stomach Neoplasms in the Center of Iran Based on a Population-Based Study, 2009-2014: Application of the Poisson-Based Probability Model.

Background: A better understanding of the spatial pattern of stomach cancer can be helpful in the implementation of preventive strategies. This study is one of the first studies to establish a study unit based on the smallest possible size for cluster analysis. This study includes a novel evaluation of spatial differences in different geographical areas of Arak. The present study seeks to discover the spatial clusters of stomach cancer from 2009 to 2014 in Arak. Methods: All of the addresses of the stomach cancer cases were geocoded. After that, the number of stomach cancer cases in each census block was calculated to be entered in the SaTScan software. A discrete Poisson-based probability model was used to analyze this cluster. Results: In Arak, there are 5502 census blocks with a population of about 526,182. The number of identified and registered stomach cancer cases with an acceptable residence address was 392. Totally, 11 stomach cancer clusters were established in the area of Arak, from these; two clusters were detected statistically significant. Relative risks of the first and second clusters were 1.75 (P = 0.01) and 17.60 (P = 0.04) and those are located within the radius of 1.73 and 0.085 km, respectively. Conclusions: Our results have confirmed that two areas are at a higher risk than others. However, based on the results of this study, community-based interventions in certain geographical areas can be designed to reduce and control the incidence of stomach cancer.

Effect of theory-based education on promoting a healthy lifestyle in pre-diabetic women: RCT.

BACKGROUND: Due to the fact that pre-diabetic people are at higher risk of developing diabetes, it is possible to reduce the risk by taking preventive measures. Therefore, the present study aimed to determine the effect of theory-based education on promoting a healthy lifestyle and fasting blood sugar (FBS) in pre-diabetic women. METHODS: This is a cluster-randomized controlled trial that was performed on 71 pre-diabetic women referred to Arak Comprehensive Health Service Center. Thus, using cluster sampling method, one center was randomly assigned to the intervention group and one center to the control group. The data collection tool was a questionnaire based on the theory of planned behavior (TPB) and healthy lifestyle behavior that was completed before and at least 3 months after training and FBS test was performed. The experimental group received 3 training sessions of 60 to 90 min and finally the data were analyzed using statistical software. RESULTS: After the intervention, the mean scores of knowledge (P < 0.001), attitude (P = 0.047) and perceived behavioral control related to physical activity (P = 0.046) and dietary function (P = 0.01) increased significantly in the intervention group. In addition, fasting blood sugar in the intervention group (99.70 ± 11.06) improved significantly compared to the control group (110.94 ± 17.09) (P = 0.003). CONCLUSION: Education based on the theory of planned behavior, by holding face-to-face meetings along with following up the samples after the educational intervention, can promote healthy lifestyle of pre-diabetic women. Therefore, designing and implementing similar interventions on all pre-diabetic individuals seem necessary. TRIAL REGISTRATION: The master's thesis in health education is approved by Arak University of Medical Sciences, Iran and is registered in the Iranian Registry of Clinical Trial (IRCT20190304042921N1). Prospectively registered 22/07/2019, https://en.irct.ir/trial/40596.

Distribution of chigger mites (Acari: Trombiculidae) over hosts, parasitopes, collection localities, and seasons in northern Iran.

We studied the distribution of chigger mite species over mammal hosts, attachment sites on the host body, habitats, and seasons in Iran. The study was based on 2155 specimens of 36 chigger species collected from 10 species of Muridae, Cricetidae, and Soricidae across six provinces of northern Iran. A high level of mixed infestation by chiggers was recorded-76% of hosts parasitized by chiggers were infested by more than one (2-8) species. Statistically significant differences in the preference for anterior and posterior parts of the host body were found. Three species-Neotrombicula lubrica, N. delijani, and Cheladonta firdousii-preferred the posterior part of the host body; 12 species were characterized by the occurrence in the anterior part and differed from one another by the frequency of presence in the posterior part. One species, Hirsutiella alpina, was found only in the anterior part of the host body (inside the ears of rodents). The most diverse chigger fauna was on the fringe of Golestan National Park (species richness = 21, Shannon-Wiener index = 2.823). The chigger fauna of the high-mountain localities on the Alborz Range was the least diverse (species richness = 16, Shannon-Wiener index = 2.439). The seasonal aspect of activity was evident for Neotrombicula elegans, which exposed the autumn-winter period of the occurrence on hosts, and N. vernalis, with the winter-spring peak of abundance.

Effect combined learning on oral health self-efficacy and self-care behaviors of students: a randomized controlled trial.

BACKGROUND: In order to prevent oral diseases, the use of appropriate oral health education at childhood is one of the most important strategies for improving oral health knowledge and by extension positive oral health habits. Therefore, the present study aimed to evaluate the effect of animations and games as a strategy for improving oral health self-efficacy and self-care behaviors among 6-12-aged students. METHODS: In this interventional study, 82 students were selected based on cluster random sampling including 38 for the case and 44 for the control group. The case group received four sessions of combined learning per week including animations and games while the control group received routine school education. The data were collected in six domains including demographics, self-care, knowledge, attitude, behavior and self-efficacy before and 5 months after the intervention using a questionnaire. SPSS version 20 was used for data analysis. RESULTS: Five months after the intervention, the mean score of self-care, self-efficacy, behavior increased from 3.8 to 4.8, 36.8 to 48.9, and 17.07 to 18.29, respectively indicating a significant change (p < 0.05). However, no significant change was reported in these variables in the control group (p  > 0.05). CONCLUSION: The use of animation combined with other strategies for oral health self-care education can positively influence the students' performance and self-efficacy. IRCT registration number This trial was registered at IRCT. IRCT2017042133565N1 Registration date: 2017-05-17 https://en.irct.ir/trial/25851.

Clinical features and disease severity in an Iranian population of inpatients with COVID-19.

Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 inpatients with different severities. This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P < 0.05 was considered statistically significant. Overall, 200 patients with mean age of 69.75 ± 6.39 years, of whom 82 (41%) were female were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age, malignant comorbidities, dyspnea, nausea/vomiting, confusion, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P < 0.05). Moreover, complications including shock, coagulopathy, acidosis, sepsis, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities (P < 0.05). O2 saturation, nausea/vomiting, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR 0.342, 45.93, and 25.48, respectively; P < 0.05). Our results indicate O2 saturation, nausea/vomiting, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors to predict severe disease in COVID-19 patients.

Effect of Acetamiprid on spatial memory and hippocampal glutamatergic system.

Acetamiprid (ACE) is one of the widely used neonicotinoid insecticides. In mammals, in spite of the low-affinity nAChRs, neurotoxic effects following the Acetamiprid exposure have recently been reported, which suggests some concerns regarding the impacts on the nervous system of mammals. This study aims to investigate the effect of Acetamiprid on spatial memory and possible vulnerability of hippocampal glutamatergic system following the Acetamiprid exposure. 10, 20, and 40 mg/kg doses of Acetamiprid were administered to male rats by gavage once per day for 28 days. The spatial memory was examined with the Morris water maze apparatus. The amount of Acetamiprid in the serum and hippocampus was measured. In addition, glutamate level and changes in the expression of NR1, NR2, and NR2B genes were measured in the hippocampus; also, the hippocampus tissue was histologically evaluated. A significant increase in training parameters which consist of escape latency and traveled distance was observed on the first and second day of training in Acetamiprid-treated groups (20 and 40 mg/kg) compared to the control group (p < 0.001). In the probe test, rats in all Acetamiprid-treated groups significantly spent less time in the target quadrant compared to the control group (p < 0.001). Acetamiprid concentration dose dependently increased in the serum and in the hippocampus followed by Acetamiprid exposure. In all Acetamiprid-treated groups, a significant reduction of glutamate level in the hippocampus was observed (p < 0.05). The reduction of NR1, NR2A, and NR2B gene expression in the hippocampus was observed at a dose of 20 mg/kg. The histological evaluation showed neural degeneration in the dentate gyrus area of the hippocampus at a dose of 40 mg/kg in the Acetamiprid-treated group. The results of the present study indicate that Acetamiprid impairs memory consolidation through the reduction of glutamate and the expression of NMDA receptor subunits in the hippocampus at low doses, along with the loss of neural cells in dentate gyrus at high dose.

Efficacy and safety of convalescent plasma therapy in severe COVID-19 patients with acute respiratory distress syndrome.

Since SARS-CoV-2 infection is rapidly spreading all around the world, affecting many people and exhausting health care resources, therapeutic options must be quickly investigated in order to develop a safe and effective treatment. The present study was designed to evaluate the safety and efficacy of convalescent plasma (CP) for treating severe cases of COVID-19 who developed acute respiratory distress syndrome (ARDS). Among 64 confirmed cases of severe COVID-19 with ARDS in this study, 32 patients received CP besides first line treatment. Their clinical response and outcome in regard to disease severity and mortality rate were evaluated and compared with the other 32 patients in the control group who were historically matched while randomly chosen from previous patients with the same conditions except for receiving CP therapy. Analysis of the data was performed using SPSS software. Patients with plasma therapy showed improvements in their clinical outcomes including a reduction in disease severity in terms of SOFA and APACHE II scores, the length of ICU stay, need for noninvasive ventilation and intubation and also showed an increase in oxygenation. They also showed reduction in mortality which was statistically significant in less severe cases with mild or moderate ARDS. Early administration of the convalescent plasma could successfully contribute to the treatment of severe COVID-19 patients with mild or moderate ARDS at risk of progressing to critical state.

The effect of educational program based on theory of planned behavior on promoting retinopathy preventive behaviors in patients with type 2 diabetes: RCT.

BACKGROUND: Diabetic retinopathy is the most common microvascular complication of diabetes and it is a leading cause of visual impairment and blindness among patients with diabetes. This study aimed to investigate the effect of educational program based on Theory of Planned Behavior (TPB) on promoting retinopathy preventive behaviors in patients with type 2 diabetes. METHODS: The present study is an educational randomized controlled trial research that was conducted on 94 patients with type 2 diabetes who had gone to diabetes clinic. The samples were randomly assigned to the intervention (N = 47) and control groups (N = 47). Data collection instrument was a researcher-made questionnaire based on TPB and FBS and HbA1C tests. Then, educational program was performed for the intervention group through four educational sessions. After 3 months, data collection was repeated for the two groups and FBS, HbA1C testes were done again and data were analyzed. RESULTS: The performance of the intervention group on preventive behaviors of retinopathy increased from 2.48 ± 1.42 to 4.48 45 1.45 after the education (p < 0.001). The mean of FBS and HbA1c in the intervention group also decreased after the intervention (P < 0.05). CONCLUSION: Applying the TPB model proved is very effective in developing an educational program for patients with diabetes, to control their blood sugar and enhance preventive behaviors of retinopathy. Besides such programs, follow-up education for controlling and monitoring are highly recommended. This theory serves as a helpful theoretical framework for health-related behaviors and can be an appropriate pattern to plan for educational interventions. TRIAL REGISTRATION: This trial has been registered at Iranian Registry of Clinical Trials, IRCT20180819040834N1 . Prospectively registered 8 Apr 2019, https://en.irct.ir/trial/38401.

Visceral leishmaniasis in an adult case in Northeast of Iran: A case report and literature review.

Leishmaniasis is a rare complication in adult cases even in endemic areas. Here, the first report of visceral leishmaniasis in a young woman in northeast of Iran has been described.

Knowledge, Attitudes, and Practices Toward Coronavirus Disease 2019 in the Central Area of Iran: A Population-Based Study.

Background: The spread of the coronavirus disease 2019 (COVID-19) pandemic has imposed high threats on global health, life and work style, and social and economic development. The current study aimed to extract knowledge, attitudes, and practices related to COVID-19 among the general population in the central area of Iran. Method: A cross-sectional study was conducted in Arak City between April and May 2020. Stratified random sampling was applied to select the study participants. Phone interview was applied to collect the data. Data were collected using a questionnaire that was constructed and validated in this study. The questionnaire included demographic variables and items about knowledge, attitudes, and practices toward COVID-19. Descriptive and inferential analyses were conducted in STATA software. Results: In total, 544 participants completed the questionnaire; 76% of the participants accounted COVID-19 as a high threat 1 month from the onset of COVID-19. From the maximum attainable scores of 1, 6, and 6, for COVID-19-related knowledge, attitudes, and practices, means of 0.77 (0.13), 4.97 (0.63), and 5.35 (0.70) were obtained, respectively. Females had a higher practice score (5.4 ± 0.6). The participants with a family history of heart and respiratory diseases had significantly higher attitude and practice scores. SMS from the Ministry of Health had a significant impact on knowledge, attitude, and practice scores (p < 0.05). Conclusion: Higher attention should be given to increase the knowledge, attitudes, and practices of men and the housewife group. COVID-19 preventive messaging from the Ministry of Health was among the most influential methods of increasing knowledge that attracted public attention.

Contributions to the fauna of chigger mites (Acariformes: Trombiculidae) of Iran.

Chigger mites of northern Iran were studied on the basis of field collections from rodent hosts. Thirty-five species were recorded. Two new species, Cheladonta afshari Stekolnikov and Shamsi sp. nov., collected on Apodemus sp. in Guilan and Mazandaran Provinces, and Neotrombicula tehranensis Stekolnikov and Shamsi sp. nov., collected on Cricetulus migratorius and Chionomys sp. in Tehran Province, are described. One new synonym is established: Neotrombicula vernalis (Willmann, 1942) (= Neotrombicula kermani Kudryashova, 1977 syn. nov.). Seventeen species were recorded in Iran for the first time; thus, the number of known Iranian chiggers constitutes 104. The record of Neotrombicula autumnalis (Shaw, 1790) in Iran is important from the veterinarian and medical points of view, as this species attacks humans and domestic animals.

Effect of hydroxychloroquine on COVID-19 prevention in cancer patients undergoing treatment: a structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: In this study, we investigate the effect of hydroxychloroquine on the prevention of Novel Coronavirus Disease (COVID-19) in cancer patients being treated. TRIAL DESIGN: This is a multi-centre, two-arm, parallel-group, triple-blind, phase 2-3 randomised controlled trial. PARTICIPANTS: All patients over the age of 15 from 5 types of cancer are included in the study. Patients with acute lymphoid and myeloid leukemias in the first line treated with curative intent, patients with high-grade non-Hodgkin's lymphoma treated with leukemia protocols and patients with non-metastatic breast and colon cancer in the first line of treatment will enter the study. The exclusion criteria will include known sensitivity to Hydroxychloroquine, weight below 35 kilograms, history of retinopathy, history of any cardiac disease, acute respiratory tract infection in the last 2 months, having COVID-19 in the first two weeks of entering the trial, having Diabetes Mellitus, having an immuno-suppressive disease other than cancer, having chronic pulmonary disease and taking immuno-suppressant drug other than chemotherapeutic agents for current cancer. This study is performed in five academic centres affiliated to Mashhad University of Medical Sciences, Mashhad, Iran. INTERVENTION AND COMPARATOR: Patients are randomly assigned to two groups; one being given hydroxychloroquine and the other is given placebo. During two months of treatment, the two groups are treated with either hydroxychloroquine (Amin® Pharmaceutical Company, Isfahan, Iran) or placebo (identical in terms of shape, colour, smell) as a single 200 mg tablet every other day. Patients will be monitored for COVID-19 symptoms during the follow-up period. If signs or symptoms occur (fever, cough, shortness of breath), they will be examined and investigated with a high-resolution computed tomography (CT) scan of the lungs, COVID-19 specific IgM, IgG antibody assay and a nucleic acid amplification test (NAT) for the SARS-CoV-2 virus. MAIN OUTCOMES: The primary end point of this study is to investigate the incidence of COVID-19 in patients being treated for their cancer over a 2-month period. RANDOMISATION: Randomisation will be performed using randomly permuted blocks. By using an online website (www.randomization.com) the randomization sequence will be produced by quadruple blocks. The allocation ratio in intervention and control groups is 1:1. BLINDING (MASKING): Participants and caregivers do not know whether the patient is in the intervention or the control group. The outcome assessor and the data analyst are also blinded to group assignment. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The calculated total sample size is 60 patients, with 30 patients in each group. TRIAL STATUS: The trial began on April 14, 2020 and recruitment is ongoing. Recruitment is anticipated to be completed by June 14, 2020 There has been no change in study protocol since approval, protocol version 1 was approved April 12, 2020. TRIAL REGISTRATION: This trial has been registered by the title of "Effect of Hydroxychloroquine on Novel Coronavirus Disease (COVID-19) prevention in cancer patients under treatment" in Iranian Registry of Clinical Trials (IRCT) with code "IRCT20200405046958N1", https://www.irct.ir/trial/46946. Registration date is April 14, 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.