Immune-mediated necrotizing myopathy following vaccination with the AstraZeneca (AZD1222) COVID-19 vaccine: A case report and brief review.

Immune-Mediated Necrotizing Myopathy (IMNM) after vaccination has been reported previously, however it is rare after COVID-19 vaccination. We report the first case of IMNM two weeks after vaccination with the AstraZeneca (AZD1222) COVID-19 vaccine. There was a probable temporal relationship between the COVID-19 vaccination and the development of IMNM due to lack of known causative factors for IMNM. This may have been due to 1) autoimmunity directly caused by the vaccine, 2) exacerbation of autoimmunity triggered by the vaccine or 3) autoimmune syndrome triggered by the vaccine adjutants. Further studies are needed to assess the underlying mechanisms.

Size-dependent molecular interaction of nontraditional 2D antibiotics withStaphylococcus aureus.

The application of nanomaterials for their antibacterial properties is the subject of many studies due to antibiotic resistance of pathogen bacteria and the necessity of omitting them from food and water resources. Graphene oxide (GO) is one of the most popular candidates for antibacterial application. However, the optimum condition for such an effect is not yet clear for practical purposes. To shed light on how GO and bacteria interaction depends on size, a wide range of GO flake sizes from hundreds of µm2going down to nano-scale as low as 10 N m2was produced. In anin-vitrosystematic study to inhibitStaphylococcus aureusgrowth, the correlation between GO flake size, thickness, functional group density, and antibacterial activity was investigated. The GO suspension with the average size of 0.05 µm2, in the order of the size of the bacteria itself, had the best bacteriostatic effect onS. aureuswith the minimum inhibitory concentration value of 8 µg ml-1, well within the acceptable range for practical use. The bacteriostatic effect was measured to be a 76.2% reduction of the colony count over 2 h of incubation and the mechanism of action was the wrapping and isolation of cells from the growth environment. Furthermore,in-vivoanimal studies revealed that 16 µg ml-1of the optimum GO has efficient antibacterial performance against the methicillin-resistant strains of the bacteria with an enhanced wound healing rate and tensiometrial parameters which is important for realized targets.

What explains socioeconomic inequalities in dental flossing? Cross-sectional results from the RaNCD cohort study.

INTRODUCTION: The magnitude and underlying determinants of socioeconomic inequality in dental flossing are poorly understood in Iran. This study aimed to measure and decompose socioeconomic inequalities in dental flossing in Ravansar, Iran. METHODS: Data of 10,002 individuals aged 35-65 years who participated in the Ravansar Non- communicable Diseases (RaNCD) cohort study in Kermanshah province, western Iran, were analyzed. Based on an asset-based method, socioeconomic status (SES) was measured using principal component analysis (PCA). The concentration index and curve were employed to measure socioeconomic inequality in dental flossing. Decomposition analysis was used to estimate the contribution of each determinant to the overall inequality. RESULTS: Of 10,002 participants, 11.74% were found to practice dental floss. The normalized CI for dental flossing was 0.327 in the entire population, 0.323 in females and 0.329 in males, indicating that the use of dental floss is more concentrated among high-SES individuals. The decomposition analysis indicated that SES (50.58%) and level of education (44.90%) respectively contributed the most to this inequality. Place of residence (10.55%) and age group (2.7%) were the next main contributors, respectively. CONCLUSIONS: We found a low prevalence of dental flossing among participants in RaNCD study. We also observed a relatively high degree of pro-rich inequality in dental flossing. The observed inequality was mainly explained by socioeconomic status, level of education and place of residence. Policy interventions should consider these factors to reduce inequalities in dental flossing.

Serial interval and time-varying reproduction number estimation for COVID-19 in western Iran.

There is no report on the serial interval (SI) of coronavirus disease 2019 (COVID-19) in Iran, the present report aims to estimate the SI and time-varying R of COVID-19 in western Iran. In this study, there were 1477 confirmed, probable and suspected cases of severe acute respiratory syndrome coronavirus 2 for Kermanshah from 22 February to 9 April. The close contacts of the confirmed cases were identified using telephone follow up of patients and their contacts. The SI distribution was used as an alternative. We fitted different models using the clinical onset dates of patients with their close contact (infector-infectee). Also, we applied a 'serial interval from sample' approach as a Bayesian methodology for estimating reproduction number. From 22 February to 29 March, 247 COVID-19 cases were confirmed by RT-PCR. Close contact between 21 patients (21 infector-infectee pairs), including 12 primary cases and 21 secondary cases, was confirmed. The mean and standard deviation of the SI were estimated as 5.71 and 3.89 days. The R varied from 0.79 to 1.88 for a 7-day time-lapse and ranged from 0.92 to 1.64 for a 14-day time-lapse on raw data. Also, the R varied from 0.83 to 1.84 for 7-day time-lapse and from 0.95 to 1.54 for a 14-day time-lapse using moving average data, respectively. It can be concluded that the low reproduction number for COVID-19 in Kermanshah province is an indication of the effectiveness of preventive and interventive programmes such as quarantine and isolation. Consequently, continuing these preventive measures is highly recommended.

Access Matting Reduces Mixedgrass Prairie Soil and Vegetation Responses to Industrial Disturbance.

Substantial interest exists in understanding the role of low-disturbance construction methods in mitigating industrial impacts to native grassland soils and vegetation. We assessed soil and vegetation responses to conventional high-disturbance sod-stripping and revegetation on sandy soils, and the alternative practice of low-disturbance access matting to provide a temporary work surface on sandy and loamy soils. Treatments were associated with high-voltage transmission tower construction during 2014 within the Mixedgrass Prairie. High-disturbance sites were hydroseeded in May of 2015, while low-disturbance sites recovered naturally. We assessed soil physical (bulk density, water infiltration) and chemical properties (organic matter, pH, and electrical conductivity) after construction and herbage biomass for three growing seasons. Sod-stripping led to 53% greater soil bulk density and 51% less organic matter than nondisturbed controls, while water infiltration increased by 32% in these high-sand (>80%) soils. In contrast, access matting led to minimal soil property changes regardless of the texture. While total herbage biomass was unaffected by all construction treatments, sod-stripping reduced grass biomass by 80% during the first growing season, which coincided with a 119% increase in forb mass. Root biomass (0-15 cm) also declined 77% with sod-stripping. Vegetation biomass on sites with access matting remained largely unaffected by the disturbance. Overall, low-disturbance construction methods using access matting were more effective than sod-stripping in mitigating the negative impacts of industrial development on Mixedgrass soil properties, as well as vegetation biomass, and are recommended as a best management practice during industrial disturbance.

The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis.

INTRODUCTION: Urinary tract infection is one of the most common diseases in childhood, and can lead to severe complications such as renal scarring in case of lack of diagnosis and timely treatment. OBJECTIVE: The aim of this study was to investigate the prevalence of kidney scarring caused by urinary tract infection in Iranian children by meta-analysis. STUDY DESIGN: English -language databases including Science Direct, PubMed, Scopus, Web of Science, and Springer, and Persian -language sites including SID, Magiran, Iranmedex, and Medlib, and the Google Scholar search engine were searched by in March 2018 using MeSH keywords. The heterogeneity of studies was studied using the I2 index. Data were analyzed using STATA software, version 15.1. RESULTS: In 18 studies, the prevalence of kidney scarring from urinary tract infections in Iranian children was 31% (95% confidence intervalCI: 22%-39%), (which was 14% in girls and 23% in boys. Also, the prevalence of kidney scar in children with urinary reflux was 47% and in children without urinary reflux was 12%. The most common symptom of the renal scar was fever in 61%, followed by urinary reflux in 45% (unilateral in 42% and bilateral in 30%). Also, the prevalence of mild, moderate, and severe reflux, respectively, was 31%, 27%, and 13%. Meta-regression also showed that the prevalence of kidney scar due to urinary tract infections had no significant relationship with the number of samples and years of research (P > 0.05). DISCUSSION AND CONCLUSION: About one-third of Iranian children suffering from urinary tract infections had kidney scarring, so that the prevalence is lower in girls than in boys. Also, the prevalence of renal scarring in children with urinary reflux is about four times higher than that in children without urinary reflux.

The reliability of self-reporting chronic diseases: how reliable is the result of population-based cohort studies.

OBJECTIVES: To evaluate the reliability of self-reporting chronic diseases in the baseline data of the Ravansar Non-Communicable Diseases (RaNCD) cohort study in Kermanshah province, western Iran. METHODS: The study was conducted in RaNCD cohort study. To assess the reliability of self-report of chronic disease, a random sample of 202 participants were asked about some of chronic conditions 30-35 days (mean = 32) after recruitment. RESULTS: A range of kappa agreement between 39.52-100%, which the lower statistics was for hypertension and hepatitis and the higher one for cancer, cardiac ischemic, and diabetes. CONCLUSION: The self-report of chronic diseases was relatively reliable. Therefore self-reporting data for some conditions can be used in situations where the validity is acceptable.

Association of the CYP17 MSP AI (T-34C) and CYP19 codon 39 (Trp/Arg) polymorphisms with susceptibility to acne vulgaris.

The aim of this study was to detect the association of the cytochrome P450 (CYP) 17 T-34C and CYP19 T

Biocompatibility of hydroxyapatite coatings deposited by pulse electrodeposition technique on the Nitinol superelastic alloy.

The present study deals with pulse electrochemical deposition of HA on NiTi alloy and in vitro evaluation of coatings. At first step, a thermo-chemical surface modification process was applied to control the Ni release of the alloy. The electrochemical deposition of CaP coatings was examined at both dilute and concentrated solutions. The morphology and the composition of coatings were studied using scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Plate like and needle like morphologies were formed for dilute and concentrated solution respectively and HA phase was formed by increasing the pulse current density for both electrolyte. The thickness of the samples was measured using cross sectioning technique. Fibroblast cell culture test on the coated samples revealed that the HA coating obtained by dilute solution shows the best biocompatibility. Also, MTT assay showed the highest cell density and cell proliferation after 5days for the HA coating of dilute solution. The contact angle of samples was measured and the coated samples showed a hydrophilic surface. Soaking the sample in SBF revealed that the crystallization rate of calcium-phosphate compounds is higher on the plate like HA coating as compared to the needle like morphology. The P release of the HA coated samples was measured in a physiological saline solution and the results show that the ions releasing in the plate like coating are less than the needle like coating. It seems that the stability of the plate like coating in biological environments is responsible for the better biocompatibility of the coating.

Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran.

Since quality of life (QoL) is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient (ICC) for all 15 QLQ.C30 domains was moderate to good (ICC = 0.41-0.76). Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL.

Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran

Since quality of life [QoL] is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient [ICC] for all 15 QLQ.C30 domains was moderate to good [ICC = 0.41-0.76]. Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL

La qualité de vie étant de nature subjective, l'auto-évaluation constitue l'instrument de choix pour la mesure de celle-ci. Pour autant, dans certaines circonstances, le patient n'est pas capable d'évaluer sa situation. Au cours de cette étude transversale, 148 patients adressés à l'Institut du Cancer de République islamique d'Iran pour un cancer du sein ont été sélectionnés avec leurs aidants à l'aide d'une méthode d'échantillonnage consécutif. Cinq oncologues travaillant dans ce centre ont également évalué la qualité de vie de ces patients. Le questionnaire Qualité de vie [QLQ] de l'Organisation européenne pour la Recherche et le Traitement du Cancer a été rempli par ces trois groupes et les résultats ont fait l'objet d'une comparaison. Le coefficient intra-classe [CIC] patient-aidant pour les 15 domaines du QLQ-C30 allait de modéré à bon [CIC= 0,41-0,76]. La concordance entre les scores des patients portant sur la qualité de vie et ceux des oncologues étaient compris entre [ modéré ] et [ bon ], excepté dans quatre domaines. La comparaison patient-aidant donnait une concordance exacte dans 55%, et la comparaison patient-médecin une concordance de 45%. Les résultats peuvent être utilisés au cours du processus de décision clinique et de planification des soins quand les patients atteints d'un cancer du sein ne sont pas en mesure d'évaluer eux-mêmes leur niveau de qualité de vie

ACL reconstruction using bone-patella tendon-bone autograft: press-fit technique vs. interference screw fixation.

PURPOSE: The gold standard in ACL reconstructions has been the bone-patellar tendon-bone autograft fixed with interference screws. This prospective, randomized clinical trial aimed to compare two methods of fixation for BPTB grafts: press-fit fixation vs. interference screw, over a 12-month follow-up interval. METHODS: 158 patients with an average age of 29.8 years, between 2011 and 2012, were treated for torn ACL. 82 patients underwent reconstruction with BPTB autograft with a press fit fixation technique, and in 76 cases an interference screw was used. At the time of final follow-up, 71 patients in press-fit group and 65 patients in interference screw group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications. RESULTS: At 12-month follow-up, 59 (83 %) and 55 (85 %) in press-fit and screw group, respectively had good-to-excellent IKDC score (p > 0.05). The mean laxity assessed using a KT-1000 arthrometer improved to 2.7 and 2.5 mm in press-fit and screw group, respectively. Regarding Lachman and pivot shift test, there was a statistically significant improvement in the integrity of the ACL in both the groups, but no significant differences was noted between groups. There were no significant differences in terms of femur circumference difference, effusion, knee range of motion, pain and complications. CONCLUSIONS: The press-fit technique is an efficient procedure. Its outcome was comparable with the interference screw group. Furthermore it has unlimited bone-to-bone healing, no need for removal of hardware, ease for revision and cost effectiveness.

Treatment of intertrochanteric fractures in elderly highrisk patients: dynamic hip screw vs. external fixation.

INTRODUCTION: Although the use of a dynamic hip screw (DHS) is considered to be the preferred treatment for intertrochanteric fractures, the external fixation device could produce clinical outcomes comparable to the outcomes obtained with conventional treatment. Furthermore, because external fixation is minimally invasive, we expected a lower rate of morbidity. Therefore, we compared the two treatments in a clinical trial of elderly patients with intertrochanteric fracture. METHODS: 60 elderly high-risk patients with an average age of 78 years were treated for intertrochanteric fracture, resulting from a low energy trauma. Patients were randomly divided in two groups regarding to treatment. In Group A the patients were treated with DHS, while in Group B were treated with external fixator. RESULTS: The fixator was well accepted and no patient had significant difficulties while sitting or lying. The average intraoperative time was 73 min in Group A and 15 min in Group B (p<0.05). 27 patients of Group A need blood transfusion postoperatively and none in Group B (p<0.05). The mean duration of hospitalization in Group A and Group B was 8.4 and 2.2 days, respectively (p<0.05). 9 of patients Group B had pin-track infection grade 2 that all were treated by oral antibiotics. There were no differences in comorbidities, quality of reduction, screw cut out, bed sore and HHS between the two groups. CONCLUSION: Treatment with external fixator is an effective treatment for intertrochanteric fractures in elderly highrisk patients. The advantages include quick and simple application, minimal blood loss, less radiation exposure, adequate fixation, pain reduction, early discharge from hospital, low costs and favourable functional outcomes.

Trends of skin cancer incidence in 6 geographical regions of the Islamic Republic of Iran, 2000-2005.

Data about the incidence of skin cancer in the Islamic Republic of Iran are lacking. This study investigated trends in the incidence of skin cancer (lCD-10 category C44, other malignant neoplasms of skin) in 6 regions using data from the Iranian cancer registry from 2000 to 2005. The standardized incidence rates in each year were calculated by the direct method using the standard World Health Organization population and a Poisson regression model was applied to analyse trends. Over the study period, 30 701 cases of cancer were identified, rising from 2353 in 2000 to 8484 in 2005. The male-to-female ratio was 1.6. The age-standardized incidence rose significantly from 3.8 cases per 100 000 in 2000 to 13.0 in 2005 (slope = 0.26), and the same trend was seen in all regions except the region to the east of the Caspian Sea. This increasing incidence of skin cancer in the Islamic Republic of Iran is similar to that reported in other countries.

Study of operated primary and secondary (recurrence) hydatidosis in hospitals of Kermanshah, west of Islamic Republic of Iran.

Cystic echinococcosis, caused by the larval stage of Echinoccocus granulosus, is a global public health threat. The aim of this study was to determine the demographic and clinical characteristics of cases of primary and secondary hydatid cyst in the west of the Islamic Republic of Iran. A retrospective record review was made in 7 public and private hospitals in Kermanshah from 2004 to 2009. Of 526 files of suspected cases analysed, 291 cases of hydatid cyst had been operated upon and confirmed. Of the patients, 51.5% were females, 57.7% lived in urban and suburban areas and the largest age group (17.5%) was 31-40 years. The major organs involved were liver (64.9%) and lung (26.8%) and 18 cases (6.2%) were confirmed as secondary hydatidosis. Most patients (79.4%) had been treated with albendazole. Kermanshah province should be considered an endemic region for human hydatid cyst disease; greater efforts in prevention are needed.

Study of operated primary and secondary [recurrence] hydatidosis in hospitals of Kermanshah, west of Islamic Republic of Iran

Cystic echinococcosis, caused by the larval stage of Echinoccocus granulosus, is a global public health threat. The aim of this study was to determine the demographic and clinical characteristics of cases of primary and secondary hydatid cyst in the west of the Islamic Republic of Iran. A retrospective record review was made in 7 public and private hospitals in Kermanshah from 2004 to 2009. Of 526 files of suspected cases analysed, 291 cases of hydatid cyst had been operated upon and confirmed. Of the patients, 51.5% were females, 57.7% lived in urban and suburban areas and the largest age group [17.5%] was 31-40 years. The major organs involved were liver [64.9%] and lung [26.8%] and 18 cases [6.2%] were confirmed as secondary hydatidosis. Most patients [79.4%] had been treated with albendazole.Kermanshah province should be considered an endemic region for human hydatid cyst disease; greater efforts in prevention are needed

Prevalence of food contamination with Listeria spp. in Kermanshah, Islamic Republic of Iran

Listeria monocytogenes is a human pathogen causing serious diseases. We aimed to determine food contamination with Listeria spp. in Kermanshah, Islamic Republic of Iran. Samples [185 dairy, 187 meat products and 158 ready-to-eat foods such as salads] were randomly collected from markets. After processing, samples were cultured in half-Fraser and Fraser broth followed by cultivation on PALCAM and Oxford media. Confirmatory tests including carbohydrate utilization were performed on isolates to determine species. Bacteria were isolated from 66/530 samples [12.5%]. Meat products showed the highest [27.2%] and dairy products the lowest [3.8%] contamination rates. L. innocua was found in 56 [10.6%] samples, but L. monocytogenes was only found in 3 samples [0.6%]. The results indicate that the rate of contamination with L. monocytogenes, even for ready-to-eat foods, was low but for other Listeria spp., in particular strains of L. innocua, the rate of contamination was higher, suggesting that more control on food sanitation is required

Trends of skin cancer incidence in 6 geographical regions of the Islamic Republic of Iran, 2000-2005

Data about the incidence of skin cancer in the Islamic Republic of Iran are lacking. This study investigated trends in the incidence of skin cancer [ICD-10 category C44, other malignant neoplasms of skin] in 6 regions using data from the Iranian cancer registry from 2000 to 2005. The standardized incidence rates in each year were calculated by the direct method using the standard World Health Organization population and a Poisson regression model was applied to analyse trends. Over the study period, 30 701 cases of cancer were identified, rising from 2353 in 2000 to 8484 in 2005. The male-to-female ratio was 1.6. The age-standardized incidence rose significantly from 3.8 cases per 100 000 in 2000 to 13.0 in 2005 [slope = 0.26], and the same trend was seen in all regions except the region to the east of the Caspian Sea. This increasing incidence of skin cancer in the Islamic Republic of Iran is similar to that reported in other countries

Evaluation of the care for diabetes patients by general practitioners in the province of Khouribga, Morocco

Diabetes is a disease of concern due to its increasing frequency and high cost of care. This cross sectional study evaluated the types of care provided to diabetes patients in primary care for management of the condition. Between December 2010 and March 2011, 54 general practitioners [GPs] in health centres in Khouribga province were asked to complete a pretested questionnaire on their care of diabetes patients. For type 2 diabetes, 46% of the GPs would prescribe diet and lifestyle treatment alone. The practice setting influenced how treatment was managed for type1 diabetes patients: 88.5% of rural doctors prescribed premixed insulin versus 58.3% of urban GPs [P = 0.02]. Insulin analogues were prescribed by 20.8% of urban GPs as against 3.8% of rural GPs [P = 0.09]. There are several shortcomings in the quality of care for diabetes patients. Training GPs could be a solution, especially with the lack of specialists in our country