Comparison of Diagnostic Quality of Multidetector Computed Tomography and Cone-Beam Computed Tomography in High and Low Resolution Modes for Assessment of the Nasal Cavity.

Background: We aimed to compare the diagnostic quality of multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) in high (HR) and low (LR) resolution modes for assessment of the nasal cavity and paranasal sinuses. Methods: This in vitro study was conducted on 5 dry human skulls by using a CBCT and a MDCT scanner in HR and LR modes to assess their diagnostic quality for 21 anatomical landmarks of the nose. The quality of images was evaluated by two oral and maxillofacial radiologists and a dentist using a four-point Likert scale of (I) poor, (II) decreased, (III) good, and (IV) excellent. Data were analyzed by STATA at 95% confidence interval. The Chi-square test was applied to compare the quality of visualization of landmarks based on the type of scanner. Results: The diagnostic quality of HR CBCT and CT for the majority of landmarks was higher than that of LR CBCT and CT (P<0.05). The diagnostic quality of HR CBCT for agger nasi cells (P=0.010), olfactory cleft (P=0.032), sphenoethmoidal recess (P=0.032), and nasolacrimal duct (P=0.014) and LR CBCT for the middle turbinate (P=0.046) and middle meatus (P=0.031) was significantly higher than that of MDCT. Conclusion: The diagnostic quality of HR CBCT and CT for the majority of the landmarks in the nasal cavity and paranasal sinuses was higher than that of LR CBCT and CT. For the majority of landmarks, the diagnostic quality of CBCT and CT was the same; while for some landmarks, the diagnostic quality of HR and LR CBCT was higher than HR and LR CT. In general, CBCT has high efficacy for evaluation of the paranasal sinuses and the nasal cavity, and provides diagnostic information comparable to those provided by CT, but with a much lower radiation dose.

Effect of Low-Level Laser Therapy on Differentiation and Proliferation of Human Dental Pulp Stem Cells: A Systematic Review.

Introduction: Considering the positive impact of laser treatment on the proliferation of certain cell types, we opted to perform a systematic review aimed at evaluating the effects of laser therapy and photobiomodulation on the proliferation and differentiation of human dental pulp stem cells (hDPSCs). Methods: We included all research studies examining the impact of laser therapy on hDPSCs, without limitations on publication dates or article languages. The major international databases, including PubMed, ISI Web of Science, and Scopus, were searched from inception to April 2022 by the relevant keywords. Results: In total, 1886 studies were identified in the initial search from the mentioned databases and other sources. Finally, 17 relevant studies were included in the present systematic review after removing duplicates and non-relevant articles. The results indicated the useful effect of low-level laser therapy (LLLT) on the hDPSCs. Conclusion: The findings of this systematic review indicate the useful role of LLLT in cell therapy, proliferation, and differentiation associated with hDPSCs.

The association of arsenic exposure with mortality due to cancer, diabetes, Alzheimer's and congenital anomalies using Poisson regression.

The present study aims to determine the relationship between the concentration of arsenic in the groundwater of Hamadan province and the mortality rate due to various types of malignancies, congenital anomalies, diabetes mellitus and Alzheimer's. Mortality data due to various causes of death in Hamadan province were collected for five years (2016-2020). Sampling of drinking water was determined in the reference laboratory using polarography method. Poisson regression was used to investigate the relationship between arsenic level and the death rate due to various types of disease, at a significant level (p value < 0.05). According to the results of Poisson regression, among the various causes of death (N = 8042), Alzheimer's 5.94 (3.67-9.61), diabetes mellitus 4.05 (3.5-5.37), congenital malformations 2.98 (1.88-4.72), breast cancer 2.72 (1.56-4.71), leukemia 1.90 (1.24-2.92), stomach cancer 1.64 (1.28-2.10), Liver cancer 1.58 (1.58-2.30), other digestive organs 5.86 (3.38-10.16), meninges and brain cancer 1.57 (1.02-2.41) showed the highest relationship with arsenic contamination. The results of this study could be evidence for a positive and significant relationship between arsenic concentrations and mortality rates due to cancers, diabetes mellitus, Alzheimer disease, and congenital malformations. Therefore, it's necessary to use appropriate water treatment methods to remove arsenic at the source in contaminated areas.

Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis.

Background: COVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19. Methods: PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the corticosteroid drugs were included. The hazard ratio (HR) with a 95% confidence interval (CI) was used to summarize the effect size from the network meta-analysis (NMA). Results: Out of 329 retrieved references, 12 RCTs with 11,455 participants met the eligibility criteria in this review. The included RCTs formed one network with six treatments. In addition, five treatments in two RCTs were not connected to the network. Methylprednisolone + usual care (UC) versus UC decreased the risk of death by 0.65 (95% CI: 0.47, 0.90). Among treatments in the network the highest P-score (0.89) was related to Methylprednisolone + UC. Conclusion: Based on the results of this NMA it seems Methylprednisolone + UC to be the best treatment option in patients with COVID-ARDS and COVID pneumonia.

Pharmaceutical Therapies for the Treatment of Obesity: A Network Meta-analysis.

PURPOSE: Despite the introduction of various pharmaceutical therapies for treating obesity, selecting the optimal treatment remains challenging for both patients and physicians. Therefore, in this network meta-analysis (NMA), we aim to simultaneously compare the available drugs for treating obesity to determine the most effective treatment options. METHODS: International databases, including PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched for studies published from database inception to April 2023. The consistency assumption was evaluated using by the loop-specific and design × treatment interaction approaches. The effects of treatment in the NMA were summarized using mean differences based on a change score analysis. The random-effects model was used to report the results. Results were reported with 95% CIs. FINDINGS: Of 9519 retrieved references, 96 randomized controlled trials, including 68 with both men and women, 23 with women only, and 5 with men only, met the eligibility criteria for this study. There were 4 treatment networks in the trials of both men and women, 4 in the trials of women only, and 1 in the trials of men only. The best-ranked treatments in the network in the trials of both men and women were (1) semaglutide, 2.4 mg (P-score = 0.99); (2) hydroxycitric acid, 4667 mg 3 times daily, supervised walking, and 2000-kcal/d diet (P-score = 0.92); (3) phentermine hydrochloride and behavioral therapy (P-score = 0.92); and (4) liraglutide plus advice to diet and exercise (P-score = 1.00). In women, the best-ranked treatments were beloranib (P-score = 0.98) and sibutramine, metformin, and hypocaloric diet (P-score = 0.90). In men, there was no significant difference among treatments. IMPLICATIONS: According to the results of this NMA, semaglutide seems to be an effective treatment option for both men and women, whereas beloranib appears to be particularly effective for women with obesity and overweight, but its production has been stopped since 2016 and is not available.

Arsenic level in drinking water, its correlation with water quality parameters, and associated health risks.

This study aimed to evaluate the occurrence and likelihood of health risks related to arsenic in drinking water of all counties of the Hamadan province in the northwest of Iran. In this work, 370 samples were collected from all of the water resources of urban and rural regions, during 5 years (2017 to 2021). Oracle Crystal Ball software was used to perform the Monte Carlo simulation and investigate the potential health risks. According to the results, the average values of arsenic in the nine counties were in the order Kabudarahang (40.1 ppb), Malayer (13.1 ppb), Nahavand (6.1 ppb), Bahar (2.05 ppb), Famenin (0.41 ppb), Asadabad (0.36 ppb), Tuyserkan (0.28 ppb), Razan (0.14 ppb), and Hamadan (< 0.1 ppb). The highest concentration of arsenic occurred in Kabudarahang with a maximum value of 185 ppb. In the spring season, the average concentration of the cations, including calcium, magnesium, sodium, lead, cadmium, and chromium, obtained 109.51 mg/l, 44.67 mg/l, 20.50 mg/l, 88.76 ppb, 0.31 ppb, and 0.02 ppb, respectively. Based on the Delphi classification, the P 90% of oral lifetime cancer risk, in Hamadan province, were within level II (low risk) to VII (extremely high risk). The risk analysis revealed there was a possible carcinogenic risk to humans from oral exposure to As-contaminated groundwater, especially in Kabudarahang county. Therefore, there is an urgent need for management and precise measures in contaminated areas to reduce and prevent the adverse health effects of arsenic.

Applications, Shortcomings, and New Advances of Job Safety Analysis (JSA): Findings from a Systematic Review.

Background: Job safety analysis (JSA) is a popular technique for hazard identification and risk assessment in workplaces that has been applied across a wide range of industries. This systematic review was conducted to answer four main questions regarding JSA: (1) which sectors and areas have used JSA? (2) What has been the aim of employing JSA? (3) What are the shortcomings of JSA? (4) What are the new advances in the field of JSA? Methods: Three main international databases were searched: SCOPUS, Web of Science, and PubMed. After screening and eligibility assessment, 49 articles were included. Results: Construction industries have used JSA the most, followed by process industries and healthcare settings. Hazard identification is the main aim of JSA, but it has been used for other purposes as well. Being time-consuming, the lack of an initial list of hazards, the lack of a universal risk assessment method, ignoring hazards from the surrounding activities, ambiguities regarding the team implementing JSA, and ignorance of the hierarchy of controls were the main shortcomings of JSA based on previous studies. Conclusion: In recent years, there have been interesting advances in JSA making attempts to solve shortcomings of the technique. A seven-step JSA was recommended to cover most shortcomings reported by studies.

Efficacy of stereotactic radiosurgery as single or combined therapy for brain metastasis: A systematic review and meta-analysis.

To determine the efficacy of stereotactic radiosurgery (SRS) in treating patients with brain metastases (BMs), a network meta-analysis (NMA) of randomized controlled trials (RCTs) and a direct comparison of cohort studies were performed. Relevant literature regarding the effectiveness of SRS alone and in combination with whole-brain radiotherapy (WBRT) and surgery was retrieved using systematic database searches up to April 2019. The patterns of overall survival (OS), one-year OS, progression-free survival (PFS), one-year local brain control (LBC), one-year distant brain control (DBC), neurological death (ND), and complication rate were analyzed. A total of 18 RCTs and 37 cohorts were included in the meta-analysis. Our data revealed that SRS carried a better OS than SRS+WBRT (p = 0.048) and WBRT (p = 0.041). Also, SRS+WBRT demonstrated a significantly improved PFS, LBC, and DBC compared to WBRT alone and SRS alone. Finally, SRS achieved the same LBC as high as surgery, but intracranial relapse occurred considerably more frequently in the absence of WBRT. However, there were not any significant differences in ND and toxicities between SRS and other groups. Therefore, SRS alone may be a better alternative since increased patient survival may outweigh the increased risk of brain tumor recurrence associated with it.

The Immediate Effects of Aerobic Exercise with and Without External Loads on Blood Glucose, Cardiovascular, Respiratory, and Body Temperature Indices in Type II Diabetic Patients.

Background: The long-term effects of aerobic exercise on the cardiorespiratory system have been studied extensively. This study aimed to evaluate the effects of aerobic exercise with and without external loads on blood glucose, cardiovascular, respiratory, and body temperature indices in patients with type II diabetes. Methods: The present randomized control trial recruited participants from the Diabetes Center of Hamadan University through advertisement. Thirty individuals were selected and divided into an aerobic exercise group and a weighted vest group via block randomization. The intervention protocol included aerobic exercise on the treadmill (0 slopes) with an intensity of 50% to 70% of the maximum heart rate. The exercise program for the weighted vest group was identical to that of the aerobic group, except that the subjects wore a weighted vest. Results: The mean age of the study population was 46.77±5.11 years in the aerobic group and 48±5.95 years in the weighted vest group. After the intervention, blood glucose in the aerobic group (167.07±72.48 mg/dL; P<0.001) and the weighted vest group (167.75±61.53 mg/dL; P<0.001) was decreased. Additionally, resting heart rate (aerobic: 96.83±11.86 bpm and vest: 94.92±13.65 bpm) and body temperature (aerobic: 36.20±0.83 °C and vest: 35.48±0.46 °C) were increased (P<0.001). Decreased systolic (aerobic: 117.92±19.27 mmHg and vest: 120.91±12.04 mmHg) and diastolic (aerobic: 77.38±7.54 mmHg and vest: 82.5±11.32 mmHg) blood pressure and increased respiration rate (aerobic: 23.07±5.45 breath/min and vest: 22±3.19 breath/min) were seen in both groups but were not statistically significant. Conclusion: One aerobic exercise session with and without external loads reduced blood glucose levels and systolic and diastolic blood pressure in our 2 study groups.

The prevalence of uncontrolled diabetes mellitus in patients with type 2 diabetes: a multicenter cross-sectional study.

Purpose: The prevalence of diabetes is increasing worldwide. Studies have shown that poor blood sugar control is associated with the complications of diabetes, we aimed to determine the prevalence of uncontrolled diabetes mellitus (UDM) and its related factors. Methods: This multicenter cross-sectional study was conducted in 2021 on type 2 diabetic patients in three cities; Rasht (in Gillan province), Borujerd (in Lorestan province), and Khodabandeh (in Zanjan province). A predesigned checklist was used to extract the basic characteristics of participants, their hemoglobin A1C, and other required data from their medical records. The prevalence of uncontrolled diabetes was reported with a 95% Confidence Interval. Results: In this study, the medical records of 460 patients with type 2 diabetes were included. The mean and standard deviation (SD) of the age of participants was 59.17 (11.59), and 73.2% (337) of participants were female. The prevalence of UDM in Rasht, Borujerd, and Khodabandeh was 58.27%, 69.38%, and 45.65% respectively. The prevalence of UDM in obese patients was 64.78% (57.03, 71.82). Based on the results of the adjusted model, an increase in diastolic blood pressure was significantly associated with UDM, meaning each unit increase in diastolic blood pressure was associated with a 3% increase in UDM (95% CI: 1.01, 1.06), adjusted for age, gender and education. Conclusion: According to these results, the prevalence of UDM among patients with diabetes is high. Diastolic blood pressure and low level of education were associated with UDM in diabetic patients.

Development and Psychometric Properties of an Extended Theory of Planned Behavior Questionnaire for Childbearing Intentions and Behaviors in Iran.

BACKGROUND: Childbearing is the most important determinant of population fluctuations, and its study is more important than other population phenomena. Owing to the lack of a valid questionnaire based on the extended theory of planned behavior, this mixed-method study was conducted to determine the validity and reliability of a questionnaire designed to examine related belief-based factors on the intention to bear children in Iranian society. METHODS: This study was conducted in two phases in Hamadan city, western Iran, in 2021. Phase 1 consisted of an extensive literature review and a qualitative study using a directed content analysis approach to generate an item pool. Psychometrics were measured in phase 2, including content, face, and construct validity. Reliability was assessed based on internal consistency and stability. The collected data were analyzed using IBM SPSS and AMOS ver. 24.0. RESULTS: Mean content validity ratio and content validity index were 0.7 and 0.85, respectively. Exploratory factor analysis of the 32 items identified an eight-factor solution. These factors jointly accounted for 79.1% of the observed variance in the outcome variables. Confirmatory factor analysis indicated a good fit for the data. The internal consistency based on Cronbach's α was 0.85 (0.71-0.93). In addition, stability was confirmed using the test-retest method and intraclass correlation coefficient (0.74-0.94). CONCLUSION: The designed questionnaire is a valid and reliable instrument for evaluating related belief-based factors on the intention and behavior of childbearing among married men and women in Iran.

National trends and projection of chronic kidney disease incidence according to etiology from 1990 to 2030 in Iran: a Bayesian age-period-cohort modeling study.

OBJECTIVES: Chronic kidney disease (CKD) is a major public health problem worldwide. Predicting CKD incidence rates and case numbers at the national and global levels is vital for planning CKD prevention programs. METHODS: Data on CKD incidence rates and case numbers in Iran from 1990 to 2019 were extracted from the Global Burden of Disease online database. The average annual percentage change was computed to determine the temporal trends in CKD age-standardized incidence rates from 1990 to 2019. A Bayesian age-period-cohort model was used to predict the CKD incidence rate and case numbers through 2030. RESULTS: Nationally, CKD cases increased from 97,300 in 1990 to 315,500 in 2019. The age-specific CKD incidence rate increased from 168.52 per 100,000 to 382.98 per 100,000 during the same period. Between 2020 and 2030, the number of CKD cases is projected to rise to 423,300. The age-specific CKD incidence rate is projected to increase to 469.04 in 2030 (95% credible interval, 399.20 to 538.87). In all age groups and etiological categories, the CKD incidence rate is forecasted to increase by 2030. CONCLUSIONS: CKD case numbers and incidence rates are anticipated to increase in Iran through 2030. The high level of CKD incidence in people with diabetes mellitus, hypertension, and glomerulonephritis, as well as in older people, suggests a deficiency of attention to these populations in current prevention plans and highlights their importance in future programs for the national control of CKD.

Coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus during the COVID-19 pandemic.

The prevalence of coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus among referred patients in Hamadan province, Iran, from November 2, 2021, to January 30, 2022, was evaluated. Samples were obtained from 14,116 individuals with COVID-19 symptoms and screened for SARS-CoV-2 and influenza viruses using a multiplex real-time PCR panel assay. Of these patients, 14.19%, 17.11%, and 1.35% were infected with influenza virus, SARS-CoV-2, and both viruses, respectively. The majority of the coinfected patients were female outpatients aged 19-60 years.

Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis.

BACKGROUND: Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. METHODS: Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. RESULTS: In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). CONCLUSION: Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.

The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis.

OBJECTIVES: Q fever, caused by the bacterium, is a major zoonotic disease around the world. This disease is common in the Eastern Mediterranean region; therefore, we conducted the first systematic review and meta-analysis on its prevalence in humans, animals, and ticks in the Eastern Mediterranean region. METHODS: Major Iranian and international databases were searched from 2000 to 2021. We extracted the prevalence of Q fever in blood samples from animals and milk samples from animals, ticks, and humans as the main outcome. We reported the prevalence of seropositivity and molecular positivity as point estimates and 95% confidence intervals (CIs). RESULTS: In this review, 112 papers were identified. The overall seroprevalence of Q fever was 22.4% (95% CI, 19.8 to 25.1). The pooled prevalence of Q fever in ticks was 17.5% (95% CI, -1.3 to 36.4). The prevalence was 25.5% (95% CI, 16.1 to 34.9) in humans. The prevalence of Q fever in animal blood samples from goats, sheep, camels, cattle, cats, dogs, horses, and buffalo were 28.1%, 25.1%, 25.0%, 20.1%, 9.8%, 8.4%, 6.5%, and 6.3%, respectively. Furthermore, the prevalence of Q fever in milk samples of animals was higher in cattle (20.3%) than in sheep (20.0%), goats (16.4%), and camels (3.3%). CONCLUSIONS: Coxiella burnetii infections are common in humans and in a wide range of animal species, but they are still not recognized in many countries in the Eastern Mediterranean region, thus presenting a significant threat to human and animal health in the region.

High-Risk Behaviors and Associated Factors among Iranian Adult Population: A National Survey.

Background: There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors. Methods: This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI). Results: The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68). Conclusion: More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.

Patterns of Antiepileptic Drug Reactions in Children: A Multicenter Study.

Objectives: Antiepileptic drugs are among the most common triggers of cutaneous adverse reactions. About 5-17% of epileptic patients develop idiosyncratic skin reactions at some point during their treatment course, most of which occur within the first two months of drug initiation. This study aimed to investigate the pattern of cutaneous drug reactions associated with anticonvulsant use among the pediatric population in Iran to identify high-risk individuals. Materials & Methods: In this retrospective descriptive study, medical records of children aged two months to 14 years, who were diagnosed with drug reactions due to anticonvulsant drugs between April 2007 and March 2018, were reviewed, and relevant information were extracted. This multicenter study was conducted in several provinces of Iran. Results: A total of 186 cases with a final diagnosis of the antiepileptic drug-induced eruption were evaluated. The median age of participants was 36 months (range: 2-168), and 56% were male. In approximately 70% of the children, the phenobarbital was the culprit. The median time interval between initiation of the causative drug and development of rash and fever was 10 and 7 days, respectively. The most common rash type was maculopapular rashes (69%). Overall, 33% of the patients only received antihistamines after discontinuation of the causative drug. Conclusion: Similar to previously published studies in Iran, phenobarbital was the main cause of cutaneous drug reactions to antiepileptic drugs, indicating the necessity of paying more attention when prescribing phenobarbital for Iranian pediatrics.

The Efficacy of Lactocare® Synbiotic on the Clinical Symptoms in Patients with Psoriasis: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Background: Attention to the administration of probiotics for the treatment of psoriasis has recently increased. Aim: In the present study, improvements in dermatology life quality index (DLQI), psoriasis area severity index (PASI), and visual analogue scale (VAS) scores in the psoriasis patients receiving Lactocare® probiotic were compared to psoriasis patients receiving placebo. Methods: A total of 52 psoriasis patients were included in this study and randomly divided into treatment and placebo (control) groups. The control group received topical hydrocortisone associated with placebo; in the treatment group, Lactocare® was administrated orally associated with hydrocortisone. The mean of VAS, DLQI, and PSAI scores was recorded and evaluated pretreatment and post-treatment in both groups for 3 months. The mean of the scores in the control groups was compared to the treatment group. Intragroup analysis was preformed with a comparison of the mean of these scores at baseline 4-, 8-, and 12-weeks post-treatment. Results: In the treatment group, a significant decrease was seen in PASI, VAS, and DLQI scores compared to the control group on week 12 post-treatment. Conclusion: Oral administration of Lactocare® probiotic (two times daily) associated with administration of topical hydrocortisone resulted in the improvement of PASI, DLQI, and VAS scores in the patients with psoriasis after 12 weeks of treatment. PASI reduction occurred in all patients who received probiotics.

The Dynamic Effective Reproductive Number of COVID-19 during the Epidemic in Iran.

Background: We aimed to determine the generation time, the best model for estimating reproduction number (R), and to estimate the basic reproduction number (R0) and effective reproduction number (Rt) for COVID-19 in Iran. Methods: We used the daily incidence cases of COVID-19, hospitalized due to a probable diagnosis of COVID-19 from 19 February 2020 to 17 November 2020 in Iran. Four models, including maximum likelihood (ML), exponential growth (EG), time-dependent (TD), sequential Bayesian (SB) were evaluated. The weekly reproduction number with a 95% confidence interval (CI) was calculated. Results: TD model shows the best fit compared to other models for estimating reproduction number in Iran. The R0 in Iran in the first week of the epidemic, leading up to 21 February 2020 was 7.19, 95% CI: 5.56, 9.00. The lowest value for the Rt was equal to 0.77 between 3 to 10 March 2020 and 4 to 11 December 2020. From 11 June 2020 up to13 August 2020, the Rt was more than one but after then to 24 September 2021 was less than one. Conclusion: TD model was the best fit for estimating the R in Iran. The worst situation of the epidemic in Iran was related to the weeks leading up to 26 February 2020 and 28 October 2020, and better status was related to the weeks leading up to 10 March 2020 and 11 December 2020.

Prevalence of modifiable risk factors of tuberculosis and their population attributable fraction in Iran: A cross-sectional study.

BACKGROUND: The mycobacterium tuberculosis (Mtb) is necessary for the morbidity of tuberculosis (TB), but it is insufficient. Many risk factors increase the risk of disease among infected people. We aimed to estimate the prevalence of modifiable risk factors of TB and their related population attributable fraction (PAF) in the marginal population of Markazi province in Iran. DESIGN: In this cross-sectional study, the prevalence of the modifiable risk factors of TB was estimated. We designed and validated a questionnaire to determine the risk factors. The measures of association for the modifiable risk factors of TB were obtained via the review of published literature. We calculated the PAF for each modifiable risk factor. RESULTS: Out of the 1275 calculated sample size, 1146 people participated in this study, and the participation rate was 89.9%. The mean age was 39.26. Out of 1146 participants, 76% did not know anything regarding TB. The highest prevalence was related to the lack of physical activity (58.73%), lack of fish consumption (50.79%), lack of red meat consumption (21.20%), and secondhand smoke (19.02%). The highest PAF was related to secondhand smoke; this value based on the crude relative risk (RR) and crude odds ratio (OR) was 24.54% and 23.44%, respectively. Based on crude hazard ratio (HR) and crude OR, the PAF for smoking was 14.81% and 11.19%, respectively. PAF for lack of BCG vaccination based on the crude OR was 14.79%. CONCLUSION: Based on this study's results, poor nutrition, secondhand smoke, smoking, lack of BCG vaccination, and diabetes are the main prevalent modifiable risk factors for TB. The highest PAF for TB was related to secondhand smoke, smoking, lack of BCG vaccination, and diabetes.