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Porcelain laminate veneers (PLV) offer a conservative aesthetic solution for interdental space closure. However, space is typically not distributed symmetrically, and the mesiodistal width of the restored teeth may increase unless multiple teeth are prepared for conventional PLV to maintain appropriate individual tooth proportion. Ceramic fragments can be suggested to close the space without modifying tooth size and dental proportion. This article presents two cases where interdental gaps were closed using lingually placed porcelain laminate (LPPL). All stages of the restorative procedures, including treatment planning, temporization, tooth preparation, and cementation of these delicate restorations, are detailed. Based on the results of these clinical reports, we regard the use of LPPL as a successful treatment option in selected cases, as evidenced by 2- and 6-year follow-ups. The Modified United State Public Health Criteria is reported.
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Most occupational hazardous agents in workplaces should be evaluated and controlled. Different methods exist for identifying, evaluating and controlling these agents, such as numerical simulation tools. Numerical simulations can help experts to improve occupational health. Due to the importance and abilities of numerical simulations, this study divided occupational hazardous agents into 10 subgroups. These subgroups included air pollution, ventilation, respiratory airways, noise and vibration, lighting, radiation, ergonomics, fire and explosion, risk assessment and personal protective equipment. Recent research studies in each subgroup were then reviewed, and the codes and software used in simulations were determined. The results show that Fluent software and k-ϵ turbulence models are the most used in occupational health studies simulations. Today, different codes and software have been developed for simulation, and we suggest their use in occupational health studies.
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Occupational Exposure , Occupational Health , Humans , Occupational Exposure/prevention & control , Risk Assessment/methods , Computer Simulation , Software , Personal Protective Equipment , Ventilation , Vibration , Hazardous Substances , Ergonomics , Lighting , Fires , Explosions , Noise, OccupationalABSTRACT
INTRODUCTION: Occupation plays an important role in the spread of infectious diseases in humans. Toxoplasmosis and hydatidosis are world-wide diseases with different routes of transmission. This study aimed to investigate the prevalence of toxoplasmosis and hydatidosis and risk factors associated with these diseases among the butchers of Tabriz City, the northwest of Iran. METHODS: In this case-control study conducted in Tabriz city in 2023, 250 serum samples were collected from butchers (n = 125) and outpatients referred to Imam Reza Hospital (n = 125) and. The ELISA test was used to identify IgG and IgM antibodies against toxoplasmosis and IgG antibodies against hydatidosis. The results were analyzed by statistics tests using SPSS v. 16 software. Risk factors' association was tested using Chi square or logistic regression analysis. RESULTS: The results indicated that 66/125 (52.8%) cases and 40/125 controls (32%) were positive for toxoplasmosis IgG antibody. Also, 5/125 (4%) and 1/125 (0.8%) were positive for toxoplasmosis IgM antibody in the case and control groups, respectively. In addition, 10/125 people (8%) were positive for anti-hydatidosis IgG antibody in the case group, while no positive cases were found in the control group. The main risk factors for toxoplasmosis were age (OR: 1.014), education level (OR: 0.638), and work experience(OR: 1.695), these factors for hydatidosis included age and education level (OR: 1.765 and 0.271) respectivily. CONCLUSIONS: Our results suggest the high prevalence of toxoplasmosis and in butchers of Tabriz, which required special attention and basic measures. Moreover, the prevalence of hydatidosis IgG antibodies also requires more attention to be focused on breaking the transmission and reducing the infection.
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Background and Aims: Health policymakers face challenges in designing compulsory plan packages for medical students to encourage them to work in disadvantaged regions. Using a discrete choice experiment, this study assessed the preferences of medical students for selecting the compulsory service plan packages in Guilan Province, Iran. Methods: In total, 374 medical students responded to a survey inquiring about salary, distance from their residency city, availability of welfare amenities, work difficulty, the developmental status of their workplace, contract duration, and preference for urban or rural work settings. Results: The study revealed that students favor a compulsory service package that provides higher salaries and shorter contract duration. They also show a preference for working within their home province over other factors. For the opportunity to serve in their city of residence, they would forgo an average of US$77.93 per month. Conclusion: While financial incentives were the primary consideration for medical students when choosing compulsory service packages, a range of nonfinancial factors significantly influenced their decisions as well.
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The intersection of nanotechnology and pharmacology has revolutionized the delivery and efficacy of chemotherapeutic agents, notably docetaxel, a key drug in cancer treatment. Traditionally limited by poor solubility and significant side effects, docetaxel's therapeutic potential has been significantly enhanced through its incorporation into nanoplatforms, such as nanofibers and nanoparticles. This advancement offers targeted delivery, controlled release, and improved bioavailability, dramatically reducing systemic toxicity and enhancing patient outcomes. Nanofibers provide a versatile scaffold for the controlled release of docetaxel, utilizing techniques like electrospinning to tailor drug release profiles. Nanoparticles, on the other hand, enable precise drug delivery to tumor cells, minimizing damage to healthy tissues through sophisticated encapsulation methods such as nanoprecipitation and emulsion. These nanotechnologies not only improve the pharmacokinetic properties of docetaxel but also open new avenues in regenerative medicine by facilitating targeted therapy and cellular regeneration. This narrative review highlights the transformative impact of docetaxel-loaded nanoplatforms in oncology and beyond, showcasing the potential of nanotechnology to overcome the limitations of traditional chemotherapy and pave the way for future innovations in drug delivery and regenerative therapies. Through these advancements, nanotechnology promises a new era of precision medicine, enhancing the efficacy of cancer treatments while minimizing adverse effects.
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Docetaxel , Neoplasms , Regenerative Medicine , Humans , Docetaxel/pharmacology , Docetaxel/therapeutic use , Docetaxel/administration & dosage , Neoplasms/drug therapy , Animals , Nanoparticles/chemistry , Antineoplastic Agents/therapeutic use , Antineoplastic Agents/pharmacology , Antineoplastic Agents/administration & dosage , Treatment Outcome , Drug Delivery SystemsABSTRACT
In recent decades, emerging data have highlighted the critical role of extracellular vesicles (EVs), especially (exosomes) Exos, in the progression and development of several cancer types. These nano-sized vesicles are released by different cell lineages within the cancer niche and maintain a suitable platform for the interchange of various signaling molecules in a paracrine manner. Based on several studies, Exos can transfer oncogenic factors to other cells, and alter the activity of immune cells, and tumor microenvironment, leading to the expansion of tumor cells and metastasis to the remote sites. It has been indicated that the cell-to-cell crosstalk is so complicated and a wide array of factors are involved in this process. How and by which mechanisms Exos can regulate the behavior of tumor cells and non-cancer cells is at the center of debate. Here, we scrutinize the molecular mechanisms involved in the oncogenic behavior of Exos released by different cell lineages of tumor parenchyma. Besides, tumoricidal properties of Exos from various stem cell (SC) types are discussed in detail.
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Exosomes , Extracellular Vesicles , Neoplasms , Humans , Exosomes/metabolism , Neoplasms/pathology , Extracellular Vesicles/metabolism , Carcinogenesis/metabolism , Signal Transduction , Tumor MicroenvironmentABSTRACT
BACKGROUND: One of the modifiable risk factors for cardiovascular diseases is the inter-arm blood pressure difference (IAD), which can be easily measured. This study aimed to determine the prevalence and factors related to the Iranian population's inter-arm differences in systolic and diastolic blood pressure. METHOD: This cross-sectional study was conducted on the baseline data of participants who had Iranian nationality, were at least 1 year of residence in the area, aged within the age range of 35-70 years, and willed to participate from the Fasa Persian Adult Cohort Study (FACS). IAD for systolic and diastolic blood pressure was measured and categorized into two groups of difference < 10 and ≥ 10 mmHg. Logistic regression was used to model the association between independent variables and IAD. RESULTS: The prevalence of systolic and diastolic IAD ≥ 10 mmHg was 16.34% and 10.2%, respectively, among 10,124 participants. According to the multivariable logistic regression models, age (adjusted odds ratio (aOR): 1.019 [95% CI: 1.013, 1.025]), body mass index (BMI) (aOR: 1.112 [95% CI: 1.016, 1.229]), having type 2 diabetes (aOR Yes/No: 1.172 [95% CI: 1.015, 1.368]), having chronic headaches (aOR Yes/No: 1.182 [95% CI: 1.024, 1.365]), and pulse rate (aOR: 1.019 [95% CI: 1.014, 1.024]) significantly increased the odds of systolic IAD ≥ 10 mmHg. Additionally, high socio-economic status decreased the odds of systolic IAD ≥ 10 mmHg (aOR High/Low: 0.854 [95% CI: 0.744, 0.979]). For diastolic IAD, age (aOR: 1.112 [95% CI: 1.015, 1.210]) and pulse rate (aOR: 1.021 [95% CI: 1.015, 1.027]) significantly increased the odds of diastolic IAD ≥ 10 mmHg. Moreover, high socioeconomic status decreased the odds of diastolic IAD ≥ 10 mmHg (aOR High/Low: 0.820 [95% CI: 0.698, 0.963]). CONCLUSION: The noticeable prevalence of systolic and diastolic IAD in general population exhibits health implications due to its' association with the risk of cardiovascular events. Sociodemographic and medical history assessments have potentials to be incorporated in IAD risk stratification and preventing programs.
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Diabetes Mellitus, Type 2 , Hypertension , Adult , Humans , Aged , Middle Aged , Blood Pressure/physiology , Blood Pressure Determination , Cohort Studies , Cross-Sectional Studies , Prevalence , Diabetes Mellitus, Type 2/complications , Iran/epidemiology , Hypertension/complicationsABSTRACT
Urease-powered nano/micromotors can move at physiological urea concentrations, making them useful for biomedical applications, such as treating bladder cancer. However, their movement in biological environments is still challenging. Herein, Janus micromotors based on black TiO2 with urease asymmetric catalytic coating were designed to take benefit of the optical properties of black TiO2 under near-infrared light and the movement capability in simulated bladder environments (urea). The black TiO2 microspheres were half-coated with a thin layer of Au, and l-Cysteine was utilized to attach the urease enzyme to the Au surface using its thiol group. Biocatalytic hydrolysis of urea through urease at biologically relevant concentrations provided the driving force for micromotors. A variety of parameters, such as urea fuel concentration, viscosity, and ionic character of the environment, were used to investigate how micromotors moved in different concentrations of urea in water, PBS, NaCl, and urine. The results indicate that micromotors are propelled through ionic self-diffusiophoresis caused by urea enzymatic catalysis. Due to their low toxicity and in vitro anticancer effect, micromotors are effective agents for photothermal therapy, which can help kill bladder cancer cells. These promising results suggest that biocompatible micromotors hold great potential for improving cancer treatment and facilitating diagnosis.
Subject(s)
Urease , Urinary Bladder Neoplasms , Humans , Photothermal Therapy , Microspheres , Urinary Bladder Neoplasms/drug therapy , UreaABSTRACT
AIM: Silk fibroin/chitosan/ZnO/Astragalus arbusculinus (Ast) gum fibrous scaffolds along with adipose-derived mesenchymal stem cells (ADSCs) were investigated for accelerating diabetic wound healing. METHODS: Scaffolds with a core-shell structure and different compositions were synthesized using the electrospinning method. Biological in vitro investigations included antibacterial testing, cell viability analysis and cell attachment evaluation. In vivo experiments, including the chicken chorioallantoic membrane (CAM) test, were conducted to assess wound-healing efficacy and histopathological changes. RESULTS: The incorporation of Ast to the silk fibroin@ chitosan/ZnO scaffold improved wound healing in diabetic mice. In addition, seeding of ADSCs on the scaffold accelerated wound healing. CONCLUSION: These findings suggest that the designed scaffold can be useful for skin regeneration applications.
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Chitosan , Fibroins , Mesenchymal Stem Cells , Nanofibers , Tissue Scaffolds , Wound Healing , Zinc Oxide , Chitosan/chemistry , Animals , Wound Healing/drug effects , Fibroins/chemistry , Fibroins/pharmacology , Nanofibers/chemistry , Mice , Zinc Oxide/chemistry , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/drug effects , Tissue Scaffolds/chemistry , Cell Survival/drug effects , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Humans , Diabetes Mellitus, Experimental , Chorioallantoic Membrane/drug effects , ChickensABSTRACT
The development of eco-friendly, efficient, and economical demulsifiers for the demulsification of water in crude oil emulsion is one of the important issues in the petroleum industry. Demulsifiers with suitable performance in several demulsification methods are good choices for effective and economical demulsification. In this study, recyclable magnetic cellulose nanocrystals have been synthesized from cotton by a simple method and used in the demulsification of water in crude oil emulsions. Chemical and magnetic demulsification by magnetic cellulose nanocrystals has been investigated. In addition, the effects of time, temperature, and demulsifier concentration on the demulsification efficiency have been evaluated. According to the results, this demulsifier can be used as an effective demulsifier for both chemical and magnetic demulsification and displayed a demulsification efficiency of 100 % at 50 °C without a magnet and 90 % at 20 °C with a magnet. The chemical demulsification efficiency of Fe3O4 nanoparticles was investigated and it showed lower DE compared to magnetic cellulose nanocrystals. The recyclability tests of the demulsifier indicated that magnetic cellulose nanocrystals can be used up to 4 times. Finally, the demulsification mechanism and interfacial tension measurements revealed that this demulsifier reduced the interfacial tension between water and crude oil and increased the water droplet sizes.
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Nanoparticles , Petroleum , Emulsions/chemistry , Cellulose , Water/chemistry , Nanoparticles/chemistry , Magnetic PhenomenaABSTRACT
BACKGROUND: This is the first clinical trial to investigate the effectiveness of maggot debridement therapy (MDT) for full-thickness burn injuries in comparison to conventional silver dressings. METHODS: Thirty-one cases with full-thickness (grade III based on ICD-10 classifications version 2019) burns were assigned into larval therapy (15 cases) and conventional treatment (16 cases) groups. Participants in the MDT group have received loose larvae on days 0, 2, 4, and 6, while controls received a conventional regimen comprised of sharp debridement, silver sulfadiazine, antibiotic therapy, and offloading every day. The primary and secondary outcomes were defined as the time to debridement (from admission to skin autograft) and time to healing (from admission to complete healing post-skin autograft). Patients in two groups were also compared in terms of necrosis resolution, granulation, and granulation/necrosis (g/n) ratio during study time periods. RESULTS: Participants who received larvae had significantly decreased necrosis on days 2 (p = 0.028) and 4 (p = 0.023) compared to those who received control treatment. Significant differences (p < 0.001) were also observed for granulation between the two groups in favor of MDT and the fold changes of g/n in the larvae group were 5, 15, and 13 times higher than that for the conventional regimen on days 2, 4, and 6 of treatment, respectively. Strikingly, a subgroup analysis of high necrotic burns (necrosis > 50%) revealed a significant improvement (p < 0.001) for MDT compared to the control treatment. There were also significant differences (p < 0.001) for the time to debridement and time to healing between the two groups. However, bacterial contamination did not show significant changes between the two treatment regimens. CONCLUSIONS: Our findings revealed that MDT has a favorable superiority over conventional regimen for the treatment of grade-III burns, and thus further clinical trials with larger sample size are warranted to confirm these results.
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Burns , Silver , Humans , Animals , Burns/therapy , Bandages , Larva , NecrosisABSTRACT
BACKGROUND: Multiple sclerosis (MS) is an autoimmune central nervous system (CNS) disorder indicated by demyelination, chronic inflammation, and neuronal destruction. Regional demyelination, inflammation responses, scar development, and various axonal damage are pathological characteristics of MS. Curcumin is a hydrophobic polyphenol extracted from the rhizome of the turmeric plant. In addition to anti-inflammatory effects, beneficial therapeutic effects such as antioxidant, anti-cancer and nerve protection have also been seen from this compound. The purpose of the current investigation was to provide light on the potential benefits of Curcumin in treating experimental autoimmune encephalomyelitis (EAE), the animal model of MS. METHODS AND RESULTS: in Female C57BL/6 mice were used to induce EAE through myelin oligodendroglial glycoprotein (MOG). Curcumin doses of 100 and 200 mg/kg were administered orally in the treatment groups starting on the first day of EAE induction. Brains and splenocytes were extracted from euthanized animals on day 25 following EAE induction. Demyelination and leukocyte infiltration, proliferation, cytokine, and gene expression profiles were assessed. Our findings demonstrate that both low and high doses of Curcumin decreased the progression of EAE. Histological analyses revealed low infiltration of leukocytes into the CNS. Curcumin therapy enhanced Th2 and Treg cell secretion of IL-4, IL-10, and TGF-ß although considerably decreasing IFN-γ and TNF-α. Curcumin-induced Th2 and Treg cell cytokine production and transcription factor gene expression (IL-13, GATA3, STAT6 and IL-35, CTLA4, Foxp3) and anti-inflammatory cytokines (IL-27, IL-33). CONCLUSION: Overall, these findings provide additional evidence that Curcumin can slow disease development and alleviate symptoms in EAE through stimulating Treg and Th2 cell polarization. They support Curcumin's potential therapeutic role in MS.
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Curcumin , Encephalomyelitis, Autoimmune, Experimental , Multiple Sclerosis , Animals , Mice , Multiple Sclerosis/drug therapy , Curcumin/pharmacology , Curcumin/therapeutic use , Spices , Mice, Inbred C57BL , Cytokines/metabolism , Inflammation/drug therapy , Immunity , Anti-Inflammatory Agents/therapeutic use , Patient AcuityABSTRACT
BACKGROUND: The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. METHODS: A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. RESULTS: During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05). CONCLUSION: The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.
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Diabetes Mellitus, Type 2 , Prediabetic State , Adult , Humans , Prediabetic State/epidemiology , Incidence , Diabetes Mellitus, Type 2/epidemiology , Prospective Studies , Glycemic Index , Triglycerides , Lipoproteins, HDL , CholesterolABSTRACT
Background and Aim: The use of helmets has been reported to reduce the incidence and severity of head injuries in motorcyclists. However, there remains a significant gap in knowledge regarding the effectiveness of helmets, especially in preventing jaw and tooth injuries. Patients and Methods: In this retrospective analytical study record, all traffic accidents that occurred continuously from 2017 to 2019 in which the motorcyclists were on at least one side of the collision based on inclusion criteria. Data from injury variables in medical records were merged with data related to helmet use in the trauma registration system in Excel software. Then, the final analysis was performed with STATA software version 14 at a significance level of < 0.05. Results: In total, 1807 people participated in the study, and 160 (9.37) people used helmets. The incidence rate of jaw and tooth injuries was 86 (5.04%). Logistic regression implied that the odds ratio for helmet use was 0.7, which considering the p value of 0.419, shows no significant relationship between wearing helmets and jaw and tooth injuries. Conclusion: Helmets alone cannot prevent jaw and tooth injuries, and designers should design helmets that protect the head and the jaw and tooth. In prevention programs and campaigns for motorcyclists, every age, gender, job, grade group and marital status are target groups.
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INTRODUCTION: Autism spectrum disorders (ASD) encompass a range of neurodevelopmental disorders that affect the patient's communication and behavior. There are some reports about the increasing prevalence of ASD in recent decades, mostly due to the improvement in diagnosis and screening status. Few studies suggested a lower prevalence of ASD in North Africa and Middle East compared to more developed regions. The aim of this study is to provide a comprehensive outlook of ASD in the region. METHODS: We used Global Burden of Disease (GBD) data from 1990 to 2019 in North Africa and Middle East, which is one of the seven super regions of the GBD categorization. In this study, we reported the epidemiologic indices, including prevalence, incidence, and years lived with disability (YLDs) for ASD in the 21 countries of the super region. We also compared these indices between the countries based on their sociodemographic index (SDI) which was calculated according to income per capita, mean education, and fertility rate. RESULTS: Age-standardized prevalence rate (ASPR) of ASD in the region is 304.4 (95% uncertainty interval 251.2-366.1) per 100,000 in 2019 with less than one percentage change since 1990. Age-standardized YLDs and incidence rates were 46.4 (30.4-67.5) and 7.7 (6.3-9.3) per 100,000 in 2019. The ASPR was 2.9 times greater in males compared to females in 2019. The highest age-standardized prevalence, incidence, and YLD rates among the countries were seen in Iran in 2019 (370.3, 9.3, and 56.4 per 100,000, respectively). High SDI countries had higher age-standardized YLDs rates compared to the other countries of the region. CONCLUSION: In conclusion, the trends of age-standardized epidemiologic indices remained approximately steady through the years 1990-2019 in the region. Though, there was a wide discrepancy between the countries of the region. The difference of YLDs among the countries of this region is related to the SDI of the countries. Monetary and public awareness status are the SDI factors that may affect the quality of life of ASD patients in the region. This study provides valuable information for governments and health systems to implement policies for maintaining the improving trend, achieving more timely diagnosis, and bettering the supportive actions in this region.
Subject(s)
Autism Spectrum Disorder , Global Burden of Disease , Male , Female , Humans , Quality of Life , Autism Spectrum Disorder/epidemiology , Global Health , Prevalence , Incidence , Africa, Northern/epidemiology , Middle East/epidemiologyABSTRACT
The inter-arm blood pressure difference has been advocated to be associated with cardiovascular mortality and morbidity. Our study aimed to investigate the association between Inter-arm systolic and diastolic blood pressure differences and Cardio Vascular Disease (CVD). A total of 10,126 participants aged 35-70 years old were enrolled in a prospective Fasa Persian Adult Cohort. In this cross-sectional study, the cutoff values for inter-arm blood pressure difference were less than 5, greater than 5, greater than 10, and greater than 15 mm Hg. Descriptive statistics and logistic regression were used to analyze the data. Based on the results the prevalence of ≥ 15 mmHg inter-arm systolic and diastole blood pressure difference (inter-arm SBPD and inter-arm DBPD) were 8.08% and 2.61%. The results of logistic regression analysis showed that inter-arm SBPD ≥ 15 and (OR<5/≥15 = 1.412; 95%CI = 1.099-1.814) and inter-arm DBPD ≥ 10 (OR<5/≥10 = 1.518; 95%CI = 1.238-1.862) affected the risk of CVD. The results showed that the differences in BP between the arms had a strong positive relationship with CVD. Therefore, inter-arm blood pressure could be considered a marker for the prevention and diagnosis of CVD for physicians.
Subject(s)
Cardiovascular Diseases , Vascular Diseases , Humans , Adult , Middle Aged , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Blood Pressure , Cohort Studies , Cross-Sectional Studies , Prospective StudiesABSTRACT
Despite advances in clinical research, the long-term effects of COVID-19 on patients are not clear. Many studies revealed persistent long-term signs and symptoms. In a survey study, 259 hospitalized confirmed COVID-19 patients between 18 and 59 years were interviewed. Demographic characteristics and complaints were studied through telephone interviews. Any patient-reported symptoms that continued or developed from 4 weeks up to 12 weeks after the onset of the disease were recorded only if they did not exist prior to infection. The 12-Item General Health Questionnaire was used for screening and assessing mental symptoms and psychosocial well-being. The mean age of participants was 43.8 ± 9.9 years. About 37% had at least one underlying disease. 92.5% showed ongoing symptoms that the most prevalent complications were hair loss (61.4%), fatigue (54.1%), shortness of breath (40.2%), altered smell (34.4%), and aggression (34.4%), respectively. In terms of factors affecting patients' complaints, there were significant differences between age, sex, and underlying disease with long-remaining complications. This study shows a high rate of long COVID-19 conditions that should be considered by physicians, policymakers, and managers.
Subject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , Humans , Adult , Middle Aged , COVID-19/epidemiology , Aggression , Survivors , Health StatusABSTRACT
Objective: This study aimed to investigate blood glucose levels in patients with brain injury caused by mild traumatic brain injury (TBI) as a foundation for determining whether these patients need a brain CT scan or not. Methods: This cross-sectional study was conducted on patients with mild TBI, who were referred to the emergency department from March 1, 2022, to September 1, 2022. After the confirmation of mild TBI by an emergency medicine specialist, blood samples were taken from the patients to measure blood glucose levels. Then a brain CT scan was performed, and blood glucose levels were compared between patients with and without CT indications of brain injury. A checklist was used to collect data, and the data were analyzed using SPSS software (version 23). Results: In the CT scans of the 157 patients included in the study, 30 patients (19.2%) had a brain injury in the CT scan. The mean blood glucose level was significantly higher in patients with brain injury, especially in the presence of vertigo and ataxia, than patients without brain injury in the CT scan (p<0.0001). There was a significant positive correlation between age and blood glucose level (r=0.315, p<0.0001). Conclusion: Patients with mild TBI who had signs of brain injury in the CT scan had significantly higher blood glucose levels than patients with normal CT scan findings. Although indications for performing a brain CT scan are usually based on clinical criteria, blood glucose levels can be helpful in determining the requirement for a brain CT scan in patients with mild TBI.
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Objectives: Traumatic brain injury (TBI) is preventable and expensive. The medical costs of TBI can be too high for some households and might lead to poverty, malnutrition, and loss of assets, which are called catastrophic expenditures. In this study, we investigated the incidence of catastrophic costs associated with TBI caused by road accidents in a province in northern Iran. Methods: This prospective study involved a 1-year follow-up after the accident. Data of 220 patients were collected from the medical records of the Poursina Hospital, Rasht, Iran from March 2018 to February 2020. Direct and indirect costs faced by the households of patients with TBI and catastrophic costs related to TBI were calculated. Regression models were obtained and sensitivity analyses were performed at the end of the study. Results: In total, the prevalence of households TBI-related catastrophic costs (TBICC) was 45.5% . Households of female patients (odds ratio [OR]: 0.289, p=0.042), households of retired patients (OR: 0.053, p=0.005), and households falling in the fifth quintile of wealth (OR: 0.370, p=0.050) faced lower TBICC compared to other groups. The Activities of Daily Living scores had a significant negative relationship with TBICC. Conclusions: Political interventions such as implementation of insurance schemes, exemptions from payment for certain groups, identification of poor households, and coverage of assistance services can protect households from catastrophic health expenditures.
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BACKGROUND: Research interest in the impact of comorbidities in MS has been expanding. Based on studies, certain comorbidities are more prevalent in MS population such as depression, anxiety, hypertension and hypercholesterolemia, diabetes, and hypothyroidism. OBJECTIVE: This study aims to describe the prevalence of comorbidities in MS population based on the health insurance claims data. METHOD: This retrospective database analysis was conducted using patient-level medicinal and pharmacy claims data from a leading insurance group (Iranian health insurance) in 2007-2016. MS population was identified based on their Disease Modifying Therapies prescribed by a neurologist (qualified to diagnose MS). Comorbidities in MS and non-MS population were assessed by their prescriptions. Crude and age-standardized prevalence rate (ASPR) of coverage of comorbidities in different age and sex groups and their odds ratio versus non-MS population were assessed. RESULTS: The most common comorbidities were depression (15.50%) and anxiety (10.1%). Hypercholesterolemia, diabetes, hypertension, and hypothyroidism were prevalent in 6%, 3.6%, 3.5%, and 2.7% respectively. Anxiety and depression were more prevalent in middle age group (45-65 years old). But other comorbidities were more prevalent in older age groups. All comorbidities were more prevalent in female except hypertension in patients ≥45 years old. The odds of all comorbidities were higher for male patients with MS rather than their parallel age group in non-MS patients. These also applied for female patients with MS 18-44 years old (except hypertension). CONCLUSION: Using claims data, the prevalence of taking treatment for selected comorbidities in MS population and their association with sex and age, can guide patients, healthcare providers, and policy makers to help improve MS patients' wellbeing.