RESUMEN
Objectives: Animal bite is considered a serious social, economic, and health risk for societies with poor animal bites and population management. The objective of this study was to propose a model for animal bites management in Golestan Province. Methods: The present study is a multi-method study conducted quantitatively and qualitatively. First, as a cross-sectional study, the animal bites in Golestan Province and the country were calculated and their trend was predicted. Secondly, in the qualitative study (content analysis), the challenges, barriers, and methods of animal bite control were extracted through conducting semi-structured interviews and focused group discussion meetings. Finally, the model of animal bite management was developed and it was confirmed by Round Delphi. The data were analyzed via content analysis using MAXQDA18. The participants in this study consisted of university professors, managers, and executive officers involved in animal bite and rabies control plans. Results: This study revealed that the animal bite in Golestan Province had an upward trend, as in the country, and dogs were the main cause of bites (90%). The obstacles and challenges of current animal bites control program in eight areas were expressed by the participants. Also, the animal bite management model, which was obtained from the data of different stages of this study, included nine fields and 41 sub-fields. The fields of the animal bite management model included: providing a cultural package, resolving barriers to animal population control plans, wide coverage of dog vaccination, passing and enacting preventive laws, attracting financial support, constructing standard equipment, providing proper medical services, enhancing inter-departmental coordination, and controlling rabies in the wild. This model was confirmed in a Delphi round. Conclusion: Our study indicated that Golestan Province with an average bite higher than twice the country's average is one of the leading provinces in this regard. Thus, revising the animal bite and animal population control plans in this province is necessary. The model designed in this study can be used as a practical guide by policy makers and officials to manage animal bite and related consequences in this province.
RESUMEN
Background: Coronavirus disease 2019 has become a public health concern with a high number of fatalities. Thalidomide can target inflammatory mediators and decrease inflammation in SARS-CoV-2. Materials and Methods: An open-label, randomized controlled trial was conducted on patients with compatible lung high-resolution computed tomography scan for COVID-19 pneumonia and moderate involvement. Childbearing-age women were excluded. A total of 20 patients in the control group receiving usual treatment were compared with 26 patients in the case group who in addition to the same regimen also received thalidomide. The primary outcome was time for clinical recovery (TTCR) and intensive-care unit (ICU) admission. Results: From April 25 to August 8, 2020, based on the inclusion criteria, 47 patients were assigned to the study. Patients receiving thalidomide had a mean TTCR of days 5.5 (95% confidence interval [CI], 0.7-10.3), as compared with days 5.3 (95% CI, 1.7-8.9) with control (odds ratio 0.01; 95% CI, -1.58-1.59, P = 0.807). The incidence of ICU admission was 27% in the thalidomide group compared with 20% in the control group (odds ratio 3.89; 95% CI, 0.55-27.4, P = 0.425). The mean length of stay in hospital in both groups was 10 days. Progressive improvement in respiratory rate, fever, and O2 saturation during the study was seen in both groups without a significant difference between the thalidomide and control group (P > 0.05). Conclusion: This study investigated the effects of thalidomide to treat moderate COVID-19 clinical outcomes. The results established that this drug regimen did not add more effect to usual treatment for moderate COVID-19 pneumonia.