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Millions of people are subject to infertility worldwide and one in every six people, regardless of gender, experiences infertility at some period in their life, according to the World Health Organization. Assisted reproductive technologies are defined as a set of procedures that can address the infertility issue among couples, culminating in the alleviation of the condition. However, the costly conventional procedures of assisted reproduction and the inherent vagaries of the processes involved represent a setback for its successful implementation. Microfluidics, an emerging tool for processing low-volume samples, have recently started to play a role in infertility diagnosis and treatment. Given its host of benefits, including manipulating cells at the microscale, repeatability, automation, and superior biocompatibility, microfluidics have been adopted for various procedures in assisted reproduction, ranging from sperm sorting and analysis to more advanced processes such as IVF-on-a-chip. In this review, we try to adopt a more holistic approach and cover different uses of microfluidics for a variety of applications, specifically aimed at sperm separation and analysis. We present various sperm separation microfluidic techniques, categorized as natural and non-natural methods. A few of the recent developments in on-chip fertilization are also discussed.
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Separação Celular , Técnicas de Reprodução Assistida , Espermatozoides , Humanos , Masculino , Espermatozoides/citologia , Separação Celular/instrumentação , Dispositivos Lab-On-A-Chip , Técnicas Analíticas Microfluídicas/instrumentação , AnimaisRESUMO
BACKGROUND: Despite technological advancements in perinatal imaging, autopsy examination is still regarded as the reference standard to determine the time and reason of the fetal death. PURPOSE: This study was conducted to identify the intrauterine postmortem magnetic resonance imaging (PMMR) findings of fetuses, who underwent radiofrequency ablation (RFA). STUDY TYPE: Prospective. POPULATION: Fifty-three twin/triplet complicated pregnancies scheduled for selective reduction of one of the fetuses by RFA were included. FIELD STRENGTH/SEQUENCE: The imaging methods used are T1-weighted gradient-echo imaging (T1 GRE), T2 half-Fourier acquisition single-shot turbo spin-echo (SSTSE), and diffusion-weighted imaging (DWI) sequences. ASSESSMENT: The MRIs were interpreted by three radiologists. STATISTICAL TESTS: Data were analyzed using the software package SPSS Statistics Version 22.0. The used tests included one-way analysis of variance (ANOVA) and Duncan tests (significance level: P value <0.05). This analysis was performed with scikit-learn library (version 1.1.1) in Python version 3.9. RESULTS: Average PMMR scores of orbit, brain, and abdomen showed significant differences among different PM interval subgroups. The brain apparent diffusion coefficient (ADC) numbers of reduced and living fetuses were significantly different at any PM interval. To determine which findings are closely associated with the timing of fetal death, five different methods of feature selection were employed. The top eight selected features achieved the highest area under the curve (AUC) of 78.19%. DATA CONCLUSION: In utero, PMMR findings may be associated with the time of fetal death. Among different fetal organs evaluated, particularly PMMR top eight features specifically scores of orbits were associated with PM intrauterine time after death. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Morte Fetal , Feto , Gravidez , Feminino , Humanos , Autopsia , Estudos Prospectivos , Feto/diagnóstico por imagem , Morte Fetal/etiologia , Imageamento por Ressonância Magnética/efeitos adversos , Imagem de Difusão por Ressonância Magnética/métodos , Gravidez MúltiplaRESUMO
INTRODUCTION: The middle ear sound transmission features can impact acoustic sounds reaching the inner ear. Wideband tympanometry (WBT) or wideband acoustic immittance is an effective and desirable measurement of conductive conditions in newborns and adults and has appropriate sensitivity to distinguish different pathologies like otosclerosis from other middle ear conflicts. Recently, there has been an increased utilization of WBT, which highlights the importance of collecting population-based normative data as a necessary step in the standardization of this test, as well as for its clinical application. This study aimed to obtain normative data on WBT in the adult Iranian ethnic. METHODS: There were 101 participants (202 ears) consisting of 53 males (57.4%) and 48 females (42.6%) in the age range of 19-29 years. The Titan WBT device (Interacoustics, Assens, Denmark) was used for WBT measurements. The broadband click was utilized as the probe tone between frequencies of 250 Hz and 8,000 Hz. All the participants underwent ear, nose, and throat assessments, pure-tone audiometry, and conventional tympanometry (226 Hz). Features like equivalent ear canal volume (Veq), tympanometric peak pressure, gradient, resonance frequency (RF), energy absorbance (EA), and admittance (Ad) were tested. RESULTS: In this cross-sectional study, 202 ears were tested for WBT. EA increased by frequency enhancement; at 1 kHz and 2 kHz the EA was the most prominent; at 2,519 Hz, it started decreasing, and at 8 kHz, there was a slight increase. There was also a significant difference in the Veq and Ad between males and females. Studies have shown that the Veq may vary between male and female subjects based on body size. CONCLUSION: In this study, normative data for the WBT were obtained from young Iranian adults with normal hearing ranges and middle ear conditions. We hope that this study and the resulting norm will provide a basis for increasing the use of WBT in Iranian diagnostic and clinical practices.
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Testes de Impedância Acústica , Orelha Média , Adulto , Humanos , Masculino , Recém-Nascido , Feminino , Adulto Jovem , Testes de Impedância Acústica/métodos , Irã (Geográfico) , Estudos Transversais , AudiçãoRESUMO
Emerging infectious diseases are a growing threat in sub-Saharan African countries, but the human and technical capacity to quickly respond to outbreaks remains limited. Here, we describe the experience and lessons learned from a joint project with the WHO Regional Office for Africa (WHO AFRO) to support the sub-Saharan African COVID-19 response.In June 2020, WHO AFRO contracted a number of consultants to reinforce the COVID-19 response in member states by providing actionable epidemiological analysis. Given the urgency of the situation and the magnitude of work required, we recruited a worldwide network of field experts, academics and students in the areas of public health, data science and social science to support the effort. Most analyses were performed on a merged line list of COVID-19 cases using a reverse engineering model (line listing built using data extracted from national situation reports shared by countries with the Regional Office for Africa as per the IHR (2005) obligations). The data analysis platform The Renku Project ( https://renkulab.io ) provided secure data storage and permitted collaborative coding.Over a period of 6 months, 63 contributors from 32 nations (including 17 African countries) participated in the project. A total of 45 in-depth country-specific epidemiological reports and data quality reports were prepared for 28 countries. Spatial transmission and mortality risk indices were developed for 23 countries. Text and video-based training modules were developed to integrate and mentor new members. The team also began to develop EpiGraph Hub, a web application that automates the generation of reports similar to those we created, and includes more advanced data analyses features (e.g. mathematical models, geospatial analyses) to deliver real-time, actionable results to decision-makers.Within a short period, we implemented a global collaborative approach to health data management and analyses to advance national responses to health emergencies and outbreaks. The interdisciplinary team, the hands-on training and mentoring, and the participation of local researchers were key to the success of this initiative.
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COVID-19 , África Subsaariana/epidemiologia , COVID-19/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Saúde Pública , Recursos HumanosRESUMO
BACKGROUND: Despite the improvements to enhance skin flap viability, the effects of ischemia-reperfusion (IR), oxidative stress, necrosis, and apoptosis are still challenging. Crocus sativus L. (Saffron) is highly noticeable due to its tissue-protective and antioxidant properties. So, we aimed to investigate its effects on skin flap viability, oxidative stress, apoptosis markers, histopathological changes, and mTOR/p-mTOR expression. MATERIALS AND METHODS: 40 Sprauge-Dawley rats, weighting 200-240 g, were divided into four groups including: (1) Sham (8 × 3 cm skin cut, without elevation); (2) Flap Surgery (8 × 3 cm skin flap with elevation from its bed); (3) Saffron 40 mg/kg + Flap Surgery; and (4) Saffron 80 mg/kg + Flap Surgery. Saffron was administrated orally for 7 days. At day 7, flap necrosis percentage, histopathological changes, malondialdehyde level, Myeloperoxidase and superoxide dismutase activity, Bax, Bcl-2, mTOR, and p-mTOR expression were measured. Protein expressions were controlled by ß-Actin. RESULTS: Saffron administration decreased flap necrosis percentage (p < 0.01), which was not dose-dependent. Treatment groups showed significant histological healing signs (Neovascularization, Fibroblast migration, Epithelialization, and Epithelialization thickness), decreased MDA content (p < 0.01), increased SOD (p < 0.01) and decreased MPO activity (p < 0.01). Bax and Bcl-2 expression, decreased and increased respectively in treated groups (p < 0.0001). mTOR and p-mTOR expression were not changed significantly in Saffron treated groups. CONCLUSION: Saffron could increase skin flap viability, alleviate necrosis, decrease oxidative stress and decrease apoptotic cell death, after skin flap surgery, but it acts independent of the mTOR pathway. So, Saffron could potentially be used clinically to enhance skin flap viability. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. https://www.springer.com/00266.
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Apoptose , Crocus , Retalhos de Tecido Biológico , Preparações de Plantas , Animais , Ratos , Necrose , Proteínas Proto-Oncogênicas c-bcl-2 , Serina-Treonina Quinases TOR , Preparações de Plantas/farmacologiaRESUMO
Corticosteroids improve the complications of Covid-19 but may cause some side effects such as hyperglycemia. Royal jelly is one of the bee products that exert anti-inflammatory, insulin-like, and hypoglycemic activities. The present study was conducted to investigate the effect of royal jelly capsules on blood sugar and the clinical course of Covid-19 in the patients receiving corticosteroid therapy. In this clinical trial, 72 Covid-19 patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and pulmonary involvement hospitalized in Shahrekord Hajar Hospital were enrolled and randomized into two groups: treatment (receiving corticosteroids and Royal Jelly 1000â mg capsules daily for 7 days) and placebo (given corticosteroids and placebo). Laboratory tests, blood sugar, and clinical courses were determined and compared. Data was analyzed using SPSS version 16. On day 7 after the onset of the intervention, the dosage and frequency of insulin, FBS level, and required corticosteroid showed a decrease in both groups but the inter-group difference was not significant (P > .05). As well, the Spo2 level indicated a non-significant increase and hospital stay length indicated a non-significant decrease in the intervention group (P > .05). Among the symptoms, only headache, cough, and dyspnea indicated an improvement in the intervention group (P < .05). Overall, the results indicated the short-term consumption of royal jelly could not significantly improve blood sugar and the clinical course of Covid-19; however, it could significantly improve headache, cough, and dyspnea in the patients.
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COVID-19 , Transtornos da Cefaleia Primários , Hipoglicemia , Insulinas , Abelhas , Animais , Glicemia , Hipoglicemia/tratamento farmacológico , Progressão da DoençaRESUMO
OBJECTIVES: Tablet manufacturing development is costly, laborious, and time-consuming. Technologies related to artificial intelligence like ,predictive model ,can be used in the control process to facilitate and accelerate the tablet manufacturing process. predictive models have become popular recently. However, predictive models need a comprehensive dataset of related data in the field, due to the lack of a dataset of tablet formulations, the aim of this study is to aggregate and integrate fast disintegration tablet's formulation into a comprehensive dataset. DATA DESCRIPTION: The search strategy has been prepared between the years of 2010 to 2020, consisting of the keyword's 'formulation' ,'disintegrating' and 'Tablet', as well as their synonyms. By searching four databases, 1503 articles were retrieved, from these articles only 232 articles met all of the study's criteria. By reviewing 232 articles, 1982 formulations have been extracted, afterward pre-processing and cleaning data, contain steps of unifying the name and units, removing inappropriate formulations by an expert, and finally, data tidying was done on data. The developed dataset contains valuable information from various FDT's formulations, which can be used in pharmaceutical studies that are critical to the discovery and development of new drugs. this method can be applied to aggregate datasets from the other dosage forms.
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Química Farmacêutica , Agregação de Dados , Química Farmacêutica/métodos , Inteligência Artificial , Solubilidade , ComprimidosRESUMO
Herein we describe an efficient, simple, and precise micelle-mediated microextraction strategy based on the aggregation behavior of surface-active ionic liquids (SAILs) for the preconcentration and determination of cobalt ions in pharmaceutical preparations. Unlike the commonly used hydrophobic ionic liquids in IL-based microextraction methods, a water-soluble surface-active ionic liquid [1-hexadecyl 3-methylimidazolium chloride (C16MeImCl)] was used. A modified cloud point extraction (CPE) procedure based on the C16MeImCl-Triton X-114 mixed micellar system was proposed as an efficient extracting phase. A comparison of the analytical features of the extraction process with and without SAILs revealed the benefits of the proposed method. Advantages such as a wider linear range, lower detection limit, higher reproducibility, and improved extraction efficiency highlighted the proposed method over the conventional CPE method. These attractive specifications are due to the higher extraction efficiencies achieved in the presence of the SAIL and its favorable effects at the phase separation stage. Various parameters affecting the extraction efficiency were optimized by univariate and multivariate (Box-Behnken design) approaches. The calibration curve was obtained in the optimal experimental conditions with a linear range from 0.01 to 5.5 mg L-1 of cobalt ion concentration (R = 0.9992) and a detection limit of about 0.005 mg L-1. The RSD% for 10 replicate determinations of 1.0 mg L-1 Co was 0.9%. The proposed method was successfully applied to determine cobalt ions in vitamin B12 ampoules and tablets.
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INTRODUCTION: As one of the most efficacious methods of cancer immunotherapy, chimeric antigen receptor-modified immune cells have recently drawn enormous attention. After the great success achieved with CAR-T-cells in cancer treatment both in preclinical setting and in the clinic, other types of immune cells, including natural killer (NK)-cells and macrophages, have been evaluated for their anti-cancer effects along with their potential superiority against CAR-T-cells, especially in terms of safety. First introduced by Tran et al. almost 26 years ago, CAR-NK-cells are now being considered as efficient immunotherapeutic modalities in various types of cancers, not only in preclinical setting but also in numerous phase I and II clinical studies. AREAS COVERED: In this review, we aim to provide a comprehensive survey of the preclinical studies on CAR-NK-cells' development, with an evolutional approach on CAR structures and their associated signaling moieties. Current NK-cell sources and modes of gene transfer are also reviewed. EXPERT OPINION: CAR-NK-cells have appeared as safe and effective immunotherapeutic tools in preclinical settings; however, designing CAR structures with an eye on their specific biology, along with choosing the optimal cell source and gene transfer method require further investigation to support clinical studies.
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Neoplasias , Receptores de Antígenos Quiméricos , Terapia Genética , Humanos , Imunoterapia/métodos , Imunoterapia Adotiva/métodos , Células Matadoras NaturaisRESUMO
Peritoneal adhesion is a significant problem following gastrointestinal surgeries, accompanied by a significant economic burden and morbidity for patients. Punica granatum seed oil (PSO) possesses antioxidative, anti-inflammatory, and anticancer effects. Thus, we aimed to evaluate the antiperitoneal adhesive properties of PSO in rats. Forty-eight Wistar rats (200-250 g) were randomly and equally divided into six groups: sham group, control group; peritoneal adhesion without any treatment, vehicle group; peritoneal adhesion with saline + Tween-80.5% treatment, and experimental groups; peritoneal adhesion with 0.5%, 1.5%, and 4.5% v/v PSO treatment. In addition, peritoneal adhesion was examined macroscopically along with evaluating the oxidative stress (malondialdehyde [MDA], nitric oxide [NO], and glutathione [GSH]) inflammatory (interleukin [IL]-6, IL-1ß, and tumor necrosis factor-α [TNF-α]), fibrotic (transforming growth factor-ß [TGF-ß]), and angiogenic (vascular endothelial growth factor [VEGF]) factors. Our results revealed that the levels of adhesion scores, MDA, NO, IL-6, TNF-α, IL-1ß, TGF-ß, and VEGF, were propagated in the vehicle group while the GSH level was alleviated (p < 0.001). In contrast, premedication with PSO, especially at the lowest concentration, notably lessened the levels of adhesion scores, MDA, NO, IL-6, TNF-α, IL-1ß, TGF-ß, and VEGF as well as GSH in comparison to the vehicle group following the peritoneal adhesion induction (p < 0.001-0.05). As a result, PSO may prevent peritoneal adhesion through its antioxidant, anti-inflammatory, antifibrotic, and antiangiogenic properties. Therefore, PSO could be considered a beneficial candidate for the treatment of postoperative peritoneal adhesion.
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Antioxidantes , Punica granatum , Ratos , Animais , Antioxidantes/farmacologia , Fator A de Crescimento do Endotélio Vascular , Fator de Necrose Tumoral alfa , Interleucina-6 , Ratos Wistar , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Estresse Oxidativo , Glutationa , Fator de Crescimento Transformador beta , Óleos de Plantas/farmacologia , Óleos de Plantas/uso terapêuticoRESUMO
BACKGROUND: There is increasing evidence supporting a central role of the viral-induced hyper-inflammatory immune response in the pathogenesis of COVID-19. Serum procalcitonin (PCT) is an emerging prognostic marker in coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the relationship between serum procalcitonin and clinical severity and outcomes in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Hematological and biochemical parameters were evaluated in patients with COVID-19 infection from February to April 2020 at Hajar Hospital in the Shahrekord University of Medical Science, Shahrekord, Iran. RESULTS: The results showed that total lymphocyte counts, albumin, calcium, and creatinine levels were significantly different between the two moderate and severe groups, and the mean of procalcitonin level in COVID-19 patients with severe disease was higher (0.36 ng/mL) compared with the patients with moderate disease, and its level was found to be >5 ng/mL in 14.2% of5 ng/mL in 14.2% of patients in the former group. CONCLUSION: PCT may be a marker of disease severity in COVID-19 and may contribute to determining the severity of patients infected with SARS-CoV-2. Moreover, serial PCT measurements may be beneficial in predicting the prognosis.
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COVID-19 , Pró-Calcitonina , Biomarcadores , COVID-19/diagnóstico , Humanos , Irã (Geográfico) , Prognóstico , Estudos Retrospectivos , SARS-CoV-2RESUMO
BACKGROUND: Prehypertension is an important global health challenge. This study determines the effect of telenursing on Blood Pressure (BP) and Body Mass Index (BMI) in patients with prehypertension. MATERIALS AND METHODS: This randomized controlled clinical trial study included 81 patients with prehypertension discharged from an emergency room at Isfahan University of Medical Sciences (Iran) in 2016. Participants joined a session about hypertension, risk factors, and lifestyle modification to reduce its risk. Using a random number table, 41 subjects were assigned to the experimental group and 40 subjects to the control group. Only the experimental group received four SMS messages each week and a 10-15 min phone call once a month to help them change their lifestyle and reinforce their health behaviors. Eventually, patients' information was collected, and the data were analyzed using independent t, paired t, and Chi-square tests. RESULTS: The experimental group after the intervention had a significantly lower mean (Standard Deviation [SD]) of Systolic Blood Pressure (SBP) (from 126.67 [5.15] to 119.21 [5.72] [t 40 = 8.40, p < 0.001]) and Diastolic Blood Pressure (DBP) [from 85.28 (2.29) to 78.79 (4.16) (t 40 = 10.02, p < 0.001)]. However, the same means were not significantly different in the control group [SBP (p = 0.116) and DBP (p = 0.096)]. The mean (SD) of changes between BMI before and after the intervention was -0.75 (0.66) in the experimental and 0.042 (0.41) in the control group, which was significantly different between the two groups (t 79= -6.44, p < 0.001). CONCLUSIONS: Telenursing can have potential benefits to maintain BP within the normal range and reduce BMI in patients with prehypertension.
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BACKGROUND & OBJECTIVE: Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values. METHODS: This case-control study included 91 COVID-19 patients and 169 healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization. RESULTS: Among patients with COVID-19, 59.3% of the patients had hypocalcemia on admission while in control group only 32.5% had low calcium level (OR=3.02, 95% CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7% vs 14.3% and 33.3% Vs 9.1%, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, 74.1% of patients in hypocalcemic group had a severe infection while 24.3% of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95% CI: 3.38-23.37, P<0.001). CONCLUSION: Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk.
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Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has affected millions of individuals worldwide. Prior studies suggest that COVID-19 may be associated with an increased risk for various cardiovascular disorders, such as myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. Early reports of non-COVID-19 patients have described the concurrence of takotsubo cardiomyopathy (TTC) and spontaneous coronary artery dissection (SCAD). However, the interplay between COVID-19, TTC and SCAD has not been well established. We herein propose two sets of two-hit hypotheses for the development of SCAD and TTC in the context of COVID-19. The first two-hit hypothesis explains the development of SCAD, in which TTC-associated formation of vulnerable coronary substrate serves as the first hit (predisposing factor), and COVID-19-associated inflammation and vascular disruption serves as the second hit (precipitating factor). The second two-hit hypothesis is proposed to explain the development of TTC, in which SCAD-associated formation of vulnerable myocardial substrate serves as the first hit, and COVID-19-associated sympathetic overactivity serves as the second hit. Under this conceptual framework, COVID-19 poses a double threat for the development of SCAD (among patients with underlying TTC) as well as TTC (among patients with underlying SCAD), thereby forming a reciprocal causation. This hypothesis provides a rationale for the joint assessment of TTC and SCAD in COVID-19 patients with pertinent cardiovascular manifestations.
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COVID-19/complicações , Anomalias dos Vasos Coronários/etiologia , Modelos Cardiovasculares , SARS-CoV-2 , Cardiomiopatia de Takotsubo/etiologia , Doenças Vasculares/congênito , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Causalidade , Anomalias dos Vasos Coronários/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , SARS-CoV-2/patogenicidade , Cardiomiopatia de Takotsubo/epidemiologia , Doenças Vasculares/epidemiologia , Doenças Vasculares/etiologiaRESUMO
INTRODUCTION: Few data on the COVID-19 epidemiological characteristics among the pediatric population in Africa exists. This paper examines the age and sex distribution of the morbidity and mortality rate in children with COVID-19 and compares it to the adult population in 15 Sub-Saharan African countries. METHODS: A merge line listing dataset shared by countries within the Regional Office for Africa was analyzed. Patients diagnosed within 1 March and 1 September 2020 with a confirmed positive RT-PCR test for SARS-CoV-2 were analyzed. Children's data were stratified into three age groups: 0-4 years, 5-11 years, and 12-17 years, while adults were combined. The cumulative incidence of cases, its medians, and 95% confidence intervals were calculated. RESULTS: 9% of the total confirmed cases and 2.4% of the reported deaths were pediatric cases. The 12-17 age group in all 15 countries showed the highest cumulative incidence proportion in children. Adults had a higher case incidence per 100,000 people than children. CONCLUSION: The cases and deaths within the children's population were smaller than the adult population. These differences may reflect biases in COVID-19 testing protocols and reporting implemented by countries, highlighting the need for more extensive investigation and focus on the effects of COVID-19 in children.
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COVID-19 , Adulto , África Subsaariana/epidemiologia , Teste para COVID-19 , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Recém-Nascido , SARS-CoV-2RESUMO
The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. It brought about the implementation of various measures and restrictions at a global level. Iran has been one of the countries with the highest rates of COVID-19 cases. This study reviews the initial outbreak of COVID-19 in Iran and examines the mitigation strategies adopted by the country. Moreover, it reports the socioeconomic challenges faced by the authorities during the efforts to contain the virus. A transdisciplinary literature review was carried out and a political measures timeline was constructed. A broad overview of the initial phase of the COVID-19 outbreak in Iran is presented, starting from the first confirmed case on 19 February 2020 until April 2020. The results of this epidemiological and socioeconomic case review of Iran suggests that the political measures undertaken by the Republic of Iran contributed to the decrease of the prevalence of COVID-19. However, due to the existing financial bottleneck, Iran has faced limited health system resources. Therefore, the response was not sufficient to restrict the spread and the efficient handling of the virus in the long-term.
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COVID-19/epidemiologia , COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Fatores Socioeconômicos , Controle de Doenças Transmissíveis/organização & administração , Humanos , Irã (Geográfico)/epidemiologiaRESUMO
BACKGROUND: Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN. METHODS: A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. The8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them. RESULTS: No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in post-intervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001). CONCLUSION: The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.
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BACKGROUND: Addiction for narcotics is a dangerous reality, especially in teenagers and young persons, and is one of the most important socioeconomic and health problems, threatens the human society and leads to social stagnancy in various aspects. OBJECTIVES: The present study aimed at determining Meta-cognitive relationship with addiction potential tendency in students and determining the distribution of each Meta-cognitive dimension in predicting addiction potential tendency. MATERIALS AND METHODS: The descriptive-correlative method was used for conducting this research. The research target population included all students of Ardebil Mohaghegh University. A sample of 380 subjects was selected randomly from this demographic population by cluster multistage sampling. We used Weed and colleagues' questionnaire of addiction to assess addiction potential tendency, and the Meta-cognitive scale of Wells and colleagues for evaluating Meta-cognition. Data gathered were analyzed by multifold Regression via simultaneous entrance method. RESULTS: The rate of students' addiction potential tendency can be predicted by having characteristics of their Meta-cognition. It also appeared that among the five parameters of Meta-cognition, the role of three parameters required for controlling thoughts, uncontrollability and risk, and positive beliefs about anxiety were of great importance in predicting addiction potential tendency in students. CONCLUSIONS: The results of this research have important implications regarding the attention of students' counselors to Meta-cognitive dimensions in order to prevent students' tendency for addiction.
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BACKGROUND: The role of uric acid is well known for the development of nephropathy and retinopathy in diabetic patients. The aim of this study was to evaluate the serum uric acid levels in patients with or without diabetic neuropathy (DPN). METHODS: Forty-two patients with DPN (case group) and 42 patients without DPN (control group) matched with regard to age, gender, body mass index (BMI) and duration of their disease were entered into the study. The diagnosis of DPN was based on the nerve conduction studies on sural, peroneal and tibial nerves in lower limbs. Serum uric acid was measured in these two groups. RESULTS: The mean age of the patients in the case group was 54.6±6.9 and in the control group was 55.8±5.8 years (p=0.389). The demographic characteristics of the patients in these two groups were equal, but only the history of diabetic foot ulcer was higher in patients with DPN (p<0.05). The mean serum uric acid was 4.70±0.96 in diabetic patients with DPN and 4.36±0.89 mg/dl in patients without DPN (p=0.019). CONCLUSION: The results show the higher level of serum uric acid level in diabetic patients with diabetic neuropathy. Further studies are required to determine the role of uric acid in the development and progression of DPN.
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BACKGROUND: Stressful life events may cause initiation of drug use among people. The main purpose of this study was to evaluate the effectiveness of stress management skill training on depression, anxiety and stress levels in drug addicts after withdrawal. OBJECTIVES: The population included all drug addicts after withdrawal in 2012 in Alborz province. MATERIALS AND METHODS: The study was quasi-experimental with pretest-posttest design with a control group. Levels of emotional reactions (depression, anxiety and stress) in all referrals to a counseling center for drug withdrawal in 2012 using the Depression, Anxiety, Stress (DASS-21) questionnaire was assessed. The study population included drug addicts after withdrawal. The sampling method was available sampling and random assignment. Thirty people who had higher emotional reactions were randomly selected and divided into two test (n = 15) and control (n = 15) groups. For the test group, a stress management skill training course was held in twelve 90-minute sessions, but the control group received no intervention. The obtained data were analyzed using SPSS-19 software with analysis of covariance. RESULTS: The results showed that stress management skill training has a significant effect on reducing emotional reactions (P < 0.01). It was noted that after 2 months test group follow-up, stress management training has retained its effect. CONCLUSION: Apparently, training addicts about life skills, particularly stress management seems to be a good idea.