ABSTRACT
Objectives@#The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. @*Methods@#Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. @*Results@#In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48-11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. @*Conclusion@#The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6-10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.
ABSTRACT
Objectives@#The outbreak of coronavirus disease 2019 (COVID-19) is one of the main public health challenges currently facing the world. Because of its high transmissibility, COVID-19 has already caused extensive morbidity and mortality in many countries throughout the world. An accurate estimation of the basic reproduction number (R0) of COVID-19 would be beneficial for prevention programs. In light of discrepancies in original research on this issue, this systematic review and meta-analysis aimed to estimate the pooled R0 for COVID-19 in the current outbreak. @*Methods@#International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched to identify studies conducted regarding the R0 of COVID-19. Articles were searched using the following keywords: “COVID-19” and “basic reproduction number” or “R0.” The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to estimate R0 in this study. @*Results@#The mean reported R0 in the identified articles was 3.38±1.40, with a range of 1.90 to 6.49. According to the results of the random-effects model, the pooled R0 for COVID-19 was estimated as 3.32 (95% confidence interval, 2.81 to 3.82). According to the results of the meta-regression analysis, the type of model used to estimate R0 did not have a significant effect on heterogeneity among studies (p=0.81). @*Conclusions@#Considering the estimated R0 for COVID-19, reducing the number of contacts within the population is a necessary step to control the epidemic. The estimated overall R0 was higher than the World Health Organization estimate.
ABSTRACT
Background: Human Development Index [HDI], maternal mortality rate [MMR] and children aged under 5 years mortality rate [U5MR] are fundamental issues, especially in low- and middle-income countries.
Aims: The aim of this study was to evaluate the changes in HDI, MMR and U5MR from 1980 to 2010 in certain West Asian countries as well as the relationship between these indexes.
Methods: In this ecological study, HDI, MMR and U5MR information from studied countries during 1980 to 2010 was extracted from the gap minder site and then analysed using descriptive and analytical methods, including Spearman correlation.
Results: The lowest and highest rates of HDI and MMR in 2010 were seen in the United Arab Emirates and Pakistan [HDI: 0.49, 0.81; MMR: 7.14, 335.45 respectively]. HDI is rising in all countries studied, with the highest increase in the Islamic Republic of Iran [0.21]. MMR and U5MR saw a decline over the years, with the greatest decrease seen in India, and the lowest and highest child mortality rate in 2010 found in Bahrain and Pakistan [8.3, 91.8 respectively]. However, there was a negative relationship between HDI and MMR [r = -0.7, P < 0.001].
Conclusions: HDI increased during 1980-2010. The highest rate of HDI decrease was observed in the Islamic Republic of Iran, and the greatest reduction of MMR was seen in India. Also, the highest decrease in U5MR was related to India as well, while MMR and U5MR rate decreased. Hence, improving HDI might have a definite impact on decreasing MMR and U5MR, especially in low- and middle-income countries.
ABSTRACT
Background: The virginity is a matter of concern in many eastern countries, especially Muslim societies. In some cultures, integrity of hymen before marriage causes deprivation of social rights for the females; even in some cases an honor killing is plausible
Materials and methods: In this descriptive cross-sectional study, total records of all virgin patients who underwent hysteroscopy for medical reasons in Hazrat Rasool Hospital between 2004 and 2014 were studied. Data were analyzed by SPSS version 19 using descriptive scales and simple proportion and ratios
Results: 400 women with AUB [abnormal uterine bleeding] were referred to Hazrat Rasool Hospital for the diagnosis and treatment. 12 cases [3%] were virgin and 388 [97%] were non-virgins. In 12 Virgin patients admitted for hysteroscopy, 3 [25%] hymenal damage were reported, and in 9 virgin patients hymen remained intact postoperatively
Conclusion: Regarding the high prevalence of congenital and acquired uterine diseases and successful treatment of these problems by hysteroscopy, it seems prudential to focus on more comprehensive teaching programs in the gynecologic endoscopic field. This will help better and earlier diagnosis and treatment of virgin patients, due to seeking earlier medical care
ABSTRACT
Background: Intensified strategy includes special attention to the symptoms such as cough [more than two weeks], fever [more than three weeks], night sweats [more than three weeks], and weight loss [more than 3 kg per month]. If any of the above symptoms was positive, in suspected individuals for TB, more assessment should be done. The aim of this study was to compare between intensified and routine case finding for a better case selection method for diagnosis of pulmonary tuberculosis among HIV-Infected Persons
Methods: The sample size was calculated 237 patients [474 for the two groups]. In the current study, the patients were divided randomly into two groups: A] intensified case finding group and B] routine case finding group. Considering the sputum culture as the gold standard, we calculated the sensitivity and specificity, Positive predictive value [PPV], Negative predictive value [NPV] for fever, weight loss, coughing more than two week, night sweats, and PPD test
Result: A total of eight positive cases of tuberculosis were detected in the intensified while four were found in the routine case finding group. Sensitivity, specificity, PPV, and NPV for cough in diagnosis of TB were 25%, 87%, 6%, and 97%, respectively. For weight loss, they were 62.5%, 83%, 10.8%, and 98.5% respectively while these amounts were, 7%, 85%, 97.6, 37.5 for night sweats. For fever, they were, 25%, 92.9%, 10.5%, and 97% respectively, and for PPD they were 87.5%, 40%, 4.6%, and 98.9%, respectively
Conclusion: Key symptom screening, such as cough, fever, weight loss and night sweats, has an important role in detecting TB among HIV-infected patients